Access to fertility services for lesbian women in Canada.

Objective: To determine reproductive services offered to lesbian patients by Canadian fertility clinics, policies of practice, ease of access to these services, and sensitivity of clinics to this population of patients.

Design: Survey sent to assisted reproductive technology (ART) clinic directors.

Setting: Academic medical center, university-based ethics institute.

Vulvar inflammation as the only clinical manifestation of Crohn disease in an 8-year-old girl.

Recognition of Crohn disease in children who present with cutaneous vulvar lesions as their initial clinical manifestation is often difficult. We report here the case of an 8-year-old girl with chronic vulvar edema, which on biopsy revealed granulomatous inflammation of the vulva. Further investigation and biopsy of the terminal ileum demonstrated similar findings and was consistent with a diagnosis of Crohn disease.