Government-Funded Fertility Treatments: The Good, The Bad And The Painful Truth

Fertility treatment can get very pricey and can cost over $15,000 per one IVF cycle.

In December 2015 Ontario launched a $50 million fertility program which aimed at increasing accessibility of fertility treatment.

This came as a relief to thousands of Ontarians who are struggling with infertility and cannot afford it. Fertility treatment can get very pricey and can cost over $15,000 per one IVF cycle. It is a huge financial burden and added stress to a process that is already stressful on its own (to say the least). The need for affordable, accessible fertility treatment is clear. Did Ontario funding plan meet the high expectations? Let’s explore the fine print of the funding program.

Who is eligible?

All residents of Ontario with valid Ontario Health Insurance Plan (OHIP) and a doctor’s referral for a fertility treatment. The only restriction for funded IVF cycles is that women must be under the age of 43 in order to participate.

The good news is that this funding is offered equally to all patients in need of fertility treatments regardless of gender, family status and sexual orientation, which also includes non-medical infertility patients such as single parents and same-sex couples.

In addition, patients who undergo medical procedures which cause infertility have access to funded fertility preservation. This means that cancer patients can now receive the needed fertility-preserving treatment allowing them to conceive after being in remission.

What is covered?

  • Unlimited cycles of Intrauterine Insemination (IUI)
  • One cycle of in-vitro fertilization (IVF) per patient per lifetime which includes one egg retrieval and embryo freezing and transfer of all viable embryos originating from the funded retrieval.
  • Fertility preservation (FP) – One egg retrieval and/or one surgical sperm retrieval and freezing of one batch of egg and/or sperm sample

The program also focuses on the safety of the procedure by only funding single embryo transfer which lowers the rate of high-risk multiple pregnancies. Safety is paramount. However, the concern in restricting the funding to only single embryo transfer is that it doesn’t take into account doctor’s judgment for the best outcome for their patient. This is especially true when only one cycle is funded which in most cases is not sufficient.

What is not covered?

  • Fertility drugs
  • Genetic testing
  • Sperm, egg and embryo storage
  • Counseling

Since the initiation of the program, more than 28,000 people have utilized IVF, IUI and FP services, at the cost of $70 million a year. While these numbers are quite impressive, the reality is that the demand is far higher than the supply and unfortunately there are few loopholes in this well-intended program.

First, this funded program is only available for about 5000 patients a year and is only available in 48 clinics in Ontario. This creates long waiting lists, in some clinics the waitlist is more than several years long. For a service that is age sensitive with a very narrow success window and eligibility age limit, this long wait time could be devastating.

The clinics are left to manage their waitlists to their best of their knowledge which is unbelievably frustrating and heartbreaking at the same time. Whether it is a first-come-first-served model, lottery, or any other format the result is the same, far too many people are turned down.

Another disadvantage is that the allocated budget for a clinic is not proportional to the population which means that bigger cities where the demand is higher are underserved.

Dr. Bentov, Juno’s Medical Director, agrees, “The Decision not to update the funding program to compensate growth of the population or even the distribution of fully funded services will end up reducing the quality of services and accessibility in the long run.”

This funding program is a step in the right direction and more work is needed to make reproductive care more affordable and accessible to those in need.

 

Further reading:

https://www.ontario.ca/page/get-fertility-treatments

https://news.ontario.ca/opo/en/2017/01/ontario-helping-people-start-and-grow-their-families.html

https://globalnews.ca/news/3930138/ontario-fertility-program/

https://globalnews.ca/news/3066040/heres-what-you-need-to-know-about-ontarios-fertility-program-one-year-later/

http://nationalpost.com/health/huge-demand-for-ivf-treatment-in-ontario-where-its-fully-funded-has-wait-lists-stretching-to-2018

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