Public Funding Gives Couples Reason To Be Optimistic
Prevention and Treatment Walk down any street in Canada and you’ll see babies strapped into car seats, sleeping in strollers, or cradled in their parents’ arms.
It would be easy to assume any couple wanting a child could have a child. But, the reality is much different.
Infertility is a growing problem across the country. In Ontario alone, about 16 percent of couples are coping with it — and almost all of them are dealing with some degree of financial and emotional strain. But they have new reason to feel optimistic.
Government funding offers hope
“This initiative will allow a lot of people to have children who otherwise wouldn’t be able to.”
A few months ago, the Ontario government announced that it would designate $50 million to fund fertility treatment. That amount was on top of the $20 million already being spent annually by OHIP on assisted reproductive services for women.
The government said it would fund one cycle of in vitro fertilization (IVF) and unlimited rounds of artificial insemination for eligible people at fertility clinics across the province. Singles and same-sex couples would be eligible. Women would have to be under 43 years of age.
The government also said it would subsidize fertility preservation, which involves the freezing of sperm or eggs to be used later — for patients who have to undergo chemotherapy or other treatments that could lead to infertility. However, patients would have to pay for the cost of fertility drugs and some other ancillary services out of pocket.
Fertility clinics playing a role
In December, 52 clinics started participating in the province’s new fertility program — each one setting its own guidelines on which eligible patients to treat.
“Today marks a significant milestone for thousands of Ontarians who, due to the high cost of IVF, have been unable to seek the medical intervention needed to improve their chances of conceiving.”
Danielle Xavier, head of IVF advocacy group Conceivable Dreams, was jubilant. “Today marks a significant milestone for thousands of Ontarians who, due to the high cost of IVF, have been unable to seek the medical intervention needed to improve their chances of conceiving,” she said in a press release.
Dr. Clifford Librach, Associate Professor, Department of Obstetrics and Gynecology, University of Toronto and Director of CReATe Fertility Centre in Toronto, one of the clinics involved in the program, says the new initiative could end up saving the province money.
He explains that because IVF is so expensive — about $10,000 per cycle — physicians are often pressured by patients, who are paying out of pocket, to transfer more than one embryo into a woman’s uterus in one cycle to increase her chances of getting pregnant and avoiding the cost of further efforts to conceive.
This strategy increases the chance of a high-risk pregnancy involving a multiple birth, often leading to prematurity for newborns whose fragile health can prove costly. Many of these babies require neonatal intensive care and some develop lifelong medical conditions. The health risk is also higher for the mother.
A safer pregnancy
High risk pregnancies will be less of a problem going forward because the government has agreed to cover the cost of transferring all viable embryos produced in a given cycle, one at a time.
“Between the Ontario government’s initiative and recent advances in reproductive medicine, women in the province who are hoping to conceive have reason to feel optimistic.”
In Québec, where the government has been covering costs of IVF for 6 years, single embryo transfers have reduced multiple births from 30 percent to 5 percent.
Even better, new technology enables physicians to select the best embryos to transfer. Through preimplantation genetic testing, which is not government-funded, specialists can check for an abnormal number of chromosomes, so that genetically unhealthy embryos are not transferred to the uterus.
A reason to be optimistic
“Between the Ontario government’s initiative and recent advances in reproductive medicine, women in the province who are hoping to conceive have reason to feel optimistic,” says Dr. Librach, who has been at the forefront of the effort to secure public funding of fertility treatment. (He was part of the Fertility Program Implementation Advisory Working Group.)
“The government has done a very noble and altruistic thing,” he adds. “This initiative will allow a lot of people to have children who otherwise wouldn’t be able to. I hope other provincial governments will do the same.”
And, if that happens, we’ll be seeing a lot of happy new parents across Canada in years to come.