On July 13, 2010 Health Minister Yves Bolduc announced that, starting Aug. 5, 2010, the provincial government would pay for infertile Québec couples to get up to three treatment cycles egg harvesting, in-vitro fertilization, pre-implant genetic testing, embryo transfer and sperm sample collection. IVF will be offered to people who are already parents. Single women and lesbian couples can get free sperm donations.
Minister Bolduc said he expected the number of publicly-financed fertilization cycles to double from about 3,500 this year to 7,000 by 2014. The free-IVF program would cost about $25 million the first year, rising to almost $64 million by 2014.
In 2005 there were 1,700 private fertility treatments in Québec, each costing $7,000 to $15,000.
Thus Premier Jean Charest fulfilled his 2008 election promise of free IVF in Québec. At the time he said he expected the free service would double the demand for IVF.
Free IVF, and fewer premature babies
Although the program will cost Québec taxpayers, it is also expected to save money because of fewer premature births clinics would use single embryo transfer. Currently women opt to implant two or more embryos at a time to save money, leading to a high rate of multiple births and an increased risk of premature deliveries.
Conservative procedures would produce fewer multiple pregnancies and attendant medical complications. Minister Bolduc said that, thanks to implanting only one embryo at a time, he hoped the proportion of multiple pregnancies from IVF would drop from 30% to 5%. (Critics of state-funded IVF maintain that it is ovarian stimulation, not IVF, which accounts for multiple pregnancies.)
Dr. Hananel Holzer of the McGill Reproductive Centre in Montréal expressed his approval for the free treatment plan (BioNews, Mar. 14, 2010). The Centre now does 1,000 cycles of embryo implantation a year, at $10,000 a cycle. With free treatment that number could to rise to 3,000 to 4,000 cycles by 2014.
The Canadian fertility community reacted positively to the news. Beverly Hanck, executive director of the Infertility Awareness Association of Canada, said, "This is wonderful news".
The subsidized procedures will take place in both private and public clinics. Following the announcement, prospective patients hurried to get their applications in and get a good spot on the waiting lists.
Doctors warn that the government's plan could overload the system. There's a shortage of specialists, according to Dr. Robert Sabbah, (BioNews, July 26, 2010). vice-president of the Québec Association of Obstetricians and Gynaecologists. "Right now we are missing 60 to 70 gynaecologists in the province just to follow normal pregnancies. We do not have enough specialists in fertility in the province to follow all those patients."
Echoing his concerns was Dr. Seang Lin Tan (Globe and Mail, July 20, 2010) at the McGill Reproductive Centre. "Medicare can't cope with many areas of medicine. The price we pay for free treatments is waiting lists. It will just be more of a burden on the system if we eliminate private treatments."
Caroline Amireault, a spokeswoman for the Association des Couples Infertiles du Québec, presented Minister Bolduc with a 25,000-signature petition from Québecers wanting the government to cover the medical costs associated with infertility. "The recognition of infertility as a sickness is a very big victory for our association," Amireault said.
On June 18, 2009 the Québec National Assembly adopted Bill 26, An Act Respecting Clinical and Research Activities Relating to Assisted Procreation (pdf) which approved public funding of assisted reproduction. On July 21, 2010 two regulations were published, on how the Health Ministry will supervise clinical activities, and how it will fund them under the Health Insurance Act.
Ontario: only with blocked Fallopian tubes
Most Canadian provinces do not cover assisted reproduction treatments. Since 1994 Ontario has paid for three IVF cycles only if women have both fallopian tubes blocked. Ontario has ignored advice to do more.
In July 2008 Ontario formed an 11-member Expert Panel on Infertility and Adoption to report on ways to make fertility treatment more accessible and affordable.
It said the Ontario Health Insurance Plan should pay for three IVF cycles for Ontarians under 42 seeking the treatment. Included should be the cost of intracytoplasmic sperm injection, freezing and storing embryos, and up to two frozen embryo transfers per egg retrieval. (Ontario clinics provide about 5,000 IVF cycles a year. In 2006, there were over 1,500 babies born in Ontario from IVF.) The panel found that the single greatest barrier to assisted reproduction services is the high cost: about $10,000 for an IVF cycle.
But Ontario's Premier Dalton McGuinty did not act on the panel's recommendations, saying on Aug. 27, 2009 that Ontario is in difficult financial straits.
Meanwhile, would-be parents have rallied to demand that Ontario fund IVF. In February 2010 infertile Ontario couples protested against a lack of government funding in a rally organised by Conceivable Dreams, a group representing 1,100 infertile couples who say they are suffering because the government refuses to help them.
Manitoba: tax credit for infertility treatment
Manitoba offers residents a Fertility Treatment Tax Credit of up to $8,000 a year (40% of $20,000 in expenses) for fertility treatment fees paid to a Manitoba clinic after September 2010.
Québec goes one better. Its Tax Credit for the Treatment of Infertility offers a refundable tax credit for artificial insemination or IVF expenses. The credit is 50% of expenses, for a maximum credit of $10,000 a year.
Alberta: fund to help pay for IVF
The Regional Fertility Program at the Foothills Medical Center, Calgary, offers financial help for those unable to pay for IVF. The Generations of Hope Fertility Assistance Fund is supported by corporate and individual donations.
The petition IVF coverage in Alberta was published online by Darla Connolly on Apr. 9, 2008. It asks the Alberta government for infertility insurance coverage and has 517 signatures at Sept. 17, 2010.
British Columbia: Hope Fertility Fund
The University of B.C. Centre for Reproductive Health, and the charity VGH & UBC Hospital Foundation have set up the Hope Fertility Fund for British Columbia residents who have had difficulty in conceiving and need help paying for treatment. Fertility procedures are not covered by the B.C. government's health insurance policy.
The Canadian Fertility and Andrology Society supports the provision of publicly-funded in-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment across Canada.
The Toronto-based Infertility Network has a report on Canadian campaigns for IVF funding
under medicare and news items
on funding infertility treatment.
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