Nelligan O'Brien Payne gratefully acknowledges the contribution of Erin Walkinshaw, Student-at-Law to this blog post.
Although Ontario’s recent announcement to fund one cycle of in vitro fertilization (IVF) provided some relief for individuals currently struggling with fertility issues, the lack of details has brought more questions than answers.
What we do know is that a funded IVF cycle will include one egg retrieval procedure, which may result in multiple embryos. A cycle will also include a one-at-a-time transfer of all viable embryos to reduce the risks and associated costs of multiple births. The funding does not include the cost of fertility drugs or embryo freezing.
Age appears to be the only eligibility restriction so far – only women under the age of 43 will be eligible. Some services in support of fertility treatment will also be included in one funded cycle. As of right now, surgical sperm retrieval is the only support service we know is included.
We also know that this funding will be available to those who are both medically and non-medically infertile. The Government has said that there will be no funding discrimination based on sex, gender, sexual orientation or family status. Therefore, same-sex couples and people who are single will also have access to funded IVF.
Most other details remain unclear, including:
1. Start date: The Government said Ontarians could expect funded IVF to begin this December. However, at the time of the announcement, there were no funding agreements with any of the private fertility clinics, and the committee charged with implementing the program had not yet met.
2. Wait lists: Some clinics are already estimating a year. The Government has said that funded IVF will help about 4000 Ontarians annually so each clinic may be restricted to a certain number of funded IVF cycles per year.
3. Coverage when using donors: It appears that known donors and surrogates will likely be included in the funding program. However, those who use anonymous donors to build their families will still have the additional expense associated with accessing donated sperm and eggs.
4. How many kids you can have through funded IVF: The Government has not yet indicated whether having a live birth prevents a woman from having any further viable embryos implanted through the funded program.
5. Whether funded IVF will change how the province regulates the fertility sector: Currently, healthcare providers who offer fertility services are regulated by their governing colleges, but there is no overarching legislation or body in the province to set quality assurance measures, or standards for data collection, use and disclosure within the fertility sector. It will also be interesting to see whether regulations for implementing funded IVF will change privately-funded practices. For example, will multiple embryo transfers still be possible for individuals paying for IVF out-of-pocket, even though the public program insists on single embryo transfers?
We don’t know these answers yet, but time will tell.