IVF treatments drop dramatically since Quebec funding cut 6 months ago

After six failed attempts to get pregnant using artificial insemination, Léa's doctor said her chances of conceiving without in-vitro fertilization are zero. But since last fall, the Quebec government no longer pays for the full cost of the procedure, leaving Léa and her boyfriend scrambling to find the money.

Couples now have to pay about $10,000 up front for the procedure. They will get some money back, based on a sliding scale of tax credits, but regardless, it's a big investment.

"My boyfriend will work extra time this summer to save more money," said Léa, who asked that her last name not be used. "We won't go on a vacation. We want to change cars, but we won't do that this year. "

The pair is even looking for second jobs to help save up for the procedure. Léa is just one of thousands of women whose dreams of getting pregnant are in limbo.

From 2010 to 2015, the government paid for three full IVF attempts. Last November, the publicly funded IVF program ended, replaced with tax credits for one full IVF attempt. Only Quebecers without children can access the tax credits, which range from 80 per cent for a family with an income of less than $50,000 annually to 20 per cent for families whose combined income is more than $120,000 a year.

Half a year after the funding changes went into effect, the number of IVF procedures has dramatically dropped off. In the first four months of 2015, the MUHC Reproductive Centre, Quebec's largest public fertility clinic, performed 700 IVF cycles. In the same period this year, the centre has only done 250 procedures.

Dr. William Buckett, the centre's director, said the number of procedures done in 2015 may have been artificially high, as people rushed in to have treatment before the program was changed. But if the current trend continues, Buckett anticipates a 50 per cent drop in in-vitro fertilization procedures at the clinic.

Buckett says many couples are now opting for intrauterine insemination – or IUIs – as the cost of that procedure continues to be covered by the province. The goal of IUIs is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilization. The downside is, it often involves taking drugs that stimulate the ovaries. This medication can increase the chance of releasing several eggs, which can lead to a multiple pregnancy – and an increased risk of complications.

Under the publicly funded IVF program, Quebec reduced the multiple birth rate to less than 10 per cent of all IVF deliveries. By law, clinics are only able to transfer a single embryo during IVF in Quebec. "This is our anxiety now about people having IUI," said Buckett. "People increasingly want aggressive treatment, and it may be we have higher numbers of multiple births as a result of that."

Buckett admits that one of the downfalls of the system when Quebec was paying in full for the procedure is that there were no limits put on the number of egg retrievals. As well, many couples would go through with an IVF procedure even if doctors told them their chances of success was low. Buckett says the centre is no longer treating those patients. "In that sense, it's a good thing," said Buckett. "But that is far and away outweighed by the lack of access to treatment for so many couples, which is the tragedy of the change in the legislation."

But he says rather than getting rid of the publicly funded system altogether because of its high cost to taxpayers, the government could have simply modified the program – setting age limits and enforcing stricter guidelines.

When Léa learned IVF was the only option left to her, she hadn't made up her mind to do it, but her doctor encouraged her to buy the medication she needed right away whether she proceeded with the treatment or not.

The province is currently reviewing how much it will subsidize fertility medications, which can run into the thousands of dollars. A decision is expected next month. Léa always imagined her life as a mom, so she says the sacrifice is worth it, but she can't help but see the irony in the fact that the more she works to save money, the higher her family income will be. "If I work more, I'll make more, so I'll have less (of a) tax rebate," said Léa.

With fewer procedures being performed, the MUHC Reproductive Centre has had to reduce staffing by about 10 per cent. Buckett says both the MUHC and government are committed to keeping open the fertility clinic, but it has to pay for itself. The centre was left behind at the historic old building of the Royal Victoria when the rest of the hospital moved to the Glen last year. A decision will be made in the coming weeks about where it will be relocated.

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