Infertility affects one in six heterosexual couples in Canada, and for same-sex couples, clinical options are often the only option to have a baby. But the treatments don’t come cheap, especially the most-common and the most-effective treatment, IVF, or in-vitro fertilization. Here’s what you need to know about your options.
What exactly is IVF?
A quick health class refresher: During ovulation women typically release one egg from their ovaries into one of the fallopian tubes. With IVF, follicle-stimulating hormones (FSH) are injected into the ovaries so they produce multiple eggs. Before the eggs are released during ovulation, they are retrieved with a needle, with the aim of gathering as many as possible, usually between eight and 15. "We work with the existing number of eggs and rescue eggs that may have been destined to die that month,” explains Dr. Sonya Kashyap, medical director at Vancouver's Genesis Fertility Centre. Then, as the name suggests, egg and sperm are combined in vitro — outside of the body, in a lab — to make an embryo. Embryos can be either frozen for future pregnancy attempts or transferred back into the patient's uterus within three to five days. At this point, they will have multiplied and contains several dozen or even a hundreds of cells and have a higher chance of implanting to the uterine wall.
How much does IVF cost in Canada?
In Canada, one round of IVF — which includes all of the above — can range from $10,000 to $20,000. There's a big difference between those two figures, we know. Here’s why: Pricing varies from clinic to clinic (some low-cost clinics have opened in Canada, to mixed reviews), but how much you pay also depends on the medication required (about half of IVF costs are for meds). There’s the ovary-stimulating FSH, yes, but also antibiotics to treat possible complications such as pelvic infections during the retrieval process; drugs to produce higher-quality eggs; prenatal vitamins; and vitamin D and folic acid for a healthy pregnancy. The remainder of your bill goes to the cost of storage, retrieval, embryo transfers, and genetic testing to screen for the best embryo. Fertility tests, which you would do before starting IVF if you are having trouble conceiving, are generally covered by the province.
IVF gets expensive because the most any province will cover is one round (more on that below) — and on average, it takes 2.7 rounds of IVF in order to get pregnant. This added financial stress on top of the emotional stress puts a lot of pressure on patients make sure they’re getting the most out of their IVF cycles. Diagnoses, like endometriosis, can also complicate the process, leading to thousands of more dollars spent, although age is the biggest factor for men and women because, as we know, sperm and egg quality decrease as we get older.
And what if you need an egg or sperm donor? The cost of sperm in Canada varies from $400 to $700, depending on where you live (the closer you are to a metropolitan area, the less shipping and handling you’ll have to pay). Finding an egg in Canada is harder since it is illegal to purchase eggs. Parents have to find a donor, and typically only a friend or family member would be altruistic enough to do this. Otherwise, parents have to travel outside of Canada.
What is — and isn’t — covered in each province?
East Coast to West Coast, you’ll pay out of pocket for fertility drugs: Most private health insurance companies don’t include these costs in benefits packages, and, in a growing gig economy, where one in five Canadians are working part-time and self-employment is on the rise, employee benefits aren't something everyone can rely on anyway.
That said, some provinces offer help. Ontario, which was the first province to fund IVF, covers one IVF cycle for patients under the age of 43, and is the only province to cover unlimited intrauterine insemination (IUI). (During IUI, sperm is directly injected into the uterus; the procedure is generally less-effective than IVF.) Patients still have to pay for the cost of drugs, tests, and storage for sperm and ovarian reserves.
In Manitoba, you can apply for a tax credit for about 40% of the cost of fertility treatments (including prescription drugs), up to a maximum of $8,000 per year. Quebec, which used to have a fully funded IVF program, has also moved to a tax-credit model, which covers IVF expenses for a maximum of $20,000 per year. Meanwhile, New Brunswick offers a one-time grant that allows people to claim half of IVF (or IUI) costs.
If you live anywhere else in Canada, you’re on your own: provincial and territorial governments cover nothing in terms of treatment (some, like Yukon, the Northwest Territories, and Nunavut, will cover initial fertility testing, but that's it). Others provinces, such as Prince Edward Island and Newfoundland and Labrador don’t even have IVF clinics.
"This [lack of funding support] makes parenthood unattainable for a lot of people," says Tara Wood, board member of Conceivable Dreams, a grassroots advocacy group that aims to make fertility treatments more affordable in Ontario. "We want people to be able to base their family-planning decisions on more than finances."