Ontario doctors to decide who receives publicly-funded IVF treatments

Some fertility doctors are trying to figure outthe fairest method possible to spend $50 million worth of provincial government funding set aside for in-vitro fertilizations (IVF).

• Ontario offering 50 public fertility treatment clinics
• Some fertility doctors will use lottery to prioritize patients
• Ontario increasing IVFfunding by $50M a year

"Our biggest concern is just the number of people who might want to access treatment," Dr. TomHannam, founder of theHannamFertility Centre, told CBC Radio'sMetro Morningon Monday."You can put rules in place but they are inevitably somewhat arbitrary."

In October, the Ontario government announced it was setting aside $50 million for IVF treatments. On Monday, the province said it was offering the fertility treatments at 50 publicly-funded clinics.

It's very generous, which is why we suspect it's going to be very popular, as well.- Dr. TomHannam, fertility centre founder

The decisions about how to allocate the funds arebeing left to doctors in clinics who must decide which families receive the government-sponsored assistance.

The province is estimatingone in six Ontario couples are affected by infertility. With these funds coming on top of $20 million already available as part of the Ontario Health Insurance Plan (OHIP),more and more people are expected torequestthe treatment.

"It's very generous, which is why we suspect it's going to be very popular, as well," Hannam said.

Onlyone rule must be followed: no woman 43 years of age or older is allowed to participate in the program.

The $50 million figure was decided upon based on the number of people who have sought help privately each year. Typically, this amount should be able to aid with roughly5,000 cycles, the doctor said, addingclinics have been advised to use their "best clinical judgment" when making calls on who getstreatment.

Taunya Johnston,a fertility advocate and mother in Cambridge, Ont.,also spoke toMetro Morningon Monday and said her family has spent about $30,000 on fertility treatment.

At her clinic, publicly funded IVFs were being distributed "based on medical needs" with doctors looking for the "ideal time for the patient to receive the treatment."

But not all clinics are handing out these treatments the same way because Hannam said there aremore people who wantthe care than we have space for.

"If there were five times more people than we could accommodate, that would be a five-year wait list," the doctor explained.

A lottery is being chosen by some doctors, a system the Hannamcalled "brutal" yet "objectively fair." At his clinic, staff have said no to the lottery system and to firstcome, first serve.

"With fertility, we should be taking the people who are most likely to succeed," Hannam said."Triage is routinely reserved for people where things would be the most successful."

Several eggs and embryos can be made available during just one treatment cycle, if successful.

In Quebec, a similar program that was meant tosave money for the province ended up becoming "impossibly expensive," Hannam noted. That's brought cost concerns to the tablein Ontario, a province already saddled with mounting debt.

"It's not going to be an endless cost, it's not going to spiral out of control, it's going to be exactly what it is every year," the doctor insisted.

Johnston was eventually successful after a "long road" and "lots of obstacles." She gave birth to a baby girl named Cecelia and told CBC News the process was time-consuming. With the new government program, she's been selected to have another child, except this one won't cost her tens of thousands of dollars because it is funded by the province.

"It was an unexpected gift and we're filled with gratitude," the mother said of the newinitiative, admitting "there could be growing pains."

But overall, Johnstonsees the program as a good thing for the people of the Ontario.

"If we look at it from where we are today, 5,000 families are eligible for funding. Three months ago, none of those families were eligible."