Fecund or Infertile: The Choice to Conceive

"Patients ... are absolutely thrilled. [To afford IVF] some people are remortgaging their house, some people are not buying their house, some people are getting their inheritance from their parents early. It's a huge financial burden."
Gloria Poirier, acting head, Infertility Awareness Association of Canada

"It's the smart thing to do, in terms of cost savings and avoiding twins and higher-order multiples. And it's also the right thing to do because these people suffer from an illness ... Infertility is recognized as a disease."
Dr. Art Leader, Ottawa fertility doctor

"Doctors should practise good medicine. You should not be creating multiple births, and you cannot turn around and say to the government 'the only way for me to practise good medicine is for you to fund it.'"
Dr. Francoise Baylis, bioethicist, Dalhousie University, IVF expert

The Ontario Liberal government never did find it difficult to champion a mission it felt might resonate with voters that feel no amount of compassion for those unable to achieve their dreams is enough, including the metering out of huge sums of provincial tax funds for universal health care. So it has announced its intention to fund in-vitro fertilization [IVF] for those unable to conceive on their own.

This is a move, rather unsurprisingly, heralded by IVF specialists who have long lobbied government to follow the lead of Quebec. The decision to expend large sums of money to fund the process is a personal one, presumably well considered by those feeling it to be a sacrifice well worth the production of a child, and as such it should remain their judgement call. To bring the ordinary taxpayer into the equation represents feckless thinking.

Quebec notoriously receives over $6-billion in annual top-ups to its more meagre-than-most provincial tax coffers through GDP, so federal equalization takes from the so-called wealthier provinces and gives to the needy ones. Quebec has always been a needy province. It needs funding from provinces unable to themselves fund such social welfare items as half-fare university tuition, $7-a-day child day-care, and IVF funding, to name a few, to enable it to do so.

Ontario was once considered a wealthy province, enough so that it had no need of additional help from the federal government. It remains a sturdy engine of the Canadian economy but it has been hobbled latterly by the disappearance of factory jobs leading to straitened circumstances. Much exacerbated by a Liberal government that has wasted tax funding in breath-taking grabs of $1-billion a pop, with wastage from initiatives such as eHealth, Ornge, and cancelled gas plants.

And now the inheritor of the McGuinty administration, Premier Kathleen Wynne's administration, has decided that since it is emulating Quebec in grasping for federal hand-outs, it might just as well copy its IVF formula as well. Deb Matthews, Ontario Health Minister speaks of "going to be talking about fertility treatment and IVF and increasing access to them", offending those who insist taxpayers will be on the hook to solve a 'problem' engineered by for-profit fertility groups.

The province estimates it will take $85-million over three years to buy into the in-vitro industry to please those who want to conceive, but cannot. Quebec began funding IVF in 2010 with the proviso that one embryo only be transferred per "cycle", seeing the multiple birth rate drop to 7.9% from 30%. Saving, according to the experts hundreds of millions. Multiples risk birth complications and long-term health problems.

This is, of course, a personal decision, to spend large sums of money for IVF treatments that may or may not work, so people decide on multiple embryos being transplanted to ensure that at least one may take. If the doctors treating them were ethical, they would refuse to implant more than one, but then their business would suffer. Society is left to pick up the pieces in hospital-medical costs when the resulting babies require additional health-remediation treatment.

Dr. Baylis points out sensibly that fertility specialists should not be permitted to hold the medicare system "to ransom", by agreeing in exchange for medicare payment, to hold the line on embryo transplant numbers. The funding of fertility treatment, she points out, should not be seen as a priority given the huge demands on the medical system and the growing costs of administering it, from the cost of drugs, to hospitals and doctors' fees.

Fertility specialists have created a market and one they will be thrilled to expand to meet a growing demand from people taking advantage of the system offering to aid in conception. In Quebec $60-million annually has been spent providing treatment for 8,000 individuals, leading some doctors to question whether single mothers, same-sex couples and those with no medical infertility problems should be regarded as eligible.