The Economics of IVF

Money matters, public health spending, and policy decision-making. When mixed with the life sciences and babies, these issues become even  more complex.

In an earlier article, I wrote about legal developments in the sperm donation industry, which have raised questions about reproduction technologies and sperm banks in Canada and beyond.

I noted that three separate Ontario families have recently launched lawsuits against a U.S.-based sperm bank and its Canadian retailer, alleging they were misled about their sperm donor’s background history – and this included a criminal record and significant mental illness. Not minor oversights.

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The families – all of whom used Donor 9623 – have brought suits against Xytex Corp., a Georgia-based company, and Ontario-based Outreach Health Services because, they were allegedly deceived.

Donor 9623 was marketed as very well-educated, a model of fitness, and a popular donor, and allegedly this wasn’t the case at all.

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Ontario is leading the country in other ways. According to the National Post’s Tom Blackwell, “‘Huge’ demand for IVF treatment in Ontario — where it’s fully funded — has wait lists stretching to 2018.”

Essentially, Ontario’s decision to become the lone province to fully fund in-vitro fertilization has proven incredibly popular, with clinics taking just weeks to sign up this year’s limit of 5,000 patients. As Blackwell put it, this created “an almost instant logjam.”

The Ontario policy took effect late last December, but fertility specialists say they’re booking would-be parents into as late as 2018.

“Clinic caseloads.” writes Blackwell,  “have more than doubled in some instances, as the clientele grows increasingly diverse for a service that normally costs patients up to $10,000 a shot.”

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The Toronto Star called this policy a “Baby Lottery.” Rather sensationally, the Star criticized the policy like this: it was “supposed to be a solution for people struggling to make a child. Instead, would-be parents are finding themselves bumped from oversubscribed waiting lists, weeded out entirely, or competing in a high-stakes baby lottery.”

Most provinces, including Saskatchewan, still do not fully fund the service (where embryos created by combining egg and sperm in a lab are inserted in the patient’s womb), although Manitoba and Quebec provide partial tax credits and New Brunswick offers a one-time grant.

On the one hand, public funding has been promoted partly as a means to stem the epidemic of multiple births stemming from fertility treatments. According to Blackwell, patients paying out of pocket “often push for use of two or more embryos at a time —increasing the likelihood of multiples as well as pregnancy…” And the Ontario program mandates that just a single embryo be “transferred.”

On the other hand, critics suggest that the lucrative industry should stick to single-embryo treatments regardless, and argue there are much more “pressing” demands for scarce health-care resources.

What do you think?

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