New Quebec IVF treatment restrictions leave couples 'devastated'

Changes to Quebec's publicly-funded IVF program has caused mass confusion at fertility clinics around the province.

When Bill 20 was passed on Tuesday, it meant couples seeking IVF now have to pay for it.

Clinics including the MUHC's reproductive centre were scrambling Tuesday to come up with a plan to break the news to patients that if they hadn't started their medication, they'd have to pay for treatment — a cost of about $10,000. 

"It's terrible," says Dr. William Buckett, medical director of the centre.

"You knew they were already excited that this was going to start, that treatment was beginning today."

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Other clinics cancelled appointments outright on Wednesday unsure who was covered under the old rules and who wasn't.

On Friday, three days after the bill was passed, and after dozens of frantic calls to the health ministry from both devastated patients and clinics, the ministry sent out information to fertility clinics, clarifying who makes the cut.

'Temporary confusion'

According to Health Minister Gaétan Barrette, couples who purchased their injectable medication before Nov. 11 and have a receipt to prove it will have the procedure covered by the province.

If a woman had the prescription, but hadn't yet filled it before that date, it won't be covered.

"When you have a new bill, new regulations, it's always the same, there is temporary confusion in clinics," says Barrette.

"We have sent clinics the proper documentation. We expect by early next week, things will be cleared up."

When asked why the government didn't give the clinics a heads up or send out an explainer on the day of the bill, he said that there was no guarantee the bill would pass on Tuesday.

They had to wait for the bill to be adopted to send any documentation.

It's my property. It's my DNA and now I have to pay to access my own embryos? No.- Alain Manguy, whose wife's embryos are stored at the MUHC reproductive centre

While fertility clinics knew the changes were coming, no one anticipated the rules would be effective immediately.

Buckett says he was shocked there was no transition period or cutoff date for patients already scheduled for treatment in the coming weeks and months.

No grace period?

Several clinics openly wondered why the government did not set a cut-off date or grace period.

There are hundreds of couples scheduled to start treatment in the coming weeks who haven't bought their medication, but knew they needed IVF, and had an appointment set for after November 10th.

But Barrette says that would have created a rush of patients trying to access the system, thereby bypassing the new law. 

A spokesperson for the health ministry says the bill was first tabled in November 2014, so patients who knew they needed IVF, had a year to make an appointment and undergo the procedure.

'It's my DNA'

Many couples have embryos in storage.

The Quebec goverment says will continue to cover storage fees for another three years.

But if they want to use the embryo and have it transferred to try and get pregnant, they have to pay for it themselves.

That procedure usually costs between $1,000 and $1,500. The health minister said it may seem like an arbitrary choice, but they needed to set an end date.

"We were not willing to grandfather everything forever regarding the past," says Barrette.If a couple has a successful IVF, other viable embryos are frozen if the couple wants to use them for a future sibling.

There are approximately 15,000 embryos from 3,000 Quebec families stored just at the MUHC Reproductive Centre.

Alain Mainguy and his wife conceived their three-year-old daughter Beatrice with IVF and have stored embryos.

They are in the process of trying to get pregnant again with one of the embryos, but the appointment isn't scheduled for another few weeks.

"It's my wife's and I's, not the government's," Mainguy says.

"It's my property. It's my DNA and now I have to pay to access my own embryos? No."

Short-sighted?

Some critics of Quebec's new program say it is short-sighted and will cost the government in health care costs in the long run.

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By law, clinics can only transfer a single embryo during IVF in Quebec.

That law helped bring the level of multiple births in Quebec from about 30 per cent to about 5 per cent, significantly reducing health complications in both the pregnant mothers and the resulting babies.

But in other provinces and states, multiple embryo transfers are allowed.

Buckett says he's already had couples ask about undergoing IVF or doing embryo transfers in Vermont, Albany, Ontario or the Maritime provinces.