Patients want IVF offered in N.L. and say $5K subsidy is 'pennies': redacted report

A report into the first year of a subsidy program aimed at easing the burden of accessing fertility treatments outside of Newfoundland and Labrador found staff and patients want a clinic closer to home and more financial support.

Patients have to travel to get in-vitro fertilization (IVF) from clinics outside the province. In March 2022, the provincial government introduced an IVF subsidy, which was retroactive to 2021, that allowed approved patients to claim up to $5,000 per IVF cycle up to three cycles, for a total of $15,000.

Through an access-to-information request, CBC News has obtained the Newfoundland and Labrador Health Services report evaluating the subsidy's first year from a period between May 2022 and May 2023. The report was prepared in Oct 2023.

"My understanding is that we have physicians ready to provide private IVF services in N.L.," one respondent quoted in the report said. "Surely this would be better than sending [patients] to a private clinic in another province? The time off work and travel costs are barriers to using the subsidy."

The unnamed individual added, "it doesn't make sense to me as a taxpayer, a family physician, and as a former patient who had three expensive IVF trips."

The report found that both Newfoundland and Labrador Fertility Services (NLFS) staff and patients said they want to see an IVF clinic within Newfoundland and Labrador, and said the subsidy wasn't adequate.

Staff also said the IVF process often costs more than $25,000, after paying for associated costs like medications, treatment and travel costs, and the patient might still not have a successful treatment that results in a pregnancy, said the report.

The survey echoes findings found in a report tabled by Thinkwell Research + Strategy in Sept. 2024 that reviewed current fertility services and made recommendations.

CBC News obtained that report, in which Thinkwell also recommended that the province begin to offer IVF and fertility preservation at home. That report also recommended an increase to the travel subsidy.

On Thursday, Premier Andrew Furey told reporters his party committed to opening an IVF clinic during the last election and also brought in a travel subsidy.

"We understand that that's not enough, but it was a start. We wanted a report about what exactly what would be needed in terms of the facilities and the feedback from the community on establishing an IVF clinic," he said.

"And I believe that we can have that set up, hopefully as early as January 2026."

Affordability versus treatment

According to the IVF subsidy report, 114 people availed of the subsidy program in its first year, with costs to the province totalling $737,882.20. It also showed 90 per cent of the applicants were from the eastern zone of the province.

In a survey that was part of the report, 25 per cent of respondents said the subsidy allowed them to go ahead with some of the services they wanted to access, and 17 per cent said the subsidy allowed them to access all the services they wanted. The majority — 47 per cent of respondents — said they would have accessed the services with or without the subsidy.

According to the report, the overall cost for the fertility service was a barrier.

"I have not done IVF due to the outstanding cost of it all," said one survey respondent. "The subsidy has not helped us even consider IVF because it is pennies in comparison to the cost."

One NLFS staffer said in the report, "$5,000 is not the tipping point to actually increase access. Those who could afford it were going to go regardless. If you can't afford $30,000 out of pocket [for a round of IVF treatment], you can't afford $25,000."

People would also prefer to get the money up front and not have to wait to get reimbursed for their out-of-pocket expenses, according to the survey.

The survey also highlighted out-of-province travel as a barrier, noting that it increased the overall cost of treatment due to hotel, car rental and meal fees, as well as needing to take time off from work and family obligations.

One patient said the "upfront cost of IVF and the last-minute travel due to living in Newfoundland and Labrador is extremely prohibitive, and not feasible for many. Fertility services are health care and should be covered [as] such."

The conclusion and recommendations section of the report were redacted.

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