“I always found it so awkward to have a transvaginal ultrasound and then climb right back into my pencil skirt when all I wanted to do was crawl under a heating blanket and eat pizza,” says Wendy Litner, a lawyer-turned-writer and creator of the Emmy-nominated CBC original digital series How to Buy a Baby, based on her own inability to conceive.
Litner kicked off a panel discussion on how Conceivable Dreams, a volunteer-run patient group that has advocated for equitable access to fertility treatments since 2008, is now leading a national mandate to improve fertility benefits with a Fertility Benefits Matter campaign, which has hit the Internet just in time for Sexual and Reproductive Health Awareness Month.
Litner opened our eyes to the familiarity of her experience when all of the panel guests in the Zoom meeting nodded in recognition. In Vitro Fertilization (IVF) cycle monitoring sessions typically happen between 6 and 8 a.m. when most women-identifying folks have little flex time between the office and the clinic.
Funny thing is, the majority of Canadian employers do not provide any fertility coverage with the exception of New Brunswick, P.E.I, Quebec, Manitoba and Ontario, where Conceivable Dreams successfully helped secure publicly funded IVF in 2015.
Of the five provinces that do provide fertility coverage, an average lifetime payout of $3,250 is available. Considering the high costs of fertility drugs and treatments such as IVF ($20,000), surrogacy ($80,000) and adoption, it’s become apparent that current benefit plans are not adequate.
“It doesn’t feel right when you’re trying to bring your patient to treatment, but you can only move forward with someone who can afford it,” admits Dr. Marjorie Dixon, Conceivable Dreams adviser and founder of Anova Fertility.
On top of the travel costs associated to the lack of monitoring centres in provinces like P.E.I and N.L., single parents and non-heteronormative couples are relying more on alternative family building options than ever before according to a new study commissioned by Fertility Benefits Matter.
Plus, the increase in fertility challenges continues to climb according to Fertility Benefits Matter’s research, many women are choosing to start families later in life when their fertility is on the decline, which contributes to the fact that one in six Canadian couples experience infertility.
“Family building has changed. We recognize that many employers do not understand what that looks like for countless Canadians,” says Carolynn Dubé, executive director of Fertility Matters Canada. “We want to educate them so they can provide better benefits to their employees.”
The answer to building better benefits programs? Fertility Matters Canada and Conceivable Dreams believe that employers should ensure that their benefits packages cover the cost of fertility treatments, medication and otherwise, according to Tara Wood, president of Conceivable Dreams.
Wood suggests that for many employers, a three per cent adjustment or savings from current benefit offerings would allow them to provide $5,000 in fertility benefits to employees that need treatment or drugs. Fertility Matters Canada and Conceivable Dreams also propose that private insurance companies begin to offer inclusive fertility benefits (not just for heteronormative couples) and have clear language in their policies.
Both organizations also maintain that since the provincial government manages our healthcare, it’s up to them to set aside public funding and prioritize supporting their people in family making. Their proposed national fertility strategy, which would include a committee of all the stakeholders that play a role in family building like fertility experts, patient groups, employers, and insurance providers, would be produced and funded by the federal government.
“From the federal government perspective, we need a fertility strategy because Canada’s population is ageing (and declining), and our birth rate is declining too quickly to only rely on immigration—particularly during the COVID-19,” Wood said. “In terms of funding, we would hope the federal government would make this a priority alongside its commitment to women’s issues and diversity and inclusion.”
In a recent op-ed for the Ottawa Citizen, Natalie Dimitra Montgomery, a doctoral candidate in Population Health at the University of Ottawa and board member of Conceivable Dreams along with Dr. Kimberly Liu, a physician at Mount Sinai Fertility and an adviser to Conceivable Dreams, relay their support for the national fertility strategy since it would help maintain steady population growth.
Not to mention, a national fertility strategy in the time of COVID would enhance access to fertility treatment during a period of limited services and social isolation. In the spring of 2020, Conceivable Dreams surveyed more than 700 patients undergoing treatment when the outbreak began and found that three-quarters of respondents either had their treatment cycle cancelled (56 per cent) or delayed (21 per cent).
“It’s good business sense. You have to acknowledge that this is not unique to one or two employees, especially if you’re a large company,” says Maria Fraga, the global head of benefits and wellness at Manulife. “I think it’s critical to offer benefits to meet the needs of your workforce, and this is one I think is overlooked.”
Impressively, Manulife boasts one of the best fertility benefit programs in Canada. On top of the company’s yearly reimbursement of up to $20,000 for adoption, surrogacy support and fertility medication, Manulife employees are allotted a yearly $10,000 mental health benefit, which has been available since 2017. When it comes to the new fertility package, 94 Manulife employees have already taken advantage of the benefits included.
Fortunately, employers like Manulife have started “putting money where their employees are”, as Dr. Dixon points out. Now, it’s time to wait and see how many prioritize the fact that fertility benefits truly matter. —Anastasia Barbuzzi