The Star’s view: A reasonable balance

Raising a child is expensive enough, as any parent knows. For those who must also deal with the high cost of in vitro fertilization, it can be out of reach.

That’s why the Ontario government’s announcement on Thursday that it will fund IVF is such welcome news for the 4,000 Ontarians who stand to get help from the program each year, starting this December.

For too long those struggling with fertility problems have had to pay approximately $10,000 per treatment to fulfil their dream of having a child.

The new program, announced by Health Minister Eric Hoskins, comes with appropriate limits to contain costs and limit medical risks.

First, there is a cut-off age of 42 for mothers. That was made on advice from the Advisory Process for Infertility Services, a group comprised of physicians, lab directors and patients.

The age limit will irk some. Many seeking IVF treatments are over that age, and some argue that older women are just as capable as men of having a baby. But even Quebec, the first province to fund IVF, found it necessary to cap the age of those eligible for treatment. In fact, Quebec is rolling back its program and plans to offer a tax credit for the treatment instead.

Second, the program is designed to eliminate the chance of multiple pregnancies that can occur if several eggs are implanted in a woman at once. Under the rules, multiple eggs may be retrieved from a woman but only one egg at a time may be implanted. That’s a smart, money-saving decision.

The government estimates this new program will cost the province $50 million a year, on top of the $20 million it already spends on assisted reproduction services. But experts argue it will actually save the health care system money by reducing expensive multiple births.

In the absence of government-funded IVF, for example, couples may turn to hyper-ovulation drugs that can result in multiple births that cost the system more through the high cost of caring for premature babies and the ongoing health problems that twins and triplets are more likely to face.

As well, women who must pay for IVF treatments at clinics often insist on having more than one embryo implanted at a time to increase the odds of successfully giving birth.

In fact, the Ontario Expert Panel on Infertility and Adoption reported in 2009 that funding IVF would actually save Ontario taxpayers $400 million to $500 million over 10 years in hospital costs alone, plus an additional $300 million to $460 million in savings related to long-term disability costs.

With this new program, the government is also wisely responding to the reality that couples are starting families at an older age, and may, as a result, need help.

The most recent Statistics Canada figures from 2008 show the average age of marriage for men is 31 and 29.6 for women, while women’s fertility begins to decline after the age of 30.

The treatments may also help Ontario increase its fertility rate at a time when seniors outnumber children in Canada. Right now Ontario’s fertility rate stands at only 1.5 per cent, less than the average of 1.6 per cent across Canada, and much less than the population replacement level of 2.1 per cent. Denmark, which fully funds IVF treatments, has a fertility rate of 1.8 per cent.

Ontario’s program won’t please everyone. But it strikes a reasonable balance between making parenthood more accessible and making sure the costs don’t spiral out of control.

Ontario announces it will fund one IVF cycle for women up to the age of 42