funding for fertility treatment out of reach for most windsorites

by: trevor wilhelmwindsor is the only city of its size in ontario where the provincial government does not fund in vitro fertilization for people struggling to have children, according to a local fertility expert.dr. rahi victory said windsor-essex is also woefully underfunded for intrauterine insemination (iui), a less complicated process that involves injecting washed sperm into the uterus with a catheter.that inequity exists in windsor, and many other smaller communities, despite millions of dollars in funding going unused year after year, the star has learned.“we just want to be treated the same as all the other citizens of ontario,” said victory, medical director of victory reproductive care, windsor’s only ivf clinic. “why are we any different just because we’re further west? geography and politics should not determine your eligibility to have a family.”in 2015, the government created the ontario fertility program with annual funding of $20 million for iui and $50 million for in vitro fertilization (ivf), the process of combining the egg and sperm in a lab.without funding, victory said ivf treatment starts around $10,000, with medication costs on top of that which can run into thousands of dollars.though it does not fund an ivf clinic in many areas, including windsor, the ministry of health said the ontario fertility program increases access to fertility treatment by helping with the high costs of the service.most of the 19 clinics that receive ivf funding are clustered around the greater toronto area, with six in toronto centre, according to the ministry of health website. mississauga has three. hamilton-niagara, scarborough, vaughan, markham, richmond hill and ottawa each have one. kitchener-waterloo has two funded clinics and there is one in london.west of london, and in all of northern ontario, there are zero.the ministry of health told the star that funding was based on historical volumes, anticipated demand, geography and clinic capacity to provide services when the ontario fertility program (ofp) began six years ago.clinics that did not provide the services at the time, or that have opened since, are not eligible.“all existing program funding has been fully allocated among participating fertility clinics, including two funded iui clinics located in windsor,” spokesman david jensen said in an email.“any changes to the ofp funding allocation to accommodate a new clinic would require a reduction in funding for another clinic due to the capped nature of the program’s budget.”

the two windsor clinics that do the iui process — and which is partially funded by the province — are victory reproductive care and the pattinson clinic.government documents obtained by the star show that while the provincial money is allocated to various clinics, millions of dollars have gone unused.during the 2018/2019 fiscal year, more than $6.3 million in available iui funding was not used. in the 2019/2020 fiscal year, the unused amount was more than $6.7 million.pushed further on the issue, the ministry acknowledged some clinics have not used all of their iui funding. but instead of sending that money to areas that don’t receive funding, the province said it redistributed the excess money to clinics that are already part of the ontario fertility program.“since the program was launched, ivf/fp funding has been fully used every year,” the ministry said. “some clinics have been unable to completely utilize their iui funding and in some years the ministry has been able to effectively re-allocate this unused funding to deliver additional services at other funded clinics.”victory said the government has repeatedly denied his clinic’s request for ivf funding, and does not provide enough iui funding to meet demand, on the basis that no more money is available.if that much unused funding exists, he said, it could be reallocated to iui and ivf programs at unfunded clinics where it’s needed.the province said it is currently evaluating how it funds fertility treatments.“the ministry is reviewing various aspects of the ofp program including funding allocations to assess program effectiveness, compliance and patient access,” said jensen. “no decisions have been made at this time.”sherry levitan, board director of the canadian fertility and andrology society, said the system may not be perfect, but it has made a difference.“i think everybody is thankful that the ivf funding is there,” said levitan, also a toronto-based fertility lawyer. “could there be a way of fine tuning the system? absolutely.“but i don’t want to come across as being critical of it because, really, there was nothing for a very long time and it’s helped a lot of people.”despite that, she said inequities do exist. there are cities where the service is not available at all, funded or otherwise.“it’s a bigger issue,” levitan said. “it’s access to care. if you live in sudbury or you live outside of a major centre, you are travelling for ivf care. it is the truth.”for many people, she said it’s more than a drive down the 401.“it is the nature of the geography of this country that so many of us live along the southern border, and if you choose to live in an under-serviced area, you are going to have a really hard time in getting any kind of care,” said levitan.“there are lots of people in northern ontario, and they really have to budget for a flight to get to toronto to do an ivf cycle. it’s hugely expensive.”

but along with being far from remote, victory said windsor-essex is much larger than other communities where ivf funding is unavailable.“there is no community the same size as ours in ontario that does not have an ivf program,” he said.despite repeated applications, he said the province has refused to allocate funding for patients in the windsor area to receive ivf treatments on their home turf.people are forced to spend years on waitlists, travel out of town in search of treatment or spend thousands of dollars out of pocket.with funding, he said the cost of ivf before medication is about $1,000. without it, he said a single treatment cycle starts at $10,000.“if you’re older and you need genetic testing, it’s more,” he said. “if you need more medication, you could spend $6,000, $8,000, even sometimes $10,000 just on meds.”the burden of dealing with all that just piles onto an already stressful situation, said victory. he pays for a psychologist, a social worker, a naturopath, a family doctor who does counselling and an online program to help people cope with it.“that kind of gives you an idea of the toll it’s taking,” said victory. “it’s non-stop tears, frustration, anger, loss of opportunity.”victory said there are only two ivf centres in ontario that don’t receive funding. along with his windsor clinic, he said there is one in ottawa. but he added there is a second ottawa clinic that does receive funding.

victory has 25 to 30 patients a month from sarnia, chatham and essex county receiving ivf treatment, and around 120 on a wait list. about 10 or 15 of the patients get funding for ivf, but only because they go to toronto.victory said he works part-time at a toronto clinic that receives funding so he can bring windsor patients there.“i’m getting 20 cycles a year from the place i’m working at, so basically everybody’s going to be waiting three to five years,” he said.victory said he does receive around $108,000 a year for iui procedures, enough for about 120 iui cycles. he does 400.he said iui treatments cost $350 to $450 each, when they’re funded.“but if we run out of funding, which we do in august, it goes from $350 to $1,125,” said victory.to cover the demand for iui and ivf treatment in essex county and sarnia, where he has a second clinic, victory said he would need another $2.5 million.“it’s not rocket science,” he said. “somebody push the button that makes this happen so that windsor patients are not treated inequitably, that we get the same rights as citizens that everybody elsewhere in the province does.”twilhelm@postmedia.comfirst instalment in a three-part series this week by reporter trevor wilhelm. infertile ground looks at the difficulties windsor-area couples face when seeking fertility treatment, including the lengthy, complex process involved and the low level of government funding supports compared to other ontario cities.