Fertility care in Atlantic Canada comes with lengthy travel and wait times

HALIFAX — When Ledon Wellon started trying to have a baby, she assumed it would happen quickly. She was young — 24 at the time — and she was watching her friends start families. She and her husband, who first talked about having kids as 18-year-olds on their second date, were hopeful.

“We had no reason to believe it wouldn’t happen right away,” Wellon said in a recent interview. The 32-year-old from Mount Pearl, N.L., didn’t know at the time that one in six Canadian couples deal with infertility.

For the Wellons, the “heartbreaking” journey of trying to conceive a baby took five years, tens of thousands of dollars and nine rounds of intrauterine insemination. It also included pregnancy loss and a 25-day stay in Calgary for in vitro fertilization, which is not available in Newfoundland and Labrador.

By the ninth round of intrauterine insemination, she had almost lost hope, but it worked. And about nine months later, Wellon gave birth to her now-11-month-old daughter Freya, whom she named after the Norse goddess of fertility.

Wellon and others say the already difficult process of dealing with infertility is made harder and more expensive by the shortage of fertility treatment available in Atlantic Canada. Across the four provinces, there are just three fertility clinics, and only two of them offer IVF. That means longer waits and costly travel for those who need medical assistance to conceive.

Theresa Hudson’s years-long process of trying to get pregnant also took her out of the province. The teacher living in Dartmouth, N.S., underwent three rounds of IVF in Halifax and Toronto, which cost a total of about $60,000 — even after having 80 per cent of fertility medication costs covered through her spouse’s insurance plan.

“The demand for fertility care is just as high as everywhere else in the country, but we don’t have the clinics to deal with the demand and the wait is huge,” Hudson said.

Like Wellon, Hudson endured pregnancy loss while trying to conceive — miscarriages occur in 15 to 20 per cent of pregnancies in Canada. More than four years after she and her husband started trying, Hudson got pregnant and carried her baby to full term. Up until she was nine months pregnant, Hudson said she still “couldn’t believe that it’s real.”

Carolynn Dubé, executive director of the national charitable organization Fertility Matters Canada, said in a recent interview that out-of-pocket costs of about $20,000 per round of IVF — whether in a private or non-profit clinic — are the biggest barrier to fertility treatment. 

In vitro fertilization is a multi-step procedure that requires hormone treatments, egg retrieval, lab fertilization and an embryo transfer. Intrauterine insemination is a less complex procedure where sperm is injected into the uterus.

Subsidies for residents pursuing fertility vary by province. In Ontario and Quebec, the province will fully cover one round of IVF.

Nova Scotia’s fertility subsidy, introduced in March of this year, offers a refundable tax credit for 40 per cent of the treatment cost to a maximum annual tax credit of $8,000. New Brunswick offers a one-time maximum grant of $5,000 and Prince Edward Island provides between $5,000 and $10,000 annually for three years for IVF or intrauterine insemination.

Newfoundland’s fertility support program offers a subsidy of $5,000 per IVF cycle for a maximum of three times. Wellon and her husband took out a loan and fundraised another $10,000 for treatment costs, which included care at a private clinic in Calgary and totalled about $35,000.

“You know, $5,000 is great … but it’s not enough to help someone who already can’t afford this,” Wellon said. 

Second to cost, the biggest obstacle is the limited availability of resources, Dubé said. “We do not have equitable access to fertility care in this country,” she said, adding: “It’s hardest for people in the Atlantic region.”

Andrew Meikle, CEO of The Fertility Partners, a Toronto-based firm that owns 20 private fertility clinics in Canada and five in the United States, said he believes Atlantic Canadians wait longest for care.

“We know this because we see patients from the East Coast in Ottawa, in other parts of Ontario and out west. They’re flying across the country to get care because of the wait times,” Meikle said in an interview.

The Fertility Partners acquired New Brunswick’s only fertility clinic, Conceptia, in June 2021, where demand is high, Meikle said. The Moncton facility is the only private clinic in Atlantic Canada and it’s one of two clinics in the region that provide IVF. A spokesperson for The Fertility Partners said in an email that across Canada, its clinic wait times vary, but on average a patient waits around six weeks for treatment.

Meikle said there was a spike in demand for fertility care during the pandemic that has slowed down, but overall the need for fertility care remains high as couples have children later in life and more single people and LGBTQ families seek reproductive assistance. Meikle said he expects demand will continue to grow as more employers expand insurance coverage for fertility treatment for their workers and provinces continue to roll out financial support for the care.

Halifax’s non-profit Atlantic Assisted Reproductive Therapies, the other IVF-providing centre in the region, has three part-time reproductive endocrinology infertility specialists. Because of the clinic’s non-profit structure, these specialists also do gynecological and obstetrics procedures in other areas of Nova Scotia’s health system and teach at Dalhousie University’s medical school.

It sees about 1,000 new patients from across the region each year, and wait times range from six to 12 months. The clinic’s medical director, Dr. Renda Bouzayen, said she would like to see the wait time cut to no more than three months.

In Newfoundland and Labrador, the fertility services department of Eastern Health’s children and women’s health program provides assessments and a limited range of treatment options. Wait times for an initial assessment in Newfoundland range from six months to three years, a health authority spokesperson said.

While wait times for fertility care are similar to what patients face in other areas of Atlantic Canada’s strained health system, Bouzayen said, the lost months can directly affect chances of success.

The IVF success rate for someone under 36 years old is around 60 per cent, she said, which drops to about 40 per cent between the ages of 36 and 40. Between ages 40 and 43, IVF is successful about 20 per cent of the time, and over 43 the success rate drops to about one per cent.

“You can easily go from having a chance of conception to no chance,” Bouzayen said.

This report by The Canadian Press was first published Oct. 24, 2022.

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This story was produced with the financial assistance of the Meta and Canadian Press News Fellowship.

Lyndsay Armstrong, The Canadian Press