Fertility patients seek BC health coverage

By Juvarya Veltkamp,
Special to The Post

$50,000 - that’s how much my husband and I forked out for four rounds of IVF over the course of a year.
‘You should have just gone on a cruise!’, you say. ‘Why don’t you just relax?’, I hear. It can be difficult to wrap your head around this mysterious world of baby-making or to imagine how this fundamental gift of giving life could become so scientific.
My husband and I are guilty of being human. We have anatomies, and this means that things can go wrong.
Infertility is a medical disease, recognized by the World Health Organization. It can affect anybody, at any age, and is caused by a wide variety of underlying medical conditions. Ten percent of women suffer from endometriosis, which often takes more than 9 years to diagnose and leaves 30-40 percent of patients infertile. Another five to ten percent of women suffer from polycystic ovarian syndrome (PCOS), which is the leading cause of female infertility. Other women may experience tubal obstructions, or as in my case, diminished ovarian reserve.
And that’s just one side of infertility. Female factors lead to infertility in 30 percent of cases. In another 30 percent it is male factor. Men can experience blockages in the ducts that carry sperm, or may have suffered from mumps as a child causing sterility later in life. In some cases, both partners may have issues, or be faced with the diagnoses that they have genetic material that is in conflict.
So no, my husband and I are not simply extravagant people, with more money than sense, who would rather try fancy scientific approaches rather than the old fashioned way.
We are regular people, without large bank accounts, suffering from a recognized medical disease with a treatment that the Province of B.C. has determined will not be covered by public health insurance.
We had to scrape together every penny we could to pay for our own treatment and will continue to pay back what we were able to borrow for many years to come.
So why did the Province of B.C. determine that IVF will not be covered by public health insurance? In response to my letter to Health Minister Terry Lake, Health Insurance B.C. wrote that they regretted our situation but that public health insurance couldn’t possibly cover everything. Well, then, who decides what it does cover? And how do these people make their decision?
The Canada Health Act requires the provinces to provide public health care insurance that is 'comprehensive'. This means that all necessary health services, including hospitals, physicians and surgical dentists, should be insured. The problem is, the process to determine what is or isn’t covered, is neither open, nor transparent.
In 1993, the Canadian Royal Commission on New Reproductive and Genetic Technologies recommended full public funding for fertility treatments such as IVF. Twenty-eight out of thirty-four OECD member countries (more than 80 percent) publicly fund IVF, including Australia, New Zealand, Japan and most of the EU. Belgium, France, Israel, Slovenia and Sweden offer multiple, fully funded IVF cycles. Even 15 states in the United States require private insurers to cover the costs of IVF. But over 20 years after the Royal Commission findings, we still have no public funding in B.C. Only the governments of Manitoba, New Brunswick, Ontario and Quebec have shown any leadership on this very important family issue.
The fact remains that one in six Canadian couples will experience fertility problems or difficulty achieving pregnancy, and that seeking infertility treatments is not a ‘lifestyle choice’.
A lifestyle choice is when you go skiing and break your arm. Our public health systems pay for your broken limbs to be repaired despite that fact that you engaged in a risky behaviour.
Because there are so many misconceptions about fertility, may people choose to suffer in silence when they don’t find the support they need. But by keeping this topic taboo, we never get to really discuss public policy around fertility, and even family doctors dole out advice that is closer to some sort of magic voodoo. My physician told me I needed to ‘stop thinking’ about it, and that I’d only get pregnant once I ‘stopped trying’; she resisted giving me a referral to a specialist for 18 precious months.
We need better public health policies around planning for fertility. Young women shouldn’t have to agonize over whether they are leaving it ‘too late’ to have children.
Doctors should be required to provide regular tests (AMH/AFC/FSH) to give women information on their ovarian reserve so that we can make informed decisions about our fertility.
These are inexpensive tests and it is only because female fertility is widely mystified and misunderstood that this hasn't happened yet.
I know for many it is inconceivable to think that people might actually need medical intervention to get pregnant. Babies may be magical but fertility is not an enchanted wonderland, where good, relaxed women in touch with their femininity are able to have children and where career-focused, stressed out, 'desperate' women are not.
Right now in B.C. we say those that need help can only grow their families if they can afford it. To the rest we say sorry you couldn’t procreate. I hope we can start a public process to evaluate the benefits of public funding for IVF in our province, and that one day all British Columbians, regardless of income or geography, will have the opportunity to build their families safely.
I know having a child will priceless. I hope we can all agree to that.
For more information go to www.facebook.com/fundivfnow.

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