When Quebec launched its publicly-funded in vitro fertilization (IVF) program in 2010, it was internationally praised for its generosity.

A cycle of IVF generally costs about $10,000. Quebec's current program allows couples to access up to 3 cycles of IVF.

Initially budgeted at $30 million, the IVF program ballooned to nearly $70 million last year.

The Liberals decided it wasn't sustainable and tabled Bill 20 last November which effectively puts an end to fully funded treatment and restricts who can access it.

Eligibility requirements

Under the proposed bill, couples would need to pay for IVF upfront.

'There is a group of women that is feeling some pressure.' - Carolynn Dubé, executive director of Infertility Awareness Association of Canada

They'd receive tax credits for one cycle of IVF based on their family's income.

A family earning less than $50,000 a year would be given a tax break equal to 80 per cent of the procedure's cost. The tax credit slides down to 20 per cent for families making $120,000 or more a year.

However, they would not be eligible if they already had a child. They also wouldn't have access to public or private treatment over the age of 42.

Carolynn Dubé is the executive director of the Infertility Awareness Association of Canada, which will appear before the parliamentary committee that is studying the bill today.

Dubé hopes the government is still open to compromise.

"There is a group of women that is feeling some pressure. I've got to get in. I've got to get this done before they take the funding from me. Especially couples that are getting closer to that 42 cut-off," Dubé says.

Most fertility clinics allow women to use their own eggs up to the age of 42 or 43 years old if they are in good physical health, Dubé says. Past that age, donors eggs or donor embryos are an option.

Under the new program, women over the age of 42 would be banned from treatment even if they want to pay for it themselves.

The province would fine doctors as much as $50,000 if they perform the procedure on patients older than the threshold or direct those patients to clinics outside the province.

"Let's say a couple has conceived a child through fertility at age 38 and they have frozen embryos. If they wait until 43, they would not be able to use their biological embryos at all," Dubé says.

Potential savings?

Bill 20 would continue to publicly fund artificial insemination or IUIs.

Dubé understands the province wants to rein in costs, but says in some cases, IUIs are not the best treatment plan.

IUIs typically have a lower success rate and can result in more multiple births which end up costing the health care system in the long run, Dubé says. She says money could perhaps be saved by reducing IUIs.

"By continuing on with a single embryo transfer through IVF, it's a much safer practice. Quebec actually has one of the lowest multiple birth rates in the world," Dubé said.

Pressed for time

Elodie Mantha is feeling the pressure of the province's proposed bill.

IVF family Elodie Mantha

Elodie Mantha and her husband had their son Benjamin two and a half years ago through IVF. (Photo courtesy of Elodie Mantha)

She and her husband had their son Benjamin through IVF two and a half years ago.

Diagnosed with early on-set menopause, they'd like to add to their family and are hoping to undergo IVF with a donor egg soon before the rules change.

'It feels unfair and quite judgemental.' - Elodie Mantha, mother who underwent IVF treatments

She is part of a group called Vague Espoir that tries to raise awareness about infertility and what the proposed cuts will do to the future of assisted reproduction in Quebec.

The group will hold marches in Montreal and Quebec on March 22 at 1 p.m.

"I find the age limit from the government doesn't take into account the science of assisted reproduction. It doesn't take into account the societal pressures that are placed on women. We're expected to go to school, to build careers, to do all these things before we can turn to building our families. And to suddenly tell women in their late 30s that they're almost done and they won't be helped if they need the help — it feels unfair and quite judgemental," Mantha says.

By tightening access to IVF, the provincial government hopes to save $48 million.

But Mantha says the government needs to look at the big picture.

"This program has saved costs. It's reduced multiple births. It's actually saving costs to other parts of the health care system that would need to deal with pre-term babies," Mantha says.

"It's 0.2 per cent of the health care system. How much of a dent is this going to make in our financial situation? And what's the human cost tied to that? I can't think of another program in the health care system that actually leads to new babies being born."


The parliamentary committee will hold hearings until March 25.

Feedback from health groups, doctors and patients will be considered and amendments can be made.

Bill 20 could be passed as early as this spring.