Prioritization of Patients for Publicly Funded IVF in Ontario: A Survey of Fertility Centres.
On December 21, 2015, Ontario began funding one cycle of IVF for any Ontarian under age 43, with a program cap of 5000 cycles per year, which is below expected demand. Our objective was to determine how fertility clinics are prioritizing patients for limited-funded IVF cycles.



An electronic survey was emailed to medical directors of all 25 fertility clinics providing funded IVF in Ontario.



From January to March 2016, 22 (88%) of the clinics responded. All reported providing access to funded IVF, and 100% already had a wait list. Eight clinics prioritized patients on a first-come, first-served basis; two used a lottery; 11 reported using multiple patient factors to determine priority for funding; and one declined to answer. Of the clinics reporting multiple factors, the five most common factors were first-come, first-served (90.9%); older aged patients (81.8%); patients about to lose their funding eligibility (63.6%); duration of infertility (36.3%); and duration at current clinic (36.3%).



There is variation in how patients are prioritized for publicly funded IVF in Ontario. Some clinics have chosen to prioritize patients in a first-come, first-served manner, whereas others have chosen to prioritize patients based on multiple factors that would favour older patients. This is the first study providing the public and government insight on how the new fertility program has been implemented by individual clinics. This information is important for patients to understand their own chances of receiving a funded IVF cycle because this may vary depending on individual clinics.
Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; Mount Sinai Fertility, Sinai Health Systems, Toronto, ON. Electronic address: Tomas.Gotz@sinaihealthsystem.ca.
Tamas
T
Gotz
Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; Mount Sinai Fertility, Sinai Health Systems, Toronto, ON.
Claire
C
Jones
D000328:Adult; D000367:Age Factors; D004608:Eligibility Determination; D005260:Female; D005307:Fertilization in Vitro / Q000191:economics*; D005380:Financing, Government; D061889:Healthcare Financing; D006801:Humans; D007246:Infertility / Q000628:therapy*; D009864:Ontario; D018579:Patient Selection; D040841:Resource Allocation / Q000379:methods*; D011795:Surveys and Questionnaires; D013997:Time Factors
Infertility; ethics; health policy; in vitro fertilization; resource allocation