Looks like Canada is taking a step back.

Upsetting to hear this news… just when we thought Ontario was just on its way. QC was always a leader in the IVF community. So. SAD.

In vitro fertilization dropped from RAMQ in new Quebec health bill

In vitro fertilization will no longer be covered by the public health insurance plan, if a bill tabled by Quebec Health Minister Gaétan Barrette at the National Assembly on Friday passes.

• Quebec in vitro fertilization program to be scaled back

Bill 20 — or, An Act to enact the Act to promote access to family medicine and specialized medicine services and to amend various legislative provisions relating to assisted procreation — proposes to cut public health insurance (RAMQ) coverage for IVF treatments.

It also limits the number of embryos a woman can be implanted with to one at a time, except for women aged 37 or older, who would be able to be implanted with two embryos.

The bill also seeks to ban IVF for women under 18 or over 42 years of age.

Under the proposed bill, the only assisted reproductive measure that would be covered by RAMQ is artificial insemination.

At a news conference Friday afternoon, Barrette expanded on the proposed bill.

He said some exceptions could be made for women who have tried other therapies but had failed to conceive. However, women who had had a tubal ligation, men who had had vasectomies or a parent or parents who already had one child would not benefit from this exemption.

He also said women seeking IVF could also benefit from a variable tax credit.

He said doctors who advised their patients to seek IVF treatments outside of the province would be subject to hefty fines. 

IVF program a victim of its own success

The new bill is Barrette’s response to an IVF program that has been so successful that it overran its budget.

In his previous job as head of the Quebec’s Federation of Medical Specialists, Barrette criticized the program.

He called it an "open bar" and said it was not an essential service.

Quebec was the first province in Canada to fully fund IVF treatments.

The new legislation would also force family doctors and specialists to accept a minimum number of patients, and spells out steeper fines for doctors who do not operate within the guidelines set out in the bill.

This is just insane!!!????

http://www.theglobeandmail.com/news/national/calgary-fertility-clinic-in-spotlight-over-policy-to-restrict-donations-to-patients-of-same-ethnicity/article19813167/

Calgary fertility clinic in hot water after refusing to help with mixed-race babies 

 

A Calgary fertility clinic is at the centre of an ethical and political controversy after it refused to help a woman become impregnated with sperm from a donor who did not share her skin colour.
The Regional Fertility Program, a privately owned company that is the only facility of its sort in Calgary, said in a statement on Monday that one of its doctors was voicing his own opinions when he told a single Caucasian woman seeking in vitro fertilization that she could receive sperm from only white donors.

The clinic went on to say that a ban on creating mixed-race babies that was in place for decades was removed last year, but the website was not properly updated to reflect the change.
Monday’s statement that the clinic had revised its approach did not come until after the old policy had received a strong rebuke from federal government and fertility experts across the country. The incident also highlighted the fact that fertility clinics in Alberta and other parts of Canada are not regulated and that the doctors who work in them set their own parameters.
Matt Gysler, the past president of the Canadian Fertility and Andrology Society, says fertility doctors “essentially write their own rules and then the clinic, which is maybe a group of physicians, will rewrite their own rules and then agree to practice in a similar way.”
But the doctors are governed by the standards of their provincial colleges of physicians, Dr. Gysler said. “That’s a very strong protection.”
The Calgary doctor who told the woman he would not help her conceive a mixed race baby was Calvin Greene, the clinic’s administrative director. He told the Calgary Herald last week that the policy against mixing races had been in effect since the 1980s and he believes it is better to raise children who resemble their parents.
“I’m not sure that we should be creating rainbow families just because some single woman decides that that’s what she wants,” Dr. Greene said. He went on to say the clinic’s approach is consistent with the spirit of Ottawa’s Assisted Human Reproduction Act, which discourages doctors from helping create “designer babies.”
But federal Health Minister Rona Ambrose disagrees. “Our government believes that discrimination in any form is unacceptable,” her spokeswoman said on Monday. “Race is not a part of the Assisted Human Reproduction Act.”
Alberta Health Minister Fred Horne said the controversy at the Regional Fertility Program in Calgary, which is a private clinic that receives no funds from his government, has raised some important questions for Alberta as it explores the possibility of paying for in vitro fertilization.
“This is a good example of how some of these decisions are actually complex and they involve ethical considerations that really have to be worked through,” Mr. Horne said.
The federal Assisted Human Reproduction Act was gutted after the Supreme Court ruled in 2010 that the provinces have the jurisdiction to regulate fertility clinics. The act continues to prohibit some practices such as creating hybrids of human and animal life forms, but it is largely left up to fertility doctors to decide what procedures are in their patients’ best interests.
That can be a difficult situation, said Shawn Winsor, an ethicist at the LifeQuest Centre for Reproductive Medicine in Toronto, because they are considering what’s best for someone who has not been conceived. Society has to get better at helping doctors make these decisions, Mr. Winsor said.
Gloria Poirier, the executive director of the Infertility Awareness Association of Canada, which was created to help Canadians with reproductive issues, said the Calgary clinic’s old policy was entirely inappropriate.
“Clinics are private, they have standards, they have best practices, they have a code of ethics, and ... this is not something that’s ethical,” Ms. Poirier said. “We certainly don’t support that.”
And Sara Cohen, a fertility law attorney in Toronto, said she assumes the clinic had good intentions and was looking out for what it considered to be the best interests of the child. “But it is inappropriate for a clinic to make greater social policy for a province,” Ms. Cohen said.
Some patients said the policy is not a concern because they are so focused on making their parenthood dreams come true or because they already planned to pick someone of the same race to protect their own privacy.
One couple, who asked to remain anonymous because because not all of their friends know about their personal history, said they were told about the policy at the Regional Fertility Program when they went for treatment a couple years ago, but were not bothered.
“We didn’t have a problem with it because we wanted to keep it pretty private and have kids that look as much like us as possible,” one of the parents said. “We were kind of in our own little bubble.
“I can see why some people would be bothered by it.”
With reports from Tu Thanh Ha in Toronto and Allan Maki in Calgary

Follow us on Twitter: Carrie Tait @CarrieTait, Gloria Galloway @glorgal

 

No mandatory standards for in vitro fertilization clinics

http://www.theglobeandmail.com/news/politics/no-mandatory-standards-for-in-vitro-fertilization-clinics/article19868390/

Would-be parents who turn to in vitro fertilization to conceive children will find inconsistent oversight of fertility clinics across the country with some facilities free to set their own policies about how to do business.
The relative autonomy of the clinics was highlighted recently when the Regional Fertility Program in Calgary refused to help a woman become impregnated with sperm from a donor who did not share her skin colour.

The clinic said this week that its ban on blending races during in vitro fertilization (IVF) was changed more than a year ago, suggesting the woman had been misinformed by one of its doctors. But Alberta does not directly regulate the clinics, nor do other provinces except Quebec.
With Ontario promising to fund in vitro fertilization, and Alberta giving thought to paying the cost of the procedure, governments and fertility experts are asking whether more regulation is needed.
“I think that people who are seeking this kind of treatment are very vulnerable. They suffer from infertility and they are desperate to get a child and they are going to take all sorts of risks,” said Colleen Flood, the Canada research chair in health law and policy at the University of Toronto.
Dr. Flood said any clinic that refused to mix races during the in vitro process could become the subject of a complaint to the provincial College of Physicians and Surgeons, which licenses doctors to practise medicine. Although doctors have been able to refuse to dispense birth control on the grounds of religious conscience, “it would be difficult to claim, I think, that your conscience requires that you can’t mix the races,” she said.
But other policies, clinical practices and even the effectiveness of the treatments are not being adequately assessed at many of Canada’s private, for-profit in vitro clinics, Dr. Flood said.
Since the Supreme Court gutted the federal Assisted Human Reproduction Act in 2010 and declared that regulation of the clinics was the jurisdiction of the provinces, there has been a patchwork of oversight.
Quebec has a law with fines of thousands of dollars for those who break the rules. Other provinces, including Ontario, which is home to half of the 43 clinics listed on the website of the Canadian Fertility and Andrology Society, do not.
In some provinces, including British Columbia and Alberta, the colleges of physicians accredit IVF facilities. They look at things such as sterilization procedures and the competence of medical staff.
But Karen Eby of the Alberta college says: “We don’t typically set standards on clinical care. We just don’t get into [that] level of detail. The things we are looking at would be ‘do you have a surgical checklist, do you have safe exits, are your staff appropriately trained, do they get annual reviews …”
Colleges of physicians in some other provinces don’t go that far.
Ed Schollenberg, the registrar for the College of Physicians and Surgeons of New Brunswick, which has one of the clinics, said his organization accredits doctors but not individual facilities. So there are no on-site inspections.
A handful of the IVF clinics have been approved by Accreditation Canada, which sets standards and does site visits to ensure they are being met. But accreditation is mostly voluntary outside of publicly funded facilities in Quebec and Manitoba.
“We have this odd approach in Canada: If it’s publicly funded, then it’s all systems go on the regulations frontier,” Dr. Flood said. But for privately funded clinics, “it’s pretty much caveat emptor, whether we are talking about IVF services or cosmetic surgery or anything. It’s pretty astonishing, actually.”

Follow Gloria Galloway on Twitter: @glorgal

Predicting if IVF is for you

http://www.dailymail.co.uk/health/article-1344100/One-minute-test-tell-woman-IVF-chances-99-accurate.html

One-minute test to tell a woman her IVF chances 'is 99% accurate'

By: Fiona Macrae

 A 60-second test which predicts couples’ chances of having a baby through IVF has been created by scientists.

The free calculator, which is available online, uses the answers to nine simple questions to work out the odds of fertility treatment succeeding.

With the results said to be almost 100 per cent accurate, the test could save couples the emotional and financial pain of going through repeated treatments only for them to fail.

Women with a lower likelihood of becoming mothers could be told early on about tweaks to their treatment that could increase their chances.

Others could be counselled to think about alternative options such as adoption.

Glasgow and Bristol University researchers obtained background information on almost 150,000 IVF treatments carried out in the UK between 2003 and 2007.

They used this to work out which factors were most important in becoming pregnant. From this, they created the IVFpredict test.

The nine questions take as little as a minute to answer in total and the results are up to 99 per cent accurate, the scientists say.

This is despite them not including information about lifestyle factors such as smoking and weight.

Those given low odds may be able to increase their chances as much as three-fold by opting for donor eggs or ICSI, in which sperm is injected directly into the egg, the journal PLoS Medicine reports.

Professor Scott Nelson, a researcher from Glasgow University, said: ‘The test provides critical information on the likely outcome for couples deciding whether to undergo IVF – up until now estimates of success have not been reliable.
‘Not every attempt at IVF is successful.

‘In the U.S. and the UK, IVF is successful in about a third of women under 35 years old but in only 5 to 10 per cent of women over 40. 

‘However, there are many other factors in addition to age which can alter your chance of success and clinics don’t usually take these into account when counselling couples or women.’ Fertility treatment can cost between £3,000 and £15,000 per course. But fewer than one in four IVF treatments leads to a birth.

Although other calculators exist, they are either less accurate or involve such intricate data about subjects such as hormone levels that they can only been done in a doctor’s surgery.

Debbie Lawlor, professor of epidemiology at the University of Bristol, said: ‘The IVF calculator is not only of use to the couples themselves but also to health care funders such as the NHS to ensure appropriate use of resources.

‘The sheer scale of the data we analysed is the key to the accuracy of this model. The more data you look at, the more accurate the predictions become.’ 

But Professor Bill Ledger, a leading fertility doctor and member of the fertility watchdog, the Human Fertilisation and Embryology Authority, urged caution.

He said: ‘While the test will give an individual some idea of their chances, it is not much use unless put alongside data from the clinic the woman attends.’

Some clinics have much higher – or lower – success rates than others, he said. The test is available at ivfpredict.com

I cannot even imagine....

I cannot even imagine the grief these families must feel at finding out their IVF sperm donations were tampered with. Hopefully in the last 20 years the security of the procedure has advanced and this could never happen again. 

http://www.cnn.com/video/data/2.0/video/us/2014/01/23/dnt-sperm-switch-ferility-clinic.ktvx.html

A mother's love! Grandmother, 58, to give birth to daughter’s daughter

Julia Navarro is serving as a gestational surrogate for her daughter and son-in-law after the couple struggled with fertility problems.

The Associated Press

PROVO, UTAH—A 58-year-old U.S. woman is set to give birth in a few weeks — to her first grandchild.

Julia Navarro is serving as a gestational surrogate for her daughter and son-in-law after the couple struggled with fertility problems.

Navarro’s daughter Lorena McKinnon said she began trying to have a baby with her husband, Micah McKinnon, three years ago.

The 32-year-old, from Provo, Utah, said she’s had about a dozen miscarriages, with the longest pregnancy lasting 10 weeks.

After several tries, the couple began looking for a surrogate. McKinnon said a friend and sister both considered carrying her baby, but ultimately decided against it.

“As a family, we have to help each other,” Navarro told The Salt Lake Tribune.That’s when her mother offered to step in.

Navarro had to undergo hormone shots for three months before an embryo fertilized by her daughter and son-in-law could be implanted. Because of her age, doctors had warned there was only a 45 per cent chance the implantation would be successful.

But the procedure was a success, and Navarro said she’s had a smooth pregnancy carrying a developing baby girl.

As with other surrogacy arrangements, the couple and Navarro needed three months of counselling.

“The psychologists wanted to make sure we knew what we were getting into — that we were mentally prepared,” McKinnon said. “Mostly, surrogacy contracts are with people you don’t know. It was weird to have a contract with my mom.”

It’s unclear how rare it is for a woman to carry her own grandchild, but recent news reports have detailed similar relationships.

Last year, a 53-year-old Iowa woman gave birth to her twin granddaughters. And in 2012, a 49-year-old woman in Maine gave birth to her grandson.

McKinnon said she was grateful and overwhelmed by her mother’s offer, which eases some of the obstacles and financial burdens for parents using a gestational surrogate.

According to Utah law, surrogates must be 21 or older, financially stable and must have already given birth once.

Couples must be married and are allowed to offer a reasonable payment to a surrogate.

On average, a couple can spend about $60,000 on procedures and paying the surrogate, but McKinnon said her mother’s offer to help is saving the couple about half of that.

Both she and her daughter said they’ve bonded over the experience.

The baby girl is due in early February.