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. 2019 Mar 16:8:32-37.
doi: 10.1016/j.rbms.2019.01.002. eCollection 2019 Jun.

Impact of government health coverage for ART: The results of a 5-year experience in Quebec

F Bissonnette  1   2 , S Phillips  1   2 , J Sampalis  3 , E M Dahdouh  2   4 , P St-Michel  5 , W Buckett  3   6 , I J Kadoch  1   2 , N Mahutte  7
Affiliations

Impact of government health coverage for ART: The results of a 5-year experience in Quebec

F Bissonnette et al. Reprod Biomed Soc Online. .

Abstract

An analysis of national registry data for 5 years of in-vitro fertilization (IVF) funding in Quebec, Canada was compared with the previous complete year of non-funded IVF cycles, as well as the first complete year following the end of funding. The number of cycles, livebirth rates, age group of patients treated, use of donor gametes, multiple pregnancy rates and cycle cancellation rates were assessed. The total number of IVF cycles performed increased dramatically during the funded period, averaging over 10,000 cycles per year. There was no change in the age group distribution of patients treated, but less egg donation was performed. Interestingly, funding was also associated with an increase in the IVF cycle cancellation rate (17.0% versus 34.4%, P < 0.001), a dramatic decline in the multiple pregnancy rate (25.6% versus 4.9%, P < 0.001), and a decline in the livebirth rate per fresh embryo transfer in stimulated IVF cycles (32.3% versus 25.5%, P < 0.001). Although the livebirth rate for stimulated IVF declined, over 9000 babies were born as a result of the coverage. Lessons learned from this experience could help develop a more fiscally responsible programme that still facilitates access to IVF care.

Keywords: IVF; multiple pregnancy rates; public funding.

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Figures

Fig. 1
Fig. 1
Number of cycles of in-vitro fertilization (IVF) and frozen embryo transfers (FET) started per year in the province of Quebec.
Fig. 2
Fig. 2
Proportion of in-vitro fertilization (IVF) and frozen embryo transfer (FET) cycles by patient age over time in the province of Quebec.
See this image and copyright information in PMC

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