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‘Significant disparity’

Biochemistry student making 'noise' about inequality of fertility care

Student Life

By Mohammad Saad Khawer

During the winter semester of my third year at Memorial University of Newfoundland, I applied for a Summer Undergraduate Research Award (SURA) position.

I came across a research position for a project titled, A Community-based Exercise Program for Women with Obesity-related Infertility.

Nutrition student

The project aimed to determine the physiological effects of a community exercise program on those affected by obesity and infertility.

I have always been highly involved in sports, and as a nutrition student, working with people living with obesity piqued my interest in the topic.

Additionally, as a student of nutrition at Memorial, I am well aware that Newfoundland and Labrador has one of Canada’s highest rates of adult obesity.

My remote research internship

During my job interview in February, we discussed my role with the research team. I would assist in performing cardiovascular fitness and metabolic testing on patients enrolled in the study.

Once the pandemic hit, everything changed, of course. My SURA position would now have to be performed remotely.

While I understood this new reality, I was initially disappointed.

However, now, in hindsight, COVID-19 provided me with an invaluable perspective on the inequality of fertility care in Canada.

“One in six couples in Canada experiences infertility.”

If you asked me six months ago what I thought about infertility care in Newfoundland and Labrador, I would have looked at you wide-eyed and shrugged my shoulders indifferently.

Since the pandemic forced our team to suspend patient research, our focus shifted to investigating the impact of COVID-19 on patients experiencing infertility.

I learned that while Newfoundland and Labrador Fertility Services, an Eastern Health clinic, offers many services, PEI and Newfoundland and Labrador are the only two provinces in Canada that do not provide in-vitro fertilization (IVF).

This is a challenge for many, as one in six couples in Canada experiences infertility.

Six years ago, Dr. Terry O’Grady, a fertility specialist, publicly advocated for the Government of Newfoundland and Labrador to provide financial assistance for IVF treatments.

To date, these costs are not covered.

Now, covering the cost of IVF is even harder for couples experiencing infertility. Job layoffs have resulted in some patients using their IVF savings for everyday essentials.

Travel bans have impacted the ability to receive IVF treatments out of province and referrals to IVF clinics have been halted. 

What makes N.L. different from other provinces?

Those who might benefit from IVF are instructed to seek treatment in other provinces.

This greatly increases the cost associated with IVF, due to the expense of flights, accommodation and additional care.

Many people cannot afford the extra costs because IVF treatments are already expensive – averaging about $10,000 per cycle.

“There are very few other specialties and subspecialties that have to rely on out-of-province treatments for the . . . gold standard of care,” said Dr. Sean Murphy, a fertility specialist at Newfoundland and Labrador Fertility Services and a member of our research team.

“If you’re looking at something that makes us a unique situation, it is access to the gold standard quality of care.”

“Newfoundlanders and Labradorians are subjected to a significant disparity when needing access to fertility care.”

As stated by Dr. Murphy, this factor differentiates Newfoundland and Labrador from other provinces.

We are dependent on out-of-province fertility care, a significant problem regardless and particularly during periods of crisis, such as the current pandemic and weather-related states of emergencies.

Through no fault of our own, Newfoundlanders and Labradorians are subjected to a significant disparity when needing access to fertility care.

Eastern Health partially resumes fertility services

On June 8 Eastern Health announced that they will soon provide limited fertility services at the St. John’s clinic.

Although fertility services in Newfoundland and Labrador have re-opened, people who were in the middle of receiving fertility care were in limbo until June 8.

The main question for our team then is: What impact will any disruption of care have on the Newfoundland and Labrador population, since we are entirely dependent on outside IVF services?

The squeaky wheel gets the grease

While inequality of care has always existed for patients seeking fertility treatment (e.g., finances and accessibility), the COVID-19 pandemic has helped to shine a light so bright that not even an unbiased third party like me can ignore.

We must find ways to increase the accessibility of fertility services for Newfoundlanders and Labradorians.

IVF services must be provided to reduce people’s costs and reliance on other provinces’ health-care systems.

As the proverb goes, “the squeaky wheel gets the grease.” Unfortunately, infertility is a stigmatized condition, and therefore many patients do not advocate for their rights.

By writing this piece, I hope to increase the “noise” and inspire others to get loud about fertility care in our province.

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