Title : Advancing fertility care equity in british columbia: A values-aligned leadership approach to public IVF funding policy
Abstract:
Background: Access to fertility care and in vitro fertilization (IVF) treatments across British Columbia remains inequitable and financially prohibitive for many individuals. As a stakeholder organization advocating for universal access to fertility care, the Fertility Coalition of British Columbia (FCBC) recognizes that providing high-quality fertility care is essential to Canadians’ reproductive health and strives to advance policy dialogue, support data generation, and collaborate with aligned partners to improve the availability and accessibility of fertility services across British Columbia. This study explored how FCBC might leverage the experiences and insights from IVF programs in other Canadian provinces to inform the design and implementation of a publicly funded IVF program in British Columbia.
Objective: To identify key advocacy strategies, system barriers, and policy opportunities that could guide the development of an equitable and publicly funded fertility care model in British Columbia.
Methods: A qualitative research methodology was employed, including a literature review, comparative analysis of provincial funding models, and semi-structured interviews and group discussions with six executive directors from fertility advocacy organizations across Canada.
Results: Five key findings emerged: (1) Funding gaps and geographical inequities present major advocacy challenges; (2) Emotional and mental health support within fertility systems is insufficient; (3) Infertility continues to be perceived as elective care, limiting policy progress; (4) Lack of continuity of care impacts patient experience and advocacy efforts; (5) Public awareness and education around IVF funding options are inconsistent across provinces.
Conclusions: Integrating evidence-informed practices and lessons from other provinces, five strategic recommendations were developed: establish a provincial IVF travel and accommodation fund; integrate specialized mental health supports into fertility care; advocate for policy reforms recognizing IVF as essential medical care; implement a provincially coordinated fertility education program; and develop a fertility care coordination system. These findings were synthesized into a visual strategy roadmap, The Tree of Life, symbolizing staged implementation toward system-wide transformation. This research offers a foundation for advancing equitable and compassionate fertility care in British Columbia.
