安省IVF资助：现状与目标
安大略省政府今年将投资1亿加元，支持全省27家IVF诊所。这是其多年计划的一部分，旨在提高生育治疗的可及性。本次讨论将探讨这些措施是否有效，以及还需要做些什么。Dr. Preethi Sharma，加拿大生育与男科学协会（Canadian Fertility and Andrology Society）主席，将详细介绍相关情况。
Original English
The Ontario government will be investing $100 million this year to support 27 IVF clinics across the province. It's all part of their multi-year plan to make fertility treatment more accessible. So is it working, and what else needs to be done? Doctor Preethi Sharma is the president of the Canadian Fertility and Andrology Society, and she joins me in studio. Great to have you here. How are you doing. >> I'm great. Thank you for having me. And thank you for allowing me to speak about this incredibly timely topic.当前IVF周期覆盖范围
当前，安大略省的资助计划允许所有安省居民，持有有效OHIP卡的患者，获得一次体外受精（IVF）周期（In Vitro Fertilization）的治疗。但存在一些限制条件：申请时必须未满43周岁。一个IVF周期包括卵巢卵巢刺激（ovarian stimulation）、取卵（egg retrieval）以及来自该周期产生的所有可用胚胎的移植（embryo transfers）。然而，此项资助不包括药物费用或基因检测等附加服务。一个典型的IVF周期大约需要两周时间，包括注射药物进行卵巢刺激，随后在镇静下进行取卵，以及后续的胚胎移植。
Original English
>> Well, let's talk about it. I want to better understand how does government funded fertility treatment right now? What does it cover currently? >> So the Ontario funding program allows any patient who's a resident of Ontario and has a valid OHIP card to receive one IVF cycle. Now, there are certain stipulations. You must be under the age of 43 at the time of your eligibility. An IVF cycle includes ovarian stimulation and the egg retrieval, and all embryo transfers from viable embryos that result from that cycle. >> I'm assuming it does not include medications or anything that's on the side. >> You are correct. It does not include medication or any add ons, like genetic testing of embryos currently. >> In terms of a cycle, how long does that actually is it or is it measured in a calendar year? How long is typically a cycle? >> Yeah. An IVF cycle typically takes about two weeks. You start ovarian stimulation at the beginning of your cycle, typically on day 2 or 3. Take medications that are injectable for about 10 to 12 days, followed by an egg retrieval under sedation and either a fresh transfer or a frozen embryo transfer at a subsequent time.辅助费用与新资金效应
为了应对药物和附加费用，安大略省去年推出了生育治疗税收抵免（fertility treatment tax credit）。这项政策旨在帮助患者支付未被覆盖的费用，如药物、胚胎基因检测以及购买捐赠配子（donor gametes，即捐赠的精子或卵子）。这些未覆盖费用可能高达7000至20000加元。该税收抵免允许患者申报高达20000加元的费用，最高可获得5000加元的年度抵免，有效减轻了患者的经济负担。
政府新宣布的1亿加元资金，被Dr. Sharma誉为对医疗保健的重大投资。首批5000万加元已用于支持约5000个额外的IVF周期，显著缩短了患者的等待时间，将原本长达两年的等候期缩短至数月，甚至立即获得治疗。未来三年，还将有另外1亿加元部署，总计2.5亿加元，预计可支持近10000个额外的IVF周期，使更多安省居民能够获得所需的生育护理。
Original English
>> All right, let's talk about some supports there. The Ontario government introduced the fertility treatment tax credit last year to help with these medications and the add on costs. What isn't covered and what is it supporting? >> So as you said, medication is not covered. Genetic testing of embryos is not covered. And the purchase of donor gametes, sperm or eggs is not covered. And so these are significant costs to patients that can be up to seven, ten even up to $20,000. So this is where the Ontario Fertility treatment tax credit has become really complimentary and helpful for patients. They can claim up to $5,000 expenses, $20,000 of expenses for a maximum of a $5,000 credit annually. And so it really does help defray the costs. >> All right. Now, the Ontario government announced a new $100 million in funding. This is really about access and affordability. How does that actually fix it? >> Well, first of all, we'd like to applaud the Ontario government for this significant investment. Fertility care is truly health care, and we're just so happy to see this investment in helping build families. So the first 50 million that was given this year covers about 5000 additional cycles. That's really incredible because many Ontarians who could otherwise not access high quality fertility care or would have to be on waitlists for up to two years, are now accessing care within a couple of months, if not immediately, there'll be another 100 million deployed each year, for a total of $250 million over three years. So you can imagine that's almost an additional 10,000 IVF cycles. And so many Ontarians are going to be able to access the fertility care they need.用户群体与不断增长的需求
数据显示，超过10万人在使用IVF技术。生育景观（fertility landscape）显示，由于经济压力、寻找合适伴侣以及追求财务稳定，女性生育年龄正在推迟，首次怀孕年龄随之增长。因此，需要IVF来组建家庭的人数正在不断增加。此外，LGBTQ+群体（LGBTQ+ population）的需求也在稳步增长，他们常常需要捐卵者（egg donor）或精子捐赠者（sperm donor），甚至代孕者（surrogate），而这些需求主要通过IVF来满足。
Original English
>> You say many Ontarians, do you ever can you give us an idea of how many families are using and people are using in vitro fertilisation? >> I mean, I think the data shows over 100,000 people are using it. But when we talk about the fertility landscape, we know that women are delaying their fertility due to economic concerns, finding the right person, wanting to be financially stable. And so the age at first pregnancy is increasing. So that number of people who need IVF to build their families is growing. The LGBTQ plus population is growing steadily, and they have unique fertility needs. Often they need an egg donor or a sperm donor or a surrogate, and this is only accessible through IVF.北部社区的可及性挑战与未来愿景
安大略省地域广阔，新诊所（如布兰普顿和奥克维尔）的建设主要集中在西南部地区。然而，北部社区患者面临着显著的地理可及性（geographic accessibility）挑战。例如，居住在蒂明斯（Timmins）的患者，与住在多伦多市中心的患者相比，其获得生育治疗的便利性差异巨大。多伦多的患者可能有多达15-20家诊所可供选择，而北部患者可能需要前往多伦多进行监测、诊断测试，这可能涉及10-15次行程，花费2000-3000加元。
为了解决这一问题，加拿大生育与男科学协会（CFAS）提议与政府合作，建立一个“中心辐射”模型（hub and spoke model），在北部设立卫星监测中心（satellite monitoring centres）。理想情况是建立一个独立的、提供全面服务的IVF中心，覆盖北部地区，使患者无需离开社区。这将需要政府在基础设施建设（infrastructure）、劳动力配备（workforce）以及相关战略规划（strategy）方面提供支持，以实现地理公平（geographic equity）。
Original English
>> All right, let's pick up on access. Ontario is pretty large. Yes. In terms of there are two new clinics also that are going to be built Brampton, Oakville. A lot of it is concentrated in southwestern Ontario. What is access look like in sort of northern communities in this province? >> Yeah, this is a great question, and Cfas would love to partner with the government. That's the Canadian Fertility and Andrology Society to help increase access in the northern communities. Now, the mandate of the government is truly there. They want to help these patients. So we really appreciate that. But you're absolutely right. A patient who lives in Timmins is very different from a patient who lives in downtown Toronto. Their access is dependent on their postal code. The patient who lives in Toronto probably has 15, 20 clinics to choose from, whereas the patient who lives in Timmins has lots of travel costs monitoring, diagnostic testing. They might need to make 10 to 15 trips to Toronto, which can cost upwards of 2 to $3000 in order to complete their cycle. And so what does that look like in the future? We see this as an opportunity for improvement. If we could build a hub and spoke model where we could have satellite monitoring centres in northern Ontario, in my dream world, I'd love to see a free standing, full service IVF centre that covers the northern region so that patients would not even have to leave that community, because we know that cost can be significant. So we ask that in the future, the government look into potentially helping fund or helping clinics build satellite clinics, build an IVF centre, talk about what infrastructure is needed, talk about the workforce and the strategy that we need to be able to populate those clinics so that we can service and allow geographic equity.标准化与质量保证（至2028年）
政府的资助计划旨在到2028年实现生育治疗的标准化（standardize care）。这意味着所有诊所都必须将其资助周期的结果（funded cycle outcomes）报告给Carter数据库（Carter database），这是一个汇集了全国IVF周期数据的聚合数据库，用于改进护理质量。此外，加拿大认证局（Accreditation Canada）要求所有诊所必须在2028年前获得认证。此认证将评估患者安全（patient safety）、治疗周期结果（outcomes of treatment cycles）、财务稳定性（financial stability）、诊所治理（governance）和感染控制（infection control）等多个层面，确保患者获得最高质量、一流的医疗服务。
Original English
>> Well, let's look into the future. The funding from the government says it's meant to standardise care by 2028. What does that actually mean? >> Yes. Well, ultimately, we want the patients to receive the highest quality health care that's available, especially in the fertility space. And so standardisation can involve multiple levels. All the clinics will be required to report their funded cycle outcomes to the Carter database. This is our aggregate national database that looks at all cycles outcomes. And we use this data ideally to make improvements in the way we deliver care. That's based on evidence. In August of 2025, we actually submitted a proposal to the federal government for a pan-Canadian national database. And the reason why is data metrics are important to allow us to deliver higher quality care. We want to be able to Analyze that data appropriately. We want to create evidence based recommendations for the future. All the clinics also need to participate in Accreditation Canada, and they need to be accredited by 2028. What does this look at? This looks at patient safety outcomes of treatment cycles, financial stability, governance of clinics, infection control. And again, this is to deliver high quality best in class care to our patients.仍存在的经济负担与全面覆盖需求
尽管有了资助和税收抵免，但生育治疗的全面覆盖（full coverage）仍是关键。药物费用（medication costs）依然显著。此外，植入前遗传学筛查（preimplantation genetic testing），包括针对非整倍体的PGT-A（preimplantation genetic testing for aneuploidy）和筛查单基因疾病的PGT-M（screening for monogenic disorders），以及同性男性群体（same sex male）所需的代孕和捐卵服务（surrogate and an egg donor），这些都带来巨额开销，可能高达8000至12000加元，甚至120000加元以上。
选择性卵子冷冻（elective egg freezing）也是一个重要的考虑因素，它为推迟生育的女性提供了生育选择。提供这些生殖选择和机会（reproductive choice and options）的保障，将能让人们在最合适的时候、以他们期望的方式组建家庭。