Gotz Tamas, Jones Claire
Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; Mount Sinai Fertility, Sinai Health Systems, Toronto, ON.
Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; Mount Sinai Fertility, Sinai Health Systems, Toronto, ON.
J Obstet Gynaecol Can. 2017 Mar;39(3):138-144. doi: 10.1016/j.jogc.2016.11.011.
On December 21, 2015, Ontario began funding one cycle of IVF for any Ontarian under age 43, with a program cap of 5000 cycles per year, which is below expected demand. Our objective was to determine how fertility clinics are prioritizing patients for limited-funded IVF cycles.
An electronic survey was emailed to medical directors of all 25 fertility clinics providing funded IVF in Ontario.
From January to March 2016, 22 (88%) of the clinics responded. All reported providing access to funded IVF, and 100% already had a wait list. Eight clinics prioritized patients on a first-come, first-served basis; two used a lottery; 11 reported using multiple patient factors to determine priority for funding; and one declined to answer. Of the clinics reporting multiple factors, the five most common factors were first-come, first-served (90.9%); older aged patients (81.8%); patients about to lose their funding eligibility (63.6%); duration of infertility (36.3%); and duration at current clinic (36.3%).
There is variation in how patients are prioritized for publicly funded IVF in Ontario. Some clinics have chosen to prioritize patients in a first-come, first-served manner, whereas others have chosen to prioritize patients based on multiple factors that would favour older patients. This is the first study providing the public and government insight on how the new fertility program has been implemented by individual clinics. This information is important for patients to understand their own chances of receiving a funded IVF cycle because this may vary depending on individual clinics.
2015年12月21日，安大略省开始为43岁以下的安大略居民提供一个周期的体外受精（IVF）资金，每年的项目上限为5000个周期，这低于预期需求。我们的目的是确定生育诊所如何为资金有限的IVF周期安排患者的优先顺序。
通过电子邮件向安大略省所有25家提供资助IVF的生育诊所的医学主任发送了电子调查问卷。
2016年1月至3月，22家（88%）诊所做出了回应。所有诊所都报告提供资助IVF服务，并且100%已经有了等候名单。8家诊所按先来先服务的原则安排患者；2家采用抽签方式；11家报告使用多种患者因素来确定资助的优先顺序；1家拒绝回答。在报告使用多种因素的诊所中，五个最常见的因素是先来先服务（90.9%）；年龄较大的患者（81.8%）；即将失去资助资格的患者（63.6%）；不孕持续时间（36.3%）；以及在当前诊所的就诊时间（36.3%）。
安大略省在为公共资助的IVF安排患者优先顺序方面存在差异。一些诊所选择按先来先服务的方式安排患者，而另一些诊所则选择根据有利于老年患者的多种因素来安排患者的优先顺序。这是第一项为公众和政府提供关于个别诊所如何实施新的生育计划的见解的研究。这些信息对于患者了解自己获得资助IVF周期的机会很重要，因为这可能因个别诊所而异。
