Medically assisted reproduction program

The medically assisted reproduction program is available since November 15, 2021.

Medically assisted reproduction (MAR) provides a medical solution for people unable to conceive a child.

The program is based on and subject to the highest standards of practice in consideration of the government’s ability to pay. It applies modern, financially sustainable criteria based on today’s couples and families and limiting both the obstetric risk to women receiving treatment and the neonatal risk for the children conceived.

Fertility project may be made by:

• Female–male couples
• Female–female couples
• Single women

The use of a surrogate mother is not a recognized practice under the Civil Code of Québec.

The program is intended for people who

• are insured by the public health insurance plan,
• have infertility problems or are unable to conceive on their own (single women and female–female couples),
• have not undergone voluntary sterilization (such as tubal ligation),
• whose partner has not undergone voluntary sterilization (such as vasectomy or tubal ligation),
• are age 18 or over when treatment begins,
  • The maximum age for women to receive MAR treatment is:
    • 41 years less a day to begin treatment. See the temporary reimbursement program to find out the exceptions to this criterion;
    • 42 years less a day for embryo transfer
• and who have not received identical insured services since program inception (except in the case of insemination after a live birth).

If you received MAR treatment covered by public health insurance before November 15, 2021, these services may be covered for you again as long as you meet eligibility criteria.

If you are in the process of receiving in vitro fertilization (IVF) treatment when the program begins, you may either

• Continue paying for the treatment you started, or
• Start a fertility project through the program

If you have already begun receiving IVF treatments, the program can cover the remaining treatments you could receive. For example, someone who started ovarian stimulation before November 15, 2021, using IVF medication, is eligible for transitional measures. They can decide to complete their treatment outside of the program and keep their insured IVF for later. Or they can decide to switch to the new program and receive insured services for the remaining treatments (one egg retrieval and the embryo transfers).

If a person already has frozen embryos, they can start a complete new IVF cycle with the new program or transfer their frozen embryos if they meet the eligibility requirements. In the latter case, they will no longer have access to any further IVF services for life.

Talk to your attending physician for further details.

People who want to receive insured MAR services must first verify their eligibility. After a fertility exam at an assisted reproduction centre (ARC), your physician will check with RAMQ (Régie de l’assurance maladie du Québec) whether you are eligible for insured services.

You can still receive MAR if you do not meet the eligibility criteria (for example, if you are age 42 or over), but you will have to pay the cost in full yourself, as services will not be covered by RAMQ. Certain expenses however may be eligible for infertility treatment tax credits .

The following fertility‑project services are covered:

• A single in vitro fertilization (IVF) cycle, lifetime, which may include
  • up to two ovarian stimulations as per medical indications,
  • one egg retrieval,
  • standard IVF services (sperm retrieval and washing or surgical aspiration and micro injection of sperm [ICIS], as well as assisted hatching),
  • one straw of donor sperm from distributors approved by Health Canada,
  • a single surgical sperm cell collection,
  • freezing and storage of supernumerary embryos for one year, and
  • the transfer of each embryo (fresh or frozen) from the IVF cycle
• Services other than IVF include
  • oral or injectable non-IVF ovarian stimulation,
  • up to six donor inseminations per live birth, and
  • up to six straws of sperm from a donor bank from distributors approved by Health Canada (one straw at a time for one insemination).
• Medications covered under the public prescription drug insurance plan.

• Freezing of gametes for fertility preservation is covered to age 25 or 5 years for people age 21 and over. The service is available to people before undergoing gonadotoxic treatment or ablation of the ovaries or testicles. Gonadotoxic treatments are treatments toxic to the ovaries or testicles. They may be cancer treatments or involve medications that can cause permanent infertility.

  Treatments covered as fertility preservation services include

  • up to two ovarian stimulations as per medical indications,
  • one egg retrieval,
  • standard IVF services,
  • one surgical sperm cell collection, and
  • freezing and storage of a sperm sample, oocytes, or embryo

An IVF cycle is considered to have begun once the patient has started taking medication for ovarian stimulation, either orally or by injection.

People who are eligible receive insured services on presentation of their RAMQ card at an assisted reproduction centre licensed in Québec. Only services listed in the Insured Services section are covered.

Some of the services not included in the program may therefore be at the patient’s expense. For example, storage fees for frozen embryos and the cost of purchasing eggs from banks must be paid by patients after the first year. Your attending physician can inform you about fees before you begin treatment.

The assisted reproduction centre (ARC) where the insemination and IVF took place will reimburse eligible individuals for sperm straws purchased since November 15, 2021, as part of an insured service, up to a maximum of $850 to cover the purchase price and $100 for delivery.

People who do not meet the eligibility criteria or who exceed the service coverage limits must pay for the services they receive.