The medically assisted procreation program has been offered since November 15, 2021.
Medically assisted procreation (MAP) provides a medical solution for people who fail to conceive a child.
The program is benchmarked and based on best practice standards while taking into account the state’s ability to pay. The criteria imposed aim to offer a modern, sustainable program, respecting the new marital and family realities, while limiting the obstetrical risks for the women who receive the treatments, or the neonatal risks for the children resulting from them.
Eligibility
The procreation project may be supported by:
- a woman-man couple;
- a woman-woman couple;
- a single woman.
The use of a surrogate woman is not a recognized practice under the Civil Code of Quebec.
The program is for people:
- covered by the public health insurance scheme;
- who have an infertility problem or an inability to reproduce (single woman or woman-woman couple);
- who have not had voluntary sterilization (for example tubal ligation);
- whose partner has not had voluntary sterilization (for example vasectomy or tubal ligation);
- aged 18 and over at the start of treatment;
- for women, the age limit for receiving assisted reproduction treatments is:
- 41 years less a day to start assisted reproduction treatments,
- 42 years less a day for an embryo transfer;
- who has never received the same services provided since the beginning of this program (except for inseminations after live birth)?
If you received ART treatments covered by the public health insurance scheme before November 15, 2021, you can benefit from the covered services again, provided you meet the eligibility criteria.
At the start of the program, if you are in the process of in vitro fertilization (IVF) treatment, you have the choice:
- to continue to pay the costs associated with the treatments started or;
- to begin a reproductive project under the program.
If you have started receiving IVF services, you may also receive insured services under the program for any treatments you have yet to receive. For example, a person who would have started ovarian stimulation before November 15, 2021, with the taking of medication for IVF, can take advantage of the transitional measures. She can decide to complete her treatment outside the program and keep her IVF insured for later. She can also decide to switch to the new program and benefit from the services provided for the remaining treatments (an ovarian puncture and embryo transfers).
If a person already had frozen embryos, they can start a new full cycle of IVF with the new program or transfer their frozen embryos if they meet the eligibility conditions. In the latter case, she will no longer have access to other IVF services for life.
For more details, contact your treating physician.
Verification of eligibility
Verification of eligibility is mandatory for a person who wants to receive insured ART services. Following the fertility evaluation appointment at the assisted reproduction center (APC), the doctor will check with the Régie de l’assurance Maladie du Québec (RAMQ) if you are eligible for insured services.
If you are not eligible
If you do not meet the eligibility criteria (for example, if you are aged 42 or over), you will be able to benefit from ART services, but you will have to pay for them in full since they will not be insured by the RAMQ. Certain expenses may, however, be eligible for the tax credit for the treatment of infertility.
Insured services
The services provided within the framework of a procreation project are:
- a single lifelong in vitro fertilization (IVF) cycle that may include:
- a maximum of two ovarian stimulations, depending on the medical indication,
- an ovarian puncture,
- standard IVF services (sperm collection and washing or a surgical sperm aspiration technique, sperm micro-injection (ICIS) and hatching assistance),
- a donor sperm straw,
- a single surgical collection of spermatozoa,
- freezing and storing additional embryos for one year,
- the transfer of each embryo (fresh or frozen) resulting from the IVF cycle;
- non-IVF services:
- oral or injectable ovarian stimulation outside IVF,
- a maximum of six artificial inseminations per live birth,
- a lifetime maximum of six semen straws from a donor bank (one straw at a time for insemination);
- Medications provided according to the parameters of the public prescription drug insurance plan;
- Preservation of fertility by freezing gametes. It is insured until the age of 25 or for 5 years if the person is aged 21 or over. This service is accessible before having carried out gonadotoxic treatments or before the removal of the ovaries or testicles. Gonadotoxic treatments are treatments that are toxic to the ovaries or testicles. It can be oncological treatments or taking certain medications that can cause infertility permanently.
- The treatments covered for the fertility preservation service are:
- a maximum of two ovarian stimulations, depending on the medical indication,
- an ovarian puncture,
- standard IVF services,
- a surgical collection of spermatozoa,
- freezing and storing the sample of sperm, oocytes, or embryos.
An IVF cycle is considered started when the patient has started taking medication for ovarian stimulation, either by injection or by mouth.
Costs
Eligible persons can benefit from insured services by presenting their RAMQ card at an assisted procreation center with a Québec permit. Only the services listed in the Insured Services section are supported.
Therefore, various services not included in the program could be at the patient’s expense. For example, costs for storing frozen embryos beyond one year will have to be borne by patients or the purchase of eggs from banks. Your doctor will be able to inform you of the different prices before starting the treatments.
Semen straws purchased since November 15, 2021, as part of an insured service are reimbursed by the assisted reproduction center (APC) where the insemination and IVF were performed, for eligible persons, until the maximum amounts payable of $850 for purchase and $100 for delivery.
People who do not meet the eligibility criteria or who have exceeded the number of insured services will have to pay for the services they receive.