Prioritization of Patients for Publicly Funded IVF in Ontario: A Survey of Fertility Centres  Tamas Gotz, MD, Claire Jones, MD  Journal of Obstetrics and Gynaecology Canada   Volume 39, Issue 3, Pages 138-144 (March 2017) DOI: 10.1016/j.jogc.2016.11.011 Copyright © 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada Terms and Conditions

Figure 1 Survey participants. Journal of Obstetrics and Gynaecology Canada  2017 39, 138-144DOI: (10.1016/j.jogc.2016.11.011) Copyright © 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada Terms and Conditions

Figure 2 IVF funding distribution strategies (n = 22 clinics). Journal of Obstetrics and Gynaecology Canada  2017 39, 138-144DOI: (10.1016/j.jogc.2016.11.011) Copyright © 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada Terms and Conditions

Figure 3 Specific factors reported by clinics that use a variety of patient characteristics to determine position on wait list (n = 11 clinics). aFirst-come, first-served basis for spot on wait list. bFavours older age patients over younger patients. cPatients who are about to lose eligibility for funding (e.g., approaching age 43, moving out of province). dFavours longer total duration of infertility regardless of age. eRapidly declining ovarian reserve regardless of patient age (e.g., close to premature ovarian insufficiency). fFavours patients who have been at the current fertility clinics for a longer duration compared to new referrals. gFavours patients who have failed less invasive treatments such as intrauterine insemination. hPrioritizes patients who cannot afford IVF without government funding. iFavours patients without lifestyle factors that decrease success (ie. smoking, high BMI, recreational drug use). jFavours patients with increased chances of successful conception and live birth (e.g, favours a 30-year-old with blocked tubes over a 42-year-old with diminished reserve). kFavours patients who have never had a child (primary infertility) over patients with other children (secondary infertility). lOne clinic reported that it takes into consideration whether a patient has appropriate social supports and medical clearance prior to IVF. One clinic reported that it favours patients who have completed all of their preliminary workup. One clinic reported favouring patients who required egg donation who had an altruistic egg donor ready to donate. Journal of Obstetrics and Gynaecology Canada  2017 39, 138-144DOI: (10.1016/j.jogc.2016.11.011) Copyright © 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada Terms and Conditions

Figure 4 Personnel involved in the creation of formalized IVF wait list policy (n = 18; three clinics had no formal committee involved in creating their wait list policy, and one clinic declined to answer). Journal of Obstetrics and Gynaecology Canada  2017 39, 138-144DOI: (10.1016/j.jogc.2016.11.011) Copyright © 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada Terms and Conditions

Figure 5 Reasons for limiting the number of funded IVF cycles per week (n = 16). aRefers to either staffing or equipment/infrastructure capacity. bOne clinic reported limiting starts for high-priority cases like fertility preservation, older age patients, or third-party reproductive cases. One clinic reported limiting starts to maintain academic training volumes. Journal of Obstetrics and Gynaecology Canada  2017 39, 138-144DOI: (10.1016/j.jogc.2016.11.011) Copyright © 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada Terms and Conditions