# 2015-249 - Expansion of the Spectrum of Care for Infertility Treatments, In Vitro Fertilization

Expansion of the Spectrum of Care for Infertility Treatments, In Vitro Fertilization

Case Summary

F&R Date: 2015–12–24

The grievor and her service spouse unsuccessfully attempted to conceive a child for a number of years. It was determined that the grievor's husband suffered from male factor infertility. As a result, the couple required intra-cytoplasmic sperm injection (ICSI) and in vitro fertilization (IVF). Under the Spectrum of Care (SoC), the Canadian Armed Forces (CAF) would only cover the cost of ICSI, and not IVF, as the grievor did not meet the criteria required in the SoC. As a result, the grievor submitted a grievance requesting funding for IVF.

The Surgeon General, acting as Initial Authority (IA) denied the grievance. He stated that since the grievor did not meet the eligibility requirements for coverage of IVF, she was not entitled for reimbursement of costs. He stated that the fertility benefits found in the SoC are comparable to those received by the vast majority of Canadians and, generally, are more comprehensive.

The Committee acknowledged that the grievance was not about the grievor's infertility, but that of her husband's. The Committee also found that, as part of a service couple, the grievor was grieving the fact that IVF funding is not included in the SoC as part of the couple's infertility treatment.

As part of its research, the Committee contacted a specialist doctor in the field of infertility and reproductive medicine, who certified that ICSI cannot be conducted without IVF, and that ICSI alone is meaningless as an assisted reproductive technique. The Committee concluded that ICSI is an infertility treatment which involves two persons, a man and a woman. In addition, the Committee found that to exclude IVF from ICSI treatment would represent an incomplete and meaningless treatment. The Committee found that since the CAF has included ICSI in the SoC coverage for male factor infertility up to a maximum of three cycles, the IVF portion of the grievor's husband's ICSI treatment(s) should be reimbursed to him.

The Committee recommended that the CAF reimburse the grievor's spouse for the IVF portion of his ICSI treatments, up to three cycles.

FA Decision Summary

The FA did not agree with the Committee's findings and recommendation.

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