When people talk about fertility, they usually talk about biology: age, hormones, egg quality, sperm health. But there’s a much bigger piece of the puzzle that doesn’t get nearly enough airtime in Canada... access.
Who actually gets to build a family using fertility care?
Who can’t afford to?
Who lives close enough to a clinic?
Who has insurance coverage that makes treatment possible?
We like to imagine Canada as a place where healthcare is universal. But when it comes to fertility, the reality looks very different.
Fertility treatments are rising, but access isn’t equal
Recent data from Manulife showed that fertility drug use among Canadian women increased by nearly 15% in the last year alone. That’s a huge jump and reflects what many people already feel: more Canadians are seeking help to grow their families.
At the same time, the number of employers offering fertility coverage is still surprisingly low and most people paying out of pocket face steep costs (sometimes upwards of $10,000–$20,000 per cycle). That’s not accessible.
So while more people are needing support, not everyone has the same chance to access it.
Where you live matters, more than it should
Canada’s fertility landscape isn’t evenly distributed. If you live in a major city like Toronto, Vancouver or Montreal, you may have multiple clinics within driving distance. But if you’re in rural areas or smaller provinces, your options narrow quickly.
Many patients report traveling hours (or even out of province) just to get to an appointment. That means:
- missed work
- expensive travel
- extra childcare costs
- long wait times
Fertility is time-sensitive and geography shouldn’t determine someone’s family-building timeline. But right now, for many Canadians, it does.
Financial barriers hit some communities harder
Costs don’t impact everyone equally.
For people with lower incomes, treatment can be completely out of reach. For single parents by choice and LGBTQ+ families, the baseline cost often starts higher because of donor needs or additional medical steps. For marginalized communities, including Indigenous, racialized and newcomer Canadians, systemic inequities in healthcare create added layers of difficulty navigating care.
Even in provinces with partial public coverage (like Ontario’s funded IVF cycle), limitations and long waitlists often mean that only certain people benefit.
When a system isn’t built with everyone in mind, the people with the fewest resources are the ones who get left behind.
The emotional burden is just as real
Fertility struggles already come with uncertainty, grief and logistical overwhelm. Adding accessibility issues on top of that can make the emotional load even heavier.
Imagine knowing what treatment you need (and knowing it’s working for others) but realizing it’s financially or geographically out of reach for you. That’s not just a barrier, it’s a form of reproductive inequity.
So how do we move toward more equitable fertility care?
There isn’t a single fix, but there are real and doable steps that could make a big difference.
1. More employer coverage
Fertility benefits are one of the most effective ways to level the playing field. Even offering partial coverage can drastically improve access, especially for younger workers.
2. Expanded public funding
Provinces that offer partial IVF funding show that policy shifts can change outcomes. But these programs need broader criteria, shorter waitlists and more transparency.
3. More clinics in underserved regions
Opening new clinics (or funding satellite locations) would reduce travel burdens and shorten wait times across the country.
4. Clearer fertility education
People shouldn’t be learning about fertility from TikTok or trying to navigate the system in crisis mode. Organizations, providers and policymakers can all play a part in making trustworthy information easier to access.
5. Community support matters
Sharing stories, lifting the visibility of underrepresented groups and normalizing the fact that fertility care isn’t a level playing field, these things spark change.
Why these conversations matter
Fertility isn’t just a medical issue. It’s a human issue, tied to identity, family, equity and opportunity.
While treatments, technology and science are advancing faster than ever, access isn’t keeping up. If we want a future where family-building support is truly inclusive, we need to talk openly about who gets care… and who doesn’t.
The more we shine a light on these inequities, the closer we get to a fertility landscape in Canada where everyone has a fair shot at the family they dream of.