Mr. Speaker, I have a Return to Written Question Number 8-20(1) asked by the Member from Great Slave on October 30th, 2024, regarding improving fertility and family planning supports in the Northwest Territories.

The Member for Great Slave asked what additional resources are required to begin tracking prenatal screenings so the GNWT can collect data on individuals struggling with infertility.

Prenatal screenings are undertaken as part of care during pregnancy so this would not be an avenue to collect data on individuals struggling with infertility. The Health and Social Services system does not explicitly track infertility because the metrics to measure infertility are complex in that it's generally accepted that difficulty conceiving becomes infertility only after a full year of actively trying to conceive. Once a person has tried to conceive for at least a year or six months if they are over 35 years of age, there are multiple procedures both partners must go through to determine if there are underlying medical conditions that could be responsible for the inability to conceive. The process of diagnosing an underlying medical condition is covered under the NWT Health Care Plan.

Where the cause of the infertility is not readily known and a resident wishes to request further investigation, the request may be submitted to the Department's Health Services Administration office. Health Services Administration reviews the specifics of each case. This process, referred to as 'prior approval', is used in situations where the treatment may be outside the Health and Social Services system's usual referral pathway or when circumstances warrant further examination.

If no underlying medical condition is determined, the diagnosis may be infertility. Currently, there is no plan to add additional data tracking specific to infertility to the system. The focus of the Health and Social Services system remains the delivery of quality insured health services.

The Member asked what additional resources or processes are required to allow patients to self-report their usage of IVF supports for the purposes of data collection to better understand territorial demand for IVF.

There is no plan or system capacity to create a mechanism for NT residents to self-report their usage of IVF supports.

The Member asked what additional resources would allow the Department of Health and Social Services to better track the number of IVF referrals to fertility clinics provided to Northwest Territories residents each year.

Once the individual has received a diagnosis of infertility, there are no further insured services available under the NWT Health Care Plan. At this point, individuals may make private inquiries for further consultation. There are no formal referrals to IVF clinics. A primary care physician may make a recommendation, however, because IVF is not an insured service and there is no reciprocal billing or formal referral pathway to access IVF services, there is no tracking. Currently, there is no plan or system capacity to begin tracking informal recommendations to IVF clinics.

The Member asked if the Department could provide a comprehensive list of fertility-related issues which could allow for medical travel supports for residents, in comparison to other jurisdictions.

Fertility-related investigations vary from person to person and there is no comprehensive list of fertility-related issues that could allow for medical travel supports for residents. Rather, medical travel supports are available to access services related to the investigation of underlying medical conditions that may be causing infertility. The investigation of underlying medical conditions may include things like semen analysis, pelvic ultrasound, and other gynecological procedures. Once preliminary investigations are complete and the patient has experienced 12 months of infertility or, if over 35 years of age, 6 months of infertility, a referral to a specialist may be made for further investigation of underlying medical conditions.

Medical travel supports are in place to assist NWT residents with costs associated with accessing insured health services. If the health service is insured under the NWT Health Care Plan, it is eligible for medical travel supports. In comparison to other jurisdictions, the NWT has one of the most generous medical travel benefits in Canada. For example, the Travel Assistance Program provided by the Government of British Columbia consists of a discount to ferry costs only. The Government of Ontario provides medical travel supports through the Northern Health Travel Grant that reimburses travel costs based on a rate of 41 cents per kilometer with a 100-kilometer deductible of each trip. Also, there is no coverage for any other expenses. This Grant is limited to residents in the northern part of Ontario. Thank you, Mr. Speaker.