Introduction

Background

The Ontario Fertility Program (OFP) was established in 2015 to provide public funding for in vitro fertilization (IVF), intra-uterine insemination (IUI) and fertility preservation (FP) for eligible patients through Transfer Payment Agreements (TPAs) with the Ministry of Health (the ministry). These services are not covered under the Ontario Health Insurance Plan (OHIP), rather, these services are publicly funded and provided through the OFP. Patients may also access these services on a private pay basis.

Beginning in 2025-26, the Ontario government is expanding the OFP to support the delivery of IVF services for more growing families. This includes consideration of increasing funding allocations for existing OFP clinics as well as expanding the program to new clinics.

Publicly funded fertility services are and will continue to be governed and funded under TPAs with the ministry. The TPAs describe the details of the services to be provided, the target service delivery volumes (with a maximum dollar value) and reporting and accountability requirements to ensure the quality of services provided under the program.

Program description — Overview of fertility services

The OFP consists of three streams of service delivery:

  1. IUI: The provision of IUI (sperm is injected into the uterus to facilitate oocyte fertilization, and also includes non-IUI artificial insemination techniques that involve placing sperm in the vagina or cervix to facilitate oocyte fertilization) and necessary supporting services
  2. IVF: The provision of IVF (sperm and oocytes are combined in a laboratory and the resulting embryo(s) are transferred to the patient's uterus to facilitate pregnancy) and necessary supporting services
  3. FP: The provision of FP (oocyte or sperm preservation for patients who have been diagnosed with a medical condition where a side effect of the planned treatment is known to affect fertility and may lead to infertility) and necessary supporting services

This OFP funding expansion is focused on the IVF service delivery stream.

In addition to providing publicly funded fertility services, clinics participating in the program are also able to continue providing unfunded fertility services to patients. Eligible patients are also able to choose whether or not they wish to participate in the program.

The program operates using a transfer payment funding model, where the ministry enters into individual TPAs with selected fertility clinics, including both hospital-based clinics and community-based clinics located outside of hospitals. Under each new TPA, the ministry will fund the clinic to provide funded IVF services, according to the established price and volume, at a specified location/address. Clinics are also required to maintain appropriate quality standards, participate in quality initiatives or programs, and engage in data reporting activities, as determined by the ministry.

Funded IVF services

OFP-funded IVF consists of a basket of services, including a number of funded supporting services. Funded clinics are eligible to be paid a specified amount by the ministry (a bundled payment) for the basket of services provided in accordance with the terms of the TPA. Please note that not all patients will require all of the services within the basket, and which services are necessary will depend on what is clinically appropriate for each patient in consultation with the physician.

Clinics are responsible for allocating the funding within their own businesses, such as providing remuneration to all persons involved in providing services to or for the clinic’s patients (for example, physicians, nurses, laboratory technology staff, etc.).

The basket of funded IVF services includes:

  • Medical assessments and counselling by a physician or nurse
  • The following diagnostic laboratory services:
    • Biochemical (blood or urine) tests for Estradiol, Progesterone, Prolactin, Luteinizing Hormone (LH), Human Chorionic Gonadotropins (HCG), Pituitary Gonadotrophins (FSH), and Thyroid Stimulating Hormone (TSH)
  • The following diagnostic imaging services:
    • Intracavitary, pelvic, trans-pelvic, and trans-vaginal ultrasounds
  • Cycle monitoring
  • Oocyte retrieval
  • Sperm collection or sperm retrieval if necessary
  • Preparation of sperm resulting from sperm collection, sperm retrieval, or pre-existing donor sperm batches, including thawing and sperm washing
  • Embryology services required to fertilize and culture the embryos, including fertilization of the oocytes with sperm using traditional IVF or intra-cytoplasmic sperm injection (ICSI) if necessary, assisted hatching, and blastocyst culture
  • Preparation and cryopreservation (freezing, including vitrification) of any excess embryos
  • Embryology services required for the thawing and culture of frozen embryos
  • Embryo transfer of all fresh and frozen embryo(s) resulting from the funded oocyte retrieval procedure or from a single batch of pre-existing oocyte(s) or embryo(s)

In addition, specified common elements of the funded IVF services are included. Some IVF services are not funded, such as storage fees for frozen materials, etc.

IVF payment

Clinics with a TPA are eligible to receive payment from the ministry, following the provision of funded IVF services to the patient, based on how far the patient progresses in the funded IVF cycle:

  • Payment of $8,994.90 once the patient receives all the funded services required to reach and complete the fresh embryo transfer stage, allowing for the fact that the cycle may end at an earlier stage if the ovulation stimulation, oocyte retrieval, sperm collection, or embryology steps fail.
  • Additional payment of $2,643.15 if the patient proceeds to the frozen embryo transfer stage. This payment covers the transfer of all frozen embryo(s) resulting from the funded oocyte retrieval procedure or from a single batch of pre-existing oocyte(s) or embryo(s).

The payment includes all of the operating costs – including costs of the premises, equipment, supplies and personnel – required to perform the funded IVF services. The payment does not include services excluded from the basket of funded IVF services (for example storage, etc.).

Out-of-scope for OFP  funding

Start-up funding, such as that used for fixed assets (for example, purchasing equipment, renovations, etc.) or for additional resources (for example, hiring staff, etc.), will not be provided. Clinics must be able to provide the funded services within their existing operations.

Additionally, OFP funding does not cover associated fertility drugs and other ancillary services delivered in support of IVF, including genetic testing, purchasing genetic material, and storing or transferring genetic material.

IVF and patient eligibility

Patient eligibility for funded IVF is not based on sex, gender, sexual orientation, or family status, and is not restricted to people with a medical diagnosis of infertility, and does not exclude those who require a surrogate. Determining whether fertility services are appropriate remains a matter between the patient and the physician, based on the patient’s medical circumstances and the physician’s clinical advice.

Patients are eligible to receive funded IVF services if they meet the following criteria:

  • Hold a valid Ontario Health Card
  • Have not yet received one funded IVF cycle per lifetime in this program (unless as a surrogate)
  • Be under age 43 years old

Each patient is limited to 1 funded IVF cycle per lifetime, although there is an exception for 1 additional funded IVF cycle while acting as a surrogate.

Other program requirements

Each clinic chosen as a TPA recipient must provide oocyte retrieval and embryo transfer procedures at the particular clinic’s location/address as specified in the TPA.

If a clinic has multiple sites where these services are performed, then each site will be considered as a separate clinic for the purposes of funding, and will require a separate TPA in order to participate in the program.

Although a target service volume will be specified in the TPA (with a maximum dollar value), funding will be based on the actual total number of funded IVF services provided by the clinic in a funding year. Regular reconciliations will be performed by the ministry, and any overpayments above the maximum amount will be recovered.

Clinics must be in compliance with all applicable Acts (and their applicable Regulations), including, but not limited to those listed in the Appendix.

Clinics are also required to maintain appropriate quality standards, participate in quality initiatives or programs, and engage in data reporting activities, as determined from time to time by the ministry, in order to remain eligible for payment.

Data regarding the volume of IVF cycles and types of IVF cycles provided in each clinic must be reported to the Better Outcomes Registry and Network (BORN) Ontario, for inclusion in the BORN-Canadian Assisted Reproductive Technologies Register (CARTR) Plus database, and certain specified data must be released at the clinic-level to the ministry upon request.

In addition, each funded embryo transfer procedure (using either fresh or frozen embryos) provided by the clinic as part of funded IVF services must adhere to the ministry’s Single Embryo Transfer (SET) policy in order to be eligible for payment:

SET policy for funded IVF  services

Age*Maximum number of embryo(s) permitted per transfer
(applies to both fresh and frozen embryos)
Up to Age 351 embryo per transfer, regardless of the embryo’s development stage.
Ages 36 & 371 embryo per transfer, if at blastocyst stage of embryo development; or 2 embryos per transfer, if at day 3 of embryo development.
Ages 38+2 embryos per transfer, regardless of the embryo’s development stage.
Exception:After 3 failed transfers using 1 embryo per transfer, may proceed to 2 embryos per transfer.

* Age does not refer to the age of the Primary IVF Patient at the time the Embryo Transfer is performed, but instead refers to the age of the Primary IVF Patient (or Secondary IVF Patient or egg donor) at the time the Oocyte Retrieval was performed.

Submission of application

This is an application process for the selection of TPA recipients to participate in the OFP expansion (existing OFP clinics and new clinics) anticipated for September this is not a procurement process or request for proposals.

The accompanying Application Form should be completed by persons wishing to apply for funding to deliver funded IVF services in a clinic located in Ontario.

One Application Form must be completed for each location/address of the clinic that is seeking to deliver funded oocyte retrievals and embryo transfers.

This application process is open to all Applicants, including:

  • New clinics interested in applying to be selected as transfer payment recipients and join the OFP-funded program,
  • Existing OFP clinics interested in applying for additional IVF funding over and above their current IVF allocation (at the address specified in the TPA), and
  • Existing OFP clinics interested in applying for a new TPA for funding at an additional site equipped with an embryology lab (a new address not already specified in an existing TPA).

The completed Application Form is to be sent electronically, via email, to the ministry at fertilityprogram@ontario.ca. The deadline for submission of the completed Application Form is July 24, 2025, at 5:00 p.m. (EST), according to the time that the email is received in the ministry’s email system.

Please note that the documentation required must be completed and submitted in its entirety.

The accompanying Application Form must be filled out, signed, and submitted as a PDF file.

The Application Form must be submitted electronically. Do not submit a hard copy of the Application Form, or any part of it. The ministry will not review any hard copy documents.

Applicants should:

  1. Fully review these Application Guidelines and the accompanying Application Form.
  2. Complete the Application Form, referring to these Application Guidelines as necessary.
  3. Provide all of the required information, including the Data Release Form (required for new clinics and new sites for existing OFP clinics).
  4. Submit the completed Application Form via email to the ministry, using “Fertility Services Transfer Payment Application” in the subject line, to the following email address: fertilityprogram@ontario.ca.

Applicants can expect to receive an email from the ministry within two business days confirming that their application has been received. Applicants are responsible for ensuring that they complete the Application Form in its entirety.

Any costs associated with completing and/or submitting the Application Form are solely the responsibility of the Applicant. The ministry is not responsible under any circumstances whatsoever for any expenses related to the Application process.

Assessment of application

Clinics are required to complete the applicable Application Form by the deadline in order to be considered by the ministry as a potential TPA recipient or to be considered for additional funded IVF service volumes under an existing OFP TPA.

The ministry will review all Applications based on such factors as the ministry, in its sole discretion, determines to be relevant and appropriate, using these Application Guidelines as a non-exclusive guide.

The ministry is looking to maximize access and value for its investment by allocating funding to clinics across the province, including to support expansion in underserved regions such as northern communities. To aid in this assessment, Applicants must indicate an optimal annual volume of funded IVF services the clinic can provide, based on the clinic’s ability to deliver timely access for patients, considering the clinic’s current volume of IVF patients, waitlists, physical space constraints, etc. Where applicable, the ministry is also seeking the minimum amounts of funded IVF services the clinic is interested in providing.

The ministry, in its sole discretion, will determine the volume of funded IVF services to be allocated to each clinic when preparing the TPAs.

Some of the considerations taken into account when reviewing Applications submitted by clinics may include the following:

  • Total Volumes of IVF services provided in Fiscal Years 2023/24 and 2024/25
  • The ability to deliver the funded IVF services as per the program description
  • The ability to partition service delivery, funding, and reporting under this program from similar services not funded by this program (that is, funded vs. unfunded patients); and
  • Providing access for patients living in underserved regions such as northern communities

The ministry may also reject any or all Applications, consider only part of any Application, or request further information, clarification or modification of any Application at any time.

If the information provided in the Application is incomplete or unclear, the ministry, in its sole discretion, may deem the Application incomplete and discontinue its review.

These Application Guidelines and the submission of the Application Form and/or other material in connection with the Application do not create any contractual or other legally enforceable obligation on the ministry to the Applicant or to anyone.

Short-listing

The ministry reserves the right, in its sole discretion, to identify a short list of Applicants following the Application deadline, and to request such further information from those Applicants, as the ministry, in its sole discretion, considers necessary or appropriate.

The ministry also reserves the right, in its sole discretion, to discontinue its review of any Applications that are not short-listed.

Timelines

The ministry reserves the right to take the time the ministry, in its sole discretion, determines is necessary or appropriate to complete its review and decision-making process.

The application submission deadline is July 24, 2025, 5:00 p.m. (EST) and it is anticipated that successful Applicants will be notified starting in Fall 2025.

Questions and answers

If clinics require any clarifications on the Application process, Applicants are encouraged to send questions to the ministry via email at the following address: fertilityprogram@ontario.ca.

Successful applicants

Clinics will receive notice by the ministry on the outcome of the Application (whether successful or unsuccessful).

Final selection will be subject to a clinic entering into a TPA with the ministry that will outline the service volumes, associated funding, and other terms and conditions of the program.

Otherwise, the ministry may, in its sole discretion and without penalty or liability, withdraw its approval of the Application.

Instructions

Completing the Application Form

The Application Form consists of several sections, all of which must be completed in their entirety using the format identified in the Application Form. These sections are:

  1. General information
  2. Operational information
  3. Capacity information
  4. Declaration

Please complete each section and answer each question as completely as possible. You may use as much space as you consider necessary, and attach additional pages as required.

One Application Form must be completed for each location/address of the clinic that is seeking to deliver funded oocyte retrievals and embryo transfers.

The following headings will guide you through the different sections in the Application Form.

Section 1 — General information

This section provides the ministry with information about the Applicant.

Applicant overview

The ministry requires information about the Applicant such as their full and accurate name(s) and key contact information.

Clinic overview

The ministry requires information about the clinic such as the full and accurate address for the location/address at which the clinic provides services to patients.

Legal status

The ministry requires information about the current legal status of your clinic. If the Applicant is incorporated, provide specific details on the corporate status. If the Applicant is not incorporated, provide any other relevant information on its legal status.

Section 2 — Operational information

Clinical team capacity

Applicants must demonstrate that they have sufficient staff or capacity to accommodate the delivery of the funded IVF services at the specified location. The Applicant must demonstrate strong business, human resources, and financial capacity. Please provide information on how long the clinic has been in operation, the staffing complement at the clinic, and any current and relevant fertility services credentials, qualifications and/or accreditations.

Services overview

Applicants must demonstrate that they have experience in providing the supporting services required in order to deliver funded IVF services. They must also outline which services are provided on-site or off-site, and which services are sub-contracted.

Quality assessment

The ministry requires information about the clinic’s internal quality initiatives or programs, as well as the clinic’s participation in any relevant external quality initiatives or programs, including accreditation programs such as Accreditation Canada. Where applicable, provide details of any inspections conducted by the College of Physicians and Surgeons of Ontario (CPSO) under the Out-of-Hospital Premises Inspection Program (OHPIP), or any inspections conducted pursuant to the Health Protection and Promotion Act.

Applicants must also demonstrate that services provided in the clinic are done so in accordance with generally accepted professional standards, and that all persons who provide services in the clinic are qualified to do so, according to generally accepted professional standards.

Financial management

Applicants must demonstrate that the clinic is solvent and in strong financial health, and also has the business and financial capacity to properly administer and manage public funds.

Applicants must also demonstrate that they have a plan to operate the program within a defined annual budget and manage the delivery of services across different patient populations and prioritize patients on waitlists.

Section 3 — Capacity information

A key objective of the expanded program is to ensure patients from across the province can access publicly funded services, including those who live in underserved regions such as northern communities. The selection of each successful Applicant, and the volumes allocated to each successful Applicant, will reflect the needs and priorities identified by the ministry. There may be multiple Applicants within a geographic area, and the ministry will seek to optimize the distribution of service delivery.

Under each TPA, clinics participating in the program will be eligible to receive payment for the provision of funded IVF services. Each TPA will also set target service volumes.

In order to make this determination, the ministry must assess the historical service volumes at the clinic as well as the clinic’s estimation of its optimal service volumes.

Historic services volumes

For new clinics, the ministry requires information about the clinic’s capacity to provide funded IVF services, based on the historic annual service volumes of IVF cycles provided at this location.

Applicants are asked to provide the total volume of IVF cycles provided in the specified location in Fiscal Years 2023/24 and 2024/25.

The volumes will be measured by the number of IVF cycles (fresh and frozen) provided in those years, for patients for which the oocyte retrieval and/or embryo transfer was performed by the clinic at the identified location.

Future service volumes

The ministry requires information about the projected capacity the clinic has available to provide funded IVF services to patients in the program at that location.

Applicants are asked to set out the optimal and minimal volumes of funded IVF cycles that could be provided at the clinic in Fiscal Years 2025/26 and 2026/27.

Section 4 — Declaration

Applicants must complete and sign the declaration in order for the Application to be considered by the ministry in the TPA recipient selection process.

Appendix

Glossary

Application: A completed Application Form (including supporting documents and/or Data Release Form, if applicable) for public funding for IVF services in Ontario submitted to the ministry by an Applicant.

Application Form: The specific document provided by the ministry, to be filled out by persons wishing to apply for funding to deliver funded IVF services in a clinic located in Ontario. One Application Form is required for each clinic location/address.

Application Guidelines: This document, which provides important information for preparing and completing the accompanying Application Form.

Better Outcomes Registry and Network (BORN): A registry that collects and protects critical data about pregnancy, birth, and childhood in the province of Ontario.

Canadian Assisted Reproductive Technologies Register (CARTR) Plus database: Database that holds treatment cycle data from Canadian fertility clinics.

Clinic: Site for the delivery of funded IVF services. Each location/address of a clinic is required to enter into a separate TPA to deliver the program.

Clinical Team: The people involved in the direct patient care delivery of the fertility services.

College of Physicians and Surgeons of Ontario (CPSO): The governing body for the practice of medicine in Ontario.

Data Release Form: A form that must be submitted by IVF clinics in order to allow the ministry access to data on the volume of IVF cycles and types of IVF cycles provided in each clinic.

Deadline: The completed Application Form must be received in the ministry’s email system by July 24, 2025, at 5:00 p.m. (EST).

Intra-cytoplasmic Sperm Injection (ICSI): An IVF technique involving injection of a single live sperm directly into an oocyte.

Management Team: The staff members who facilitate or support the delivery of the proposed funded IVF services program within a clinic.

Ontario Health Card: Card that is issued to an individual entitled to receive insured health services under OHIP, in accordance with the Health Insurance Act.

Ontario Health Insurance Plan (OHIP): government-run health insurance plan for the province of Ontario under the Health Insurance Act.

Out-of-Hospital Premises Inspection Program (OHPIP): A program regulated under the Medicine Act that develops and maintains standards for the provision of medical procedures in Ontario out-of-hospital premises, and performs inspection-assessments for safety and quality.

Physician: A legally qualified medical practitioner lawfully entitled to practice medicine in the province of Ontario.

Single Embryo Transfer (SET) Policy: The ministry’s OFP policy to limit the number of embryos used in IVF, in order to avoid risks associated with multiple births. The policy is set out in the chart under “Other Program Requirements” in this document.

Transfer Payment Agreement (TPA): The funding agreement between the ministry and a clinic which sets out the terms and conditions for funding under the program.

Legislation

Clinics must be in compliance with all relevant Acts (and their applicable Regulations), including, but not limited to: