Shortage of public fertility tests delaying efforts to conceive, says North Vancouver woman

Lusine Khatryan felt relieved when she got a referral for fertility testing earlier this spring.

The 38-year-old and her husband had been trying to conceive a child naturally for six months, and wanted to know if there was a possible medical reason she wasn't pregnant yet. 

Khatryan's gynecologist ordered a hysterosalipingogram (HSG) test, which uses contrast dye and an X-ray to examine a patient's uterus and fallopian tubes for abnormalities or blockages.

But five months later, Khatryan says a shortage of appointments at the six Lower Mainland hospitals and clinics that perform the test is delaying her efforts to conceive.

HSG tests can only be performed within 10 days after a person's period starts, which means they can't be pre-booked. 

"I've been trying to call every day on the first day that I see my period ... then they just look at the dates and they see that there's no spot available and they just reject you," Khatryan told CBC News in a park near her North Vancouver home.

"I feel like I'm losing valuable time and my fertility decreases each cycle."

When Khatryan called the Abbotsford Regional Hospital, she says she was told they only perform one or two tests a day, and reject about 15 people who call to book it each day.

Khatryan is one of many people whose fertility journeys are being delayed by test shortages and long waits for essential appointments in B.C., according to Blaise Hunter, a reproductive rights advocate who founded Footprints, a non-profit society that supports people experiencing infertility and pregnancy loss.

"We're seeing a very hard time to get medical tests, to get referred, to be in the queue to get into the system," said Hunter. "We're not looking at three to six months, we're looking at a year, two years before you can even get some answers or clarity."

The delays are due to a shortage of necessary staff and equipment, according to a statement from Lower Mainland Medical Imaging (LMMI), the Provincial Health Services Authority agency responsible for medical imaging across Vancouver Coastal and Fraser Health authorities.

"Human health resources, in particular technologists and radiologists, are in short supply and requests for imaging procedures are in high demand so these requests are prioritized based on urgency," read the statement, which noted LMMI is "focused on finding avenues to expand access and exam volumes."

"We recognize the importance of these tests to patients with fertility challenges, and that access to and wait times for diagnostic tests and results can be stressful."

In a separate statement, a spokesperson for the Ministry of Health echoed these concerns and said ensuring timely testing access is a priority.

"We know that there is a strain on the health-care workforce in British Columbia," read the statement. "That's why in September 2022 we announced our Provincial Health Human Resources Strategy with 70 concrete actions to recruit, train and retain health-care workers."

Waiting exacerbates stressful situation

Khatryan says the province should be doing more to increase testing capacity for her and other people trying to get pregnant. Her doctor said he couldn't recommend next steps without the results.

Approximately one in six couples experience infertility, according to the Canadian Fertility and Andrology Society.

B.C. MSP covered more than 3,600 fertility tests and investigations, including HSG tests, between April 2020 and March 2021, according to the Health Ministry, but the province doesn't cover intrauterine insemination or in vitro fertilization, which can cost up to $20,000 per round.

Khatryan says she found a private clinic that could perform the HSG test for $850, a sum she doesn't want to pay if there's a chance she could have it done for free.

Waits are emotionally taxing, says Hunter, which can make it difficult to advocate for oneself during the process.

"Our health-care system is bursting at the seams and we're seeing the growing pains everywhere, not just in this regard," Hunter told CBC News, "but because there's an element of stigma related to infertility and loss that you're not getting maybe the impact and the awareness and the attention it needs."

As the months passed by, Khatryan has looked into out-of-province options, like a clinic in Calgary that says it could take her if she got a doctor's referral within the province.

Travel and accommodation there and back may be cheaper than a private clinic in B.C., she says.

"I couldn't just understand how come British Columbia cannot accommodate a growing need for this X-ray test, while Alberta can help people not only in Alberta but outside of the province," said Khatryan.

"Not being able to secure a simple, a common test that is just 30 minutes long, it's putting so much more stress on a woman who is already in a very vulnerable, delicate situation."