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Join RESOLVE’s leadership team for an in-depth look at what it takes to pass pro-family legislation, protect IVF, and what we’re up against.
HOSTS
President & CEO, Barb Collura
Chief Engagement Officer, Betsy Campbell
Chief External Affairs Officer, Rebecca Flick
ABOUT RESOLVE
RESOLVE: The National Infertility Association is the largest non-profit patient advocacy organization in the country focusing on increasing access to all family building options through insurance coverage and policy changes as well as protecting fertility care like IVF from legislation.
Hi there. Welcome to Infertility Discourse, a podcast from RESOLVE, the National Infertility Association. I'm one of your hosts, Rebecca Flick.
Barb Collura:Hello. This is Barb Collura.
Rebecca Flick:And we have a really special episode today. I realize I don't have a song yet for this episode. "Oh, Canada" comes to mind. Anything by Shania Twain, Brian Adams.
Barb Collura:Celine Dion.
Rebecca Flick:Celine. You know? So I've got my choices for sure. So the name of the episode will be a surprise to all of us after we're done recording. But with us today, we have a really special guest, a really special person, a really special friend, executive director from Fertility Matters Canada, Carolynn Dube.
Rebecca Flick:Welcome.
Carolynn Dube:Thank you. I am so excited to be here. I can't believe we're finally doing this. Yay.
Rebecca Flick:I know. Well, truth be told, you were the inspiration for this podcast. You sat me down when we were in New York City, and you're like, Rebecca, get some mics. Get a headset. Get a recording platform. You can do it.
Barb Collura:Wow.
Rebecca Flick:Mhmm.
Barb Collura:I did not know that. That's awesome. I know this is a podcast, but we do oftentimes post a few little screenshots. But we are wearing Rebecca and I are wearing green. Carolynn, in honor of you and Fertility Matters Canada, tell us the significance of green.
Carolynn Dube:Oh, I'm so excited. I thank you so much for doing that. So in Canada, unlike the US, the color of fertility here, and infertility, and our patient community is green. And so it represents hope and new life. And so we do several, you know, events. People wear green, there's a lot of leaves and trees and logos of fertility clinics and those types of things. So that's why we use the color green.
Barb Collura:So I want to know is my green the color, the pantone or is Rebecca's? Because I'm feeling like maybe it's me that I got it right, but maybe it's Rebecca.
Carolynn Dube:You know what? I love both. If we do Light the Night, we're doing a really special event, and I know we're gonna probably talk about fertility awareness week.
Rebecca Flick:Let's do it.
Carolynn Dube:Coming up this month. But we've got over 60 monuments across the country, lighting green, and they always ask me what the Pantone color is. And I've not nailed down the perfect one yet. So I let the the monuments choose, and someday we'll look at which one looks best.
Barb Collura:So you already know you've got 60 different monuments, buildings, etcetera, lit up across Canada. Wow. And it's the same week as National Infertility Awareness Week here in The US. And you two talk a lot about National Infertility Awareness Week and Fertility Awareness Week in Canada. Are we doing anything together?
Carolynn Dube:Yeah. We are. Rebecca, do you want to tell everybody?
Rebecca Flick:Oh, well, this was all you're doing. You and your team reached out, and we're doing some great videos with Barb and Carolynn doing a little interviewing of each other, different than this, of course. And this is my favorite thing. I mean, lighting the Empire State Building orange was a big moment for me personally, career wise, for National Fertility Awareness Week, but I underestimated how emotionally excited I got last year when we were able to light Niagara Falls, a mixture of orange and green during awareness weeks last year. And I when I saw that, I was like, oh my gosh.
Rebecca Flick:Because it happens for fifteen minutes only.
Barb Collura:Gotta be watching.
Rebecca Flick:Gotta be watching. And we were texting. We were so excited.
Rebecca Flick:It's a really great visual of the work that we've done together over all of these years and how we keep growing this partnership that RESOLVE and Fertility Matters Canada has. And, yeah, it's just it's gonna keep getting better. And I think this year, it's really good with this content that we're working on. We're gonna be together in New York City, which is always a favorite time. So we wanna introduce our our listening audience to you, Carolynn.
Rebecca Flick:Tell us a little bit about your personal connection to this cause and how you came to be executive director.
Carolynn Dube:Well, would love to tell you more. So I am, you know, like the two of you, a fertility patient. And I came to the realization that fertility treatment was gonna be the way forward if I wanted to have a family like many people do. Had met my husband, we dated, we had jobs. He was in the military at that time.
Carolynn Dube:We moved around the country and got married, bought a house, and then decided, okay. We're we want kids now. We're ready. And really quickly realized it wasn't happening. Unlike lots of people, you know, people wait for twelve months, eighteen months before they sort of talk to a doctor.
Carolynn Dube:I had an old, well, she wasn't old. But in a former job, I had a manager who had worked in the fertility industry, and she would educate us young gals about our reproductive health and, like, your fertility. She said it's, I won't say the word. She used a, she was a lovely Irish lady, and she used a curse word. And it was it's sort of BS to wait for twelve months.
Carolynn Dube:If the doctor tells you that, don't listen to that. You're young, you're 35, you're healthy, you're not getting pregnant in six months, you know your body, go get tested. And that's what we did. And we found out really quickly that we actually had male factor infertility. And so we had no idea.
Carolynn Dube:We had no one in our lives that was openly talking about it, no one in our family. And this was thirteen years ago, I guess, at this point. So it was really a hard time in our lives. Like I, my husband was crying, I was crying, I was angry, he was still crying, then he'd be angry and I'd be crying, you know, that sort of roller coaster. Because we didn't have anybody to talk about these things with, I just really pulled back.
Carolynn Dube:I didn't know how to talk about it. For months I hadn't told my own family, like my parents, my girlfriends, who I've been really close with. I have really great strong relationships. So that's where we were when we were stuck there for a few months until someone actually said to my husband, you need to get a social, like support outside of your relationship. And so we both went to seek.
Carolynn Dube:He had found an individual that he could talk to. He knew in the military that was going through something similar, and I found an online support group. And then we ended up going through IVF, and we're now on the other side of our fertility journey. We know how very thankful we are to be here, and that it's not the story that everybody will experience, but we have three boys. My eldest is 11, and my twins are six.
Carolynn Dube:And then I started, when my eldest was six weeks old, I was asked to do some provincial advocacy. So in Canada, we're set up in provinces like your states, and we don't have public funding for fertility care here, even though we have universal healthcare. We can get into that in a little while. But it's where I started using my voice to advocate and sort of fell into the role of executive director, ironically enough, through that old manager a previous job who had gone back to work in the fertility industry and saw this come up and said, "Hey, this is a job that you should really apply for." So that's a little bit about me and how I got here.
Rebecca Flick:And how long has Fertility Matters Canada been in existence?
Carolynn Dube:So we've been around for forty years and we started as a support group in someone's living room in Ottawa, Ontario. And it eventually became a charity after three or four or five years maybe, moved to Montreal. And then actually that's where I was, because my husband, as I mentioned, was in the military. We were posted to Montreal and living there when this job came up. And so it's been in existence for forty years. And so we're really fortunate to have that longstanding history.
Rebecca Flick:Barb and I have a very funny story about being in Montreal. Nineteen years ago, twenty years ago, at the, when ASRM meeting, the annual meeting was in Montreal. And I still remember we had that shared booth space bar right with Fertility Matters Canada.
Carolynn Dube:You're kidding.
Barb Collura:Did the name change?
Carolynn Dube:Yes. So, yes.
Barb Collura:A C A or I A A.
Carolynn Dube:Yes. It used to be called the Infertility Awareness Association of Canada, IAC.
Barb Collura:Yeah. IAC.
Carolynn Dube:I did not know this story.
Barb Collura:We shared we had a booth that we shared with with your organization back years ago at that at that meeting. Yeah.
Rebecca Flick:Yeah. It was the first ASRM I had ever been to. So, yeah, like, nineteen years ago. And our shipment
Barb Collura:Probably 2005 or 2006, one of those two years.
Rebecca Flick:And our shipment got stuck in a UPS center, and Barbara, had to like, rent a car and drive to like rural Montreal.
Barb Collura:These warehouse areas.
Rebecca Flick:Oh gosh.
Barb Collura:Industrial.
Rebecca Flick:Financial times were tough at RESOLVE at that point. That's why we shared the space, and we were like trying not to go through international shipping.
Barb Collura:We probably shared a hotel room too. I mean, honestly.
Rebecca Flick:Yeah.
Barb Collura:You know, let's be real. There's a lot that we've been through here at RESOLVE over the years. And the good news is we don't have to share hotel rooms anymore.
Rebecca Flick:There you go.
Barb Collura:But Carolynn, yeah, that was a really interesting meeting. We got to meet your colleagues who preceded you. But it's been great getting to know you. You come to New York for National Infertility Awareness Week, Fertility Awareness Week in Canada. You travel across the border.
Barb Collura:How come we don't go to Canada?
Carolynn Dube:I know. Well, I know. It's a big week. It's like you have lots of things, and that's the that's the big challenge. We need to organize some other opportunity.
Rebecca Flick:And you actually changed the awareness week to align with NIAW.
Carolynn Dube:Yes. Ours used to be in May. It was at one point Canadian Infertility Awareness Week when we established it in 2007, and that probably came about because of your meeting with my predecessors in Montreal.
Barb Collura:Now it's all fitting together.
Carolynn Dube:That's it. And so it was when I started here ten years ago in May. And then, you know, I had sort of, one of my first jobs here was to sort of take us through this rebrand from IAC to Fertility Matters Canada. It's a bit more positive and more inclusive certainly in its language and how it presented the organization. But yeah, it was established and then it didn't make sense to sort of compete with NIAW.
Carolynn Dube:It made more sense to align for this more North American movement of advocacy and awareness, especially given social media and how conversations, especially in our communities. I mean, it's just so many American influencers and patients that we follow and certainly that would follow us. So it just made more sense.
Barb Collura:Awesome.
Rebecca Flick:As we get our act together and align better. So thank you. Thank you.
Barb Collura:Can we talk a little bit about something you said at the beginning, which was you had started doing some advocacy work. This is a podcast about advocacy and about public policy. And so I am super curious to have you walk us through the advocacy work that you do in Canada because I know you do public policy and advocacy work. What is it you do? And tell us a little bit about what role your organization plays, and then we'll go from there.
Carolynn Dube:Yeah. So for your listeners, especially I assume most are American, in Canada, so we live in the land of universal healthcare. We go to the hospital, we have a new replacement, we have a baby, whatever it is. We don't pay for that. Well, I mean, we do through our taxes, but we don't get a bill from the hospital when we leave.
Carolynn Dube:But fertility, as a disease, doesn't fall under the protections of Canada's Health Care Act. And so it is left, all of our health care is delivered provincially. So the federal government doesn't have its hands in how each of our 10 provinces and three territories build out programs to support patients in that universal healthcare lens. So because it is delivered provincially, we have to advocate at each of the provinces and territories to help them realize that this is a disease. One in six Canadian adults are experiencing it or will experience it.
Carolynn Dube:And then we have to help them, the policymakers, agree that this is an important health care, mental health care, social, financial, economic issue that they need to care about. So when I started advocating, it was the winter of twenty, it was January 2014. My son was just a couple of weeks old and I was living in Nova Scotia at that time, no public funding. So I had paid 100% of my fertility bill out of my own pocket.
Carolynn Dube:We did have really good drug coverage actually, because my husband was in the military and they had good drug coverage and some coverage for some of the procedures that happened with him, but of course not with me, the IVF, which is the most expensive portion. My clinic had said, "Listen, we'd love to have you get you involved in some advocacy work." And that's sort of where it started. And at that time, only two of the 10 provinces had a funding model in place. So ten, eleven, twelve years ago, whatever that was, eleven years ago. I can't do math anymore.
Carolynn Dube:Since then, we are seeing more and more of the provinces stepping up and coming to the table. And actually, just this month- sorry, last month, because it was in March, we now have nine of our 10 process public funding programs in place.
Barb Collura:Wow.
Rebecca Flick:That's amazing.
Carolynn Dube:Or there's two who don't have funding in place, but have promised to roll it out by spring summer 2025. So it's been in the budget. The announcements have been made. And the programs are set to roll out, which is fantastic.
Barb Collura:And that is due to your advocacy of Fertility Matters Canada.
Carolynn Dube:Yeah.
Barb Collura:Wow.
Carolynn Dube:For sure advocacy from FMC, but also the grassroots advocacy groups across the country. So, not all of the provinces, but quite a few have these grassroots advocacy groups that exist. Some have been in place for many years.
Carolynn Dube:Some have been in place, some are recently established as of January of this year. And they advocate for programs to actually get up and running and started like in British Columbia. That surprisingly is one of our most, it's a province that surprises people that a program did not exist until it was announced a year ago. And that program is rolling out starting July, but a lot in part to the advocacy group that exists in that province and the clinicians who have been advocating for years for programming there. And then other programs like in Ontario, who've had a program since 2015. There's a grassroots organization in that province who's been doing a lot of work and they just made a $150,000,000 promise to roll out over the next two years to triple the number of families that can access IVF in that province.
Carolynn Dube:So it is really exciting. And what is nice is, you know, when we look at sort of, we had four provincial elections happen this fall. Three of those four provinces had fertility coverage in their campaign platforms.
Barb Collura:Wow.
Carolynn Dube:Publicly. All of three of those provinces had different leadership. So in Canada, have more than two party a two party system provincially and federally. The Conservatives, the Liberals, and one of the other major ones is the NDP, New Democrats.
Carolynn Dube:So we had a New Democratic government come in British Columbia with a program, a really conservative government come in in Saskatchewan with a funding program in place. And then where I am in New Brunswick, a liberal, a new government under a liberal leadership to make improvements to our current program. So in here, it's not an issue of it's not doesn't belong to one party or another. It's really across the board an important conversation and policy piece for policy makers.
Rebecca Flick:Do they view access differently? Like, so when you talk about, you know, the funding programs, is there like a standard of care that FMC wants to make sure is established? Or like, do you have to fight anything there? Is there any misunderstanding among these parties of what actually good patient care is?
Carolynn Dube:Yeah, that's a really good question. And a lot of our advocacy is actually on that. So although we have these provincial programs rolling out in nine of the provinces, not one of them is the same. So in provinces like Ontario and Quebec, they have a fully funded round of IVF and then the payment for frozen embryo transfers result of embryos that result from that initial funded IVF cycle. In other provinces, like Nova Scotia, they have a refundable tax credit.
Carolynn Dube:So the upfront out of pocket cost is, you know, on the shoulders of the patient. But annually they can submit receipts for up to $20,000 and get 40% of that back in their pocket. So the challenge becomes, you still have to have the money upfront and out of pocket in those provinces that reimburse you. For provinces that have a paid IVF cycle, there's no coverage for drugs or genetic testing or travel or surrogacy. So that becomes a bit of a balance.
Carolynn Dube:That's where the advocacy continues until everybody gets this equitable access. Especially because we live in this country with universal healthcare. And one of the pillars is equitable, portable access to healthcare. That's where our fight continues.
Barb Collura:When you talk about these grassroots advocates, and grassroots organizations, and so forth, in The United States, we have, like, a federal advocacy day where people talk to their lawmakers. We do it virtually. It's coming up on May 20th. Do you guys do things like that? Do you go to the capitals of the provinces? Give me a little sense of the logistics, how the advocacy actually works. Are people writing letters? You know, what do you guys do?
Carolynn Dube:Yeah. So we aren't as established in Canada as RESOLVE and your advocacy efforts are, I would say. And I often look to you as partners to say, "Okay, this is how RESOLVE, and we model a lot of the work that we do after the work that you do, especially given the ability to now do virtual hill days. It's, you know, it makes a lot of sense. So we haven't done a formal hill day in eight, probably seven or eight years, I guess, at this point.
Carolynn Dube:But we've got one in the works, and we're planning one for it's going to depend because we're now in this we're now in the middle of a federal election here. And so it's going to depend on the outcome of the election and we're working with, we have a government relations team that we work with. So that will come up probably in the fall of 2025 or early 2026. And then when we look at the provinces, yes, some advocacy days do happen really where we have well established events like that are in the province of Ontario and in Alberta. So Alberta remains the only province in Canada without a funded program actually.
Carolynn Dube:They have a very active advocacy group there and they're doing a lot of work, a lot of meetings on the hill, breakfasts with policymakers in the capital, which is in Edmonton. So those grassroots teams really do come together to pull things. And now we've got a really active group over in Prince Edward Island, a tiny little island where I know Rebecca-
Rebecca Flick:I know.
Carolynn Dube:-really wants to go someday.
Rebecca Flick:I do.
Carolynn Dube:She's gonna drive by, pick me up in Moncton, and we're gonna pop over to the island. It's gonna be amazing.
Rebecca Flick:So can you tell me a little bit more about the advocacy groups? Are they advocating specifically just about fertility issues? Are they, you know, health care advocacy groups? You know? Because we have the Minnesota Family Building Coalition or, a coalition in Wisconsin, a coalition in Colorado, and they're really focused on family building and infertility.
Rebecca Flick:So tell us a little bit more about those advocacy groups.
Carolynn Dube:So yes, the ones that we work with specifically are primarily focused on fertility and family building. That is their, you know, reproductive health. But for the most part, IVF, funded IVF, surrogacy, and educating policymakers on what this looks like, like what it looks like for residents of their province, the realities of, you know, the economics, the link between our really low fertility rate and the economic health of our country. So there's, we look at it from multitude of levels. And again, depending on the province, depending on the government, the current government, certain messages hit differently than others.
Carolynn Dube:And so we really tailor those messages to ensure that, you know, policymakers see this as an issue. And it's really working because as I mentioned before, we're seeing it pop up in these provincial elections and it doesn't matter the party, people are putting it in campaigns. And I think that they're seeing, you know, why this is and I think they're also seeing it they're also hearing it from their constituents.
Barb Collura:Yeah. That's amazing. So what we're hearing here is grassroots advocates, a national organization working together. You have seen real progress. Congratulations. Amazing work.
Barb Collura:I'm sure you're just overwhelmed sometimes by the impact you're making and the number of lives you've impacted and those families that have been formed. And then to have politicians talking about infertility in their political platform as they're campaigning. We saw that certainly here in The United States in the presidential election. We hadn't seen that before in other kind of campaigns.
Barb Collura:So gosh, I would love to see it be something that's talked about more here, like it is in Canada. So great work. It's such an honor to have you and to hear from you and to get these insights. And then I'm just so honored too that we are a resource for you all. And likewise, we learn from you. Rebecca said, we have this podcast of you. It goes both ways.
Barb Collura:Carolynn, what else do you want to share today before we wrap up? Is there anything that we haven't touched on that wanna make sure we talk about?
Carolynn Dube:Well, you know, to your point, we've got this grassroots stuff happening in the provinces. And like I mentioned, we're in the middle of a federal election campaign. It wraps up our our election days April 28, and we're gonna be launching a federal advocacy grassroots campaign out of the Fertility Matters Canada office.
Barb Collura:Wow.
Carolynn Dube:Yeah. It's happening this week. I'm really excited. And it's gonna be an opportunity the first time because listen. We have a federal election once every four years, typically, similar to you. This is a once in a four year opportunity.
Barb Collura:Yeah.
Carolynn Dube:And so we're hoping that Canadians, this is an opportunity for us to give Canadians a voice, to reach out to their local candidates. Again, it's that grassroots movement to their candidates in their writings because, you know, for again, for your listeners, we don't vote for our prime minister. We vote for our local candidate. And then the party with the most number of candidates forms government, and the leader of that party becomes prime minister. So it's different than The US.
Carolynn Dube:And so this is an opportunity for us to have real conversations with the people in our writings to say, what's your party's stance on helping more Canadians gain access to fertility care in Canada? And so I'm really excited to launch that and hopefully see some really positive responses from our from our leadership.
Barb Collura:That is fantastic. Good luck. And for listeners that we're recording this in early April, and your federal election is the April, so this is gonna be going on during the month of April. We're so honored to work alongside you. Can't wait to see you in a couple weeks in New York. And here we are in our green.
Carolynn Dube:Love it. Thank you.
Rebecca Flick:Yep. And we'll put in, in the show notes links to their website, your podcast, the campaign. So send that to me, please. And, we're really happy that you made time for us this morning.
Carolynn Dube:Oh, always have time for you.
Rebecca Flick:Remind myself, is she an hour ahead? I think she's an hour ahead.
Carolynn Dube:I'm ahead. It's okay. But you can call me or text me anytime.
Rebecca Flick:Speaking of time, tell us a little bit when we always like to hear from our guests. We reserve the right to get smarter, better at something. And I know you and I have embarked on getting smarter about our mornings.
Carolynn Dube:Yeah. So I have been really super focused on getting up early in the mornings. I've got three young kids, a busy life, and I know that I function better... For years I've said I was a night owl, a morning person. And so I've been really focused on getting up in the 05:00 hour of the morning when the house is quiet and I have a bit of time for myself and I can journal and plan my day and have a hot coffee without having to microwave it.
Carolynn Dube:And so I've been posting on that on social media to become more productive. I am, I find that I'm so much more calm and chill and focused through my day. So, yeah. And I see Rebecca online, so I know she's following along.
Rebecca Flick:I am. It's been wonderful. Until, I will say, I'm going to give you a heads up, when they become teenagers and they have later activities, I struggled to stay up last night until my son got home around 09:45.
Rebecca Flick:I must have fallen, like, asleep three times before he got home, but heard him come in the door. So there'll be some balance ahead of ahead for you.
Carolynn Dube:Definitely.
Rebecca Flick:Well, Carolynn, thank you so much. Thank you for listening, and we'll talk to you soon.
Barb Collura:Bye.
Carolynn Dube:Bye.