The A.R.T. of the Waiting Game: Navigating Assisted Reproduction in Ontario, Canada

Format: Papers, RSD6, Topic: Policy & Governance

Denise Philpott, Laura Halleran, Sonia Tagari and Windemere Jarvis

Patient experience

In Ontario, Canada, one in six couples are impacted by infertility at some point in their lives. Additionally, Statistics Canada reports the average age of first-time mothers in Canada has increased to 30 years old, to-date the oldest recorded. In this harsh reality lies the fact that women are having children outside their ideal reproductive window. Coupled with the prevalence of reproductive disability and disease, this reality has created a need for assisted reproductive technologies. Ontario’s Fertility Program was established to regulate these technologies and provide them as a service for Canadian women. Unfortunately, a current gap in the program is the lack of a unified resource that empowers women with the information necessary to address their reproductive health and navigate this system. Online ethnographic investigation of infertility support forums and a thorough literature review of peer reviewed and white papers formed the research basis of the argument for a unified tool.

This gigamap and report theorizes a response to this unmet need by serving as a tool to assist women in their navigation of a complex socio-technical system, while also showcasing ways in which policy is hindering optimal access. Through a combination of systemigrams, causal loops, and patient journey maps, this gigamap provides a holistic understanding of what is required to complete a publically funded round of IVF in Ontario. Furthermore, it also highlighting gaps in policy and points for potential legislative intervention. Taking a woman-centered view of population health by centralizing the reproductive journey and using accessible, personalized language, this gigamap considers how cultural expectations for women and fiscal and personal resources influence the use of assisted reproductive technology. This is an ongoing project that continually incorporates user feedback to best address the needs of the women it serves.

Citation Data

Author(s): OCTOBER 2017
Title: The A.R.T. of the Waiting Game: Navigating Assisted Reproduction in Ontario, Canada
Published in: Proceedings of Relating Systems Thinking and Design
Article No.:
Symposium Dates:
First published: 12 October 2017
Last update:
Publisher Identification:

Copyright Information

Proceedings of Relating Systems Thinking and Design (ISSN 2371-8404) are published annually by the Systemic Design Association, a non-profit scholarly association leading the research and practice of design for complex systems: 3803 Tønsberg, Norway (922 275 696).


Open Access article published under the CC-BY-NC-ND 4.0 International License. This permits anyone to copy and redistribute the material in any medium or form according to the licence terms.

Suggested citation format (APA)

Author(s). (20##). Article title. Proceedings of Relating Systems Thinking and Design, RSD##. Article ##.

Publishing with RSD

Proceedings of Relating Systems Thinking and Design are published online and include the contributions for each format.

Papers and presentations are entered into a single-blind peer-review process, meaning reviewers see the authors’ names but not vice versa. Reviewers consider the quality of the proposed contribution and whether it addresses topics of interest or raises relevant issues in systemic design. The review process provides feedback and possible suggestions for modifications.

The Organising Committee reviews and assesses workshops and systems maps & exhibits with input from reviewers and the Programme Committee.

Editor: Cheryl May
Peter Jones
Ben Sweeting

The Scholars Spiral

In 2022, the Systemic Design Association adopted the scholars spiral—a cyclic non-hierarchical approach to advance scholarship—and in 2023, launched Contexts—The Systemic Design Journal. Together, the RSD symposia and Contexts support the vital emergence of supportive opportunities for scholars and practitioners to publish work in the interdisciplinary field of systemic design.

The Systemic Design Association's membership ethos is to co-create the socialization and support for all members to contribute their work, find feedback and collaboration where needed, and pursue their pathways toward research and practice outcomes that naturally build a vital design field for the future.


Verified by MonsterInsights