In the baby business
Money Magazine Australia|October 2021
While assisted reproduction can be a prolonged and expensive process, for many women it’s well worth it
NICOLA FIELD

In the time it takes for you to read this article, 11 newborns will have made their way into the world across Australia. Close to 300,000 babies are born annually around the nation, making pregnancy and childbirth a commonplace event. What’s extraordinary is that one in 20 of those babies relied on in vitro fertilisation (IVF).

Forty years ago, Australia was an IVF pioneer. Today IVF and assisted reproductive technology (ART) are big businesses, supporting a wide variety of private clinics, many of which are owned by publicly listed companies.

These companies have followed the money trail. IVF is not cheap and it’s not widely available through the public health system. The cost varies between private clinics, but as a guide expect to pay around $220 to $350 for a first consultation. From there, an initial IVF cycle can cost $8680. After allowing for a Medicare rebate and Medicare safety net (more on this later), the likely out-of-pocket cost to the patient can be about $3800.

These figures may be base estimates only. For couples relying on intracytoplasmic sperm injection (ISCI), which can be used to assist with male infertility, the cost of an initial cycle can rise to $9560, with the out-of-pocket expense likely to be in the order of $4200.

The real clincher is that it can take multiple cycles to fall pregnant. According to the Victorian Assisted Reproductive Treatment Authority (VARTA), most people who go through IVF, regardless of age, do not have a baby after just one cycle.

A 2020 report by the UNSW, found that in 2018, over 84,000 IVF cycles were initiated Australia-wide. Yet in that same year, only 14,355 IVF babies were born. That’s about a 16% success rate. In reality, success rates vary significantly, and while infertility is a complex issue, a critical factor can be a woman’s age.

How many cycles?

As the table (IVF success rates) shows, a woman under 30 has close to a one-in-two chance of getting pregnant on the first round of IVF. That can rise to almost seven out of 10 after three cycles.

However, by the time a woman is in her mid-40s, she faces a near-zero prospect of pregnancy even with IVF. As Your Fertility, a coalition of fertility experts notes, both men and women experience a natural decline in fertility as they age. Not even the technology involved with IVF can compensate for this. That said, VARTA points out that if a woman in her 40s uses eggs donated by a younger woman, she faces the same odds as a woman the age of the donor.

No guarantee of success

These figures can fuel the view that IVF is a numbers game – the more cycles you have, the greater the odds of falling pregnant. But nothing is set in stone.

For Alice Almeida, who was diagnosed with endometriosis in her early 30s, it took five years and four cycles of IVF before she gave birth to her now three-year-old daughter. That was followed by three more unsuccessful attempts to have a second child through IVF.

“IVF is one of the few industries where you pay but there is no guarantee you will get the end product – a baby,” says Almeida. “It is critical for people to realize that IVF gives you a chance of a baby, but there are no guarantees of success.”

What it can cost

For couples and women about to embark on an IVF journey, there are options to manage the cost.

In NSW, the state government has expanded the availability of lower-cost IVF treatment at three publicly supported IVF clinics: the Royal Prince Alfred Hospital, the Westmead Fertility Centre, and the Royal Hospital for Women. At Westmead, for example, an IVF cycle, including embryo freezing, three months’ storage, and day surgery, can now cost only $1000.

In Victoria, the Royal Women’s Hospital is one of the few places that makes low-cost IVF available.

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