02.Mounting costs
One reason IVF treatment costs so much is that public purse support has been rolled back. In January 2010, the government capped the benefit for assisted reproductive treatment (ART) procedures under the Medicare Safety Net. This means out-of-pocket costs have gone up by $500 to $1500 per IVF cycle. In addition, since 2009 the median total cycle fees (before Medicare) have gone up by $2300 to $8300.
But there are significant price differences between clinics. In Sydney, for example, the out-of-pocket costs after Medicare benefits and safety nets for three IVF cycles can range from $1870 at the private Westmead Fertility Centre (aligned to a major public hospital – operating surplus goes back into the business) to almost $9000 at major private clinics Genea (owned by its shareholders, including current and former doctors) and IVF Australia, which belongs to the largest network of clinics in Australia and is partly owned by private equity company Quadrant.
On top of this, there can be charges for diagnostic tests, some medications and theatre fees that aren’t always included in the initial quote. The level of service provided and procedures used vary across clinics.
Some allow egg collections and embryo transfers at any day of the week, while others have set days. In Westmead and other clinics aligned with public hospitals, some procedures may be performed by trained gynaecologists under the supervision of a fertility specialist. In other clinics – Genea and IVF Australia, for instance – procedures will usually be done by your own specialist.
Success rates
Some larger, more expensive clinics told CHOICE they have better success rates than less expensive ones, but both industry experts and other clinics hotly dispute this claim.
The truth is that success rates can vary widely between clinics of all sizes and prices levels. In 2010, on average, 18.1% of IVF cycles resulted in a baby. But the range of performance rates across the 35 fertility centres in Australia and New Zealand is reported by Australian Institute of Health and Welfare (AIHW) to be between 4.4% and 31% per fresh embryo transfer cycle, and between 5% and 33.3% per frozen embryo transfer cycle.
The wide variation is likely caused by individual centre averages being drawn from different patient groups and sometimes very small numbers. Some clinics don’t accept all patients, and so other clinics may see a higher proportion of patients with difficult fertility problems.
This doesn’t mean it’s not worth asking a clinic about their success rates, but the only success rate that matters is the one for people in your particular circumstances. The most important factors are your ages and specific issues. There can also be large variations in success rates per cycle commenced, per egg collection, per embryo transfer and whether a fresh or thawed embryo is transferred.
Another factor is the developmental stage of the embryo – with the transfer of blastocysts (more-developed embryos) resulting in a higher rate of pregnancies. Each clinic should be able to tell you live birth rates per cycle commenced, as they’re obliged to report these to the AIHW.