Women who use low-cost or bulk-billed IVF (in vitro fertilisation) clinics could be putting themselves at increased risk of health complications, the peak association of IVF doctors says.
- Primary IVF, which offers bulk-billed treatment in Sydney, is opening its second clinic, in Melbourne
- IVF doctors are concerned by health risks of low-cost clinics
- Success rate data for Primary IVF is not made public
- Primary IVF says it follows modern protocols
It comes as Australia’s only bulk-billed clinic, Primary IVF, which has been operating in Sydney since 2014, opened its doors in Melbourne on Monday.
While IVF treatments can cost patients up to $15,000 in high-end clinics, Primary IVF in Preston will offer them essentially for free.
Supporters say it gives women with fertility problems, who could not otherwise afford it, the chance to have children.
However, critics are concerned that with the low cost comes less expertise, lower success rates and in rare cases, health risks.
Professor Michael Chapman, the head of the Fertility Association of Australia and a practising IVF doctor, said he was worried women were being treated more aggressively at low-cost clinics.
“I’m concerned patients attending the cheaper clinics are being directed straight into IVF [but] there are many other treatments that are available,” he said.
[Primary IVF] has been running for 12 months in Sydney, there have been complications – we have treated patients with hyperstimulation from that clinic and obviously we have concerns.Professor Michael Chapman, Fertility Association of Australia
“Controlling IVF and limiting it to the people who actually need it is very important and that selection of patients is something I have concerns about in the Primary model.
“[Primary IVF] has been running for 12 months in Sydney, there have been complications – we have treated patients with hyperstimulation from that clinic and obviously we have concerns.”
Ovarian Hyperstimulation Syndrome (OHSS) is when a woman reacts to the dose of drugs given to stimulate egg growth – in extreme cases, it can lead to the death of the woman or complications in the newborn baby.
Professor Chapman said it was too early to say whether it was a trend.
“I don’t think we’ve seen enough numbers to say that, but I know that we’ve seen two to three cases at a hospital I’m associated with at a time when, from our clinics, I don’t think we’ve had a case of hyperstimulation in the past 12 months,” Professor Chapman said.
He said clinics with good practices have been able to eradicate OHSS in recent years, a claim corroborated by many IVF doctors contacted by the ABC.
However Primary IVF has rebutted the claims.
“We do not have an excessive amount of OHSS. We follow the modern IVF protocols of low-dose, short-stimulation cycles.”
“We offer the highest quality of care and clinical practices, and have helped close to 100 Australian couples have a successful birth. The fundamental difference with our service is that we’re not burdening Australian families with thousands of dollars of cost,” the clinic said in a statement.
Bulk-billed clinic does not release success rate data
Mystery surrounds the success rates at the bulk-billed IVF clinic, as Primary IVF does not disclose its data.
While data from the Australian and New Zealand Assisted Reproduction Database (ANZARD) taken in 2012 showed the live birth success rate varies from 4 per cent at the worst rating clinic to 30 per cent at the best performing clinic, it is not compulsory for clinics to disclose their success rates to the public.
Monash IVF, which charges up to $15,000 per treatment, boasts one of the highest success rates in Australia.
IVF Doctor Associate Professor Luk Rombauts said Monash was one of the first IVF units in the world.
“What I think we’ll continue to tell our patients if they come to us is they will have the very best techniques, the very best methods of culturing techniques, the very best safety approaches as well … and that does cost money,” he said.
“That’s the reassurance that we can give our patients.”
Bulk-billed IVF ‘fantastic’ for access
Katharine Hirano, 39, believes it is fantastic that Primary IVF has opened in Melbourne and that more women will be able to access IVF treatment.
She is finally 20 weeks pregnant with twins, after spending more than six-and-a-half years receiving IVF treatment.
She had 20 cycles in all, at a cost of about $250,000.
“To be honest this was the most important thing for us in life to try and have children so we were happy to pay whatever it took to try and succeed,” she said.
“[But] there were many times when my husband and I thought to ourselves as we handed over another $10,000 or $15,000 for the next cycle: ‘How on Earth can people on lower incomes afford this?'”
She said there were no low-cost options available close to where she lived, and thought the price tag was just the price of having children.
“I think [bulk-billed IVF] is a fantastic idea and I think that it’s necessary, because otherwise IVF is just an elitist form of health service,” she said.
“And everyone should be able to access help if they’re experiencing infertility.”