Ideas for Australia: Rethinking funding and priorities in IVF – should the state pay for people to have babies? (2023)

The Conversation has asked 20 academics to examine the big ideas facing Australia for the 2016 federal election and beyond. The 20-piece series examines, among others, the state of democracy, health, education, environment, equality, freedom of speech, federation and economic reform.

How much should the state spend on helping people to have children? At present, government support for infertility treatment is approximately A$240 million a year. The success of fertility treatments such as IVF is good if you are under 35 years of age, but once a woman hits 40 it plummets, falling to an almost futile one-in-80 chance of producing a baby for women 45 years and older. This raises the question – is IVF a cost-effective use of taxpayers’ money? And what about for older women?

Decisions about funding are usually made on grounds of cost-effectiveness. In Australia, the cost-effectiveness threshold is about A$40,000 per “QALY”. A QALY is a quality adjusted life year. Thus the government will spend, for example, A$40,000 to add a year of full health, or improve the quality of life by 10% for 10 years.

Is IVF cost-effective? It depends on how we measure it.

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The life of the child

If we count the life of the child who is produced by reproduction as a benefit, then IVF for infertility is highly cost-effective. Latest figures state that more than 13,000 babies were born through IVF treatment, at an average cost to government of A$19,000 per child.

Likewise pre-implantation genetic diagnosis to test for genetic disorders in potentially fertile couples is cost-effective. Genetic testing costs on average A$3,000-$5,000 per cycle of IVF, plus the additional IVF treatment costs. Even for a 45-year-old woman, at A$5,000 per cycle, total cost to bring about a live birth would be A$400,000. But this buys a whole life of 80 QALYs, so works out to be A$5,000 per QALY, well below the threshold and great value for money.

While the Australian government does pick up the tab for the majority of IVF costs, it pays absolutely nothing towards the costs of genetic testing, which are borne by the prospective parents. This appears to be a strange position when one considers the costs associated with care for a child born with cystic fibrosis, estimated to be over A$30,000 a year.

Let’s say the person with cystic fibrosis lives 30 years. This gives a total cost of nearly A$1 million for lifetime care. Genetic testing costs maximum about A$5,000 and IVF about A$19,000. That is A$1 million versus A$24,000.

It is thus vastly more cost-effective to provide genetic testing for free and have children born without cystic fibrosis. It could be that fears of “designer babies” are holding back improving access to this life-saving and economically sound medical care.

If we count the value of the life of a child produced by IVF as a benefit, it is a hugely cost-effective medical procedure.

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The life of the parents

There is great philosophical debate about how to value bringing new people into existence. For example, it is much worse to kill someone than to decide not to have a child (using contraception or abstinence). Killing someone harms them but failing to bring someone into existence harms no one. Likewise, it is often said that bringing someone into existence does not directly benefit any individual.

For this reason, it can be argued that the relevant harms and benefits are those to the parents. That is, the success of IVF should not be counted in terms of the life of the child produced but in terms of the unhappiness, anxiety and other mental distress couples or individuals feel at not being able to have a child. This makes IVF much less cost-effective because the benefits are so much smaller.

Impersonal reasons

Should the life of the child count in us deciding how to fund and prioritise IVF? We think it should, but in a way that is different to counting its full value. Consider the simple case of genetic selection to avoid a genetic disease such as cystic fibrosis.

If IVF and genetic testing are used to select a healthy embryo, call her Jane, we avoid hundreds of thousands of dollars in lifetime health-care costs and all the difficulty and misery of a life with cystic fibrosis. But did the genetic selection benefit Jane? No – if it were not performed, another child, call him Peter, would have been born with cystic fibrosis.

This is puzzling. We want to say it is good that people don’t have genetic diseases in the future, but when this is achieved by genetic selection it does not appear to benefit anyone. Of course parents and society benefit by not having to care and worry about treatment for cystic fibrosis. But we also feel intuitively that a world without cystic fibrosis is a better world.

Sometimes these reasons are called “impersonal reasons”, reasons that are unconnected to harm and benefit to persons. These reasons give us some cause to act. But they appear weaker than ordinary person-affecting reasons, which involve direct harm and benefit to persons. For example, it is worse to give someone cystic fibrosis who was previously healthy than it is to fail to have genetic selection and so conceive a child with cystic fibrosis.

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Nonetheless, impersonal reasons to care about the next generation are an important ground for making the world a better place – for example, by selecting policies aimed at reducing carbon emissions. Such policies will inevitably affect the timing of reproduction, and so the identity of who is born. Nonetheless the world is better for these different future people.

The implication of this for IVF and genetic selection is that we have some direct impersonal reasons to support these. These arguments extend to having children. It is better if there are children in the future.

Many European and Asian countries are suffering from having too few young people to support their ageing populations. Of course the limitation of resources places an upper limit on how many people there should be. But in the absence of such a limit, it is better if there are more happy, healthy people.

These arguments suggest much more funding should be put into IVF and genetic selection to avoid serious disease. But they also extend to other non-disease traits. It is better if people have talents and gifts, are happy, co-operative, empathetic, altruistic and so on.

What goes on the list of personally and socially valuable traits is contentious, but there is consensus on some traits. Psychopathy is not a trait there is a reason to preserve, or to select for. We should support selecting against it, just as we should support preventing disease.

Genetic selection should be supported to have children who will have better lives, not merely healthier lives. It ought to be a priority.

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Now that whole genome analysis is becoming cheap and widely available, it ought to be employed where IVF is already being used for infertility or avoiding genetic disease. But should we lift laws that prevent access to IVF for healthy couples?

Should the state support genetic selection where there is not a high risk of genetic disease or infertility? The answer to this question will depend on just how much genetic selection is capable of adding to the quality of the lives of the next generation or the benefits to future society.

At present, most complex traits like intelligence have many genes contributing. When only 20 embryos are produced, it is not possible to select across a large number of genes. For this reason, genetic selection is unlikely to be cost-effective when dealing with polygenic traits.

Nonetheless, laws banning such genetic selection ought to be lifted. And if technologies that amplify genetic selection for polygenic traits become available, perhaps the state ought to provide these.

Including the value of new people in our moral and economic thinking would cause us in many cases to give greater economic support to IVF and genetic selection than we currently do.

You can read other articles in the series here.

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FAQs

Is IVF Australia government funded? ›

IVF Cost NSW FAQ's

No, IVF treatments in NSW are not free. However, the NSW government offers fertility treatment rebates, and some fertility treatments may be covered by private health insurance policies.

What does the Australian law say about IVF? ›

(A) Infertile couples

If you are undergoing IVF as a result of you and/or your partner being unable to conceive naturally, both you and your partner will need to give valid written consent, prior to any procedures being undertaken.

What percentage of Australian babies are IVF? ›

In 2019, that rate had gone down to 2.9%, which is one of the lowest rates worldwide. This is partly explained by the increased amount of IVF cycles where a single embryo is transferred – from 70% in 2010 to 92% in 2019.
...
IVF success rate increasing in Australia.
At least daily
6%
Rarely
56%
4 more rows
22 Sept 2021

Is there a charity for IVF? ›

The Fertility Foundation UK provides free support and financial assistance in the way of IVF grants to anyone affected by fertility issues. We are the UK's leading fertility charity with large percentage of our services users living in London and the surrounding areas.

Why should the government fund IVF? ›

As a result, many patients resort to alternative treatments that have a lower chance of success and/or a higher risk of multiple pregnancies. Public funding of IVF with eSET has been shown to reduce the risk of twins and highorder multiples that may result from fertility treatments dramatically.

Is IVF good for the economy? ›

Conclusions: Lifetime net taxes paid from a child relative to the child's initial IVF investment represent a 700% net return to the government in discounted US dollars from fully employed individuals.

What are the arguments for IVF? ›

The ultimate advantage of IVF is achieving a successful pregnancy and a healthy baby. IVF can make this a reality for people who would be unable to have a baby otherwise: Blocked tubes: For women with blocked or damaged fallopian tubes, IVF provides the best opportunity of having a child using their own eggs.

Why is IVF considered an ethical issue? ›

In vitro fertilization (IVF) is morally objectionable for a number of reasons: the destruction of human embryos, the danger to women and newborn infants, and the replacement of the marital act in pro- creation.

Why is Australia's fertility rate so low? ›

Mothers are also getting older. The average age of mothers giving birth has risen from 30.0 years to 30.9 years. The average age of first-time mothers is 29.6 years, up more than a year from the previous decade. One of the biggest influences on that figure is the decline in teenage pregnancy.

What gender is more common with IVF? ›

You are 3- 6% more likely to have a baby boy than a girl when using IVF to conceive. IVF increases the odds of a boy from 51 in 100 when conceived naturally to 56 in 100 with IVF.

Do IVF babies have 3 parents? ›

Also called mitochondrial replacement or transfer, three-parent IVF is an intervention comprising two distinct procedures in which the genetic materials of three people-the DNA of the father and mother and the mitochondrial DNA of an egg donor-can be used to create a child.

How do I get IVF without money? ›

If insurance doesn't cover your IVF treatments, here are other ways to finance the costs and who they're best suited for.
  1. Fertility specialist loan. Who it's best for: Those who want a lender that works directly with their fertility clinic. ...
  2. Credit union loan. ...
  3. Online personal loan. ...
  4. HELOC. ...
  5. IVF grant.
7 Nov 2022

How can I raise my money for IVF? ›

Three ways to supplement the costs of IVF treatments
  1. Grants for IVF. Many organizations offer financial assistance through the use of scholarships or grants. ...
  2. IVF financing and shared-risk programs. ...
  3. Crowdfunding for IVF.
7 May 2021

Who is eligible for IVF funding? ›

Eligible Individuals:

Singapore Citizens or Singapore Permanent Residents, physically based in Singapore; and. Successfully completed IBF-STS accredited course (including passing all relevant assessments and examinations)

What are the pros and cons of IVF? ›

Pros and Cons of IVF
  • Fallopian Tubes Not Necessary. A woman's fallopian tubes may become blocked due to a previous pelvic infection such as appendicitis or chlamydia. ...
  • Low Sperm Count. ...
  • Lowered Chance of Abnormality. ...
  • Multiple Pregnancy. ...
  • No/Fewer Eggs Collected Than Expected. ...
  • Emotional Toll.

What are the problems with IVF? ›

IVF increases the risk of multiple births if more than one embryo is transferred to your uterus. A pregnancy with multiple fetuses carries a higher risk of early labor and low birth weight than pregnancy with a single fetus does. Premature delivery and low birth weight.

Are IVF babies disadvantaged? ›

IVF can increase the risk of prematurity in the baby

In IVF, the risk of premature birth increases due to high stimulation. Premature delivery may increase the child's risk of long-term health problems. High estrogen levels can affect the uterine environment of the uterus.

What impacts IVF success? ›

The Quality of Egg, Sperm, and Embryo

Factors like age, ovarian reserve, and stimulation protocol affect both the egg cells' and embryos' quality. And if the male partner has fertility issues, then the treatment process success rate will also be affected.

Are IVF success rates improving? ›

IVF success rates have increased over the last 10 years, especially in older women, which can be reassuring for people who plan to start their families via IVF. IVF can be challenging both mentally and physically, so it's important to take steps to protect your mental health.

What is the future of IVF? ›

The growing utilization of IVF will transform the way a substantial proportion of the human species procreates. It is likely that in the near future, as many as 10% of all children will be conceived through IVF in many parts of the world.

What is an IVF baby called? ›

"Test tube baby" is a term sometimes used by the media to refer to children conceived with in vitro fertilization (IVF).

What is the oldest age you can have IVF? ›

Age Limits for In Vitro Fertilization
  • The age limit is usually between 42 and 45 at most programs in the US.
  • The IVF live birth rate is < 1% for women older than 45 years old. ...
  • Most IVF clinics allow a woman to be a recipient of donor eggs through about age 50.
16 Sept 2020

Why is IVF not allowed in Christianity? ›

Why is the Catholic Church against IVF? Catholic church states that assisted reproduction removes the child's conception through the sexual relationship between the couple.

How does IVF affect society? ›

The technique has changed traditional notions of family structure, too. Egg donation and surrogacy, the freezing of embryos, and techniques such as mitochondrial transfer and genome editing alter long-held views about biological relations, kinship and the constraints of time, space, gender and genetics on procreation.

What religions are against IVF? ›

On the contrary assisted reproduction is totally unacceptable to Roman Catholicism, while Protestants, Anglicans, Coptic Christians and Sunni Muslims accept most of its forms, which do not involve gamete or embryo donation.

Why does the Catholic Church not allow IVF? ›

The Catholic Church believes that IVF is never acceptable because it removes conception from the marital act and because it treats a baby as a product to be manipulated, violating the child's integrity as a human being with an immortal soul from the moment of conception (Donum Vitae 1987).

Does Australia need more babies? ›

Since 1976, Australia's total fertility rate has been below replacement level (about 2.1 babies per woman). Replacement level is the level at which a population is replaced from one generation to the next without immigration.

What is the average age to have a baby in Australia? ›

The average age of mothers has been rising over time, from 30.0 in 2010 to 30.9 in 2020. Average maternal age has risen for both first-time mothers (from 28.3 years in 2010 to 29.6 in 2020) and those who have given birth previously (from 31.3 years in 2010 to 32.0 in 2020).

What age should you have your first child? ›

Experts say the best time to get pregnant is between your late 20s and early 30s. This age range is associated with the best outcomes for both you and your baby. One study pinpointed the ideal age to give birth to a first child as 30.5. Your age is just one factor that should go into your decision to get pregnant.

Can parents choose the gender of their child in IVF? ›

Gender Selection via IVF is a fertility procedure used to choose the gender of a baby prior to conception. Gender selection is performed by creating embryos and then testing the embryos prior to transfer.

Can you do IVF to have a boy? ›

You cannot select a baby's gender during IVF, but you can select its sex. To do this, you must get your embryos genetically tested. You can do this through preimplantation genetic testing (PGT).

Does IVF affect baby gender? ›

Here's why. Babies born by in vitro fertilization — when a woman's egg is fertilized outside of her body and then implanted back into her uterus — skew more heavily male than babies conceived naturally.

Can a baby have 3 fathers? ›

Recently, researchers with the Institute of Life in Athens, Greece, announced that a healthy baby boy was born who basically had the DNA from three people. The child was born to a 32-year-old woman who had failed in four cycles of in vitro fertilization (IVF).

Can a baby have two fathers? ›

Superfecundation is the fertilization of two or more ova from the same cycle by sperm from separate acts of sexual intercourse, which can lead to twin babies from two separate biological fathers. The term superfecundation is derived from fecund, meaning the ability to produce offspring.

Do IVF babies look like mom? ›

Because a donor egg won't share any of its genes with its intended mother, there's a chance the baby will not resemble its mother. However, if her partner's sperm was used, the baby may look like its father because they share the same genetics.

How long does it take to get funding for IVF? ›

It usually takes up to 6 weeks for the funding application process. All people referred by a GP or hospital will be assessed for NHS funding once an initial registration questionnaire has been returned. We'll apply for funding on their behalf and will complete the documents needed as part of the application.

Why does IVF cost so much? ›

There are add-ons, including genetic testing of the embryos and surgical procedures (such as sperm extraction or laparoscopy), which can increase the cost of I.V.F. by thousands of dollars. Most people will require more than one round of treatment, though exactly how many cycles you'll need is hard to predict.

Is IVF funded by Medicare? ›

Any NSW resident who is eligible for Medicare and who is referred by their doctor can access the publicly supported IVF clinics. The clinic must also deem IVF treatment clinically appropriate for the patient.

What are some good fundraiser ideas? ›

14 Easy Nonprofit Fundraising Ideas
  1. Donation Jars. In the age of cryptocurrency and digital wallets, we often forget about cash as a quick donation option. ...
  2. Community Yard Sale. ...
  3. 50/50 Raffle. ...
  4. Bake Sale. ...
  5. Concession Stand. ...
  6. Car Wash. ...
  7. Team Trivia Night. ...
  8. Sports Tournament.
13 May 2022

Does Starbucks pay for your IVF? ›

Starbucks, which faces a national labor organizing campaign, has long been known among people struggling with infertility as one of the only major U.S. employers to offer coverage for procedures like IVF to part-time workers. Word about Starbucks' benefits has spread widely online in recent years.

Can I sell my eggs from IVF? ›

The simple answer, no. The truth is that women who donate their eggs are, in fact, donating their eggs to another, anonymous, couple.

Is IVF a disability? ›

According to the United States Supreme Court case Bragdon v. Abbott, 524 U.S. 624 (1998), infertility is considered a major life activity and therefore is a disability under the ADA.

Can unmarried couples get IVF? ›

ASRM states that patients should not be denied fertility services because they are unmarried, gay, or lesbian.

Can you get free IVF in Australia? ›

Any NSW resident who is eligible for Medicare and who is referred by their doctor can access the publicly supported IVF clinics.

Does Medicare cover IVF treatment in Australia? ›

As well as IVF, most ART (Assisted Reproductive Technology) treatments receive some level of Medicare rebate, including IUI (intra-uterine insemination), Frozen Embryo Transfer, and ICSI. These rebates are not means tested and are available to all holders of a current Medicare card.

Is IVF free on Medicare? ›

IVF and fertility

If your doctor refers you for fertility treatments, you can claim some money back from us. There is no limit on the number of treatment rounds you can have. Most people will still have to pay some of the costs themselves.

Is IVF bulk billed in Australia? ›

The majority of your IVF cycle fees are bulk billed, as are consultations with the Doctor & Nurses (no fee to yourself). Typically, the only out of pocket costs you will have are for treatment room fees for egg collection and medications – this will total approx. $900-$1,020.

Which IVF clinic has the highest success rate Australia? ›

News Corp analysis of Yourivfsuccess.com.au data shows the most successful IVF clinics Australia-wide are Genea's Newcastle, Wollongong and Canberra clinics. Among women aged under 35 success rates are 64.79 per cent, 60 per cent and 59.42 per cent at these clinics.

Who owns IVFAustralia? ›

At IVFAustralia, a part of Virtus Health, your doctor, counsellor, nurses, care team and laboratory team work together to give you the best possible chance of success.

How much does it cost to have a baby in Australia without Medicare? ›

Average costs of delivering a baby in Australia
Baby delivery medical procedures in AustraliaAverage cost with no insuranceAverage cost with insurance or Medicare coverage/rebates
Cesarean section in the hospitalA$14,000A$0 - A$12,000
Home birth and delivery with midwifeA$3,000-A$5,000A$1,000-A$3,000
3 more rows
19 Jul 2018

How much does Medicare give back for IVF? ›

Eligible applicants may receive up to $2,000 depending on the total out-of-pocket cost incurred during their treatment. The new fertility treatment rebate will open for applicants to make a claim from 1 January 2023.

Who is eligible for IVF from Medicare? ›

If you are diagnosed as being 'medically infertile', Medicare will cover any eligible treatment with Hunter IVF. This includes IVF, most ART (Assisted Reproductive Technology) treatments such as IUI (intra-uterine insemination), Frozen Embryo Transfer, and ICSI.

Which insurance covers IVF in Australia? ›

Some health funds offering IVF coverage, include:

Australian Unity Ultimate Hospital (Gold) Medibank Gold Complete Hospital. Bupa Top Hospital with Pregnancy – Gold.

How many times can you do IVF in a year? ›

The research suggests most couples will need approximately 6 embryo transfers before they achieve a pregnancy! There are no limits to the number of IVF cycles you can have. This decision is entirely up to you and the fertility specialists.

What does Medicare not cover Australia? ›

Medicare doesn't cover

ambulance services. most dental services. glasses, contact lenses and hearing aids. cosmetic surgery.

Is there an age limit for IVF in Australia? ›

IVF Treatment through our Bulk Billed Program is therefore only available to women who are 45 years of age or younger (at the time of egg collection). However, if you are over 45, you may be suitable for IVF treatment through our Full-Service Fertility Program (you can see costs here).

What is the average cost of a cycle of IVF in Australia? ›

What's included in the IVF cycle fee?
ProcedureCycle costEstimated Out-of-Pocket after Medicare rebates for 1st and subsequent cycles in calendar year
IVF Cycle$10,975$5,000 - $5,500
ICSI Cycle$11,602$5,100 - $5,700
IUI Cycle$2,875$2,200
Frozen Embryo Cycle$4,195$2,600 - $2,700
1 more row

Which IVF clinic has the highest success rate? ›

PFCLA's success rates are among the top in the nation, with a 53.1% live birth rate per embryo transfer than the U.S. average of 37.8%. That means intended parents coming to PFCLA have a 40% higher chance of taking home a baby than the national average.

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