Calls for restrictions on Medicare access to IVF subsidies for older women

The IVF success rate is less than 1 per cent for women aged over 45.
The IVF success rate is less than 1 per cent for women aged over 45. Photo: File

A decade after the IVF industry defeated the federal government's attempt to restrict Medicare access to older women, the president of its peak body has says there is little taxpayer value in subsidising the treatment after a woman turns 45.

Statistics on fertility treatment outcomes released on Friday show that 73,598 women started IVF cycles in 2014, the most recent year for which statistics are available, and one in five of them (19.8 per cent) delivered a live baby.

This represented a 10 per cent improvement in the live birth rate over five years, which has been attributed to better freezing technology.

Professor Michael Chapman: "Is that value for money?"
Professor Michael Chapman: "Is that value for money?"  Photo: Domino Postiglione

But the success rate dwindled to 6 per cent for women aged 40 to 44, and less than 1 per cent for women aged over 45.

Fertility Society of Australia president Michael Chapman said if all the costs of IVF treatment for women aged over 40 were added together and then divided by the number of babies born, this worked out to $100,000 per baby, compared with about $28,000 for babies born to women aged 30.

For women aged over 45, the cost worked out at $200,000 per baby.

"Is that value for money?" Professor Chapman said. "That's a question the taxpayer has to answer.

"In healthcare you do spend a lot of money on fairly significant treatments like cancer for outcomes that are likely to be very poor, so it's a hard trade off and I think for the individual couple who are desperate to have a baby, it's worthwhile, but I think over 45 you have to think seriously about whether Medicare should cover them."

Medicare subsidises about $5000 per cycle, and patients foot $4500 to $5500 in out-of-pocket costs, depending on their clinic.

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In 2015, Medicare expenditure for assisted reproductive technologies was over $250 million.

An attempt by the Howard government to rein in the cost of IVF in 2005 was thwarted by a campaign by the industry and fertility support groups, who said that restricting access to the treatment would mean it was only available to the wealthy.

Terry Barnes, an adviser to then health minister Tony Abbott, said he had become more sensitive to the plight of IVF couples than he was in 2005, but how many attempts should be subsidised by taxpayers was a difficult debate that Australia had to have.

"We expect women to build both careers and families, so subsidised IVF for childless older women who have put off starting a family is fair," Mr Barnes said.

"But taxpayers can't be expected to fund unlimited attempts with low success rates – we need to get the balance right."

The report also showed that 74 women aged 40 to 44 had completed 10 cycles of IVF, and just three of them went on to deliver a live baby – but more than 70 per cent of them went on to have further cycles, the results of which were not collected.

Professor Chapman said fertility doctors discussed with patients their chances of conceiving after the age of 40 and the women often decided not to have further cycles, before reconsidering when the results did not work.

"These are desperate women. I say, 'You would need a miracle,' and they say, 'I want to keep trying'."

The Department of Health said the MBS review taskforce would review every item on the Medicare schedule for how it was aligned with health outcomes and evidence. A gynaecological working group would be established later this year.

"The government's arrangements for Medicare funding of IVF services are some of the most generous in the world, providing for unlimited treatment cycles, a rebate of around $5300 per stimulated cycle and no upper age restrictions on eligibility," it said in a statement.