Is low cost IVF worth the price?

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One of the worst moments — and there were many from which to choose — in my journey through IVF was being handed a price list of the services, as if I was at a day spa. The clinic no doubt thought that the nicely formatted card and glossy brochures would put me at ease.

It was quite the opposite. Being handed a price list for services to conceive a child made me sick to my sluggish ovaries and blocked fallopian tubes. It underscored the fact that the IVF version of baby-making is just capitalism after all, as cold and hard as the stirrups on the clinic bed.

As confronting as it was, my husband Chris and I handed over our credit card without a moment’s hesitation. We were fortunate enough to be able to afford it.

But with each basic IVF cycle in the vicinity of $4000 — that’s after the Medicare rebate but before anything you might get back on private health insurance — not everyone gets the ‘‘luxury’’ of picking services from this price list.

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With prices like these, it was only a matter of time before somebody identified a gap in the baby-making market and came up with a low-cost offering.

Virtus Health, the first in-vitro fertilisation company to list on the Australian Stock Exchange, has recently launched low-cost IVF clinics in Sydney, Melbourne and Brisbane. The Fertility Centre is to traditional IVF clinics what Aldi is to Coles.

"The key behind our significantly lower IVF treatment costs is our simplified and standard IVF treatment model,’’ says the website.

A ‘‘simplified and standard’’ IVF cycle at The Fertility Centre will set you back about $2000 per cycle.

Half-price babies might sound like wonderful news to the infertile, but it may come at an even greater cost. Scientific director at Monash IVF Dr Tiki Osianlis isn’t convinced that cuts can be made without curbing the quality of the procedure.

‘‘Everything we [Monash IVF] currently do within an IVF cycle is best practice. There is nothing to simplify. We currently have the best results in the fewest cycles. There are no bells and whistles to cut,’’ Dr Osianlis said.

Services at The Fertility Centre may be cheaper, but if you need more cycles to make a baby, or don’t get a baby at all, is it really value for money?

And it’s not just the direct costs of treatment that need to be factored in. It’s the cost of missing work for the continual consultations, blood tests and scans and procedures.

Beyond money, it’s the prolonged emotional cost of riding the IVF roller-coaster, putting your life on hold while you undergo treatment and lying to your nearest and dearest as to why you’re continually cancelling on them at the last minute.  

Because the budget clinics are new, there’s no data on the success rates. But one of the ways The Fertility Centre saves money is by using fewer and lower doses of hormones. This means that patients will produce fewer eggs in each cycle.

Fewer eggs can mean fewer chances of making a baby because not all eggs collected end up as babies. For example, I produced six eggs in one IVF cycle. Three died during the fertilisation process, one became my daughter and the other two were popped in the freezer for later.

Fairfax Media health editor Julia Medew reports that another cost-saving measure, employed by the Queensland clinic, is replacing the general anaesthetic for egg retrieval with weaker painkillers such as Panadeine and nitrous oxide gas.

‘‘It’s just two quick stabs with a needle,’’ said David Molloy, clinical director of Queensland Fertility Group. ‘‘Some patients find it pretty rugged, but the vast majority of patients tolerate it extremely well. It’s one of life’s little compromises. Patients are prepared to put up with a little bit of discomfort in return for having access to a program they previously thought was unaffordable.’’

As an IVF veteran, the thought of undergoing an egg collection operation with little more than headache medication seems barbaric. IVF is a serious medical procedure. It’s not like choosing between a standard massage or the deluxe hot stone, essential oil, pressure point experience depending on your budget.  

It’s worrying that even something as commonplace as a general anaesthetic becomes a luxury for rich women, while poorer women have to put up with ‘‘one of life’s little compromises’’.   

The low-cost IVF procedure highlights the extent to which IVF is just another business, and in the case of The Fertility Centre in particular, it’s a public company whose primary responsibility is to make money for its shareholders.

Despite the emotion of trying to make a baby and the desperate baby hunger that can drive us, we need to remember that IVF is, unfortunately, a commercial transaction.

We need to be mindful of the marketing spin from both the top and the bottom ends of town and do our research to determine if ‘‘value for money’’ is indeed value for money.

Kasey Edwards is the author of four books: 30-Something and Over It; 30-Something and the Clock is Ticking; OMG! That’s Not My Husband; and OMG! That’s Not My Child.

25 comments

  • Whenever I see articles about IVF, it is always about the private clinics. There are other way-more-affordable programs available.

    My wife and I opted to undergo IVF treatment at Westmead Fertility Clinic. Out of pocket cost for first cycle was less than a thousand (approx. $800 from memory). Subsequent cycles within the same calender year is significantly cheaper - due to Medicare safetynet.

    Were private clinics the only option available, we would never have been able to afford IVF. But thanks to Westmead, we are now expecting our first child, after undergoing 2 cycles. Its a public hospital, so you can rest your guilt about being blessed with a child via fattening some shareholders' wallets. (and don't worry - nothing they did was barbaric)

    Commenter
    Tee
    Location
    Sydney
    Date and time
    June 14, 2013, 10:41AM
    • Unfortunately those clinics don't cover all needs. You're screwed if you don't fall into the standard IVF bucket. When it is severe or complete male factor infertility, as in our case, that requires surgical sperm retrieval and possibly donor sperm, clinics like Westmead just don't offer these services. Only the private clinics do (and even then, only a few of them). Those procedures cost extra too.

      Commenter
      Not an option
      Date and time
      June 14, 2013, 12:58PM
    • @Not an option Location Date and time June 14, 2013, 12:58PM - Your comments about Westmead Fertility clinic doesn't offer treatment for severe or complete male factor infertility that requires surgical sperm retrieval and donor sperm are completely false. Check out their website, they do offer these services for male factor infertility.

      We've had sperm PESA/TESA retrieval at the Westmead Fertility clinic that showed no sperms and have had to have surgical sperm retrieval at a later date where some sperms were recovered. If my sperms were not found we'd have opted for donor sperm instead which they also offer. We've discussed this option with their counselor. We have now completed our 2nd ICSI cycles with Westmead with enough frozen embryos for future use. We've strike success on our 2nd ICSI cycle and my partner is now 7 weeks pregnant.

      As Tee above mentioned, people are too focused on the private clinics. There are other options apart from these private clinics.

      The staff at Westmead were fantastic. We were consulted & update all the way through the process. BTW egg retrieval is done excactly the same way as those expensive private clinics.

      Commenter
      Plenty of Options
      Location
      Sydney
      Date and time
      June 14, 2013, 4:05PM
  • Yes, well we all know that Labor slashed IVF rebates in 2010 (http://drmarkbowman.com/2010/08/cuts-to-ivf-reimbursement-leads-to-less-babies/ ). Disgusting with Gillard's party attacking single mothers and women like my wife with reproductive problems that she has the gumption to charge others with misogyny. Most women who need IVF aren't rich, selfish execs who've put off kids. They're mostly young women from all income groups with health problems like PCOS etc.

    Commenter
    JohnW
    Date and time
    June 14, 2013, 10:42AM
    • John,

      Read my comment above
      It's still affordable
      If you know where to look
      Stop politicising everything.
      If you want to go there, I think you need to fear the Libs more, in terms of cuts to health spending.

      Commenter
      Tee
      Location
      Sydney
      Date and time
      June 14, 2013, 10:52AM
    • Nobody 'needs' IVF. Access to public funds to support extraordinarily expensive 'treatment' for infertility is a privilege, not a right. What an absurd situation we have in this country, where people availing themselves of IVF can get tens of thousands of dollars in taxpayer-funded treatment, while dental care is unsupported by a public option. We should, as a society, be far more interrogative about this trend for IVF clinics to promise a cure to all our infertility woes, to sell this idea that any couple can realise their dream of having a child by going through this invasive, expensive process, and far more realistic about the simple fact that not everyone is going to be able to have a child, and that's perfectly acceptable.

      Commenter
      Woobie
      Date and time
      June 14, 2013, 11:15AM
  • Kasey,

    Thank you for the article. As an IVF husband veteran I empathise with the issues. The financial burden is not a welcome factor at a particularly harrowing time in life. The costs can quickly escalate even further if you start having surgery and/or treatment for conditions which have an impact on your fertility (both partners). Especially when they are recently discovered factors, or still experimental. Our costs at times were over $10,000 per cycle and in those days no private health covered costs. While we were fortunate enough to be able to continue the effort almost unabated for 8 years, it meant my wife was basically unable to work during that time. Alas we were not blessed. I am happy for you daughter, congratulations.

    Commenter
    Al
    Location
    Melbourne
    Date and time
    June 14, 2013, 10:48AM
    • "It’s worrying that even something as commonplace as a general anaesthetic becomes a luxury for rich women, while poorer women have to put up with ‘‘one of life’s little compromises’’. "

      So you would prefer that IVF remain a luxury for rich women while poorer women put up with no treatment at all?

      Anyway, calling a general anaesthetic "commonplace" is very dismissive of what is a major procedure with inherent risks and after-effects. The non-general anaesthetic approach may involve some discomfort or pain, but also involves less risk.

      Commenter
      The Bunyip
      Location
      Perth
      Date and time
      June 14, 2013, 11:02AM
      • IVF is a medical procedure, like many others. Obviously it isn't exactly the same, but I can get my wisdom teeth out under general anaesthetic or I can get them out under a local. I can get surgery at a public hospital and wait however many months or I can get it at a private one, pay more and get it done much quicker. If I go for the best eye surgeon in Australia it costs me more than getting it done at my local hospital. Private medical care is a business, plain and simple. So why the faux outrage at being given a price list or that a procedure which is done under general anaesthetic at one clinic is done with a local at another?

        Commenter
        Hurrow
        Date and time
        June 14, 2013, 11:04AM
        • Exactly. I had my wisdom teeth out at the dentist's office with a local and yes, it was really painful. You know what? It was years ago. I'm over it. By the next day I was over it. If you can't handle pain at the start of the whole thing then what are you going to do during childbirth? I hear that's pretty painful too. Not to mention, generals carry risks and require much more recovery than locals.
          I don't believe everyone has a right to have a child. I agree it's sad that rich people can afford more in life than poor people, no doubt about it, but I don't believe getting every woman pregnant should be something we as a society devote our time and money to.

          Commenter
          Alice
          Date and time
          June 14, 2013, 12:21PM

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