How much does IVF cost in Australia?

Having a baby can be an exciting time, but for many Australians, conceiving a child can be challenging. Many mums-to-be need medical assistance to conceive, often through in vitro fertilisation (IVF). In fact, around 5% – almost one in 20 babies, born in Australia require assisted reproductive technology according to a report by the University of NSW.

If you’re about to embark on an IVF journey, or are in the process of weighing up your fertility options, you’re no doubt wondering what it costs and whether you will be covered by insurance or Medicare

What does IVF involve?

In vitro fertilisation (or IVF) is a technique that aims to help women become pregnant. The process involves removing eggs from the ovaries, which are then fertilised with sperm in a laboratory. Usually, one fertilised egg, also known as an embryo, is then implanted into the woman’s uterus.

There are a few stages to the IVF process. They include:

• Initial consultation. During this appointment, your fertility specialist will look at your medical history and provide initial advice on your treatment options. From there, you will be given a treatment plan.

• Ovulation induction. You will administer hormone injections daily to stimulate your ovaries to produce more eggs. Throughout this step, you will have ongoing monitoring to check your follicle (or egg) production. Once you have an adequate amount of eggs, you will administer a ‘trigger’ injection, ready for egg collection.

• Egg collection. Your eggs will be collected at a day surgery under general anaesthetic. Sperm will be taken from your partner, or sperm donor, that morning so that the eggs can be fertilised immediately.

• Embryo development and transfer. Depending on the success of your embryo development, embryo transfer usually takes place five days after egg collection. Any extra embryos can be frozen.

How much does one round of IVF cost?

IVF cost in Australia varies considerably, depending on your individual circumstances, where you live, what services and treatments you require, whether or not you have private health insurance, and what coverage is available from Medicare.

According to IVF Australia, one IVF cycle can cost $11,566. The out-of-pocket expense could be about $6,029 on average for a first cycle of treatment.

The cost of the first round of IVF depends on whether you’re using a fresh or frozen embryo, according to Monash IVF. It can also vary significantly between clinics. Keep in mind that you might need more than one round of IVF to fall pregnant, with IVF success rates ranging widely, according to IVF Australia. You may also pay money for IVF services but not successfully conceive a child.

What are the major treatment costs for IVF?

Here are some estimates of typical IVF costs:

Ovulation induction: $397 for the first cycle out-of-pocket, and about $255 for subsequent cycles. An IVF cycle is one round of treatment, which starts with the first day of menstruation. In this stage of an IVF cycle, women may have 1–3 shots a day of self-administering hormones. This fee does not usually include IVF-related medications.

The first IVF cycle in the calendar year: about $11,566, or $6.029 out of pocket for the first cycle. Allow around $5,346 for subsequent cycles. These fees may not include day surgery fees or an anaesthetist, which together can cost an additional $2,000. If you have private health insurance, you may be covered for this cost. Day surgery fees (required for egg collection) are not covered by the Medicare rebate).

Frozen embryo transfer: The cost for a frozen embryo transfer (FET) can be $4,212 with about $2,702 of this as an out-of-pocket cost for the first cycle, and $2,474 for subsequent treatments, if required.

Medicare rebates may be available. It is a good idea to talk to your GP if you are considering fertility treatment and are seeking professional medical advice to support you in evaluating IVF providers that may offer suitable services, based on your personal medical needs.

What extra costs are there to consider with IVF?

Based on fees charged by IVF Australia, one of the largest fertility clinics in the country, here are some estimates of additional costs to consider in the IVF process:

Freezing embryos is around $625 for six months of storage.

Freezing sperm is about $475 for six months of storage.

Surgical sperm collection is up to around $850.

An ICSI cycle, (an intracytoplasmic sperm injection) might be needed by some couples as an additional step in their IVF process. This involves a single sperm being injected into an egg to assist in fertilisation. This can cost $12,526, with roughly half of this amount usually an out-of-pocket expense.

Some IVF medications are covered by Medicare and some are not. The type of medication you are prescribed varies depending on your situation. It is best to check with Medicare, your doctor or your pharmacist once you have been prescribed your medication.

Is IVF covered by Medicare in Australia?

Some of the costs of IVF are likely to be covered by Medicare, providing a doctor refers you for fertility treatments, according to Services Australia (formally Centrelink). However, there are also likely to be out-of-pocket costs, too This will depend on a range of factors including the different types of treatments, services and tests you need, your doctors’ fees (if they bulk bill or charge more than the amount Medicare will cover), and whether or not you have private health insurance. It could be a wise idea to find out a cost estimation from your doctor (and private health insurance provider) before starting any treatment plan.

You may also be eligible for other rebates during the IVF process, depending on your home state. In NSW for example, women who have received an eligible fertility treatment from 1 October 2022, can submit a claim for a one-off $2,000 rebate. Make sure to speak with your preferred fertility clinic to know what you are covered for under Medicare in your state.

The Medicare Safety Net also provides additional rebates on certain items for those who are facing large medical bills. This means once you have paid over a certain amount on medical bills in a calendar year, Medicare will pay an additional rebate on selected items. The Medicare Safety Net threshold is currently $560.40. Once you are out of pocket by more than this amount, you may be eligible for an increased rate of Medicare benefits.

If you are a concession card holder or are part of a family that receives the Family Tax Benefit Part A, you may be eligible for the Extended Medicare Safety Net (EMSN). This has an annual threshold of $2544,30, which means you could be eligible to receive 80% of out-of-pocket costs or the EMSN benefit caps for out-of-pocket hospital services.

To make a claim with Medicare, you will need a GP or specialist referral.

Bulk-billing IVF clinics

A number of fertility clinics offer bulk-billed IVF in Australia. These clinics typically cover all Medicare-eligible expenses including blood tests, ultrasound scans, GP consultations, egg and sperm collections, cycle fees, embryo transfer and pregnancy tests. However, there are other expenses that you are typically required to pay to cover services that are not on the Medicare schedule.

Your out-of-pocket expenses with these bulk-billing clinics can start at around $1,500 per treatment cycle. However, it is important to enquire about services you may have to pay for as part of the treatment plan, as well as costs associated with the storage of eggs, sperm and embryos. The type of treatment you need will also impact the cost, as will having private health insurance.

There are some eligibility conditions with bulk billing, so it’s a good idea to contact your chosen clinic before you begin the process to check if you meet their criteria. While some clinics require a GP referral, others have in-house GPs which you can book into to determine if you’re suitable for fertility treatments.

Non-bulk billing IVF clinics

For fertility clinics that do not bulk bill, you may still qualify for rebates from Medicare. The total amount Medicare will cover depends on the services you need, how much your doctor charges and whether you have health insurance. It is a good idea to talk to your doctor, specialist and insurer to find out what costs are involved and what your insurer and Medicare will cover.

Can you pay for IVF by withdrawing money from super?

Under certain circumstances, it may be possible to apply to pay for some of the costs of IVF by applying to access your superannuation on compassionate grounds. The Australian Taxation Office (ATO) has information about eligibility for the compassionate release of super.

Is IVF covered by private health insurance?

Private health insurance may help reduce the costs of in-hospital expenses associated with IVF treatment, which are not covered by Medicare. The level of private health hospital cover you have will determine whether you are covered for assisted reproductive services such as IVF, and the level of rebate you will receive.

According to privatehealth.gov.au, a gold tier of hospital cover is the only level that includes assisted reproductive services cover. Some health funds may also provide hospital cover for these services under other tiers. However, this cover may be restricted, meaning there may be out-of-pocket costs. You can compare gold tier hospital cover on Canstar’s database.

It’s a good idea to speak to your insurer directly regarding what is and isn’t covered under assisted reproductive services before proceeding with treatment. It’s also a good idea to understand any waiting periods associated with your cover. Cover for pregnancy and birth-related services are usually subject to a 12-month waiting period. If you require assisted reproductive services but you aren’t deemed to have a pre-existing condition, the waiting period may be as little as two months.

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What are the success rates of IVF in Australia?

According to IVF Australia, a woman undergoing an IVF cycle currently has about a 38.9% (two in five) chance of becoming pregnant if she is aged under 34 years, or a 5.6% (one in 20) chance per embryo if she is aged over 43 years.

As success rates can vary significantly between individuals with fertility treatment, it’s a good idea to speak to your GP or specialist about your options if you are considering whether IVF, ICSI or other assisted reproductive technologies may be suitable options for you.

The Australian Government has a website, YourIVFSuccess, that you can use to estimate your chance of success to support in your decision-making. The website includes an IVF Success Estimator that can help you to estimate your chance of having a baby using IVF, based on data from women who’ve undergone IVF in fertility clinics across Australia.

Cover image source: Natalia Deriabina//Shutterstock.com