Having a baby can be an exciting time, but for many Australians, conceiving a child can be challenging too. Many mums-to-be need medical assistance, often through in vitro fertilisation (IVF). In fact, almost one in 20 babies in Australia is born as a result of IVF, according to a recent report, while one in six couples in Australia and New Zealand experience infertility.
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 for fertilisation 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 costs vary considerably, depending on your individual circumstances, what services and treatments you require, whether or not you have private health insurance, and what coverage is available from Medicare. According to Canstar Research, one IVF cycle can cost over $8,000 on average. The out-of-pocket expense could be about $3,380 on average.
The cost of the first round of IVF depends on whether you’re using a fresh or frozen embryo, according to Members Health Fund Alliance. 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, based on fees charged by IVF Australia, Genea Clinic and Monash IVF –- three of the largest fertility clinics in Australia.
- Ovulation induction: $700 per cycle out-of-pocket. 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, self-administering hormones. This fee does not include IVF-related medications.
- The first IVF cycle in the calendar year: between $8,800 to about $10,600, with the out-of-pocket expense ranging from about $4,480 to about $5,330. These fees do not include day surgery fees or an anaesthetist, which 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 average cost for a frozen embryo transfer (FET) is $3,600, with about $2,201 of this as an out-of-pocket cost, on average.
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?
There are some estimates of additional costs to consider in the IVF process, based on fees charged by IVF Australia, Genea Clinic and Monash IVF –- three of the largest fertility clinics in Australia:
- Freezing embryos: up to $915 for six months of storage
- Freezing sperm: up to $450 for six months of storage
- Surgical sperm collection: up to $850
- ICSI cycle: some couples may require intracytoplasmic sperm injection (ICSI) as an additional step in their IVF process. This involves a single sperm being injected into an egg to assist in fertilisation. This costs between $9,694–$11,218 with roughly half of this amount usually an out-of-pocket expense.
- IVF medications: Some IVF-related 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. However, the government agency states there are also likely to be out-of-pocket costs, too, depending 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 the state. In NSW, residents undergoing pre-IVF fertility testing can receive $500 in rebates. To be eligible, a specialist must confirm you have fertility issues and you must have proof of out-of-pocket expenses related to fertility testing (which also needs to have occurred from 1 October, 2019).
According to Canstar research, roughly 59% of IVF costs can be covered by Medicare. There is no Medicare rebate available for specialist day hospital procedures, according to the IVF Australia website, and this can include egg collections and embryo transfer. While they’re not covered by Medicare, you may have cover for day hospital procedures through your private health insurance, so it’s a good idea to speak with your provider.
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 $2,184.30 for 2021, meaning 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 $697, 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
There are a number of fertility clinics who 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 which are not on the Medicare schedule.
A survey by Canstar of three bulk-billing clinics found that the average out-of-pocket expense for these clinics starts around $1,000 for the first cycle. There could also be medicines which you may have to buy 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 who 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 towards IVF by applying to access superannuation on compassionate grounds. The Australian Taxation Office (ATO) has information about eligibility for the compassionate release of super. Evidence is required to support your application, and you must meet eligibility requirements that are set by the ATO, such as not having paid for the expense yet. The ATO says that if you’re applying for a second or later IVF treatment, you need to provide a new or updated quote each time.
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 Canstar Research, a Gold tier of hospital cover must include 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.
It is a good idea to speak to your insurer directly regarding what is and is not covered under assisted reproductive services before proceeding with treatment. It’s also a good idea to understand any waiting periods associated with your cover. According to Canstar Research, cover for assisted reproductive services is usually subject to a 12-month waiting period if the reason these services are required is infertility, and this is deemed to be a pre-existing condition. 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.
What are the success rates of IVF in Australia?
A woman undergoing an IVF cycle currently has about a one in five chance of becoming pregnant, although the success rate varies quite markedly according to age and personal circumstances. 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.
Main image source: Posteriori/Shutterstock.com
Additional reporting by Jacqueline Belesky.