A review of the fertility sector has called for urgent reforms to address the falling birth rate, and improve access to assisted reproductive technology (ART) like IVF.
A new report from the Fertility Society of Australia and New Zealand (FSANZ) said demand for ART is expected to “exponentially increase” over the next decade.
FSANZ has put forward a roadmap aimed at future-proofing the sector and boosting support for “non-traditional” families.
Birth rate
Australia’s birthrate has fallen from 3.5 children per woman in 1960 to 1.63 in 2022.
This is associated with the rising median age for women giving birth, which reached 31.9 years old in 2022 (up from 25.4 in 1971).
FSANZ said this was tied to heightened fertility challenges and was contributing to increased demand for assisted fertility.
The rising number of same-sex couples and solo parents has also contributed to demand for ART, it said.
In 2021, there were 18,594 babies born in Australia through In Vitro Fertilisation (IVF). Nationally, it’s the most commonly used form of assisted reproductive technology.
This week, FSANZ – the peak body for reproductive medicine – released its proposed 10-Year National Fertility Roadmap.
The report was co-authored by former Health Minister Greg Hunt and public health expert, Doctor Rachel Swift — who called for immediate action “to ensure the system is well placed” to address future ART demand.
Discrimination
FSANZ noted that IVF treatment can cost up to $10,000 per cycle.
While some Medicare access is available, it said clinical definitions of infertility had caused “long-standing barriers to access,” including discrimination.
In clinical settings, ‘infertility’ is described as: “The inability to conceive after one year of regular, unprotected intercourse.”
The roadmap said this definition restricts same-sex couples and solo parents from accessing Medicare benefits.
The roadmap recommended updating this to ensure “non-discriminatory access to IVF and ART.”
This would allow more people and “non-traditional” families to access Medicare support “regardless of relationship status or sexual orientation”.
FSANZ also recommended establishing public IVF units or boosted subsidies to support more patients, including low-income families.
Governance
FSANZ suggested national fertility legislation to streamline regulations that differ between states and territories.
It called current inconsistencies a “primary concern” that “significantly impacts children, parents, donors, and the cost of ART in general, and, IVF in particular. “
The report called on Health Ministers to support the roadmap, “ensuring consistent legislation across the nation, leading to improved and more equitable outcomes for Australian families.”
Donations
The report suggested establishing a national register and genetic bank to centralise genetic information of donors and donor-conceived children.
It recommended national health standards for egg and sperm donation, “to ensure consistency and safe futures for children conceived by ART”.
FSANZ argues these approaches, as well as updating the clinical and legal definition of ‘infertility’, would ensure consistent reproductive and privacy standards around the country.
Advocates
Leading IVF and fertility service group City Fertility supports FSANZ’s calls to update the definition of ‘infertility’ —
which it said could eliminate “roadblocks” for many families.
“LGBTQIA+ patients have historically been required to pass significantly more hurdles to ‘prove’ their infertility status to access Medicare funding,” City Fertility said.
It called for improved engagement between the LGBTQIA+ community, clinical experts, and policymakers to better address this issue.
Response
A spokesperson for Health Minister Mark Butler said that the Government would carefully consider the report.
Shadow Health Minister Anne Ruston said the Opposition was also examining the findings and recommendations.
Ruston acknowledged that “more work” was needed to improve policies. She said it was “important to recognise the difficulties” faced by Australians dealing with infertility challenges.
