If you’re finding it hard to conceive, you’re not alone. One in six couples in Australia live with the frustration and disappointment of infertility.
And if you’ve been trying to conceive for a while, you might now be thinking about trying IVF, or in-vitro fertilisation.
We look at some common questions you might have about IVF and fertility services, and what private health insurance covers.
Why are infertility rates rising?
The number of couples experiencing infertility in Australia is rising. While infertility can be caused by health issues in either the female or male partner, the leading contributor is the fact that many women are having babies later in life, says Melbourne IVF fertility specialist Dr Kokum Jayasinghe.
As women age, their chances of conceiving falls over time, Dr Jayasinghe says. In fact, a woman’s age is the single most important factor that affects a couple’s chance of conceiving.
The other main cause of infertility is being overweight, which is linked to polycystic ovarian syndrome, or PCOS. Women with this syndrome have irregular menstrual cycles and don’t ovulate, so they find it harder to fall pregnant.
Surprisingly, the other problem is being underweight. “Sometimes being a gym junkie can bring your Body Mass Index or BMI under a healthy level. These women also have irregular cycles and a lack of ovulation,” Dr Jayasinghe says.
Should IVF be your first option?
If you’re finding it hard to become pregnant, there could be a lot of reasons why, and you might not need IVF straight away, Dr Jayasinghe says.
“It’s important for people to understand that infertility is a common problem, and a number of treatment options may be available,” she says.
“IVF is an option, but it’s not the only option. There may be other, more simple things we can do to help.”
For example, if a woman has irregular cycles and has PCOS, she would need ovulation induction rather than IVF.
If you’re having trouble conceiving, your first step should be to see your GP, who can conduct some preliminary tests. Depending on your medical history and test results, your GP will work out if and when you need to see a specialist.
Whether a couple needs to start IVF right away depends on their ages and how long they’ve been trying to conceive, Dr Jayasinghe says.
“If a woman is of an ‘advanced maternal age’ – for example in her 40s - and has been trying to conceive for three to five years, then she would move onto IVF straight away.”
What’s the difference between public and private fertility treatments?
The fertility services you can access will depend on where you live - in some areas, there are both public and private clinics.
Private clinics give you the option of seeing the doctor of your choice. As well as choosing your doctor, you’ll see that same doctor for the entire period of your treatment.
“I see all my patients, organise the investigations, go through the results, work out whether there is a correctable option, and carry out any surgery if necessary,” Dr Jayasinghe says.
If you choose to go to a public fertility clinic, you’ll be looked after by a team of doctors, rather than the same doctorthroughout your treatment.
For instance, if you have an egg collection or embryo transfer - the two most important procedures in IVF – the doctor who is rostered on that day will perform the procedure.
And not all services are available through the public system. For instance, elective egg freezing and embryo testing are only available in private clinics.
How much does IVF cost?
The cost of IVF depends on which procedures you have.
Most fertility clinics will show the entire IVF treatment cycle costs on their websites, plus costs for all aspects of your fertility treatment, including the expected out-of-pocket costs.
The rest of the fee covers other staff at the clinic – administration, nursing, blood collection staff – and the cost of the lab, staff and equipment.
How much can you claim through your health fund?
The amount you can claim back on fertility procedures depends on your health fund and your level of private hospital cover. You’ll also need to serve any waiting periods.
A small portion of IVF and fertility treatments are performed in hospital (as an in-patient). This may include hospital visits for the egg collection and the embryo transfer. This portion is claimable from a member’s hospital cover, and can be claimed from your health fund. It will include your hospital stay, as well as part of the fees for the surgeon and the anaesthetist while receiving care in hospital.
However, the majority of treatment and care is provided as an outpatient, and these services may be entitled to rebates from Medicare (not from your private health insurance cover). This includes telehealth consultations and any regular appointments with your specialist.
You can review CUA’s cover for assisted reproductive services here.
How successful is IVF?
A woman’s chances of a successful pregnancy through IVF depends mostly on her age. If you’re aged under 35, then there is about a 40 per cent chance of success with a single embryo transfer, Dr Jayasinghe says.
However, if you’re in your 40s, you may have poorer egg quality and face several other hurdles before a healthy embryo can be transferred.
“For a woman who is 45, you have about a two to five per cent chance of a successful pregnancy, and we may even need to talk about donor eggs,” she says.
“At 46, we stop doing IVF with a woman’s own biological eggs, and you really need donor eggs”.
Do all clinics offer a range of fertility treatments?
All fertility clinics are different.
Some clinics only offer IVF, while others provide a broader, more comprehensive range of reproductive services – so it’s important to be referred to a specialist in a clinic that offers the treatment options that are best suited to your needs.
Your GP is a good person to discuss this with initially.
What to do next?
Trying to get pregnant can be a stressful time for many couples, and feelings of anxiety, frustration and sadness are common.
If you’re one of the many couples in this situation and you’d like to investigate your options, then discuss this initially with your GP. They’ll be able to provide advice and potentially refer you to local reproductive services to assist and support you and your partner further.
It’s best to contact a few specialists before booking an appointment, as you may experience delays if a specialist has a waiting list. Unfortunately, your health fund can’t control waiting times, so it pays to research a few specialists to have some options.
Dr Kokum Jayasinghe is a fertility specialist with Melbourne IVF
