Health: It just a matter of priorities – IVF and Autism


Before I start I know that this is going to be controversial … but hey … sometimes you need to be controversial to get people talking … and draw out problems in the system. Love to hear your opinions … including if you hate mine :)

… I have chosen a controversial topic this time. And before I start … I actually do agree with IVF being partially funded (as it is today) … but if I had to be the health minister and I had to put my priorities lists together … well it would be lower down … and maybe that would mean it didn’t get funding. I just want to say that I do have tremendous sympathy for families with infertility issues and the street and heartache that this can cause … but I am sorry … but my sympathy is more for a family with a child with autism. A family that struggles everyday with their child with a medical condition that has no ‘real’ government funding … that may have to cash out their superannuation, get a second mortgage .. or just dry out their finances to pay for the required therapy … or worse … know what they need and just can’t afford it … and do what the government institutions offer which can be a 12 month wait for services that are at best less than 10% of the minimum requirement (as outline in the Government’s own guidelines). Why should IVF get unlimited funding … and autism gets left out in the cold?

In a previous post I started what I hope to be a series of posts showing comparisons between funding for Autism and other medical conditions. What I hope to show are the inequities that exist within the current system. I don’t believe that there should be a distinction between conditions dependent on whether they are treated by doctors, drugs and hospitals or by other health care professionals (ie Allied Health care professionals such a psychologists, Speech Pathologists and Occupational Therapists). But in this post I am asking the question … should treatment for infertility (IVF – in-vitro fertilisation) be given priority (and therefore funding) over other conditions (like autism …. that currently doesn’t). Why should a condition that may have no health detrimental effect be given priority for funding (without cap) over a condition that effects every aspect of a person’s life and can be the difference between them living a full and independent life … or instutitionalised? Does it make a difference if the need for IVF is because of ‘lifestyle’ choices (whatever they maybe) … why should government funding (or health insurance funding) be provided for these treatments over autism … So for today’s post I am doing a comparison between IVF and Autism – government funding, health insurance funding … and everything in between.


What do we know about IVF?

  • In vitro fertilisation is the most common assisted reproductive technology in Australia, costing on average $7000 to $8000 a cycle.  (SMH). However prices are not set it is not uncommon for costs to be over $10,000 per cycle dependent on the technologies used, prices for specialists and required drug therapies and unique health requirements. (Huggies)
  • IVF is the process of uniting a sperm and an egg together in a dish at a laboratory. Once the egg and sperm are united, they will be injected into the uterus via the cervix in the hopes that a pregnancy will occur. IVF is performed in cycles and each cycle involves 6 steps. Each time these six steps are completed, it is considered one cycle and one cycle is considered to be one attempt at achieving a pregnancy.(
  • Medicare subsidies for IVF tripled between 2003 and 2007 to $158.7 million, though they have since been restrained by new caps on entitlements last year.Under the new policy, patients and doctors said out-of-pocket costs doubled from about $1000 to $2000 a cycle. (SMH)
  • IVF is not means-tested under Medicare and there is not a limit on the number of cycles funded under Medicare. There is also no age limit or age cap.
  • According to a recent report by The Australian Institute of Health and Welfare report in Australia and New Zealand in 2009 (AIHW)
    • there were 70,541 assisted reproductive technology (ART) treatment cycles undertaken in Australian and New Zealand. Of these cycles, 17.2% resulted in a live delivery (the birth of at least one liveborn baby).
    • The average age of women undergoing autologous (treatment cycle in which a woman intends to use or uses her own eggs) cycles was 35.8 years. One in four (26.8%) autologous  fresh cycles undertaken in 2009 was in women aged 40 years or older. Women of this age (40-45) using donor eggs where found to have 6.8% chance of live delivery from initiated cycle and women over 45 were found to have 0.5% chance of live delivery from initiated cycle.
    • The average age of women undergoing treatment using donor oocytes/embryos was 40.8 years. Women of this age using donor eggs where found to have 8.3% chance of live delivery from initiated cycle.
    • For women aged 45 years or older, only one live delivery resulted from every 200 initiated cycles.

Therefore to bring it back to the simple numbers in 2009

  • For women aged 40 years – 45 years from the
    • Fresh 10771 cycles  … it resulted in only 6.8% live births.
    • Thawed 4082 cycles  … it resulted in only 9.7% live births.
    • Donor 765 cycles  … it resulted in only 19% live births.
  • For women aged over 45 years
    • Fresh  851 cycles … it resulted in less than 0.5% live births
    • Thawed 290 cycles … it resulted in only  2.4% live births.
    • Donor 570 cycles … it resulted in only  14.7% live births.
What I am suggesting that while I have great sympathy for people who have difficulties with conception and I recognise that it is a medical issue that causes it … why should it get priority for funding with cap or measure ahead of conditions like Autism. Looking from a perspective of society as a whole is this a better investment with our health dollars. Different research projects have shown that early intervention is extremely effective in treating children with autism and that the return to society over the children’s lifetimes up to $2.5 million per child (future savings minus current costs).
“Our findings provide strong evidence that sustained high-quality early childhood programs can contribute to well-being for individuals and society,” said Arthur Reynolds, director of the Chicago Longitudinal Study and co-director of the Human Capital Research Collaborative at the University of Minnesota. “As public institutions are being pressed to cut costs, our findings suggest that increasing access to high-quality programs starting in preschool and continuing into the early grades is an efficient use of public resources.” (Science Daily)

I wish that there was enough funding for everything but their isn’t. I just can’t understand why should an expensive elective procedure with very low success rates like IVF gets preference over treatment for Autism …

Comparison Summary

Costs of therapy (per individual)

  • Autism – Approximately $60K per year (during early intervention years)
  • IVF – Costing on average $7000 to $8000 a cycle. Rates are not set and can be over than $10,000 per cycle for specialist treatment options.

Funding by Government (estimates for 2010-2011)

  • Autism – $47.5 million ($190 million over 4 years)
  • IVF $158.7 (2007) uncapped.

Funding to Individuals

  • Autism – up to $6000 per financial year with a lifetime cap of $12,000
  • IVF – Approximately $5000 per cycle under Medicare. There are no limits on the number of cycles per year and there are no lifetime limits on the number of cycles. Additional funding can be available under health insurance and together with Medicare may result in no out of pocket costs expenses.

Does this really seem fair?? I understand that health care decisions can be difficult … but if there is enough money to fund IVF … there should be more than enough to fund therapy for children with autism.

Photo:IVF BUB…. by Nina Matthews Photography, on Flickr Attribution 2.0 Generic (CC BY 2.0)