AN Australian study into the commercialisation of in-vitro fertilisation has raised concern some fertility doctors are putting their financial interests ahead of their patients.
The authors of the paper, published in journal Human Fertility, say they found evidence of conflicts of interests among some doctors working within commercial IVF clinics.
This can manifest in couples being offered IVF who don’t actually need it or being offered repeated cycles of treatment even whey they aren’t likely to succeed, says lead author Dr Brette Blakely, a bioethicist at the Australian Institute of Health Innovation at Macquarie University.
“This is obviously significant, not only in financial terms due to the cost to patients – and the government – of multiple cycles, but also the physical and psychological impact on the woman because ovarian stimulation and egg retrieval may be harmful in the short term and potentially the longer term,” said Dr Blakely.
A round of IVF can cost up to $12,000 in Australia and there is currently no Medicare limit to the number of cycles that can be reimbursed or the age of the woman receiving IVF.
Dr Blakely says even with such rebates, there is an out of pocket per cycle cost, which can vary from a few hundred to many thousands of dollars, depending on the actual fees set by individual doctors.
With an estimate that one in 25 babies now born in Australia have been conceived using ART, Dr Blakely says there is a need to further investigate the commercialisation of the industry.
Leading fertility specialist Professor Bill Ledger, who does work for IVF Australia, concedes there may be a rare number of doctors putting their financial interests first but believes there is no cause of alarm.
He says often the problem is convincing couples with a strong desire to have a baby that its time to stop the endless rounds of “fruitless” IVF.
“OK we make money when we do a cycle of IVF but most of us are phenomenally busy. We have plenty of patients. We are not looking for more work,” said the head of obstetrics and gynaecology at the University of New South Wales.
For many women, particularly the older ones, IVF is like gambling on a “lottery ticket” and most fertility doctors are not good at saying no to people, says Prof Ledger.
“You spend your whole life as a doctor trying to help and admitting that you’ve got nothing left is a tough place to be,” Prof Ledger told AAP.
“I’ve not seen doctors really pushing patients when they want to stop. We’re delighted when they want to stop when it’s an appropriate time.”