UNSW to produce Australian database on success of fertility clinics for the first time

A new tool that compares the success rates of fertility clinics will be launched for the first time, giving Australian couples more information than ever before.

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Some IVF clinics have success rates as low as 9.3 per cent while others are as high as 33.2 per cent but couples desperate for a child can’t access this vital information.

News Corp can reveal that from the middle of this year a new database that compares the success rates of individual fertility clinics will be launched for the first time allowing couples to choose the best performing operators.

It will include data on the live birthrates and the pregnancy rates at individual clinics.

Couples will also be able to use a new online predictor tool that will help them calculate their chance of having a baby when they provide information on their age, weight, number of previous IVF attempts and other factors.

The new information to be provided by the University of NSW, with federal government funding, is a major breakthrough for couples who until now have been in the dark about the success rates of individual clinics.

IVF has become a $500 million a year industry with key businesses now listed on the stock exchange. Couples undergoing IVF treatment face tens of thousands of dollars of out of pocket expenses.

IVF treatment will become easier to navigate for Australian women. Picture: Virtus Health

Medical fee comparison website Mind the Gap found in 2018 out of pocket costs had skyrocketed by up to five times the inflation rate at some clinics, with many charging up to three times the Medicare fee of and almost twice the AMA recommended fee.

The entrance of discount IVF provider Adora Fertility, which bulk bills all Medicare-eligible aspects of fertility treatment, has disrupted the sector and it now has 15 per cent of the market.

Yet couples have had no way of knowing whether the cheaper or more expensive clinics are the best.

In 2016 the Australian Competition and Consumer Commission found that major fertility clinics had made false or misleading representations about their success rates on their websites and in 2018 a Victorian Government review raised concerns about success rates advertised by fertility clinics.

The new tool that will allow couples to compare success rates of clinics comes after Centre Alliance Senator Stirling Griff pushed the industry into greater transparency.

He had threatened them with a law requiring they publish their success rates and held a Senate inquiry into the issue before the industry volunteered to make the information available.

“People are drawing money to pay for IVF and they could be drawing it ten times as quickly if they were going to the worst clinic,” he said.

University NSW’s Associate Professor Georgina Chambers who manages the national IVF database said the success rates of clinics could be affected by a range of factors including whether they took on the hardest cases, or whether they treated more older women who would find it harder to get pregnant.

The university is working to adjust clinic performance data to take this into account.

IVF SUCCESS RATES LEVEL OFF

While a record number of Australian women are undergoing IVF treatment, success rates have levelled off with only one in five initiated cycles — 21.2 per cent — resulting in a successful birth in 2017.

This measure of live birth outcomes from fertility treatment is only a marginal improvement from the 19.5 per cent recorded in 2013.

However, Fertility Society Australia president professor Luk Rombauts said what seems like a tiny improvement comes against the background of major changes in IVF treatment.

Nine in 10 women undergoing IVF now have only one embryo implanted to avoid complications from multiple births and this reduced the chance of a live birth, he said.

The age at which a woman’s eggs are harvested for use in IVF is the most important factor in successful treatment Fertility Society Australia president Dr Luk Rombauts said.

In 2018, Victoria’s IVF statistics unit VARTA revealed women up to, and including, the age of 31 years, had a 68 per cent cumulative live birthrate after receiving up to three cycles of IVF but this dropped to six per cent for women of 43 years of age.

National data shows for women aged younger than 30 years, the live delivery rate per embryo transfer was 38.5 per cent when they used their own fresh eggs, and 33.1 per cent when they used their own frozen eggs.

For women older than 44, the live delivery rate per embryo transfer was 1.4 per cent when their own fresh eggs were used and 10.6 per cent when their own frozen eggs were used.

Across the board, the national database on IVF run by the University NSW shows women are more likely to achieve a baby using frozen embryos rather than fresh embryos.

The birthrate from frozen embryos (28.9 per cent) was higher than for fresh embryo transfers (24.1 per cent) in 2017.

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Professor Georgina Chambers who directs the University NSW National Perinatal Epidemiology and Statistics Unit that collects the IVF data said the live birthrate from frozen embryos was increasing.

In 2017, the live birthrate for fresh initiated (non freeze-all) cycles decreased from 17.7 per cent to 15.6 per cent, while the live birthrate per frozen cycles increased from 21.8 per cent to 27.9 per cent during the five-year period.

Combining both fresh and frozen cycles, the overall live birthrate per initiated IVF cycle increased from 19.5 per cent to 21.2 per cent over this time, Professor Chambers said.

“This improvement in success rates occurred at the same time as a continual increase in the single embryo transfer rate which reduces the risk of multiple births”, she explained.

“The proportion of twins and triplets born following IVF treatment was 3.6 per cent in 2017 – a record low in Australia and New Zealand’s 40-year IVF history and one of the lowest rates in the world,” she said.

There are a multitude of different ways of counting the success rate of IVF treatment including by treatment cycle or by embryo transfer.

Live delivery rates per embryo transfer have risen from 23.6% in 2013 to 26.8% in 2017.

Another method that counts the number of live births per egg harvest shows a slightly bigger improvement, up from 32.1 per cent in 2013 to 34 per cent in 2017.

This measure counts the number of births from all the eggs gathered in an egg harvest (most egg harvests would gather more than one egg).

A broader view shows in 2017 of the 82,215 initiated ART cycles – ART includes all fertility treatments in which either eggs or embryos are handled – 67,704 (82.4 per cent) resulted in either an embryo transfer or all eggs harvested or embryos created being frozen.

Of the initiated cycles, 22.9 per cent (18,860) resulted in a clinical pregnancy and 18.1 per cent (14,882) in a live delivery.

Professor Luk Rombauts said the industry in Australia prides itself in maintaining live birthrates even though fewer embryos were being transplanted and the age of women undergoing IVF increased from 35 to 37 and 38 years of age.

“We’re treading water but we have got considerable challenges we are facing,” he said.

Originally published as UNSW to produce Australian database on success of fertility clinics for the first time