Michel Margalit: IVF today isn't only medicine, it’s big business. So how do patients protect themselves?
In the commercialised world of IVF, mishaps run rife, scientists go unregulated and nondisclosure agreements get signed in exchange for compensation. So how do vulnerable patients – viscerally desperate to become parents – protect themselves?
The mug sitting on my IVF specialist’s desk said: “Please don’t confuse your Google Search with My Medical Degree”. Ordinarily, I would consider this to be a sensible statement, but in the commercialised world of IVF, it reflects a deeper problem. If not Google, how does a patient protect oneself?
The field of IVF medicine has moved away from traditional concepts of patient care to a high-volume model akin to ‘six-minute medicine’. I should know. Every week, my firm hears heartbreaking stories of dropped embryos, destroyed vials of sperm, infected embryos, donor sperm problems, medicine mix ups and scientifically unsupported IVF treatment causing permanent injuries.
IVF patients are particularly vulnerable. By the very nature of embryos being microscopic, patients must put their complete faith in their fertility provider. That the IVF provider did in fact transfer the embryo, undetectable to the eye. That they did in fact use the correct embryo.
Many IVF patients have a visceral desperation to have a baby. They will meet any expense, any measure, because our societal values tell us a good parent will do anything for their family, including accessing superannuation to pay for treatment.
IVF today is not only medicine; it’s big business. Theoretically, there is the perverse incentive that ongoing unsuccessful rounds of IVF allow corporations to achieve greater profits.
The potential to achieve profits goes well beyond the obvious treatment of injections and embryo transfers. There are the ever increasing ‘add-ons’: embryo glue, cervical scratch, preimplantation genetic testing.
Then there are embryo storage fees, which patients feel obligated to continue to pay, because they don’t see those embryos as inanimate but as a life. All the while, IVF providers earn passive income on storing those embryos.
Another opportunity to earn big bucks is patented medical technology. The discovery of new science doesn’t just mean an altruistic medical development. It means a marketing angle.
Much of the IVF process is under the care and responsibly of scientists, not doctors. Doctors are regulated by the Australian Health Practitioner Regulation Agency. Scientists are not. The only thing preventing a wayward scientist from continuing to work in IVF is reputation – profoundly inadequate considering all that is at stake.
Government intervention and regulatory reform is desperately needed in the IVF space. Currently, the regulations require IVF providers to self-report certain types of mishaps. But in a world where nondisclosure agreements are commonplace and signed in exchange for compensation, can we really be sure that this self-reporting is occurring?
Regulation needs to move beyond taking the IVF provider at their own word. IVF providers need to be put to task before something goes wrong, not after.
IVF remains one of the most important medical advancements of our time. I personally have IVF to thank for my own two sons. But the IVF industry has grown faster than its protections. No patient undergoing fertility treatment should have to rely on Google, blind trust, or luck.
Michel Margalit is Managing Principal at Margalit Injury Lawyers
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