Victoria’s fertility clinics may be vastly underreporting the true levels of dangerous complications from IVF treatments, a government report reveals.
The industry is under intense scrutiny across Australia after it was revealed this week that a Brisbane Monash IVF clinic had accidentally implanted the wrong embryo and a woman gave birth to a child that was not biologically hers.
An embryologist at the Monash Medical IVF clinic at the Epworth Hospital.Credit: Craig Abraham
The state’s 24 licensed assisted reproductive technology (ART) clinics last year reported 149 adverse events, including 128 instances of clinical issues and 11 “scientific issues”.
The most recent disclosures were a significant increase on the 93 adverse events reported by Victoria’s fertility clinics in 2022-23, and the 107 adverse events reported in 2021-22.
However, a report by the Victorian Agency for Health Information in September 2022 found only one in five cases of ovarian hyperstimulation syndrome (OHSS) – one of the most dangerous complications from IVF – were reported by the state’s ART clinics.
Under the regulations required to maintain their licence to operate in Victoria, ART clinics must notify the regulator of any adverse incidents or sentinel events from their procedures.
Despite the requirement, the agency concluded: “The data showed significant underreporting by ART providers, who were only reporting approximately 20 per cent of OHSS incidents involving hospitalisation over the last three financial years.
“Consultation with ART providers around the results led to a change in reporting definitions, removing ambiguity around what OHSS incidents needed to be reported to VARTA.”
The state’s former fertility regulator, the Victorian Assisted Reproductive Treatment Authority (VARTA), asked the agency for health information to undertake the review of hospital admissions amid concerns IVF clinics were not reporting all adverse events experienced by their patients.
Victoria’s IVF clinics reported 107 adverse events in 2021-22, 70 adverse events in 2020-21 and 53 adverse events in 2019-20.
The Victorian government last year axed VARTA and handed regulation of the state’s ART clinics directly to the Department of Health secretary.
A Department of Health spokesperson told The Age that Victoria’s health regulator had asked Monash IVF for more information about its operations after the Queensland mistake was revealed.
“[We] will work with them to reinforce Victoria’s strict safeguards and ensure any risks are identified and mitigated,” the spokesperson said.
While a fertility clinic must be accredited by Australia’s Reproductive Technology Accreditation Committee, each clinic must also apply for a licence to operate in each state. As part of the licence review process, the Health Department secretary can impose specific conditions or even suspend a provider’s registration.
Victoria’s Health Department is currently evaluating licence extensions required to allow Monash IVF’s clinics to continue operating in the state, with licences for its Clayton, Geelong, Sunshine, Sale and Cremorne clinics set to expire on April 30.
The Victorian Health Regulator assumed responsibility for ART clinics on January 1 and is working on improved reporting mechanisms for adverse events. The department spokesperson defended this overhaul and said the regulator now had “strengthened inspection and investigation powers”.
ART providers, as a condition of their registration, are required to notify the Department of Health of any contravention of the Assisted Reproductive Treatment Act 2008 – including any incident that is or likely to be harmful to the health or wellbeing of a patient, gamete or embryo.
Labor frontbencher Harriet Shing said on Friday the Monash IVF mistake was “just devastating”.
“The regulator is undertaking an independent review,” Shing said.
“It’s so important that this investigation be able to take its course. And I think it’s really important that we respect the privacy of the people who are obviously going through an enormously traumatic time.”
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