Thursday, 6 May, 2010

Financial compulsions lead to patients asking for more Embryos

Birth rate of twins and triplets is set to increase as more Australian women undergoing in-vitro fertilization (IVF) insist doctors to implant multiple embryos to reduce the cost of fertility treatment.

Despite multiple births carrying a five-fold greater risk of death, premature delivery or other complications, clinic chiefs say more couples are taking the chance.

According to experts, cuts to health care rebate have pushed up patient costs by about $1500 for each IVF cycle, forcing many to delay or abandon attempts to conceive. There is more pressure from cash-strapped patients to implant multiple embryos to boost chances of pregnancy in one cycle, Sydney Morning Herald reported.

'They're saying, we understand that it's more dangerous but we can't afford to do another cycle so we'll have two embryos put back and we'll deal with the consequences. If our (premature) baby... has to have eight weeks in intensive care, well medicare pays for that,' said Gab Kovacs, international medical director at Monash IVF in Melbourne.

Medical director of Fertility First in Hurstville, Anne Clark, said while some patients asked for more than a single-embryo transfer, more opted out of having a second child through IVF.

IVF Australia medical director and Fertility Society president Peter Illingworth said the trend would affect the health system.

'There can be long-term health complications for twins born as a result of IVF,' he said.

'Ideally, we would like to put one embryo in at a time because of those risks but we are getting more pressure from patients to do two.'

In January, federal Health Minister Nicola Roxon capped Medicare safety net payments - which paid 80 percent of the gap between doctors' fees and the Medicare rebate - after a review found specialists were charging patients excessive fees.

According to government, patients would be no worse off if specialists charged $6000, the cost of a typical cycle. But doctors said the average cycle cost up to $7500, or higher if patients required extra treatment.

Sandra Dill, from infertility support group Access Australia, said it had been receiving 30 to 40 calls and e-mails a week since the changes, from patients complaining to be under increased financial stress.

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