This report aims to outline the processes, eligibility criteria and Medicare funding involved with IVF in Australia, and discusses in-depth two ethical issues associated with IVF in relation to the 42 year old woman scenario.

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In vitro Fertilisation (IVF) encompasses the fertilisation of an egg by sperm outside of the human body and is currently a leading treatment for infertility. This report aims to outline the processes, eligibility criteria and Medicare funding involved with IVF in Australia, and discusses in-depth two ethical issues associated with IVF in relation to the 42 year old woman scenario.  

Processes of IVF:

Sources: (City Fertility Centre, 2009), (HCF, 2013) & (Virtus Health, 2013)

Source: (Virtus Health, 2013)

Source: (Virtus Health, 2013)

IVF in Australia:

IVF treatment is currently only available through the private healthcare system and despite overwhelming desires by infertile couples to have children; the cost of IVF fertility is still quite high as a result of insufficient support from the public healthcare system. Despite Australia’s relatively high first-treatment pregnancy rate of 47% and 19% for women under 30 and over 40 respectively (Virtus Health, 2013), there is no guarantee of success. Although IVF is available in Australia and regulated nationally by the National Health and Medical Research Council’s Ethical Guidelines on the Use of Assisted Reproductive Technology in Clinical Practice and Research (2007), legislation for IVF is State/Territory regulated (NHMRC, 2013).

Eligibility Criteria:

A couple is considered infertile after 12 months of regular unprotected intercourse without fertilisation (City Fertility Centre, 2009). Causes of infertility may range from blocked/absent fallopian tubes and irregular ovulation of the female to low sperm count/motility in the male. As such, individuals wanting to conceive a baby will usually only resort to IVF after preliminary approaches to basic lifestyle changes (weight loss, dietary adjustments or limiting drug and/or alcohol consumption) and medical treatment (drugs to stimulate ovulation, microsurgery to correct tubal defects) (HCF, 2013).

Although IVF legislation varies across the states and territories in Australia, there are general criteria that must be satisfied to be eligible for IVF treatment:

  • If the woman and her partner (if any) have given consent to the treatment.
  • If the doctor is convinced the woman is infertile and unlikely to become pregnant without the treatment procedure.
  • If a deceased person has given prior written consent confirming posthumous use of sperm, embryo or fertilised ovum by a specified recipient. 
  • If there is no risk of transmitting genetic abnormalities/diseases to the embryo.

(NHMRC, 2013)

Medicare Funding for IVF:

The cost of IVF is subject to variation across IVF fertility clinics and practitioners. Medicare, however, sets clear guidelines on financial rebate amounts that can be claimed (Department of Human Services, 2013). Whilst this is aimed to be 75% of the standard fee charge, most doctors inflate treatment costs resulting in a greater gap payment for patients (Huggies, 2013). Nevertheless, there is no limit to the amount of times a person is allowed to claim their IVF cycles through Medicare (Virtus Health, 2013).

In 2010, Medicare instigated a “Safety Net Rebate”, allowing couples an additional refund of up to 80% of out-of-pocket fees for some IVF treatment processes (specialist fees, blood tests, ultrasounds, some medications) (Huggies, 2013). As such, the final out-of-pocket cost for a standard IVF cycle is usually $3073.30 for the first year (Monash IVF, 2012-2013) and $2804 for each subsequent year (Virtus Health, 2013), compared to the original $8155 (Virtus Health, 2013).

Ethical Issues of IVF:

Rights of the Mother:

In evaluating the scenario through the perspective of autonomy, the woman is considered free to decide such an aspect of her life (McNeill, Torda, Little, & Hewson, 2004). Autonomy links inexplicably with the notion of basic human rights, where an individual has the right ‘to marry and to found a family’ as stated by the Universal Declaration of Human Rights (The United Nations, 1948), thus attaining to the right of parenthood. Accordingly, this poses the question of whether denying IVF treatment equivocates denying the woman of the right to a family. In denying what is considered an unnatural intervention, is it right to deprive the ‘basic fundamental liberty’ of having children? (Kahn, 2010). Furthermore, is the right to have a child equivalent to other basic human rights such as access to shelter or education? In applying an autonomic perspective, the right to access fertility services is a universal right that thus disregards any further question of the woman’s age, unmarried state or socioeconomic status.  Even despite the debated lifespan and decreasing IVF success rates for women over the age of 40 (Marcus & Brinsden, 1996), such considerations are also negated in value.

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Secondly, the access-to-care viewpoint synonymously supports the woman’s right to undergo IVF whilst providing an alternate perspective. The principles of beneficence entail that practitioners are ethically bound to act in the patient’s best interests and thus, obligated to help improve their situation (McNeill, Torda, Little, & Hewson, 2004). As such, autonomy and beneficence act in a cohesive manner in relation to IVF, as acting in the best interest of the patient may be equal to fulfilling the patient’s own desires. Consequently, the question of the extent to which medical professionals are obligated to help infertile women arises. In exploring this, ...

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