The high cost of IVF

As we approach adulthood, we face a number of financial hurdles: the first car, the first mortgage, student debt, the big OE. And then it's time to start a family, worry about school fees and think about retirement savings.

Well, that's for the lucky ones. For the others - one in five of New Zealand couples, according to support group FertilityNZ - the expected family does not magically appear, due to infertility.

Infertility is defined as not falling pregnant in the first year of trying to conceive naturally.

Thanks to the increasing success of in vitro fertilisation (IVF) - it offers a success rate of 65 per cent - many are opting for it in a bid to start a family.

The Government will fund two IVF treatments to women under 40, as long as they meet certain health criteria. According to FertilityNZ, around 2000 IVF treatment cycles are done in New Zealand each year and around 650 babies are born from this.

On average, women will go through three cycles of IVF, says Dr Richard Fisher, director of Fertility Associates, the private practice that has the IVF market cornered in New Zealand.

His Auckland clinic at Ascot Hospital sees 60 couples a month. Fertility Associates has clinics throughout the country, including Hamilton, Wellington and Christchurch.

The IVF procedure, if done privately, can be financially crippling. Each cycle of up to two months will cost between $7500 and $10,000. If a woman is older and is advised to use frozen donor eggs, the couple will need $10,000 to $15,000 a cycle.

Of course, the results are not guaranteed. People can end up spending a lot of money on counselling, which can cost around $95 a session. FertilityNZ says depression caused by infertility can leave a person as debilitated as someone with a serious illness.

Fertility Associates does not like to get involved with how people finance their treatment although, in the US, medical practices are not above this, according to Dr Fisher.

"Our view is that you are much better to finance it out of cash. If you haven't succeeded and there is an extended period of paying for the cycle, it is not much fun. Everyone does what is appropriate for them."

Kate Cooper, a former patient of Fertility Associates in Auckland, who attended the clinic for more than a decade and had a baby last year, jokes she and her husband must have paid for a wing at Ascot Hospital by now. "I'd be living in a mansion in Remuera if it weren't for IVF," she says.

Andrea and Guy Smalley are expecting their third IVF baby and have spent $40,000 at Fertility Associates, with just one cycle funded by the Government. They were lucky because they found out Guy was infertile in their 20s so immediately started having treatment. Andrea is now 33. Fortunately for them, they could afford it.

Andrea says: "We've had family help, otherwise it's been just making sacrifices, holding off on renovations. We have a rotten deck. But we don't ever think about what we've been through, once [the children] are here. The money doesn't mean anything, it's all forgotten. We are in a higher earning bracket - that's come to us recently - it's a matter of budgeting."

Andrea feels for the couples who struggle to find the money.

"Fertility treatment should be totally government funded. We have now produced almost three taxpayers. They can dish out the money for the dole but they can't find the money for fertility." She also believes insurance should cover fertility treatment because infertility is becoming more common.

Financial pressure

Middle-income earners such as Samantha and Alastair Fairweather say $40,000 for future fertility treatment would put them under enormous financial pressure.

They are going through their second IVF cycle, which has been government funded. If unsuccessful, they haven't decided if they would continue paying for it themselves.

Samantha, a high school teacher, and Alastair, who works for the Department of Conservation, have been trying to have a baby for about four years. Samantha receives her Fertility Associates treatment in Waikato Hospital's maternity wing. It is a painful location, watching happy parents carrying out their new babies.

The treatment affects all area of their lives. "You put all your other activities on hold. If you go through the treatment, what comes after this? At the moment I would say no to paying for IVF," she says.

But: "I'm not ready to say that I have given up."

They have thought about how they would raise the cash.

"We would have to look at the finances, at extending the mortgage. It's possible we may be able to borrow money from the family."

The couple wish the treatment was covered by the Government or insurance. "It's shocking. Infertility is viewed with such a stigma - it's a medical condition. But it's not something you can see, like a broken leg."

Unlike the US, there is no support in New Zealand from insurance companies to cover infertility treatment. This is despite the fact infertility is classified as a disease by the World Health Organisation, says Sian Harcourt, executive director of FertilityNZ.

By contrast, in Australia there is unlimited fertility treatment on Medicare. Harcourt says she has talked to couples who have thought of moving to Australia so they could have greater access to fertility help.

Sandra Dill, chief executive of Access, the Australian equivalent of FertilityNZ, says once a patient is out of pocket more than A$1000, they are reimbursed. Each cycle costs around A$4500. The society advises people to take out private health insurance which covers patients for specific in-hospital procedures.

Dill says infertility treatment used to be categorised by Australian insurers in the same class as plastic surgery but this is no longer the case.

Grant Hill, head of products and marketing at Tower Health & Life Insurance, confirmed that neither Tower nor any of their competitors offered insurance policies for fertility treatment. Fertility treatment is seen as "highly elective", says Hill. "Given its highly elective nature, it can be too expensive, particularly if people were going for repeat treatments."

FertilityNZ finds this attitude hard to understand when 20 per cent of couples have trouble conceiving.

"With the average income, there is no spare money to pay for fertility treatment," says Harcourt. "Holidays are gone, all the money goes on trying to get pregnant, none of the financial buffers are there.

"It's devastating for people who know that treatment is there but they can't access it.

"It is so heartbreaking."