Is IVF really an elective procedure?
Nearly one in 10 Australian IVF clinics declined to have their success rates published on a government-funded website designed to offer transparency to tens of thousands of people experiencing infertility.
Would-be parents will not find the birth and pregnancy results for nine clinics on the independent YourIVFSuccess site as the multimillion-dollar industry faces growing distrust, and clinics confidentially report alarming variations in success rates.
Lucy Kokkotas and Yaelle Ohana, hosts of the podcast IVF Real Talk, said would-be parents may be deterred by clinics opting out of having their results published on the independent platform.
De-identified clinic data shows success rates for live births per initiated IVF cycle ranged from 35 per cent to 4.5 per cent in 2023, according to the latest Australian and New Zealand Assisted Reproduction Database (ANZARD) report. Clinics are required to submit data to ANZARD under their licensing agreement, but participation in YourIVFSuccess is voluntary.
Medical directors of clinics that opted out said the success-rate measures were misleading because they penalised clinics that treated the most complex patients, or the small number of IVF cycles they performed meant the results were statistically unreliable.
The industry’s peak body is backing calls to introduce mandatory success-rate reporting as Australian government’s move to dismantle the industry’s failed self-policing model.
The clinics opting out
- NSW: Demeter Fertility in Hurstville and City Fertility in Liverpool and Miranda
- Queensland: Life Fertility and City Fertility in Brisbane, Gold Coast and Toowoomba
- Western Australia: Oasis Fertility
- ACT: Compass Fertility
“Patients choose an IVF clinic for many reasons but they deserve to know the performance of all clinics, not just some,” said UNSW’s Professor Georgina Chambers, who oversees the national IVF registry, the ANZARD and YourIVFSuccess.
IVF Real Talk podcast hosts Yaelle Ohana and Lucy Kokkotas said clinics that chose not to disclose success rates risked deterring patients.
“Transparency is huge, especially with all the IVF errors we’ve seen,” Ohana said, alluding to a string of high-profile scandals including two embryo mix-ups at Monash IVF clinics. “There is so much lost trust in the community.”
“We didn’t go with the clinic with the best success rates,” Kokkotas said. “We aligned with bedside manner, and a doctor we really trusted, and met our financial needs.”
The federal government will establish an independent regulator in January 2027 and develop national standards following a rapid review.
Federal Health Minister Mark Butler, father of an IVF-conceived child, said the self-regulated industry had failed thousands of families.
“I want to see more transparency in the IVF industry,” Butler said. “Wannabe parents … want to know that their systems are fit for purpose and ensure they are fully protected.”
Infertility affects an estimated one in six Australian couples. Rising numbers of single people and same-sex couples are choosing IVF to have a family, and one in 16 babies is now born through IVF in Australia.
Meanwhile, ANZARD and YourIVFSuccess are at risk of collapse within six months, with no new financing announcement in the mid-year federal budget update.
Health Minister Mark Butler announced expanding Medicare subsidy eligibility criteria to include singles and same-sex couples in February.
Without these resources, Chambers said, there was no way to regulate the $850 million private IVF industry largely paid for by taxpayers via Medicare subsidies.
Dr Karin Hammarberg, head of IVF programs at Monash University, said having an independent source of information is crucial because “clinic websites are not reliable sources of information”.
“If clinics don’t produce their data, question why,” Hammarberg said.
Chambers’ team suppresses success rates based on fewer than 10 cycles. Hammarberg said clinics with cycle numbers slightly above this cut-off could argue that a poor result was down to luck.
City Fertility NSW medical director Dr Devora Lieberman said the cycle numbers at the Miranda and Liverpool clinics were so small that it was impossible to draw meaningful conclusions about the success rates.
“I’m always very happy to provide patients with our lab’s success rates,” said Lieberman, whose Sydney CBD clinic results are on Dr Devora’s site and YourIVFSuccess.
Demeter Fertility medical director Dr David Knight said the “no barriers” clinic treats a highly complex, often older population of patients, respecting women’s wishes to attempt conception even when their likelihood of having a baby is low.
“Our results are not comparable to clinics that decline these patients, and publishing unadjusted figures risks misrepresenting our care philosophy, and misleading consumers,” Knight said. “What matters most is that our patients receive transparent, personalised information about their own likelihood of success, something we provide diligently.”
Compass Fertility medical director Dr Nicole Sides said the clinic’s decision stemmed from concerns about “league-table-style reporting” that can oversimplify and mislead because it does not account for complex patient mix or clinical decisions.
“Fertility care doesn’t work that way. It’s highly nuanced, and individual circumstances play a significant role in shaping outcomes,” Sides said, directing patients to the success-rate information published on the clinic’s website.
City Fertility chief executive Adnan Catakovic said the Gold Coast clinic had recently relocated, Brisbane had undergone a leadership transition, and Toowoomba’s datasets were too small.
Dr Petra Wale, clinical embryologist and president of the Fertility Society of Australia and New Zealand, said patients had a right to know if their clinic had a 4.5 per cent success rate, and would support mandatory reporting under an independent regulator, in line with the UK and US.
But Wale cautioned against comparing clinic success rates “league-table-style” in a way that shifts the focus away from patient-centred care, or instituting minimum success-rate benchmarks and closing down clinics that did not meet them.
“A clinic having an aggregate overall strong success rate doesn’t translate into an individual patient’s treatment,” Wale said.
She said interventions are offered to clinics with significantly low success rates to improve them.
“We don’t want to see fewer fertility options for people. We want to see more.”
Wale recommended that would-be parents use YourIVFSuccess, which calculates users’ chances of having a baby over three IVF cycles based on individual characteristics including age, infertility diagnosis and previous treatments.
Oasis and Life Fertility did not respond.
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