Australia’s leading fertility organizations are calling for a significant overhaul of Medicare’s definition of infertility, arguing that the current standards are antiquated and discriminatory. They are pressing the federal government to ensure that access to reproductive services is equitable, regardless of a person’s relationship status, sexual orientation, or gender identity.
During a recent conference in Sydney, key groups including the Australian New Zealand Society for Reproductive Endocrinology and Infertility (ANZSREI), the Fertility Society of Australia and New Zealand (FSANZ), and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) unanimously supported a revised definition of infertility. This new definition aims to better represent the needs of same-sex couples and individuals seeking to become parents.
The proposed change could significantly impact Medicare funding for fertility treatments. Currently, Medicare coverage is restricted to individuals who have been unable to conceive after one year of regular, unprotected intercourse—a criterion that excludes many people. The Commonwealth Ombudsman’s definition of infertility aligns with this restrictive criterion.
Many single individuals and LGBTQ couples face considerable financial burdens due to the need to undergo multiple unsuccessful IVF attempts before qualifying for Medicare rebates. The revised definition would broaden the scope of infertility to encompass “the inability to achieve a successful pregnancy based on a patient’s medical, sexual, and reproductive history, age, physical findings, diagnostic testing, or any combination of these factors.” It would also include those who require “medical intervention … to achieve a successful pregnancy, whether as an individual or with a partner.”
The proposed definition mirrors guidelines established by the American Society of Reproductive Medicine.
Dr. Alison Gee, President of ANZSREI, emphasized that this updated definition recognizes the diverse needs of LGBTQ individuals, single women with fertility issues, and single men pursuing surrogacy. “This is a step forward for the medical community to acknowledge and support advancements in reproductive technology, and we hope the government will align with this progress,” stated Gee, who is also a board member of FSANZ.
Professor Louise Hull, a past president of ANZSREI, argued that Medicare’s current criteria should not be a barrier to accessing fertility treatments for anyone, regardless of their relationship status or sexual orientation.
Federal Health Minister Mark Butler was informed of the proposed changes last week. A Department of Health and Ageing spokesperson indicated that the government is currently evaluating the implications of the proposed update.
“We have briefed [Butler] on the new definition and do not foresee any conflicts,” Hull said. “Although it will take time, we hope to align legislation and Medicare policies with the updated definition.”
Heather Corkhill, equality director of LGBTQ advocacy group Rainbow Families, criticized the current system for unfairly labeling LGBTQ families as socially infertile, which excludes them from accessing necessary treatments. Corkhill described the process as unjust and distressing, highlighting the arbitrary nature of the requirement for multiple failed treatments before rebates are granted.
Claire Sara, a new mother, shared her personal experience. After a burst appendix led to significant scar tissue around her ovaries, she was classified as medically infertile and eligible for Medicare rebates for IVF. However, her partner, Nina McCann, would not have been eligible for rebates under the current rules, despite her better chances of conceiving with assisted reproductive technology.
The couple’s journey to parenthood cost over $40,000, with the Medicare rebate covering only a fraction of the expenses. “The rebate doesn’t fully cover the costs, but it provides some relief,” McCann noted. The couple shares their IVF and parenting experiences on their YouTube channel.
RANZCOG President Dr. Gillian Gibson asserted that Australia’s healthcare system must adapt to meet the diverse needs of contemporary society. “The revised definition is crucial for improving access to essential reproductive services, particularly for aspiring LGBTQIA+ parents,” Gibson concluded.
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