Public fertility care services

Public fertility care services in Victoria will help to make access to in vitro fertilisation (IVF) and other fertility services fairer and more affordable for thousands of Victorians.

The public fertility care service delivery model aims to improve access to people who currently cannot access private services, such as:

• Low-income earners living in outer metropolitan Melbourne and regional Victoria
• People who need donor or surrogacy services, such as LGBTIQ+ and single people
• People who need fertility preservation due to medical treatment, such as those with cancer or undergoing gender reassignment treatment
• People who need testing for monogenic conditions.

The service model includes evidence-based access criteria.

Program status

Public fertility care services are being rolled out gradually in a staged approach to ensure safe, high-quality care for patients.

Services began in October 2022 through the Royal Women’s Hospital and Monash Health. From 2022-24 these lead services will partner will health services across Victoria to scale up in regional and rural areas and provide statewide coverage.

Patients will be able to access consultations through telehealth, and arrangements with local pathology and radiology providers will be made in some areas to minimise the need for patient travel.

Services will gradually scale up with sites in Epping, Sunshine, Bendigo and Mildura commencing services in early 2023. Further sites will be established at Warrnambool, Shepparton, Ballarat, Geelong and Heidelberg.

Service capacity will gradually increase as the required workforce and infrastructure is developed.

The program will be evaluated in 2023–24 to understand the impact and outcomes of public fertility care services to Victorians.

Services offered

Once fully operational, public fertility care services are expected to benefit up to 4,000 Victorians a year, saving them an average of $10,000 annually.

Services will include:

• Intrauterine insemination (IUI), IVF and intra-cytoplasmic sperm injection (ICSI) cycles including assisted reproductive treatments, counselling, information, and support
• Less invasive, lower cost fertility services prior to IVF or ICSI treatment
• Donor services through the establishment of Victoria’s first public sperm and egg bank
• Altruistic surrogacy services
• Fertility preservation where medical treatment may compromise fertility including cancer treatment and gender reassignment treatment
• Genetic testing where people are known carriers of serious medical conditions.

Services will scale-up as the rollout progresses.

See participating health services’ websites for the latest details.

Operating model

The operating model involves two lead services, the Royal Women’s Hospital and Monash Health, which will partner with additional health services across metropolitan Melbourne and regional Victoria to provide statewide coverage.

Service providers have been selected according to their ability to provide a high-quality, comprehensive range of person-centred fertility care services to a broad range of people, particularly those who are excluded from or unable to afford a private provider.

See the list of participating health services.

Access

To access public fertility care services, a person will need a referral from their general practitioner or relevant specialist.

They will be placed on a waiting list for an initial appointment with a fertility specialist at a public fertility care service.

The cost of the public hospital services provided will be free for most people. Some patients may incur out-of-pocket costs for medication, diagnostics and/or specialised tests depending on their individual circumstances.

Clinical access criteria

The eligibility and access criteria for public fertility care services are evidence-based and designed to make access fair for all Victorians.

To be eligible for public fertility care services, a person must:

• Be a current resident in Victoria
• Hold a Medicare card
• Have a referral from a GP or specialist.

The clinical access criteria are as follows:

• A maximum egg age of 42 years at the time of treatment. Evidence shows the chances of a successful outcome significantly decreases with increasing age.
• A public fertility care service lifetime cycle limit of two stimulated in IVF or ICSI cycles per person. This is to ensure Victorians experiencing infertility have a fair chance of creating a family.

The access criteria aligns with recommendations from the independent review into assisted reproductive treatment conducted by Michael Gorton (the Gorton Review) and the findings from the 2018 assisted reproductive treatment Medicare Benefits Schedule (MBS) review.

The Gorton Review recommended a broad range of fertility services focusing on under-served and diverse groups and the MBS Medicare review recommended that access is limited by age and number of cycles.

Referring patients

Participating health services will accept patient referrals from 18 October.

When referring patients, please advise that demand for the new public fertility care services is expected to be high and there will be a waiting list.

Waiting lists will be managed by participating health services. They will ensure people can access the service fairly, including those whose health needs mean they need urgent care.

As part of service implementation, access to services and wait times will be carefully monitored.

Patients should also continue to be referred to private providers where appropriate.

See participating health services’ websites for details on the services they currently have available.

Service providers

The Royal Women’s Hospital and Monash Health are leading public fertility care services in Victoria.

The lead services will be partnering with other health services across Victoria to provide statewide coverage, providing access to people in both metropolitan and regional areas.

Partner health services will be listed as services come online.

Participating providers

• The Royal Women’s Hospital (lead)
• Monash Health (lead)