Public fertility care services

Public fertility care services are helping 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 model is focused on improving access for people who currently have limited access to private services, such as:

• low-income earners
• rural and regional Victorians
• people who need donor or surrogacy services, such as LGBTIQA+ 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 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. These lead services are partnering with health services across Victoria, including in regional and rural areas, to support statewide coverage.

Partner health services that have already started delivering a range of fertility services include Northern Health’s Epping Hospital and Mildura Base Public Hospital.

Local services will also be available in Ballarat, Bendigo, Geelong, Heidelberg, Shepparton, Sunshine and Warrnambool by the end of 2023.

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

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

Australia’s first public egg and sperm bank was also established in Victoria in July 2023. The Royal Women’s Hospital is operating the bank as an extension of the state’s public fertility care services and it is currently accepting egg, sperm and embryo donations from the community.

Services offered

Once fully operational, public fertility care services are expected to benefit up to 5,000 Victorians a year, saving them an average of $10,000 annually.

Services will include:

• intrauterine insemination, IVF and intra-cytoplasmic sperm injection (ICSI) treatment cycles
• less invasive fertility treatments prior to IVF or ICSI treatment
• pre-treatment testing, counselling and fertility information
• donor services, supported by the establishment of Australia’s first public egg and sperm bank
• altruistic surrogacy services
• fertility preservation where medical treatment may compromise fertility, including cancer treatment and gender reassignment treatment
• genetic testing for people who are known carriers of serious medical conditions.

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 support 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 GP 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 clinical access criteria are designed to provide Victorians with fair and equitable access to public fertility care services. They are based on research and clinical best practice.

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

When referring patients, please advise that demand for the new public fertility care services, including for donated eggs, sperm and embryos, is high and that they may be placed on a waiting list.

Participating health services will actively manage waiting lists, and inform patients when they are referred about expected timeframes based on their individual circumstances. The health services 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 below to see which health services are currently accepting patient referrals, and for details on the services they offer.

Service providers

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

The lead services are 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, public egg and sperm bank host service)
• Monash Health (lead)
• Northern Health – Epping Hospital (partner)
• Mildura Base Public Hospital (partner)

Public egg and sperm bank

Australia’s first public egg and sperm bank has opened at the Royal Women’s Hospital. The bank is an extension of Victoria’s public fertility care services and is currently accepting egg, sperm and embryo donations from the Victorian community.

The bank aims to increase access to donor eggs, sperm and embryos for Victorians who are receiving public fertility care and require donor services.

Eligible Victorians seeking to access the public fertility care service – including the use of donated eggs or sperm from the bank – will need to be referred by their GP or specialist and may be placed on a waitlist.

To find out more about the Victorian public egg and sperm bank, visit the Royal Women’s Hospital website.