King announces public funding for IVF second cycle

Couples undergoing fertility treatment received a significant boost today with Health Minister Annette King’s announcement of public funding for a second IVF (In Vitro Fertilisation) cycle.

“Since 2000 this Government has been progressively improving access to fertility treatment so that it is consistent throughout New Zealand,” Ms King said. “We can now increase this to a second cycle throughout the entire country.”

Additional funding will be provided to DHBs on an ongoing basis from 2004/2005 for the second cycle treatment packages, which will be available to couples who are assessed as meeting the agreed eligibility criteria and whose first treatment cycle does not result in a live birth. The $4 million being provided in the first year includes some one-off transitional costs.

Ms King said implementation of a second IVF cycle would aim to start from 1 October. This provides a two to three month period for exact details of the implementation plan to be worked out by the Ministry of Health in conjunction with District Health Boards, patient support group FertilityNZ and IVF clinics.

“It is anticipated that about 90 per cent of patients who have completed one unsuccessful cycle of treatment will choose to undertake a second cycle.”

Improvements in IVF techniques have led to a marked increase in conception rates, with about 43 per cent of women aged 37 years and under achieving a successful pregnancy as a result of their first IVF cycle - up from 25 per cent in 1999, Ms King said.

In the past, to increase the chance of pregnancy most women received more than one embryo at one time, a practice that increased the risk of twins and the associated health problems for mothers and babies.

However, as techniques have improved and pregnancy rates increased, it has become more viable to move from multiple embryo transfers towards the preferred single embryo transfer (SET), which reduces the chance of twins and creates fewer health issues for the baby. Guidelines supported by the Ministry of Health and the six fertility clinics nationwide have prompted a move towards SET, particularly in younger women. Use of the SET guidelines in IVF procedures will become standard practice from 1 October. Each year, more than 3500 people are referred for fertility services, with about 70 per cent of them going on to receive treatment.

“I know this will be welcome news for many couples who want nothing more than to have their own baby,” Ms King said.

BACKGROUND INFORMATION

What is In Vitro Fertilisation? The IVF technique is used to treat various forms of infertility. It involves removing eggs from the woman's ovary and, in a laboratory, inseminating them with sperm. If fertilisation occurs, one or more embryos are transferred to the uterus two days later using a catheter placed in the cervix.

What Is Involved? In Vitro Fertilisation involves four steps. The first step usually involves stimulating the ovaries with fertility drugs in an attempt to produce several mature eggs. Progress is monitored using ultrasound scans and blood tests to check the size and number of follicles (which contain eggs) growing in the ovary. In the second step, the follicles are aspirated out of the ovary using a needle guided by ultrasound. The eggs are then placed in a test tube with sperm to allow fertilisation. They are cultured under carefully controlled conditions. Finally, if fertilisation has been successful, one or more embryos are placed in a catheter and gently injected through the cervix into the uterus. Any surplus embryos can be frozen and stored for future use.

What Is Infertility? Infertility is defined as an inability to conceive after one year of trying or an inability to carry pregnancies to a live birth. Approximately one in six couples in New Zealand experience infertility, with the problem affecting men and women almost equally. About 20 per cent of infertile women have damaged fallopian tubes.

What Is SET? SET involves the transfer of a single fresh or frozen embryo to the uterus, which reduces the risk of twins associated with multiple embryo transfers. Remaining embryos are frozen and stored for possible future transfer.

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