Access to assisted reproductive technology for cancer patients in Australia

Aim: To evaluate patterns of care and equity of access to assisted reproductive technology (ART) for cancer patients in Australia Methods: A review of state and national legislation and Medicare numbers relevant to ART and phone interviews with representative fertility facilities in each State and Territory. Results: There appears to be little legal restriction to ART for cancer patients although in some states, clinical practice is in fact contrary to legislation. The cost of ART is influenced by Medicare rebates and the overall cost of fertility treatments as set out by the specific fertility unit. There is no rebate for embryo and sperm storage. Costs of receiving an ART intervention vary greatly. Out-of-pocket costs ranged from nil to approximately $3000 per year for an in vitro fertilization or intracytoplasmic sperm injection cycle, from nil to $700 for embryo storage and from nil to $1500 for embryo transfer. All but two of the fertility clinics felt that the numbers of oncology patients accessing ART were low. The most common barrier to access identified by the fertility clinics interviewed was time restriction in a setting where there is a time pressure for a patient to commence anti-cancer treatment. Conclusion: Legislation is unlikely to be a barrier to the use of ART by cancer patients. The main reasons for limited access to ART may be cost or other factors including time pressure, the lack of a partner and age. Further research in this area is warranted.