When starting a family becomes challenging, can Australians truly depend on the sector designed to support them? That’s the question I’m going to explore in this week’s newsletter.

This week, the Fertility Society of Australia and New Zealand (FSANZ) released a new plan to overhaul how reproductive technologies like IVF are accessed and regulated in Australia.

The findings reveal a system that discriminates against “non-traditional” families, is legislated inconsistently across the states and territories, and may not be prepared to meet future demand for these technologies.

Let's not get lost in the legislation or acronyms; ultimately, this is about people's ability to start and grow families, and the ways in which technology can either help or hinder that process.

This new report offers 34 recommendations… So, what are they?

Like many developed nations, Australian women are increasingly waiting until later in life to have children. They are also choosing to have fewer children than the mothers who came before them.

The birth rate has fallen from 3.5 children per woman in 1960 to 1.63 in 2022. Meanwhile, the median age for women giving birth reached 31.9 years old in 2022, up from 25.4 in 1971.

We know people are choosing to forgo or delay having babies for a variety of reasons – cultural, medical, financial (... I saw a pack of nappies cost $39 dollars the other day, let’s get absolutely real.)

What’s clear is that older women face a greater chance of experiencing fertility challenges. Compounded by the increasing number of same-sex couples and solo parents, the demand for assisted reproductive technologies is “exponential”, says the report.

Unsurprisingly, the financial costs associated with fertility treatment were highlighted as one of, if not the greatest, barriers to access, with IVF costing up to $10,000 per cycle.

While some Medicare access is available, the report recommended establishing public IVF units or boosted subsidies to support more patients, including low-income families.

What readers unacquainted with the world of IVF might find surprising— like I did while writing about this —is that the very definition of ‘infertility’ presents discriminatory barriers to access for some people.

In clinical settings, ‘infertility’ is described as: “The inability to conceive after one year of regular, unprotected intercourse.”

People who fall outside of that framework – be they same-sex couples or solo parents – are therefore restricted from accessing Medicare benefits. The roadmap recommended the definition be updated to ensure “non-discriminatory access to IVF and ART.”

One expert who contributed to the report said: “It is a serious anomaly that while heterosexual couples receive Medicare support to resolve their fertility problems and have their families, people in other family circumstances… receive no support at all for their fertility problems.”

ANZSREI, the Australian and New Zealand Society for Reproductive Endocrinology and Infertility, recently extended its definition of infertility to be more inclusive, noting that “nothing in [this] definition should be used to deny or delay treatment to any individual, regardless of relationship status or sexual orientation.”

Another issue highlighted in the report is that there are 30 different pieces of legislation surrounding ARTs in the country.

Limits on donor samples, quality standards for donations, and regulations surrounding IVF procedures vary depending on what state or territory you live in. The report called the lack of uniformity a “primary concern” that “significantly impacts children, parents, donors and costs”.

Its solution: One law for the country via national fertility legislation.

By putting everyone on the same rulebook, the report argues it guarantees consistent reproductive and privacy standards around the country.

It also suggested establishing a national register and nation genetic bank to centralise genetic information of donors and donor-conceived children. It recommended national health standards for egg and sperm donation, “to ensure consistency and safe futures for children conceived by ART”.

Now, keep in mind, this is all just a proposal. A group of experts coming together to recommend what they believe is the path forward. Actually implementing these suggestions takes the work of the Government.

So I thought I’d give them a buzz to see what they think.

A spokesperson for Health Minister Mark Butler said that the Government would carefully consider the report. There wasn’t much more said but we will wait and see if there’s any movement on this issue.

On the other side of politics, Shadow Health Minister Anne Ruston said the Opposition was also examining the findings and recommendations. Ruston acknowledged that “more work” was needed to improve policies and it was “important to recognise the difficulties” faced by Australians dealing with infertility challenges.

So while there are huge political answers we still need answers to, I think it’s important not to get lost in national policies, definitions and legislation. At the end of the day, this is a conversation about people’s ability to start and grow families.

So, to round it all out, I thought I’d include some words from Arabella Gibson, CEO of Gidget Foundation Australia. Gibson said that for families dealing with fertility challenges, “we know that frequent experiences of loss can create repeated cycles of hope and disappointment among parents, as well as feelings of grief for the baby they never got to meet”.

She added that supporting parent-led conversations on a national level is “crucial” to reducing the barriers parents struggling with conception may face.

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In this week's wrap of good news, we discuss this year's Cat of the Year, the way AI could be helping society, and the new Healing Garden at a hospital in New Zealand.