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The Costs of IVF: Financing Your Fertility Journey · She's On The Money

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Speaker 1: My name's Tatasha Bamblet. I'm a proud First Nations woman
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Speaker 1: and I'm here to acknowledge country t Glenn youan Ganya, Niana,
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Speaker 1: kaka ya Ya Binahaka, nian Ar gay In, Nimbini, yakarum jar, domayagumiga, Umaga, Ithawaka, Nile,
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Speaker 1: Waman damon Immalan, Bumba bang gadaboma In and naw in
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Speaker 1: waka ghana on yak rum jar Watanadana. Hello, beautiful friends,
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Speaker 1: we gather on the lands of the Aboriginal people. We
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Speaker 1: thank acknowledge and respect the Aberiginal people's land that we're
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Speaker 1: gathering on today. Take pleasure in all the land and
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Speaker 1: respect all that you see. She's on the Money podcast
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Speaker 1: acknowledges culture, country, community and connections, bringing you the tools,
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Speaker 1: knowledge and resources for you to thrive.
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Speaker 2: She's on the Money. She's on the Money.
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Speaker 3: Hello, and welcome to She's on the Money, the podcast
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Speaker 3: where we discuss all issues affecting your personal wealth goals
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Speaker 3: so that you can feel more in control of your
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Speaker 3: financial future. I'm Victoria Devine, and today we'll be covering
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Speaker 3: a topic that's top of mind for many of you
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Speaker 3: in our community. I'm talking IVF baby, including what's involved
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Speaker 3: and what you should know about financing this life changing decision.
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Speaker 3: Joining me is a friend of the podcast, doctor Cole Hope,
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Speaker 3: who you might remember from our webinar on IVF and
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Speaker 3: egg freezing, the medical director at New Life IVF.
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Speaker 2: Doctor A.
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Speaker 3: Cole is a sought after fertility specialist helping people have
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Speaker 3: and grow their families for almost twenty years. Passionate about
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Speaker 3: supporting people to conceive doctorn, Cole is here to help
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Speaker 3: you make sure that you have all of the information
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Speaker 3: that you need before choosing the right fertility outcome for you.
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Speaker 3: And just a little preface on this conversation. This one
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Speaker 3: is quite a sensitive one. Whether you're unsure about having kids,
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Speaker 3: you're planning to start a family, or you're experiencing complex
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Speaker 3: fertility issues of your own, it can be all too
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Speaker 3: hard to talk about sometimes, and that is okay. I've
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Speaker 3: had my own issues with fertility and definitely had moments
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Speaker 3: where I had to tap out of conversations like this.
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Speaker 3: So please do exactly what is right for you. Just
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Speaker 3: know that we get it, and we encourage you to
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Speaker 3: take your time and listen back if and when you're ready. Otherwise,
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Speaker 3: my friends, let's get into it. Doctor Nicole, welcome back
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Speaker 3: to the show. It is so good to have you
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Speaker 3: in an official studio. Yes, last time we were just
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Speaker 3: were you at your house or you at your office?
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Speaker 2: We were at the office. Yeah, I was in my house, yep.
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Speaker 4: But it was a very very small office, lots of
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Speaker 4: equipment around.
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Speaker 2: So I love it for tightspace.
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Speaker 3: It was a really special conversation. And I obviously went
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Speaker 3: in having this conversation about fertility because the community had
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Speaker 3: had so many questions. But it was just so nice
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Speaker 3: talking to you. Not only are you incredibly intelligent, I
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Speaker 3: was like, this woman is a weapon. I was like,
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Speaker 3: she makes me so comfortable, Like you're a friend of
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Speaker 3: the show, please come back. I have been deep in
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Speaker 3: the dms on Instagram of the show. She's on the
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Speaker 3: money community, and I've been gathering all of your pressing
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Speaker 3: questions for our friend doctor Nicole, the medical director at
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Speaker 3: New Life IVF. So when we're thinking about IVF and
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Speaker 3: egg freezing, what is actually the difference there? Can you explain?
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Speaker 3: I guess the purpose and then the process of each
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Speaker 3: because some of our listeners have gone down a rabbit hole,
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Speaker 3: are confused or they haven't gone down the rabbit hole
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Speaker 3: and they've been avoiding it because everything is kind of
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Speaker 3: like analysis paralysis.
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Speaker 4: Sure, so they're actually very similar processes. But the crux
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Speaker 4: of it is when we do egg freezing, we are
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Speaker 4: just freezing eggs, but when we are doing IVF, we
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Speaker 4: are actually putting the eggs and sperm together to make embryos.
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Speaker 4: But in terms of the actual preparation for egg freezing
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Speaker 4: and IVF, women are doing injections to try and get
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Speaker 4: multiple eggs to grow. They are having some blood tests
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Speaker 4: and ultras sounds during that treatment to assess how they
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Speaker 4: are progressing and how many eggs are likely to be
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Speaker 4: collected at an egg collection, And usually they are on
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Speaker 4: injections for about ten days and most women are ready
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Speaker 4: to have their egg collection around day fourteen in their cycle.
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Speaker 4: If someone is doing egg freezing on that day that
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Speaker 4: the eggs are collected, that is when we will freeze
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Speaker 4: the eggs, and the eggs then can remain frozen until
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Speaker 4: the woman is ready to use those eggs. Now, that
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Speaker 4: may be that she comes back in a few years
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Speaker 4: with a partner who she wants to conceive with, or
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Speaker 4: it could be she is single and wants to do
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Speaker 4: this on her own and access donor sperm and inseminate
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Speaker 4: those eggs. But by freezing eggs, we can preserve a
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Speaker 4: woman's fertility at that age she was when she froze
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Speaker 4: the eggs. If a woman is having IVF, then that
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Speaker 4: means we need sperm available on the day and we
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Speaker 4: will inseminate the eggs and rather than just freezing the eggs,
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Speaker 4: we then grow or culture the embryos in the lab
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Speaker 4: for up to five or six days, and we only
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Speaker 4: freeze the embryos that have continued to grow and progress
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Speaker 4: and reach a certain stage of development. And so mostly
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Speaker 4: in terms of freezing embryos, people are usually doing IVF
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Speaker 4: when they have a partner who they are trying to
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Speaker 4: conceive with and maybe they have not had any success
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Speaker 4: or if they are actually have decided they want to
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Speaker 4: do this on their own and access stonor sperm, then
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Speaker 4: they might be doing IVF and creating embryos with sperm.
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Speaker 3: It's crazy to me that you can freeze, like just
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Speaker 3: the idea that you can preserve someone's fertility that age
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Speaker 3: is just so cool.
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Speaker 4: I just when I started out in IVF, we did
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Speaker 4: have egg freezing, but our freezing and throwing techniques were
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Speaker 4: not very good, and really it was something that was
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Speaker 4: just sort of put aside for women, for example, maybe
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Speaker 4: who had cancer and they needed to start chemotherapy and
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Speaker 4: we wanted to freeze eggs because chemotherapy can damage the
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Speaker 4: egg supply, But it was more of an emergency kind
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Speaker 4: of situation and the success rates were not that great.
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Speaker 4: But over the years, freezing and throwing techniques have really improved,
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Speaker 4: and now egg freezing is a really viable option, and ultimately,
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Speaker 4: until we come up with a way to reverse the
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Speaker 4: aging process, it's the best way to preserve fertility.
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Speaker 3: It is very cool, like just the whole concept of it.
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Speaker 3: When you became a doctor, was that something that you
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Speaker 3: were like, I really want to go down this route
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Speaker 3: of kind of you know, helping create life, helping create babies,
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Speaker 3: or was this something you discovered during the process. I'm
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Speaker 3: just so pervy because it's just so special.
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Speaker 4: I think I did always have an interest in this,
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Speaker 4: and when I was studying medicine, when I first applied
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Speaker 4: and started doing my training in obstetrics and gynecology, I
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Speaker 4: was thinking, I really hope I like this, because I
7:29
Speaker 4: actually can't imagine anything else that.
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Speaker 3: I've actually worked it up in my head.
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Speaker 4: Yes, this is where I want to go. And look,
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Speaker 4: I was lucky enough during my training that I did
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Speaker 4: get exposed to working with fertility patients. And so once
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Speaker 4: I had that exposure, and it just confirmed that this
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Speaker 4: is something that I was really interested in, and yeah, it.
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Speaker 3: Was interesting and to pursue my passion one hundred percent.
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Speaker 3: And I was saying this to you off camera. We
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Speaker 3: did our webinar, and for those of you who haven't
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Speaker 3: listened to it, I'll put a link in the show
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Speaker 3: notes so that you can go back, because I've made
8:04
Speaker 3: sure that we haven't doubled up on questions because I
8:06
Speaker 3: was like, if I have her in front of me,
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Speaker 3: I'm not going to be asking the same things over
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Speaker 3: and over. But I just feel like you're the right
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Speaker 3: person for this role. Like you are so warm and
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Speaker 3: so friendly, and I can imagine if I was going
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Speaker 3: through a process of IVF, You're the type of person
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Speaker 3: I would want holding my hand. But that's a really
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Speaker 3: big decision to make, right, So, for couples who have
8:27
Speaker 3: been trying to conceive for a little while, and it's
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Speaker 3: been a little bit challenging, when do you recommend that
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Speaker 3: they actually start looking into IVF? Because I remember when
8:37
Speaker 3: it was hard for me. I remember saying to my husband,
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Speaker 3: are we meant to talk to someone about this? Or
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Speaker 3: like do we just try for a few more months?
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Speaker 3: Or like what does this look like? Or are we
8:48
Speaker 3: meant to do like preliminary fatility testing?
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Speaker 2: What do we do? Yeah?
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Speaker 4: Well, look, to be honest, I think if you were
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Speaker 4: worried and it's creating anxiety, it's quite reasonable to see
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Speaker 4: your GP, get a referral to see a fertility specialist.
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Speaker 4: And when you see the fertility specialists, they should be
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Speaker 4: ordering some baseline investigations That could include like hormone tests
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Speaker 4: to confirm that you're ovulating, a pelvic ultra sound to
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Speaker 4: check that there's nothing physical that might be interfering with
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Speaker 4: getting pregnant. If you're in a heterosexual relationship, checking your
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Speaker 4: partner's sperm to make sure that's okay. And so, just
9:33
Speaker 4: because you make an appointment with a fertility specialist, it
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Speaker 4: doesn't mean that you're necessarily going to be doing IVF
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Speaker 4: next month. They would initially organize all these tests, and
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Speaker 4: sometimes there may actually be something that you can treat
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Speaker 4: without doing IVF. So, for example, if someone does have
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Speaker 4: an issue with ovulation, there are hormone medications to assist
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Speaker 4: with that. And so for some women, if you can
10:01
Speaker 4: just get them to ovulate, they will get pregnant.
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Speaker 3: Yeah, yeah, and that's quite cool exactly.
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Speaker 4: So I would say, even though I do have a
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Speaker 4: lot of patients doing IVF, I also have a lot
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Speaker 4: of patients who are doing what we call ovulation induction
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Speaker 4: and getting pregnant naturally.
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Speaker 2: How cool. Not everyone has to go to IVF.
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Speaker 3: Yeah, but it's nice to know that there are lots
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Speaker 3: of different options and it's not just Okay, I'm going
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Speaker 3: to go down this route and it's going to get
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Speaker 3: real serious really quickly, because that can be overwhelming. Yes,
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Speaker 3: I have a question because whenever I've needed to go
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Speaker 3: to the GP to get a referral to a specialist,
10:39
Speaker 3: I haven't necessarily known who I needed to see. I've
10:42
Speaker 3: always gone, oh, I need to see a doctor for
10:44
Speaker 3: there's more complex issue, and my GP says I'll refer
10:47
Speaker 3: you out. Barry down the road has a good reputation.
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Speaker 3: But I feel like with fertility, I maybe have a
10:55
Speaker 3: different experience to other people. So I'm only talking from
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Speaker 3: my I guess my my own experiences here. But before
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Speaker 3: I even spoke to a GP, and thankfully I didn't
11:05
Speaker 3: need to go down this route, I googled everything. I
11:07
Speaker 3: was looking at all the different clinics. I was looking
11:10
Speaker 3: at what other people were doing and how they were
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Speaker 3: doing it. How do you or do you have a
11:15
Speaker 3: list of things that people could look out for when
11:18
Speaker 3: looking for a clinic, because it's not for me. It
11:21
Speaker 3: didn't feel like something where I would go to my
11:23
Speaker 3: GP and just go hey, could you just give me
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Speaker 3: a random referral? Like it's so important to pick the
11:28
Speaker 3: right clinic.
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Speaker 2: Yeah.
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Speaker 4: Absolutely, And I think it's really difficult for patients to
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Speaker 4: navigate the information that's out there if you are looking
11:38
Speaker 4: at an IVF clinic. Most IVF clinics on their website,
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Speaker 4: they will advertise, for example, the cost of their treatment,
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Speaker 4: but unfortunately for some clinics, there are lots of additional
11:52
Speaker 4: costs that maybe are not always on their website. At
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Speaker 4: New Life IVF where I work, our costs are and
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Speaker 4: really quite inclusive. And what I mean by inclusive is
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Speaker 4: they include the fees of the doctor during an IVF cycle.
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Speaker 4: They include actually freezing the eggs or freezing embryos during
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Speaker 4: your treatment. They include extra lab techniques that we consider
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Speaker 4: best practice, like using an embryoscope or using embryo glue.
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Speaker 2: When we do an embryo.
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Speaker 3: Embryo glue, yes, that's a thing.
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Speaker 2: It is a thing.
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Speaker 4: There is evidence that it can help improve the chance
12:33
Speaker 4: of an embryo in plant cool And with some clinics,
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Speaker 4: they may actually charge an extra fee for using that glue,
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Speaker 4: and that may not be actually included in the fees
12:45
Speaker 4: that they advertise.
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Speaker 3: And that's disheartening because you go to someone and yes,
12:50
Speaker 3: there's a very big financial side, but there's also an
12:53
Speaker 3: even bigger emotional.
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Speaker 2: Side, that's exactly and to.
12:56
Speaker 3: Then be slapping on additional costs and feeling like, oh,
12:59
Speaker 3: I didn't see that coming. Oh I didn't see that coming.
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Speaker 3: I think it shakes the trust you have with.
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Speaker 2: Your provider, really does.
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Speaker 4: Yeah, And you know, one of the things when I
13:08
Speaker 4: heard that some clinics were doing this, it just blew
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Speaker 4: my mind because some clinics, you go through a whole
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Speaker 4: IVF cycle and then they'll say, well, if you want
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Speaker 4: to freeze your excess embryos, there's an extra cost you
13:21
Speaker 4: have to pay. And we have always just routinely included
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Speaker 4: freezing embryos as because the treatment, that's part of the treatment.
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Speaker 4: And then obviously if someone's got a lot of embryos
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Speaker 4: to freeze, then having to sort of make a decision about, oh,
13:37
Speaker 4: can I actually afford to freeze the embryos I've made,
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Speaker 4: or can I afford to freeze.
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Speaker 2: All of them?
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Speaker 4: So these are things that are not going to be
13:46
Speaker 4: advertised on the website that you do have to look at.
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Speaker 4: I think as well, like what you were saying about
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Speaker 4: the emotional cost, IVF definitely is a bit of a
13:57
Speaker 4: roller coaster ride, and for someone it's really straightforward, especially
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Speaker 4: if they get pregnant on a first attempt or such.
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Speaker 3: A wily both emotionally and also financially.
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Speaker 2: That this is exactly right.
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Speaker 4: And so one of the things that I do suggest
14:14
Speaker 4: people do is look at the success rates of the
14:18
Speaker 4: clinic that they're looking at. So there is a website
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Speaker 4: called your IVF success dot com dot aut In the
14:26
Speaker 4: show notes, this website is funded by the Australian government
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Speaker 4: and all IVF clinics in Australia are invited to provide
14:35
Speaker 4: their results and so on this website you can go
14:38
Speaker 4: through and there's like IVF success rate calculated, so you
14:42
Speaker 4: can enter your details and it will give you some
14:45
Speaker 4: idea about the overall average chance of getting pregnant per
14:49
Speaker 4: IVF cycle, but it will also show you each individual
14:53
Speaker 4: clinic and you can look at their success rates.
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Speaker 2: That's so good, and.
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Speaker 4: This is really important because if a clinic may advertise
15:03
Speaker 4: cheaper costs, but if their success rates are lower.
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Speaker 2: Round exactly, yeah, wow.
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Speaker 4: And then there's the emotional costs that go with that
15:14
Speaker 4: because obviously the longer it takes to get pregnant, it's
15:18
Speaker 4: a difficult process, and so ideally you want to get
15:23
Speaker 4: pregnant as soon as you can from an emotional point
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Speaker 4: of view and also from a financial point of view.
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Speaker 3: Yeah, and we're trying to balance both of these things
15:31
Speaker 3: as well. My goodness, I didn't know that website existed
15:35
Speaker 3: and it makes me so happy it does, because when
15:38
Speaker 3: I was looking for things like this, you relying on
15:41
Speaker 3: Google reviews, yes, and people are incredibly emotional, so you
15:46
Speaker 3: can't really rely on that when it comes down to
15:50
Speaker 3: like the bad stuff versus the good stuff. Obviously fantastic,
15:54
Speaker 3: but just the idea that you can look at success
15:56
Speaker 3: rates and have more of a tangible measure of okay, well,
16:00
Speaker 3: going to a place that is really good at what
16:02
Speaker 3: they do, and I feel quite validated in that, yes,
16:05
Speaker 3: and spending money there. What kind of cost are we
16:09
Speaker 3: actually looking at when it comes to IVF.
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Speaker 4: So every clinic, as I said, is different, and looking
16:17
Speaker 4: at what they include per cycle is also, as I said,
16:22
Speaker 4: very important to consider at New Life IVF. The out
16:27
Speaker 4: of pocket cost for if we're doing an IVF cycle
16:31
Speaker 4: for a first cycle, that can be around five to
16:36
Speaker 4: six thousand dollars for the first round that will though
16:41
Speaker 4: often include hopefully freezing of embryos. Unfortunately, with IVF, the
16:48
Speaker 4: no clinic has one hundred percent success rates and so
16:52
Speaker 4: while some women do can see first time, for most
16:56
Speaker 4: women they are having to do more than one round
17:00
Speaker 4: and so hopefully, even though the first round that's when
17:03
Speaker 4: we do the egg collection and make embryos and hopefully
17:07
Speaker 4: freeze extra embryos, if a woman is not pregnant, then
17:12
Speaker 4: potentially the next round, instead of having to go through
17:14
Speaker 4: all the injections and the egg collection, we can just
17:18
Speaker 4: take an embryo out of the freezer and put that
17:22
Speaker 4: batch into them. The cost of that treatment is a
17:25
Speaker 4: lot less.
17:26
Speaker 3: Wow, And I feel like that's actually I won't say
17:29
Speaker 3: reasonable for what it is because I've got absolutely no
17:32
Speaker 3: idea what makes that cost up But I've got friends
17:34
Speaker 3: who are paying ten twelve thousand dollars for round, so
17:37
Speaker 3: that feels a lot more accessible. Is that something that
17:40
Speaker 3: you use?
17:40
Speaker 4: Well, what I will say is there is an upfront
17:44
Speaker 4: fee and that is in that range around ten to
17:49
Speaker 4: twelve thousand, but there are many care rebateses, so that
17:53
Speaker 4: sort of five or six thousand is more that out
17:56
Speaker 4: of pocket cost.
17:58
Speaker 3: Absolutely.
17:58
Speaker 4: The other thing we which isn't at all covered by Mediicare,
18:03
Speaker 4: but is something to consider is pre implantation genetic testing.
18:08
Speaker 2: Have you heard of that?
18:09
Speaker 3: I have not done that, but I have done all
18:12
Speaker 3: of the genetic testing. So I was that crazy lady.
18:15
Speaker 3: I don't know if crazy is it. I think it's smart.
18:18
Speaker 3: But I was that crazy lady who said to her husband, right,
18:20
Speaker 3: if we're going to have babies in a couple of years,
18:22
Speaker 3: I want to do all of our genetic testing and
18:24
Speaker 3: make sure that nothing's awry. So is it similar to
18:28
Speaker 3: doing all of the blood work?
18:30
Speaker 4: It's actually a bit more similar to did you do
18:33
Speaker 4: when you were sort of ten and a half weeks pregnant.
18:35
Speaker 2: Did you do the NIT the nipped?
18:37
Speaker 3: Yep, I did the NIP.
18:38
Speaker 4: So what it's more like having the NIPPED done on
18:42
Speaker 4: the embryo?
18:43
Speaker 5: Wow?
18:43
Speaker 2: For we put it back?
18:45
Speaker 3: What a piece of mind because that NIP tea test
18:48
Speaker 3: like it's happening at ten weeks, at which point that's
18:51
Speaker 3: a very very hard decision to make.
18:53
Speaker 2: That that's exactly right.
18:55
Speaker 4: So with this PGT, as I said, it is an
18:58
Speaker 4: extra cost, and not all clinics offer it, but for
19:03
Speaker 4: all women, especially as we are in our mid thirties
19:08
Speaker 4: or older, especially if we're looking at IV, Yes, we
19:12
Speaker 4: do just naturally start to produce more abnormal eggs, and
19:16
Speaker 4: unfortunately these will result in abnormal embryos. And we can't
19:22
Speaker 4: tell if an embryo is abnormal just by looking under
19:25
Speaker 4: the microscope. So if we put back an embryo and
19:29
Speaker 4: it is abnormal, a lot of the time it just
19:32
Speaker 4: won't stick and you won't be pregnant. But if it
19:36
Speaker 4: does stick, sometimes it can result in an early miscarriage,
19:40
Speaker 4: or sometimes you can get to that time of doing
19:43
Speaker 4: the NIP test and find out there's an abnormal pregnancy.
19:47
Speaker 4: And then there are some really difficult decisions to make.
19:51
Speaker 4: So if we do this NIP test on an embryo,
19:55
Speaker 4: we can't make an embryo normal.
19:57
Speaker 2: If it's not normal.
19:59
Speaker 4: Of course, we can select to put back the embryos
20:03
Speaker 4: that have normal results and have the best chance of pregnancy.
20:07
Speaker 4: And so with that, when we put back an embryo
20:10
Speaker 4: that's being tested, not only are the pregnancy rates higher,
20:15
Speaker 4: but also the miscarriage rates are much lower. So it
20:20
Speaker 4: is an extra cost to do this testing on embryos,
20:24
Speaker 4: but it might save you money in having transfers that
20:28
Speaker 4: will ultimately not result in an ongoing pregnancy. It will
20:33
Speaker 4: also save time by identifying the best embryos upfront, and
20:40
Speaker 4: also helping with emotional cost of treatment by going through
20:45
Speaker 4: not being pregnant or miscarrying.
20:47
Speaker 3: I was about to say, you are arguably paying a
20:52
Speaker 3: insurance cost to lower your trauma correct And I just
20:55
Speaker 3: think that that as somebody who has been there, I
20:58
Speaker 3: take all of my money, like I would love to
21:01
Speaker 3: be able to lower the cost of miscarriage and stuff
21:04
Speaker 3: like that. What type of cost are we looking at
21:06
Speaker 3: if Medicare isn't going to supplement that.
21:08
Speaker 4: Again, it is a varying cost per clinic at newly
21:12
Speaker 4: five EF the cost per embryo that you test is
21:17
Speaker 4: seven hundred and eighty dollars. But by comparison, if you
21:21
Speaker 4: had a frozen embryo transfer, the out of pocket cost
21:26
Speaker 4: for that can be something like just under three thousand dollars.
21:31
Speaker 4: And so if there was an abnormal embryo and you
21:35
Speaker 4: avoid putting that back, you have actually saved outlaying on
21:40
Speaker 4: a frozen embryo transfer that was never going to work anywhere.
21:44
Speaker 3: Yeah, and not only are you kind of saving that
21:46
Speaker 3: trauma and stuff, it's also time, especially if you're in
21:50
Speaker 3: that process having held a lot of friends' hands through
21:54
Speaker 3: this process, you don't want to muck around with doing
21:57
Speaker 3: around and then having to go through the waiting process
21:59
Speaker 3: again it not working and then oh it just it
22:02
Speaker 3: sounds like a lot. Yes, is that something that is
22:06
Speaker 3: going to be added to medicare at some point because
22:09
Speaker 3: I feel like this space is so fickle because there's
22:11
Speaker 3: changes and developments all the time. So have they caught
22:14
Speaker 3: up or are they not planned to?
22:15
Speaker 4: So there is some support from medicare for people who
22:20
Speaker 4: are doing PGT to look for specific genetic conditions. So
22:24
Speaker 4: you mentioned you had all the genetic testing when you
22:28
Speaker 4: were trying to get pregnant. And so when we do
22:31
Speaker 4: have couples where they are at risk of having a
22:34
Speaker 4: child with a genetic condition, then Medicare does provide some
22:38
Speaker 4: funding for that, but not yet for the general chromosome testing, which,
22:44
Speaker 4: as I said, is an issue for all women, especially
22:47
Speaker 4: as we yeah.
22:48
Speaker 2: Exact older.
22:49
Speaker 3: Yeah, and I'm hoping that as time goes on they
22:52
Speaker 3: add more and more things.
22:53
Speaker 4: Yeah, And look, it is a little bit of a
22:56
Speaker 4: slow process with Medicare. In the last year, we have
23:01
Speaker 4: embraced a new definition of infertility which does allow more
23:07
Speaker 4: people to access treatment and have Medicare support. So it
23:14
Speaker 4: used to like the traditional definition of infertility.
23:18
Speaker 2: To ask what's the new definition.
23:20
Speaker 4: The traditional definition was sort of a heterosexual couple having
23:25
Speaker 4: sex every month for a year and not conceiving.
23:28
Speaker 3: That's what I was told. It was, Yes, like you've
23:30
Speaker 3: got to try for a year and then you can
23:32
Speaker 3: talk to a fertility expert.
23:33
Speaker 2: But that's not.
23:34
Speaker 4: Exactly no, because our society is different than it was
23:38
Speaker 4: thirty years ago. We now have people who have issues
23:42
Speaker 4: with fertility for a variety of reasons. Maybe they are single.
23:47
Speaker 4: No matter how much you try on your own, you're
23:50
Speaker 4: not getting pregnant. Maybe you're in the same sex relationship.
23:55
Speaker 3: And you can try all you might, it's just not
23:57
Speaker 3: going to happen.
23:58
Speaker 4: And so the new definition encompasses a variety of both
24:04
Speaker 4: strictly medical causes but also other circumstantial reasons that would
24:11
Speaker 4: explain infertility.
24:12
Speaker 3: That's really cool.
24:13
Speaker 4: So that's definitely made treatment more accessible.
24:16
Speaker 3: I love that you mentioned before ovulation treatment, and one
24:20
Speaker 3: of my girlfriends has gone through IUI and that was successful.
24:25
Speaker 3: Can we just touch on what that is and financially
24:28
Speaker 3: what that costs, because from my understanding, IUI is like
24:33
Speaker 3: a step down from IVF. Is that how we would
24:36
Speaker 3: categorize it.
24:38
Speaker 4: Yes, So with IUI, what it stands for is intrauterine insemination,
24:44
Speaker 4: and that's where we prepare sperm. We monitor the woman
24:50
Speaker 4: to see when she's ovulating, and then we will insert
24:55
Speaker 4: some sperm into the uterus at the time of ovulation.
24:59
Speaker 3: Direct delivery. It's express, posts correct perfect.
25:03
Speaker 4: Now with insemination, there are certain circumstances where there's a
25:10
Speaker 4: real benefit. So for some couples there are actual issues
25:16
Speaker 4: with intercourse. They're not able to have intercourse, and that
25:20
Speaker 4: can be due to pain with intercourse erection ejaculation disorders,
25:27
Speaker 4: or it can also be again a same sex couple
25:31
Speaker 4: or a single woman where they need to use stonor
25:35
Speaker 4: sperm and then we need to get the sperm into
25:39
Speaker 4: them for them to get pregnant. So there are definite
25:42
Speaker 4: indications like that. There are other indications, for example, if
25:48
Speaker 4: the sperm parameters are a little bit below normal, by
25:52
Speaker 4: doing the insemination process, we wash and prepare the sperm
25:57
Speaker 4: to get a smaller volume, but highly concentrated, swimming sperm
26:01
Speaker 4: that we can deliver directly to the top of the
26:04
Speaker 4: uterus where it needs to go. In couples where they
26:09
Speaker 4: are having regular sex and they're ovulating and the sperm
26:14
Speaker 4: is normal, the insemination doesn't offer as much of a
26:21
Speaker 4: benefitt So sometimes when I have couples who have what
26:26
Speaker 4: is called unexplained infertility, so that means we've done all
26:30
Speaker 4: their tests and they're all normal and we don't know
26:33
Speaker 4: why they're not getting pregnant.
26:35
Speaker 3: That would be so frustrating. It's very frustrating hearing like
26:39
Speaker 3: there's no good reason.
26:40
Speaker 2: Yeah, it doesn't such a reason.
26:42
Speaker 3: Person.
26:43
Speaker 2: Yes, it doesn't mean there's not a reason.
26:45
Speaker 4: It just means our tests haven't shown what the reason
26:48
Speaker 4: is yet, And unfortunately it's about ten percent of the
26:51
Speaker 4: patients that we do see have unexplained infertility. So for
26:56
Speaker 4: someone under thirty five with unexpl infertility, I would be
27:02
Speaker 4: saying to them, look, if you keep trying naturally, you've
27:05
Speaker 4: got about an eight percent chance of getting pregnant every month.
27:10
Speaker 3: If it's much lower than I thought it would be.
27:12
Speaker 4: Well, unexplaining fertility means you've already been safe trying for
27:16
Speaker 4: a year and it hasn't happened. If we do incemination,
27:21
Speaker 4: that might boost it up to twelve percent.
27:25
Speaker 3: Oh, that's not as good as I thought it.
27:27
Speaker 4: No, And if you then do IVF in someone under
27:33
Speaker 4: thirty five, the pregnancy rate per cycle with IVF is
27:37
Speaker 4: more like fifty percent. Yeah, okay, So as I said,
27:41
Speaker 4: it's I do have some patients who really want to
27:45
Speaker 4: try in semination first, and that can be just because
27:51
Speaker 4: they're not quite ready to go down to my VF
27:55
Speaker 4: pathway and they feel like they want to try everything
27:59
Speaker 4: first before they embark on the IVF journey. But a
28:04
Speaker 4: lot of patients do ask about insemination, and when we
28:08
Speaker 4: talk about the actual success rates, then a lot of
28:12
Speaker 4: them do actually bypass inseemination and go straight to IVF.
28:17
Speaker 4: But as I said, in certain circumstances, as I said,
28:21
Speaker 4: if you actually haven't been managing to have intercourse at all,
28:25
Speaker 4: a preen, there really could be a benefit from having insemination.
28:31
Speaker 3: And that's where you want a good clinic and a
28:34
Speaker 3: doctor that you can sit down with and be like,
28:36
Speaker 3: here's all my cards on the table, here's what we've tried.
28:39
Speaker 3: And you've got to be so comfortable opening up and
28:41
Speaker 3: being like, so we did this, and we tried this,
28:44
Speaker 3: and this is how life is looking for us right now.
28:47
Speaker 3: And that's a big conversation to have. Yeah, Nicole, we
28:50
Speaker 3: are I feel like just getting into the thick of it,
28:53
Speaker 3: but there is a lot more to come. Right after
28:55
Speaker 3: a very quick break, all right, we are back with
29:01
Speaker 3: doctor Nicole from New Life IVF and we're discussing all
29:04
Speaker 3: things finance when it comes to your fertility and family planning.
29:08
Speaker 3: Now we've covered the process of IVF and what egg
29:12
Speaker 3: freezing looks like, and you'd mentioned costs relating to like
29:16
Speaker 3: other medications and stuff on your price charts, but they're
29:20
Speaker 3: ranging from like two hundred to four hundred dollars and
29:24
Speaker 3: I just don't know what I'm talking about when I
29:26
Speaker 3: look at that, So can you tell me a little
29:28
Speaker 3: bit more about them, and like what the medications are
29:31
Speaker 3: for and when they're introduced.
29:34
Speaker 2: Yes.
29:34
Speaker 4: So, in an IVF cycle, usually there are three main
29:41
Speaker 4: medications or maybe actually four, three to four main medications,
29:44
Speaker 4: depending on what treatment you're having. The first medication is
29:48
Speaker 4: one to try and make multiple legs. Right, so, naturally,
29:53
Speaker 4: as women, we tend to just produce one egg every month.
29:58
Speaker 4: While it's possible to do IVF in a natural cycle
30:02
Speaker 4: and just get one egg every month, they don't all fertilize,
30:07
Speaker 4: they don't all form embryos, and so the more eggs
30:11
Speaker 4: we can get vestigat the chance we have not only
30:15
Speaker 4: of getting a good embryo to put back on the day,
30:19
Speaker 4: but also getting extra embryos that we can freeze. And
30:23
Speaker 4: again talking about cost of treatment, the more embryos you
30:28
Speaker 4: can freeze, the less egg collections you have to go through,
30:32
Speaker 4: and therefore the cost of treatment if less. Usually some
30:37
Speaker 4: money is on one injection every day to try and
30:40
Speaker 4: make multiple eggs grow. After a few days they may
30:44
Speaker 4: start a second injection, which is to make sure you
30:47
Speaker 4: don't ovulate too early, so when you have multiple eggs growing,
30:53
Speaker 4: your hormone levels are higher than normal, and the brain
30:57
Speaker 4: thinks that you're ready to ovulate, and we don't want
31:00
Speaker 4: you to ovulate because obviously we want to get all
31:03
Speaker 4: the eggs.
31:04
Speaker 3: Yeah, so no, save them for us exactly.
31:07
Speaker 4: And then usually women are on injections for about ten
31:11
Speaker 4: days in total. And as I mentioned earlier, prior to
31:15
Speaker 4: having an egg collection, a women will usually be having
31:18
Speaker 4: some blood tests and scans to see when's going to
31:21
Speaker 4: be the best time to do the egg collection. And
31:24
Speaker 4: once we make that decision, there's a final injection we
31:28
Speaker 4: call the trigger injection, and that trigger injection actually starts
31:34
Speaker 4: the ovulation process. And what we want to do is
31:38
Speaker 4: then collect the eggs before ovulation actually occurs. So the
31:43
Speaker 4: ovulation process is really important for helping to mature the
31:47
Speaker 4: egg and make it ready so it's ready, ready to
31:50
Speaker 4: be inseminated or ready to freeze.
31:53
Speaker 3: Yeah cool.
31:54
Speaker 4: Then for women having egg freezing, that will be the
31:59
Speaker 4: end of their tree. But if a woman is doing
32:02
Speaker 4: IVF and she's having what we call a fresh embryo transfer,
32:06
Speaker 4: so that's usually putting the embryo back five days after
32:10
Speaker 4: the egg collection, then often she will be starting some
32:14
Speaker 4: progesterone to support the lining of the uterus and make
32:18
Speaker 4: sure the period doesn't come too early.
32:21
Speaker 2: Yes, and with.
32:22
Speaker 4: That progesterone, often they are vaginal.
32:26
Speaker 3: As sune pestores. Had to take progesterone to support my pregnancies.
32:32
Speaker 3: They suck.
32:32
Speaker 2: I'm sorry, Nicole, they're not pleasant. There are some injectable options.
32:38
Speaker 3: No, I'd prefer the pestory, thank you.
32:42
Speaker 2: Yees.
32:42
Speaker 4: So they're injections for around ten days and then progesterone
32:47
Speaker 4: for sort of two weeks from the egg collection until
32:51
Speaker 4: the pregnancy.
32:52
Speaker 3: Two weeks. I'm not gonna lie. That sounds good as
32:54
Speaker 3: someone who had to be on it for sixteen weeks,
32:57
Speaker 3: oh wow, one out of ten do not recommend.
33:00
Speaker 2: No, that that's a long time. It was a while yet.
33:04
Speaker 4: Look, if we have someone who is pregnant, I do
33:07
Speaker 4: often continue the projest sterne for a few more weeks
33:10
Speaker 4: until the pregnancy is established.
33:13
Speaker 2: But yeah, sixteen weeks.
33:14
Speaker 3: Yeah, and I should profess that for those of you
33:16
Speaker 3: who maybe are going, what the hell, Victoria, what's going on?
33:20
Speaker 3: I had recurrent miscarriage and so that's something that they
33:24
Speaker 3: do to hopefully make sure that the pregnancy stays and
33:27
Speaker 3: sticks because there was no good reason for my miscarriages,
33:31
Speaker 3: and I'm happy to talk about it. For those of
33:33
Speaker 3: you who maybe haven't seen my social media, there's a
33:36
Speaker 3: pinned post on my Instagram talking about it. But I
33:39
Speaker 3: think it's something that is really important to be open
33:41
Speaker 3: and honest about because it's not just me going through
33:45
Speaker 3: these things. And I didn't know Nicole that I would
33:48
Speaker 3: have to take pessories for fourteen weeks. And they're not
33:52
Speaker 3: cheap either, oh, they are like ninety dollars a box. Ye,
33:56
Speaker 3: and a lot of people in my DMS when I
33:58
Speaker 3: started talking about IVF and the costs associated. I feel
34:02
Speaker 3: like a lot of us in our heads, we go, okay, cool,
34:04
Speaker 3: around is going to be ten to twelve thousand dollars
34:07
Speaker 3: and we'll get a rebate, so we can anticipate about
34:09
Speaker 3: six grand.
34:10
Speaker 5: Right.
34:11
Speaker 3: There's lots of different you know, levers there. But some
34:14
Speaker 3: of our listeners have asked, what are some other out
34:19
Speaker 3: of pocket costs that might come up during the process.
34:22
Speaker 4: With the medications? If your cycle is covered by Medicare,
34:27
Speaker 4: and if you are a Medicare card holder, I would
34:31
Speaker 4: say a majority of IVF treatment is covered by Medicare
34:35
Speaker 4: so the actual medications are covered by Medicare, but Medicare
34:41
Speaker 4: do have what they call a script fee. So I
34:45
Speaker 4: was talking about E two injections, the trigger injection and
34:50
Speaker 4: the progesterone. So that's for different medications. So Medicare will
34:55
Speaker 4: charge sixty dollars per medication, right, so you don't actually
35:02
Speaker 4: get charged for the medication.
35:04
Speaker 3: You're getting script yes, script to it.
35:07
Speaker 4: Yeah, And unfortunately that's a Medicare thing. It's not your
35:12
Speaker 4: IVF clinic charging yet. During your treatment, any blood tests
35:17
Speaker 4: and scans you have for monitoring, they should be covered
35:21
Speaker 4: by your IVF clinic fee. But the IVF cycle does
35:26
Speaker 4: only go until the pregnancy test. And so when you
35:31
Speaker 4: are pregnant, most clinics will do some monitoring for a
35:35
Speaker 4: few weeks to make sure the pregnancy has established itself.
35:40
Speaker 3: To ask, when do we get to graduate.
35:42
Speaker 4: Yes, yes, So what we usually do at our clinic
35:45
Speaker 4: is some blood tests. For so when you find out
35:49
Speaker 4: you're pregnant, you're four weeks pregnant, we usually do a
35:52
Speaker 4: blood test at four weeks, five weeks, six weeks, and
35:55
Speaker 4: then we will get patients to have an ultrasound at
35:58
Speaker 4: seven weeks and at that point in time, we are
36:02
Speaker 4: hoping to see a baby and a heart rate. And
36:04
Speaker 4: that's usually when you are graduate.
36:07
Speaker 3: You get to graduate, you get to go, which is exciting.
36:10
Speaker 4: So with the IVF cycle, those tests once you are
36:15
Speaker 4: pregnant are no longer covered by the IVF cycle fees.
36:20
Speaker 4: So yes, there can be a cost for the scan
36:23
Speaker 4: with the blood tests. If you are lucky, your clinic
36:27
Speaker 4: may b bill those ones for you.
36:30
Speaker 3: Yeah. So when we graduate, and this may be a
36:33
Speaker 3: naive question, is our pregnancy then considered vanilla pregnancy and
36:39
Speaker 3: I can just go through the public healthcare system or
36:42
Speaker 3: do I need another like private obgyn that I can
36:47
Speaker 3: work with to support it in a different way, Like what.
36:49
Speaker 2: Does that look like?
36:50
Speaker 4: Yeah, I would say, I mean IVF is so common
36:54
Speaker 4: at the moment, we sort of estimate around ten percent. Wow,
36:59
Speaker 4: kids are born through IVF. So as long as the
37:04
Speaker 4: pregnancy itself is like there's a single pregnancy and there
37:10
Speaker 4: are no you don't have any previous obstetric complications or
37:16
Speaker 4: any severe medical issues yourself, we would actually treat it
37:21
Speaker 4: just like a normal pregnancy. I do often say to patients,
37:26
Speaker 4: We're really lucky. We have a really good public hospital system,
37:30
Speaker 4: especially for obstetrics, unlike other areas in medicine. You know,
37:35
Speaker 4: you need a knee joint replacement, you go on a
37:37
Speaker 4: waiting list for however many months.
37:39
Speaker 2: You can't put pregnant women.
37:42
Speaker 3: Would you actually have your baby next year not this year,
37:45
Speaker 3: because we've got a wait list.
37:47
Speaker 2: That's not going to have it's not going to happen. No.
37:50
Speaker 4: So look, one thing with the public hospital system is
37:53
Speaker 4: they do work on a sort of triage patterns. So
37:56
Speaker 4: basically I have heard of cases where someone was going
38:00
Speaker 4: to get induced on a certain day, but then there
38:04
Speaker 4: were some other more urgent cases that came up and
38:08
Speaker 4: so their induction was pushed to the next day or
38:12
Speaker 4: the day after. But at the same time, if you're
38:15
Speaker 4: the person who does need urgent care, you were going
38:19
Speaker 4: to get looked after straight away, because as I said,
38:22
Speaker 4: you can't postpone or delay obstetric issues.
38:26
Speaker 3: Yeah, absolutely absolutely, and stuff like that can go so
38:30
Speaker 3: awry so quickly.
38:32
Speaker 2: Yeah.
38:32
Speaker 3: Yeah, I feel like it's nice to know that the
38:35
Speaker 3: public system is well equipped. And it's a funny conversation
38:40
Speaker 3: because like I had private obg ans when I had
38:43
Speaker 3: both of my children, and they were like Victoria, like
38:47
Speaker 3: the public system at the end of the day is
38:49
Speaker 3: where you'll be transferred if things go awry, and that
38:52
Speaker 3: gave me a lot of peace to go. We are
38:55
Speaker 3: in exactly the right place we need to be in.
38:57
Speaker 3: Can I just say that it has been so good
39:00
Speaker 3: to have all of this information I guess presented to
39:03
Speaker 3: you up front, like to be able to have this
39:05
Speaker 3: conversation and have someone I don't know in their car
39:09
Speaker 3: or on their morning walk, be able to listen to
39:12
Speaker 3: a conversation between two women talking about a topic that
39:15
Speaker 3: maybe they haven't opened their mouths about yet, or maybe
39:17
Speaker 3: they're not ready to reach out to their GP for
39:19
Speaker 3: their referral yet, Especially because I know that so many
39:23
Speaker 3: people in our audience are already invested but feeling really overwhelmed.
39:26
Speaker 3: It's just been really really cool to feel from my perspective,
39:32
Speaker 3: safe to ask these questions, but from my community's perspective,
39:35
Speaker 3: knowing that I've got somebody who's so well I guess
39:40
Speaker 3: equipped in this space to be like, Nope, this is
39:41
Speaker 3: what that looks like, this is what that looks like.
39:43
Speaker 3: Here are the medications. I just know that if I
39:46
Speaker 3: went into the process now, I'd be like, Okay, I've
39:47
Speaker 3: got a little bit of background, and I always say
39:50
Speaker 3: you need to know enough to be dangerous. You don't
39:52
Speaker 3: need to know the whole thing. You just need to
39:54
Speaker 3: know enough that you can ask the right questions and
39:56
Speaker 3: feel empowered. But I do feel like the financial commitment
40:00
Speaker 3: should be a very big part of this as well. Absolutely,
40:04
Speaker 3: do you have to have these conversations with people, Yeah,
40:07
Speaker 3: all the time.
40:08
Speaker 4: I think in all areas of medicine there should be
40:12
Speaker 4: financial consent that's obtained. But I do have patients where
40:18
Speaker 4: because they of their financial circumstances, I will refer them
40:24
Speaker 4: maybe to public IVF options if they're available, because it's
40:30
Speaker 4: just not possible for them to afford treatment in the
40:33
Speaker 4: private setting. But obviously, if you can do IVF in
40:39
Speaker 4: the private setting, there are so many options, And you
40:45
Speaker 4: do really need to sort of get an itemized costing
40:49
Speaker 4: to know what you're going to be up for. You
40:52
Speaker 4: do need to look at the success rates to sort
40:56
Speaker 4: of give you an idea about how many treatment cycles
40:59
Speaker 4: you're going to need. And you do need to look
41:02
Speaker 4: at what's included with your treatment, even things like counseling.
41:08
Speaker 4: So at New Life, we have counselors and we provide
41:12
Speaker 4: counseling to patients if they are struggling during treatment, and
41:18
Speaker 4: that can be women that can be their partners or
41:22
Speaker 4: the couples together. And this is just part of our
41:26
Speaker 4: routine treatment and care that we offer. And I have
41:32
Speaker 4: heard that some clinics offer counseling but only in a
41:37
Speaker 4: group session or only online, and I think that that's
41:43
Speaker 4: quite confronting, especially as you mentioned, it is so personal.
41:48
Speaker 4: And I'm always amazed at what some clinics are doing.
41:53
Speaker 4: And usually I'm actually relying on my patients to say, hey,
41:58
Speaker 4: I've come to you because I went to this other
42:01
Speaker 4: clinic and this is what they were doing, or yeah.
42:06
Speaker 4: I meet people who've come from elsewhere and I say, okay,
42:09
Speaker 4: this is these are the costs of we're doing this,
42:11
Speaker 4: this and this, and they say, oh, I don't have
42:14
Speaker 4: to pay extra for that.
42:16
Speaker 2: I'm like no, now.
42:17
Speaker 3: Of course, not, as I'm not taking advantage of you. Yeah,
42:20
Speaker 3: I feel like you are being much kinder about this
42:24
Speaker 3: than you could be, because it's like financial advice. So
42:27
Speaker 3: as someone who used to be a financial advisor, I
42:30
Speaker 3: have clients come to me and be like, this is
42:31
Speaker 3: what another practice has done, and I'd be like, oh,
42:34
Speaker 3: my goodness, like and fly absolutely off the chain because
42:37
Speaker 3: it's crazy to me how different industries and obviously your
42:42
Speaker 3: space and my space could not be further from different,
42:45
Speaker 3: but I just look at it and go, my goodness,
42:48
Speaker 3: In every aspect, there's always someone who is willing to
42:51
Speaker 3: take advantage of a situation and milk it for what
42:54
Speaker 3: it's worth, and that breaks my heart, especially when it's
42:57
Speaker 3: such an emotional field journey. And that's where I want
43:01
Speaker 3: to add a little bit more of a caveat, I suppose,
43:04
Speaker 3: because this space is filled with fertility or IVF specific
43:09
Speaker 3: loans and please, I'm not saying they're bad, but please, please,
43:14
Speaker 3: please do your research because you might just be better
43:18
Speaker 3: off getting a standard personal loan rather than an IVF
43:22
Speaker 3: branded one if you're going down that route. And that's
43:25
Speaker 3: the you know, financial decision that you've made, because these
43:30
Speaker 3: options exist, and there are lots of different options. You
43:34
Speaker 3: could even potentially access your superannuation to help you fund
43:38
Speaker 3: your IVF journey. Is that something that you've seen a
43:40
Speaker 3: lot of your patients.
43:41
Speaker 2: Yes, a few patients do that.
43:44
Speaker 4: Obviously, I would say, where possible, look at other options
43:48
Speaker 4: because your supers really important.
43:50
Speaker 3: Thank you, But it's so nice to know it's an option.
43:54
Speaker 3: Let's preserve it.
43:55
Speaker 4: So one of their things is there is a special
44:00
Speaker 4: application form and it does need to be completed by
44:05
Speaker 4: someone other than your IVF specialist or doctor. And as
44:11
Speaker 4: part of that form, one of the things is there
44:14
Speaker 4: are only certain situations where you can access your SUPER
44:19
Speaker 4: and for patients doing IVF, the main thing or indication
44:24
Speaker 4: is mental health issues. So what you need to be
44:29
Speaker 4: prepared for is the doctor completing the form has to
44:34
Speaker 4: state how your infertility has impacted on your mental health
44:39
Speaker 4: or contributed to deterioration in your mental health. Some super
44:45
Speaker 4: companies do require you to actually see a psychiatrist. Other companies,
44:51
Speaker 4: if you've had your GP managing your mental health issues,
44:55
Speaker 4: the GP can sometimes complete that form. So that can
45:01
Speaker 4: take a little bit of time to organize, especially if
45:05
Speaker 4: you are required to see a psychiatrist. I've had patients
45:08
Speaker 4: where they've had to wait several months to get an
45:11
Speaker 4: appointment with a psychiatrist. Yeah, so if you do have
45:16
Speaker 4: a GP who you've who've supported you and seen you
45:20
Speaker 4: before for mental health issues, that's what the form is.
45:24
Speaker 4: You can't just say I want to do IVF, give
45:27
Speaker 4: me my super to pay for that, there does have
45:31
Speaker 4: to be this application on mental health grounds.
45:34
Speaker 3: Yeah, and that makes sense, And I've had a lot
45:37
Speaker 3: of people say that's not fair. It's my super I
45:39
Speaker 3: should be able to spend it in line with whatever
45:41
Speaker 3: I would like. But ultimately, superanuation exists to provide for
45:45
Speaker 3: you in retirement, and quite bluntly, it's the government's priority
45:51
Speaker 3: to make sure that you're financially sound and you're not
45:54
Speaker 3: going to be destitute. And as much as it is
45:57
Speaker 3: your money and you do have control over it, it
45:59
Speaker 3: has been allocated for that, and so I get why
46:02
Speaker 3: it's such a serious process. It just breaks my heart
46:05
Speaker 3: a little bit knowing that it could be the reason
46:08
Speaker 3: you're being held up like you know that that's the
46:10
Speaker 3: only way you're going to access it, but you can't
46:12
Speaker 3: get your fertility treatment until you get a psychiatry appointment,
46:15
Speaker 3: and it's just a circus that I wish people didn't
46:18
Speaker 3: have to be involved in.
46:20
Speaker 4: But having said that, so sometimes I have patients and
46:23
Speaker 4: they are not on any psychiatric medications or antidepressants or
46:28
Speaker 4: anything like that. But nonetheless, most of my patients, by
46:32
Speaker 4: the time they are getting to do IVF, they already
46:36
Speaker 4: do have a degree of anxiety, maybe some depression as
46:41
Speaker 4: well relating to their infertility.
46:44
Speaker 2: Absolutely.
46:44
Speaker 4: So even someone might say, well, look, i've never seen
46:49
Speaker 4: my GP before for mental health issues, it doesn't actually
46:55
Speaker 4: mean that it's a no, that it's a no yeah,
46:58
Speaker 4: because even if you don't need to be medicated, you
47:04
Speaker 4: will probably still have those feelings because that's normal when
47:08
Speaker 4: you've been trying to get pregnant and it's not happening.
47:11
Speaker 3: And I cannot imagine that a doctor exists where they
47:15
Speaker 3: don't understand that the IVF process is inherently emotionally draining. Yes,
47:20
Speaker 3: So I just can't imagine you're going to a doctor
47:23
Speaker 3: and going I think I need to access my super
47:25
Speaker 3: and they go no, no, no, Like they're not financial advisors.
47:29
Speaker 3: I'm sure that they would recommend LL. Maybe you should
47:31
Speaker 3: chat to an advisor and see what your options are.
47:33
Speaker 3: But here's the process and I can help you go
47:35
Speaker 3: down it. Am I right in saying that?
47:37
Speaker 4: Okay?
47:38
Speaker 3: Very cool?
47:39
Speaker 2: Now?
47:40
Speaker 3: I shared a poll on our Instagram stories because I
47:43
Speaker 3: was like, all right, guys, I've got doctor Nicole in
47:46
Speaker 3: what are your rapid fire questions? And I've taken some screenshots.
47:50
Speaker 3: Would it be Okay, if I ask a few questions
47:53
Speaker 3: and we can rapid fire through them. Because I know
47:55
Speaker 3: that I'm running out of time, we go and I'm
47:58
Speaker 3: trying very hard to make the most of it. I'm
48:00
Speaker 3: not going to use names. I'm just going to ask
48:02
Speaker 3: the questions. Someone said, I'm three months into trying. Should
48:07
Speaker 3: I be looking at IVF? I'm thirty two years old.
48:10
Speaker 3: Is there a process I'm supposed to be following? So
48:13
Speaker 3: that's that perfect example. CGP get a referral to see
48:19
Speaker 3: a specialist and just start the investigation process. It doesn't
48:23
Speaker 3: mean you have to do IVF, but you can get
48:26
Speaker 3: the ball rolling, and it takes time to do tests,
48:29
Speaker 3: so you can still be trying in the meantime. Very cool.
48:33
Speaker 3: The next person has said, I'm thinking about freezing my eggs,
48:36
Speaker 3: but I have a partner. What are the chances of
48:39
Speaker 3: successful outcomes from egg freezing versus freezing an embryo?
48:44
Speaker 4: Well, what I would say is there is more certainty
48:49
Speaker 4: with freezing embryos. So with eggs, we have to make assumptions,
48:55
Speaker 4: like we have to assume that of the eggs, this
48:58
Speaker 4: many will fertilize, this many will form embryos, and so
49:03
Speaker 4: we can give you an estimate. When we are freezing embryos,
49:07
Speaker 4: they have already fertilized and made embryos, so our estimation
49:14
Speaker 4: is a lot clearer or precise. Yes, so I think
49:19
Speaker 4: when I'm talking to people about freezing eggs or embryos, Yeah,
49:23
Speaker 4: I have a lot of patients who do come and say,
49:25
Speaker 4: I'm in an early relationship. I'm not quite sure. Look,
49:30
Speaker 4: the main advantage of freezing eggs is that they're your eggs, and.
49:35
Speaker 3: You could pick a different partner.
49:37
Speaker 4: Exactly, or if your relationship breaks down, you're not ever
49:42
Speaker 4: you're not being tied to that. So when you freeze embryos,
49:46
Speaker 4: you are actually then tied to the person who you
49:50
Speaker 4: created embryos with. Yes, and if you meet another partner
49:54
Speaker 4: down the track, obviously you're not going to use those embryos.
49:58
Speaker 4: But sometimes I have people who who are in committed
50:02
Speaker 4: relationships and they will say, well, look, I'm thirty seven now,
50:07
Speaker 4: but we've got these various things happening over the next
50:11
Speaker 4: twelve to twenty four months, and I won't be ready
50:13
Speaker 4: to get pregnant till I'm thirty nine, and so therefore
50:17
Speaker 4: I'd rather be making embryos now when I'm thirty seven.
50:21
Speaker 4: So in that situation, if you are in a committed relationship,
50:25
Speaker 4: then definitely freezing embryos gives you a much better idea
50:29
Speaker 4: about what you've got frozen.
50:30
Speaker 3: Yeah, And it to me is kind of magic, the
50:33
Speaker 3: idea that you could freeze embryos, have a baby and
50:37
Speaker 3: still have an embryo that was made at the same time,
50:40
Speaker 3: but then all of a sudden your babies have a
50:42
Speaker 3: three or four year age difference or even more.
50:44
Speaker 4: Yeah, I have heard the term is twibblings twibblings, so
50:49
Speaker 4: twins but siblings.
50:50
Speaker 3: That's really cute. Another person has said, how does egg
50:55
Speaker 3: freezing and medicare work if you have endo?
50:59
Speaker 2: Yeah?
50:59
Speaker 4: As I said, the definitions for infertility have become a
51:04
Speaker 4: lot more inclusive. If I have a patient who is
51:08
Speaker 4: doing a freezing and they have endometriosis, I would be
51:13
Speaker 4: putting them through under medicare.
51:15
Speaker 3: Very cool. I have a question, and I have not
51:19
Speaker 3: heard this term. Someone said, what is a mosaic embryo?
51:24
Speaker 3: And do you know more about the outcomes?
51:28
Speaker 4: Yes, So what a mosaic embryo refers to is this
51:32
Speaker 4: pre implantation genetic testing I was talking about, right, So
51:36
Speaker 4: most embryos are either normal or not normal, but some
51:41
Speaker 4: embryos come back with a mosaic result. And what that
51:45
Speaker 4: means is of the cells we test, some are normal
51:49
Speaker 4: and some are abnormal, so it's a combination of normal
51:53
Speaker 4: and abnormal cells. We know that human embryos do have
51:58
Speaker 4: the capacity to repair themselves, and so there is actually
52:04
Speaker 4: quite a lot of evidence now that putting back a
52:07
Speaker 4: mosaic embryo actually they do have quite decent pregnancy rates
52:12
Speaker 4: and live birth rates. We would always recommend putting obviously
52:16
Speaker 4: normal embryos back first where possible, but there are some
52:20
Speaker 4: women who never get normal embryos, especially as they get older,
52:25
Speaker 4: and maybe their best embryo is a mosaic embryo. So
52:30
Speaker 4: when putting back a mosaic embryo, something that's really important
52:34
Speaker 4: is having good genetic counseling beforehand.
52:39
Speaker 2: And again this could.
52:40
Speaker 4: Be another extra cost through an IVF clinic, so at
52:45
Speaker 4: New Life, our genetic counseling is again included in the
52:50
Speaker 4: payments that patients are making. It's not an extra cost,
52:54
Speaker 4: but patients do just need to be aware that an
52:59
Speaker 4: embryo can correct itself, but it may not correct itself,
53:04
Speaker 4: and so if we do put back a mosic cambrio
53:07
Speaker 4: when someone gets pregnant. We would often suggest, for example,
53:11
Speaker 4: having an amniosyentesis to just confirm that result. I've definitely
53:16
Speaker 4: had quite a few patients who've put back mosic cambrios
53:20
Speaker 4: and have healthy children born from that. So, as I said,
53:24
Speaker 4: it's not our first line go to option, but it
53:28
Speaker 4: is an option, and with appropriate genetic counseling, we can proceed.
53:33
Speaker 3: That's very cool that those options exist. Now I have
53:37
Speaker 3: two more questions for you. The second last is how
53:41
Speaker 3: much does it cost to use donus sperm?
53:44
Speaker 2: That is quite complicated. Sorry, I thought very complicated.
53:48
Speaker 3: Like it's X and I'd be like cool, moving on.
53:51
Speaker 2: Yep.
53:52
Speaker 4: So with donusperm, there is clinic recruited donor sperm, and
53:57
Speaker 4: then some clinics also offer overseas donor sperm as well.
54:03
Speaker 4: The issue is it's very difficult to transcruit sperm donors.
54:09
Speaker 2: No, actually, the transport's fine.
54:11
Speaker 4: There are very specialized couriers who are experienced at moving
54:16
Speaker 4: eggs and sperm.
54:17
Speaker 3: You never know what's between states, in between countries.
54:21
Speaker 2: No, you do not know.
54:23
Speaker 4: There are specialized couriers and specialized containers and packaging to
54:29
Speaker 4: sort of keep them.
54:31
Speaker 3: You can just import it.
54:33
Speaker 2: Well, no, you can't just sound.
54:35
Speaker 4: It is a process and ultimately any sperm that we
54:40
Speaker 4: import does need to comply with our local laws and legislation.
54:46
Speaker 4: But invariably when with the overseas sperm, there's additional costs.
54:53
Speaker 4: But with the sperm, there are often fees to secure
54:58
Speaker 4: a sperm donor, and then there are fees to use
55:02
Speaker 4: sperm each time. Okay, so part of the securing a
55:07
Speaker 4: donor is for example, in Victoria, a sperm donor can
55:12
Speaker 4: donate to up to nine different women. So by securing
55:17
Speaker 4: your spot, you've got that, yeah, okay out of nine.
55:22
Speaker 4: We always do genetic testing and we do like an
55:26
Speaker 4: extended panel to make sure there are no issues with
55:29
Speaker 4: the sperm donor that you're using, and there is a
55:33
Speaker 4: cost for that genetic testing. And then every time you
55:37
Speaker 4: use the sperm, you will pay a fee per use.
55:42
Speaker 4: So for example, someone doing insemination with donor sperm, each
55:47
Speaker 4: time they have in semination, they will pay a fee
55:50
Speaker 4: to use the donor sperg whereas someone else if they
55:54
Speaker 4: are doing IVF, they will pay a fee in their
55:58
Speaker 4: first round of IVF. When we using the sperm. But
56:02
Speaker 4: when we do say a frozen embryo transfer, because the
56:05
Speaker 4: embryos already created, they don't pay anything using the sperm.
56:09
Speaker 2: Again.
56:10
Speaker 3: Yeah, wow, I had literally no idea this space. It's
56:14
Speaker 3: like equal parts of magic and mystery to me. And
56:18
Speaker 3: the last question, which I think a lot of people,
56:21
Speaker 3: especially if they're listening to this episode, are going to
56:23
Speaker 3: resonate with, how do I get over the anxiety of
56:27
Speaker 3: just starting the process. I'm really scared that I might
56:30
Speaker 3: end up paying for a loss.
56:32
Speaker 4: What I would say is, as you said, just sort
56:35
Speaker 4: of trying to work out who is someone you can see,
56:39
Speaker 4: who you can trust. As I was mentioning earlier, about
56:42
Speaker 4: ten percent of kids are blond through IVF. So actually,
56:48
Speaker 4: I think if people do start talking to friends and family,
56:52
Speaker 4: they will find someone who has done IVF. And so
56:57
Speaker 4: I think yet talking with friends and fans, family, seeing
57:01
Speaker 4: who they use, where they're happy with them. So word
57:05
Speaker 4: of mouth is really good. And I must say, I
57:09
Speaker 4: have a lot of patients where they'll say you treated
57:12
Speaker 4: my sister, you treated my friend at work, and so
57:15
Speaker 4: sometimes it's not necessarily the GP who's referred them to me,
57:20
Speaker 4: but they've gone to their GP saying I want to
57:22
Speaker 4: see this doctor because they've spoken with their friends.
57:26
Speaker 3: That's the best.
57:27
Speaker 4: Obviously, if you have like a good GP, especially a
57:32
Speaker 4: GP who's sort of more focused on younger people and fertility,
57:39
Speaker 4: they will often have other patients, and patients will speak
57:43
Speaker 4: to their GP and say I saw this person, I
57:45
Speaker 4: didn't like them. And so if you really don't have
57:48
Speaker 4: any contacts, speaking to your GP is good. And then
57:53
Speaker 4: I think as well, in this day and age, there
57:56
Speaker 4: are lots of webinars and POGs and other things, and
58:01
Speaker 4: so sometimes you can access an IVF clinics website and
58:06
Speaker 4: there will be videos or links to videos, and you
58:10
Speaker 4: can get a feel if someone's going to be a
58:12
Speaker 4: good fit for you. And obviously sometimes even locations and
58:17
Speaker 4: important things, I mean, fertility treatments hard enough. You don't
58:21
Speaker 4: want to be, you know, having to lug it.
58:24
Speaker 3: Two hours to get there when you're already tired and
58:28
Speaker 3: pumped full of hormone exactly.
58:30
Speaker 4: But at the same time, I guess this is one
58:33
Speaker 4: good thing from COVID. You know that telehealth appointments are
58:38
Speaker 4: now very common, almost the norm. So while I do
58:43
Speaker 4: like to meet my patients at least once in the court.
58:47
Speaker 4: I do have a lot of patients who we do
58:50
Speaker 4: telehealth appointments, just because it is really hard to, you know,
58:54
Speaker 4: when you're working full time to actually get out in
58:57
Speaker 4: the middle of the day go to an appointment when
59:00
Speaker 4: the petrol costs however much.
59:02
Speaker 2: At corn.
59:06
Speaker 3: Hospital parking is as astronomical as the fuel crisis is.
59:11
Speaker 3: Oh my goodness. Can I just say how grateful I
59:14
Speaker 3: am to have finally gotten you on the podcast. I
59:16
Speaker 3: got to do a webinar with you, and I was like,
59:18
Speaker 3: it's going to happen, and we finally have made that
59:20
Speaker 3: a reality. I just know that so many people within
59:24
Speaker 3: our community have had their questions answered finally. So thanks
59:28
Speaker 3: for hanging out, Thanks for your wisdom, thank you for
59:31
Speaker 3: discussing all things fertility. And I'm sure this is not
59:33
Speaker 3: the last time that I get to share you with
59:35
Speaker 3: our community. My friends. I'm going to share all of
59:38
Speaker 3: the important links that Nicole has mentioned in the show
59:41
Speaker 3: notes so that you can continue learning about your fertility
59:44
Speaker 3: options and everything that is available to you. And if
59:47
Speaker 3: you have loved this conversation just as much as I have,
59:50
Speaker 3: please share it with somebody, because I promise it's not
59:53
Speaker 3: as overwhelming as it feels once you dive in and
59:57
Speaker 3: start listening to conversations, because the people, especially people like Nicole,
1:00:02
Speaker 3: are just here to support you, and they are wildly
1:00:04
Speaker 3: passionate about doing so. Please subscribe to make sure that
1:00:08
Speaker 3: you never miss an episode, and my friends, I will
1:00:11
Speaker 3: see you on Friday for Friday Drinks. The advice shared
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