Modelling and comparing the use of IVF and ICSI in Australia

TL;DR

This study estimates how many IVF/ICSI treatments are needed in Australia and compares it to actual usage, finding that more treatments are being used than expected for certain infertility types.

Contribution

A novel model was developed to estimate IVF/ICSI demand in Australia, revealing discrepancies between estimated need and actual uptake.

Findings

Approximately 35,300 couples were estimated to require IVF/ICSI in 2019, but 46,000 couples actually underwent the treatment.

Higher-than-expected uptake was observed for unexplained infertility, ovulation disorders, and endometriosis.

Tubal and severe male infertility had uptake levels that matched expectations.

Abstract

This study estimates the need of IVF/ICSI in Australia as compared to its actual uptake.

We created a model estimating for the annual demand for IVF/ICSI in a hypothetical infertile population, using demographic data from medical literature and Australian government databases. For each category of infertility (tubal, severe male, endometriosis, anovulation and unexplained), our estimated need for IVF/ICSI was compared to the actual IVF/ICSI uptake (ANZARD 2019). The model consisted of three categories depending on couples’ cause of infertility, i.e. couples with absolute indications for IVF/ICSI (couples with severe male factor infertility and tubal obstruction); couples with anovulatory infertility (couples with ovulation disorders) and couples with ovulatory infertility (couples suffering from unexplained infertility and endometriosis). The model was applied to each of these categories to determine the number of couples that would require IVF/ICSI treatment after failing to conceive naturally or after following alternative treatment plans. The main outcomes of this study were the estimate of IVF/ICSI cycles and the difference between the estimate and the reported number of IVF/ICSI cycles (2019 ANZARD report).

We estimated that approximately 35,300 couples required IVF/ICSI treatment in Australia in 2019, while in 2019 according to ANZARD, 46,000 couples underwent IVF/ICSI. A higher uptake of IVF/ICSI cycles than expected was specifically reported in couples with unexplained infertility, ovulation disorders and endometriosis, while for tubal and severe male infertility uptake seemed adequate.

In Australia, there seems to be overservicing of IVF/ICSI, specifically for unexplained, ovulatory and endometriosis-related infertility.

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