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For health and legal professionals with an interest in bioethics
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The big business of babies
TONY Abbott and Peter Costello blundered when they tangled with the IVF industry over statistics. There is nothing in which Australia's IVF doctors are more expert than their success rates. IVF is a gamble and women seek out clinics offering the best odds. So IVF doctors never stop talking about the odds: in their journals, at their conferences, on their websites. When dodgy competitors offer better odds, they warn patients that the statistics might have been finessed. Bamboozling politicians and journalists with statistics is a doddle. It's a familiar tactic. Every subsidised industry under threat launches a blizzard of statistics and releases photos of happy customers. It's called spin doctoring. The $200 million IVF industry is not just guys in white coats and stethoscopes. It's also guys in dark suits and BMWs. If the Government trims $7 million from its Medicare budget, perhaps 250 women will miss out on funding for another attempt at artificial conception. But Australia's IVF clinics will lose $7 million in revenue. Do you think they'll give this up without a fight? Statistics about success rates are readily available, but there are precious few about anything else in the IVF industry. If fertility doctors want to protect what is arguably the most generous government subsidy for IVF cycles in the world, they should be willing to provide information about some hard questions. What about the health of IVF babies? A world-class study conducted in Western Australia suggests 9 per cent of IVF babies have birth defects, compared to 4 per cent of healthy babies. As Lord Robert Winston, one of the pioneers of IVF, has observed: ``Reports of a treatment that leaves almost 10 per cent of children handicapped in some way must not be dismissed as a mere statistical quirk''. WHY aren't any long-term studies of IVF children's health being done? More than 20 years have passed since the birth of the first IVF children. But no one has bothered to track their health, even though it is quite likely that exposing an embryo or a fetus to the harsh environment of a Petri dish can affect its health in later years. A surprisingly negative report from the UK's Medical Research Council concluded last year that the evidence for the long-term health of IVF babies was relatively weak. Where will the IVF babies stop? The proportion is climbing every year. In 1995, IVF babies accounted for about 1 per cent of births. By 2002 it was about 2.7 per cent. This is one of the highest ratios in the world, although the leader is Denmark with 4 per cent. Is this unstoppable? IVF supremos are hoping so. The chairman of Sydney IVF, Rowan Ross -- who is also an investment banker -- said last year: ``In the future you will have sex for fun, but when you want babies, you'll have IVF.'' A great business plan, Rowan, but will you still expect the Government to pick up the tab? How will IVF affect our declining population? It's stupid to whinge about declining fertility on Monday and cut back on IVF on Tuesday, say the Government's critics. Maybe not. The countries with the highest rates of IVF births are also among the countries with the lowest fertility rates. It could be that women use IVF as a safety net and postpone child bearing until the last tick of their fertility clock. But for about 65 per cent of them it will be too late. So generous IVF funding could actually be sabotaging efforts to boost the fertility rate. These are only some of the unanswered questions about the IVF industry. IF doctors can't answer them, why shouldn't the Government consider putting the sacred cow of fertility treatment on a diet? And perhaps the Government could add one more question to the list. An official report this month for the New Zealand cabinet says one IVF baby in a thousand is implanted in the wrong woman in the UK. How often does this happen in Australia? mcook@australasianbioethics.org.
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