A comparative analysis of assisted reproductive technology cycles in Australia and New Zealand 2004-2007.
BACKGROUND
There are different funding arrangements for fertility treatments between New Zealand (NZ) and Australia. In NZ, there are two options for patients accessing treatment: either meeting specified criteria for age, no smoking and BMI for publicly funding or funding their own treatment. This differs from Australia, which has no explicit eligibility criteria restricting access to fertility treatment. An analysis of assisted reproductive technology (ART) in Australia and NZ was undertaken to consider the impact of these different funding approaches.


METHODS
Data were extracted from the Australian and New Zealand Assisted Reproduction Database between 2004 and 2007. A total of 116 111 autologous fresh cycles were included.


RESULTS
In Australia, more cycles were in women aged 40 years or older compared with those in NZ (23.5 versus 16.0%, P < 0.01). Single embryo transfer was more common in NZ than that in Australia, in women < 35 years of age (75.1 versus 59.6%, P < 0.01). In women <35 years, the crude rates of clinical pregnancy (37.5 versus 31.2%, P < 0.01) and live delivery (31.6 versus 26%, P < 0.01) following fresh ART cycles were significantly higher in NZ than that in Australia. These differences in outcomes persisted in older age groups.


CONCLUSIONS
The purpose of the criteria used in NZ to access public funding for fertility treatments is to optimize pregnancy outcomes. This approach has resulted in a healthier population of women undergoing treatment and may explain the improved pregnancy outcomes seen in NZ couples who undergo fertility treatments.
Farquhar
C M
CM
Department of Obstetrics and Gynaecology, University of Auckland, National Womens Hospital, Private Bag 92 189, Auckland 3, New Zealand. c.farquhar@auckland.ac.nz
Wang
Y A
YA
Sullivan
E A
EA
D000293:Adolescent; D000328:Adult; D000375:Aging; D001315:Australia; D016208:Databases, Factual; D004608:Eligibility Determination / Q000191:economics*; D005260:Female; D006291:Health Policy / Q000191:economics; D006292:Health Priorities / Q000191:economics; D006801:Humans; D007246:Infertility / Q000191:economics / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D009520:New Zealand; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D027724:Reproductive Techniques, Assisted / Q000191:economics / Q000706:statistics & numerical data; D056826:Single Embryo Transfer / Q000191:economics / Q000706:statistics & numerical data; D055815:Young Adult