Public funding of fertility treatment – all your questions answered!

Almost every client through our doors is interested in whether they qualify for public funding of fertility treatment.  We’ve asked Repromed public funding coordinator, Vanessa Holmes, to provide answers to the common questions she is asked.

Repromed offers publicly funded treatment for Northern Region Fertility Services which covers Auckland, Waitemata, Counties Manukau and Northland, so this Q&A is relevant for those living in these areas. See the map below.

Map - publicly funded fertility services in the Northern Region

 

 

 

 

 

 

How do I know if I qualify for public funding? 

There is a list of criteria that needs to be met in order to qualify for a ‘first specialist appointment’ (FSA) which determines eligibility for public funding.  This criteria to qualify for the appointment includes the following key points:

  • Has been unsuccessful with pregnancy after 12 months of intercourse
  • The woman must be under the age of 40 at the date of referral. Her BMI must be less than 35 on the first specialist appointment date and 32 or under on the treatment start date
  • The man must be under the age of 55 years at the date of referral. His BMI must be less than 40 on both the first specialist appointment date and the treatment start date
  • Cannot have two or more children (of any age, including adopted or from previous relationship if living at home at least half the time)
  • Both parties need to be NZ citizens or NZ residents or have a valid work visa for over two years
  • Both parties must be non-smokers for three months minimum prior to treatment
  • If the criteria are met, the doctor will refer their patient to the Northern Region Fertility Service.

It’s useful to clarify that the above criteria needs to be met just to qualify for the first specialist appointment – eligibility for public funding is not determined until after this appointment.  For full details of the Northern Region Fertility Service (NRFS) eligibility, you can see the full document HERE.  If unsure of your BMI, you can just Google ‘BMI calculator’ to work it out.

I think I meet the criteria above, what do I do next?

A fertility specialist needs to assess your eligibility for publicly funded fertility treatment.  This is done during a consultation at a fertility clinic – either after referral by a GP to the Northern Region Fertility Service (NRFS) which is around a 3-4 month wait, or via a private paid consultation which can be usually be booked in a week or two at Repromed.

Eligibility is based on a scoring system called the fertility Clinical Priority Assessment Criteria (CPAC) which requires 65 points out of 100.  If the criteria is met, the fertility specialist will refer you on to the NRFS and once approved, they will allocate you a fertility clinic. If you have had a public consultation for CPAC scoring, you will stay at that clinic for treatment, if you have had a private consultation then NRFS will allocate you to one of the three clinics that provide the publicly funded treatments for the region.

Can I choose the fertility clinic for publicly funded treatment?

No, you are allocated to a clinic and are not able to choose or transfer clinics once allocated.

What is the total waiting list from start to finish?

It fluctuates depending on the number of people eligible for treatment.  NRFS ensures that wait times are similar between clinics – typically it can be a minimum two year wait, but we suggest you check the Repromed public funding page for the current wait time, click HERE.

What treatments are covered by public funding?

Public funding covers up to two packages of treatment, if required. Typically this is IVF (In Vitro Fertilisation) or IUI (Intrauterine insemination).  One package of treatment can include, if necessary, ICSI (sperm micro-injection), frozen embryo storage, donor eggs, donor sperm, gestational surrogate and transfer of stored embryos.

I’ve already got a child, can I qualify for public funding? 

Yes, however not if you have two or more children, including adopted or from a previous relationship living with you 50% of the time.

If I have frozen embryos, is the cost for any further embryo transfers (FET) covered? 

Yes, the costs are covered by public funding for all embryos from the cycle, fresh or frozen, until a live birth is achieved.  If you have a baby from the publicly funded cycle and would like to try for a sibling from any additional frozen embryos in future, this is covered under public funding (unless you have two or more children and then this would be funded privately).

If my publicly funded cycle isn’t successful, can I have another round publicly?

Yes, up to two packages of treatment are publicly funded, provided you still meet the criteria.  If you have remaining frozen embryos from the original publicly funded cycle, they need to be used before the second cycle can begin.  You’ll need to be reassessed for eligibility. Typically the wait list for the second cycle shouldn’t be more than 6 months.

Is genetic testing included in public funded cycles?

In some situations the cost of Pre-implantation Genetic Diagnosis (PGD) is covered.  For example if a future child may be seriously affected by a disorder, or where there is a 25% risk of an affected pregnancy.  It would be worth reading the Northern Region Fertility Services (NRFS) document for the details, if this applies.

Is the criteria the same for same sex couple or single women? 

It’s not the same.  The criteria list above applies, but in addition, there needs to be a clear biological fertility issue and twelve donor insemination treatment needs to be completed before being eligible.

Do transgender people qualify for public funding? 

Yes, if they meet the eligibility requirements (e.g. age, BMI, etc), as per the CPAC scoring system.  This applies to a couple, where one or both are transgender and cannot achieve pregnancy together.

How about reversal of sterilization / vasectomy, is this covered by public funding?

Yes, provided the eligibility requirements are met (e.g. age, BMI, etc), as per the CPAC scoring system.

Is the treatment different for public vs private patients? 

Not at Repromed – all our clients are valued and get exactly the same treatment, medication and heartfelt care from our team.

For full details, take a look at the Repromed Public Funding page – it has the current waiting list time and a link to the Northern Region Fertility Services (NRFS) latest version of brochure on eligibility.

Repromed provides highly personalised care for all and offers public and private fertility treatment.  If you’re interested in discussing your fertility, new clients can book a free 15 minute phone consultation with a fertility doctor.  Phone 0800 483 105 or email .