Monash IVF bungles spark transparency, regulation questions in growing industry
Sarah* says she lost faith in Monash IVF over time. (ABC News: Patrick Stone)
In short:
Two high-profile instances of embryos being transferred into the wrong patient under Monash IVF have raised broader questions about the fertility treatment sector.
Former embryologist and patient advocate Lucy Lines is among those voicing concerns about conditions in the rapidly-growing industry.
Potential changes to the way IVF is regulated in Australia have been discussed by political leaders in recent days.
When *Sarah and her partner needed fertility testing, it was Monash IVF that the pair turned to.
"Having a quick browse online, Monash IVF was one of the most prominent ones that came up on Google search and after contacting them for initial quotes, they seemed to be priced pretty reasonably," she told the ABC.
But Sarah, who wanted to protect her privacy in this story, and her partner's basic fertility testing soon turned stressful, with the former patient saying she experienced a string of small errors from the company.
"One of the first tests I had done was a blood test. When I went on the day I noticed the nurse had to make some amendments on the form," she explained.
Sarah realised her blood testing form had been filled out incorrectly, with a test that was required missing.
"Given I was just getting a fertility test, I expected this to be pretty standard procedure," Sarah said.
Later, she found out the rebate amount Monash IVF told her she would get for a pelvic ultrasound was incorrect, and that scan would be much more expensive than she'd been told.
Two embryo transfer mistakes at major fertility provider Monash IVF have come to light. (AAP: James Ross)
She complained to Monash IVF, which did respond after six weeks — but the experience left her worried about the standard of care Monash IVF was providing to its patients.
"They come across as a very trusting, leading brand in terms of IVF treatments," Sarah said.
"Throughout those treatments and experiences with Monash IVF I lost a lot of trust."
Monash IVF did not respond to the ABC's specific questions about this patient, but pointed to its previous public statement made in the wake of a second embryo transfer mix-up coming to light.
It offered an apology to the couple affected by the bungle and announced an internal investigation into the issue.
Sarah's not the only one with concerns about the sector.
Labs 'flat out' in expanding industry
Lucy Lines is a former embryologist who now works advocating for IVF patients.
She put a call out on her social media accounts asking for IVF patients and former patients to tell her about their experiences with the industry.
Lucy Lines says scientists in the industry work long hours. (ABC News: Stephen Opie)
She was flooded with responses from women reporting issues like being given the wrong medication or dosage, with patients being given other people's paperwork and one woman who reported a doctor getting both her name and age wrong.
The scientist said Australia has always had a well-regulated IVF system, but she was worried the rapid growth in the industry, and for-profit business model, could be putting staff and resources under strain.
In labs, she said, it is common for scientists to work long hours.
"There's so much pressure put on them in the lab and they are flat-out busy, can't keep up and they're working 12-13 hours days, six days a week," she said.
Lucy Lines helps people navigate the complex industry as an advocate. (ABC News: Stephen Opie)
In Australia IVF services grew between 2017 and 2022, with more than 100,000 treatment cycles overseen each year now.
Ms Lines said she would like to see mandated staffing ratios in IVF labs and for embryologists to have a national accreditation program.
Adverse events not necessarily made public
In Australia IVF services are regulated by state governments and by a national industry aligned accreditation body called the Reproductive Technology Accreditation Committee (RTAC).
Former IVF nurse and researcher Karin Hammarberg said, compared to other countries, Australia has traditionally had a strong regulatory system for IVF services.
But she wanted to see more transparency.
Fertility researcher Karin Hammarberg. (Four Corners: Ron Foley)
The researcher said the public simply don't know if there have been other embryo mix-ups or serious mistakes in IVF clinics in Australia before these two Monash IVF mistakes, because clinics are obliged to report to the regulator, which isn't obliged to reveal that information.
"Every serious adverse event has to be reported to the accreditation committee, they record that, but it's not publicly available information," she said.
The committee confirmed this to the ABC. In a statement it said: "Consistent with other non-government accreditation bodies, [the RTAC] doesn't publicly identify any clinic's audit details".
Confusion, gaps in state-based regulatory approach
This issue has caught the attention of the country's political leaders.
On Friday state and federal health ministers met in Melbourne, with IVF regulation on the agenda.
At the meeting, Victorian Health Minister Mary-Anne Thomas pushed for the immediate creation of a national, independent accreditation body.
"I think it is concerning that there may well be more errors that we don't know about and that is because the body that currently accredits fertility providers is made up of fertility care providers," she told media after the meeting.
She told media her push wasn't agreed upon by Queensland, and instead the ministers decided to set up a "rapid review" with a three-month timeline to investigate creating such a body.
Later; Federal Health Minister Mark Butler shared his concerns with the ABC, saying he was worried about public confidence in the sector taking a hit.
"My third child is an IVF baby, I know the level of trust families place in the system to deliver them what at the time feels like a miracle baby," he revealed.
The federal minister explained that Australia has "essentially eight systems of regulation across the country" because of the state-based approach.
He agreed with Victoria's push for an independent accreditation body and also raised concerns about a lack of oversight of mistakes made by the industry.
"We know in the last full year there were dozens of breaches of the code of conduct, but I don't know what as the federal health minister they were. They are not reported, they are not disclosed," he said.
The national body representing the industry, the Fertility Society of Australia and New Zealand, welcomed the review and is also supportive of an independent accreditation body being created.
"Such a move would deliver greater regulatory clarity, enhance accountability and give the accreditation system the agility needed to maintain high standards," a spokesperson said in a statement.
The industry body also pointed out that IVF services in Australia were governed "by more than 40 separate pieces of legislation", saying this created "inconsistency, confusion and gaps in oversight".
Monash IVF shareholders push for accountability
While the country's political leaders review and negotiate national reforms to regulations, there is another group also pushing for change — shareholders.
The chief executive of the Australian Shareholders Association Rachel Waterhouse said shareholders at Monash IVF were seeking answers.
"Shareholders are expecting a full review, a full internal investigation, the independent investigation and they want to know what comes out of that and what needs to change and have those changes in place," she said.
Sarah* says basic fertility testing done through Monash IVF was more stressful than expected. (ABC News: Patrick Stone)
Former fertility patient Sarah said it was important IVF patients could have faith in the system while going through a major life decision and stress.
"I think having a baby and planning for a baby is one of the biggest decisions anyone can make in their life," she said.
"And because it is such a life-changing decision I would expect that the patients who chose to get IVF done, get what they are wanting."