The whole Australian fertility sector is unsurprisingly under scrutiny. An international egg and sperm bank’s suggestion to implement a rewards program for IVF firms has alarmed some advocates. This project allows clinics to earn credits towards the costs of donor egg cohorts. It has raised alarm among medical professionals steeped in the ethical practice of medicine and fearing reputational harm.
Dr. David Molloy, chair of the IVF Medical Directors’ Group Australia, has called for a review. What weighs heavily on his mind is that this scheme will permanently damage the industry’s reputation. He warned IVF companies not to get involved, asserting that perverse financial incentives could disrupt the ethical principles undergirding assisted reproductive technology. The sector is now under fire after two different embryo mix-ups, both at Monash IVF, came to light. In reply, Australia’s health ministers are starting a fast track review of the billion dollar industry.
Ethical Implications of Reward Schemes
The World Egg and Sperm Bank (TWESB) has a different kind of proposal. It allows clinics to receive donor egg credits that can ultimately finance the cost of donor eggs for patients in their entirety. Dr. Molly Johnston, an ARC Industry Fellow at Monash University’s Bioethics Centre, has deep concerns about loyalty schemes in the area of reproductive medicine. She argues that they risk eroding patient autonomy and raising ethical concerns related to commercial incentives.
“I do think a loyalty program, where you earn points, does raise some serious questions about how commercial incentives are influencing reproductive medicine,” – Dr. Molly Johnston.
Dr. Molloy drove home the most important point of the day with his big picture perspective. Though partnerships with international providers can be beneficial, too great a reliance on them poses difficult legal and ethical complications. He stated that IVF clinics must ensure that any engagement with overseas entities aligns with Australia’s high standards for reproductive practices.
“While partnerships with overseas providers may always play a role in Australia’s IVF landscape, overreliance on international programs introduces legal, ethical and logistical complexities,” – FSANZ spokeswoman.
Recent Scrutiny in Australia’s Fertility Sector
Much of the fertility sector’s recent public scrutiny has been fuelled this year, particularly after the embryonic mix-up events at Monash IVF. These mistakes have led to calls for a national review of assisted reproductive technology. This unfortunate state of affairs further demonstrates the timely need for uniform laws nationwide.
Dr. Molloy suggested that these latest developments highlight the need for a centralised, national donor register. Such a register would further support transparency, consistency, and protections for both donors and families.
“It is really important that anything to do with donor sperm and donor eggs is absolutely managed impeccably to the highest standards,” – Dr. David Molloy.
The suggested incentive program coincides with a national conversation on increasing access to assisted reproductive technologies as their expense continues to grow. Dr. Johnston recognized that cost savings from these sorts of programs would help bring the cost of fertility treatments down for patients.
“I can see the argument for it, particularly if there are cost savings that are then passed on to patients, as we know that the cost of assisted reproductive technology is one of the greatest barriers for patients,” – Dr. Molly Johnston.
Concerns About Patient Autonomy
Even with these positive outcomes, both Dr. Molloy and Dr. Johnston warn against introducing financial incentives into the field of reproductive medicine. They contend that such programs would undermine the moral meaning of procreation and violate human dignity.
Dr. Molloy further highlighted the importance of keeping ethics in the industry as a key point. He wants to avoid putting it anywhere near the practices that would be problematic inducement schemes. He asked a very important question about fairness in access to treatment when rewards are included.
“Why should a patient pay the full amount for eggs and the next patient receive a benefit from that purchase? That makes no sense,” – Dr. David Molloy.
Debates around the proposed scheme continue. At the same time, stakeholders in Australia’s fertility sector have their eyes peeled to ensure that ethical practice trumps commercial motivations.
