Historically, infertile couples remained childless unless they adopted children. In Māori communities children were sometimes raised by relatives in a practice called whāngai, which meant that infertile people or other, usually older, family members could raise children. From the 1960s single mothers were increasingly likely to keep their children, due to the introduction of the domestic purposes benefit and changing social attitudes, so fewer babies were available for adoption. However, the introduction of assisted reproductive technologies (ART) in the early 1980s meant that infertile people could potentially have their own children.
Some infertility researchers believe that infertility treatment will lead to a higher rate of natural infertility, because it may cause a genetic predisposition to infertility to be passed on to children born of this process. Fertility treatment has not been happening long enough to confirm this hypothesis.
ART are medical procedures intended to improve the chance of conception. In-vitro fertilisation (IVF) is the most common. It involves fertilising ova or egg cells outside the womb using sperm and then inserting one or two of the fertilised embryos into a woman’s womb. Infertile people can apply for publicly funded treatment or pay for treatments at private clinics. Public clinics run by District Health Boards are located in Auckland (Fertility PLUS) and Dunedin (Otago Fertility Services). Fertility Associates has five fertility clinics in New Zealand where they do assisted reproduction, as well as clinics where doctors consult with patients in Auckland, Hamilton, Palmerston North, Gisborne, Wellington, Nelson, Christchurch and Dunedin. Repromed has clinics in Auckland, Tauranga and Whangarei. Both companies also treat publicly funded clients.
In 2014, 1,343 babies were born in New Zealand following ART (2.25% of all births), compared to 274 in 1997 (0.5% of all births).
Eligibility and cost
Infertile people are entitled to two publicly funded cycles of fertility treatment. Eligibility is determined by criteria including:
- failure to get pregnant after one year of unprotected sex
- meeting body mass index (BMI) rates (women) – this is generally 32 or under, but varies for Māori and Pacific women
- being under 40 at age of referral (for the woman)
- number of previous children
- sterilisation history.
Women need to have been non-smokers for at least three months prior to referral.
The average cost of one privately funded IVF cycle ranged from $11,000 to $13,000 in 2017.