Public Funding

Eligibility

Clinical Priority Assessment Criteria (CPAC) system

In order to be eligible for publicly funded fertility treatment, you will be scored against a Clinical Priority Assessment Criteria (CPAC) system, which takes into account:

  • Your chance of pregnancy without treatment
  • Your chance of pregnancy with treatment
  • Your ovarian reserve
  • Diagnoses affecting fertility such as severe endometriosis
  • How long you have been trying to get pregnant
  • Whether you have children living at home
  • Whether you have had a tubal ligation or vasectomy.

Other criteria

You must also meet the below eligibility criteria prior to, and during, the course of treatment:

  • Women must be aged 39 years old or under, men must be aged under 55 years old at referral.
  • Both partners are non-smokers or ex-smokers for more than three months. Smokers will be accepted for assessment but will not be accepted for publicly-funded treatment until they have stopped smoking for at least 3 months.
  • There must be no evidence of drug or alcohol abuse in either partner the 12 months prior to referral.
  • Woman’s BMI must be less than 35 and man's BMI less than 40. Note that if the woman's BMI is over 32, she can be referred for assessment but will not be accepted for publicly-funded treatment until her BMI is less than or equal to 32.
  • Both partners are New Zealand citizens or residents or possess a work permit, or a series of consecutive work permits, for at least 2 years. Australian citizens or residents are also eligible if they can prove their intention to stay in New Zealand for two years or more.
  • You must be living in New Zealand when your treatment starts and remain living in New Zealand throughout the duration of their treatment. You must be able to demonstrate eligibility to live in New Zealand for 20 months at the time of the start of your treatment.
  • You must have had at least one year of regular intercourse without pregnancy or known severe cause of infertility. Where one of the couple has had a sterilisation, the duration of fertility delay starts from the date the couple first see a doctor about having a child, not from the date of the surgery.
  • 0 or 1 child of any age to the current relationship, including adopted children.
  • 0 or 1 child of any age from previous relationships living at home at least half of the time.

Single or lesbian women and gay men 

  • Single or lesbian women can be eligible for a referral to publicly funded fertility services if they have clear biological causes of infertility. Examples of biological causes of infertility include:
    – Anovulation or very irregular periods (<20 or >42 days)
    – Known tubal infertility
    – Severe endometriosis.
  • Publicly funded services may be provided if the woman is not pregnant after at least 12 cycles of donor insemination treatment, of which six must be in a NZS8134  certified clinic. All cycles must be performed on the same woman.
  • Other eligibility criteria for treatment also applies for single or lesbian women (age, BMI, etc.)
  • A gay man with azoospermia can be eligible for a referral to publicly funded fertility services.

Transgender people

  • A couple, where either one or both persons are transgender and cannot achieve a pregnancy together, are eligible for a referral to publicly funded fertility services

How it works

A fertility specialist will calculate your CPAC score. If you score 65 points or more (out of 100 points) AND meet the criteria above, you will be offered the opportunity to enrol for publicly funded treatment. 

The anticipated wait time for your public treatment is approximately twelve months. At that point you will be contacted for an orientation appointment to commence treatment. The orientation appointment is an opportunity for you to gain an understanding of the processes involved in fertility treatment. Your individualised treatment plan will be set during the orientation appointment, and this usually commences one to two months later. 

If a package of four Intrauterine Insemination (IUI) cycles is offered, you will be able to undertake these once you have been clinically set up.

What does public funding cover?

Public funding covers up to two packages of treatment.  A package consists of one of the following:

  • one cycle of IVF treatment (including ICSI, donor egg, or surrogacy) and the use of any frozen embryos arising from that treatment; OR
  • four cycles of IUI treatment using partner or donor sperm, or ovulation induction using FSH medications; OR
  • microsurgery on the fallopian tubes or testes if that is more appropriate than IVF; OR
  • thaw cycles using frozen embryos from a privately funded treatment cycle.

A cycle is considered complete if there is an embryo to transfer in IVF or insemination takes place in IUI. If the treatment cycle is stopped before this stage, we may offer a second attempt as part of the same package. For PGT a cycle is considered complete if there is an embryo suitable for testing.

A package of care covers the IVF cycle and frozen embryo replacements until two live births are achieved, thereafter any further frozen embryos incur privately funded fees.

To continue using publicly funded treatment, all eligibility criteria must continue to be met (e.g. age, BMI, etc.).

Treatment costs

Couples receiving publicly funded treatment do not need to pay for any consultations or treatments that are covered by our funding arrangements as mentioned above.

However, there are some commonly used treatments that are not funded.

The following charges calculator is mainly provided for:

  • Couples who are not eligible for publicly funded treatment. 
  • Couples who may wish to self-fund their treatment while waiting until they either meet eligibility requirements or reach the top of the waiting list for funded treatment.
  • Couples who have used their allocation of publicly funded treatment, or have had a child through funded treatment, and now wish to have treatment privately at Fertility Plus.

Fertility treatment is personalised to each individual and couple, based on diagnosis and best treatment options. At Fertility Plus, we are mindful of the costs involved in providing fertility treatment, and our fees reflect the importance we place on ensuring our care remains as accessible as possible.  If you have any questions, email us on fertplus@adhb.govt.nz.