Kiwis who've struggled to conceive are up in arms over ASB's new ad offering loans for IVF treatment. But why do would-be parents have to pay in the first place? Adam Dudding reports.
WHEN HE first saw the slickly sentimental new ad from ASB bank offering loans for fertility treatment, Roger Gray was ironing his work shirts. He was so shocked he almost dropped the iron.
"I thought it was disgusting," says the Auckland father-of-three, two of whose children were born with the help of in-vitro fertilisation (IVF). "To me, it was exploitative of people who are in a desperate situation."
Gray and his wife went through their fertility treatment in Australia, where couples receive government subsidies that slash the cost of IVF to around $2000 per "cycle" for an unlimited number of cycles. In New Zealand would-be parents are fully funded for just one or two attempts, the waiting lists can be long, and eligibility depends on a stringent set of criteria. And outside the public system, they face spending $10,000-$12,000 of their own money per attempt. Private health insurers don't cover IVF (except, curiously, through one scheme offered only to employees of NZ Police).
"The government system here of restricting the number of opportunities to publicly fund IVF is not good," said Gray. "And then ASB is taking advantage of this to make money out of desperate people. I think it showed the worst side of banking."
Gray was just one of several parents with an insider's knowledge of fertility treatment who told the Sunday Star-Times they were uneasy, or even angry, about the 60-second IVF ad, in which a photogenically mopey couple struggling to conceive sell their vintage car to fund IVF, and then when that fails borrow ASB money for another cycle which culminates in triplets. The ad, which ASB says is based on the "real life" experiences of customers, is part of a major rebranding of the bank that seems set on portraying ASB not so much as a large Australian bank that lends and borrows money in exchange for interest, but as a quasi-benevolent organisation focused on "creating futures", and perhaps creating the odd set of triplets.
By Thursday afternoon, the Advertising Standards Agency (ASA) had received seven complaints about the ad, which first screened last Sunday, on the grounds that it was socially irresponsible, exploited a vulnerable audience or encouraged an unrealistic expectation of a successful outcome to fertility treatment.
Those are exactly the points that make Gray so angry. His family had the good fortune to get their IVF for free and to get the desired outcome, but "too many people I know don't succeed first time round", and chasing that success can be almost addictive, creating a mindset of "we can just do another $15,000; one more chance darling".
"What upset me about the ad is that people will see it and think it'll be one cycle, but then it'll be two, and then three and four, and suddenly they've got $100,000 owing, and the banks won't be giving them any leeway."
New Auckland mother Hinemoa, 37, who had her first child this year after two cycles of IVF over two-and-a-half years, was concerned at the glibly upbeat outcome to the ASB ad.
Last week, with the gurgle of her baby daughter in the background, she told the Star-Times she and her partner spent around $5000 of their own money on complementary treatments alongside $20,000-worth of state-funded fertility treatment. Even though it hadn't got to the point where they needed to start borrowing money, going through IVF was still "the hardest thing I've ever done".
For Hinemoa, the worst moment was finding out that, after the failure of the first round, they would need to use a donor egg, and she would be bearing a child not genetically related to her. "There were lots of tears, and lots of counselling and lots of support from both our families. It was two years of hell that I'd hate to go through again." And naturally, a 60-second ad for a bank can't begin to reflect the "absolute rollercoaster of emotions" of that time.
There is one positive though, says Hinemoa. The ad is making IVF topical, and she believes putting discussion of fertility treatment on the agenda is probably a good thing.
Mary Birdsall, Auckland medical director of leading fertility clinic Fertility Associates, is delighted the ad is bringing the subject out into the open. About 900 IVF babies are born in New Zealand each year, approximately 1.5% of total newborns. "It's OK to talk about IVF. Practically one child in every classroom is an IVF child."
Fertility Associates performs around 60% of New Zealand's IVF treatments, and while the subject is in the spotlight, Birdsall is happy to hammer home once more what she and other fertility clinicians have been saying for years: there should be more state funding.
Since 2004 the state has funded up to two rounds of IVF (it was previously only one) per couple; Birdsall would like to see that lifted to three. She would also like to see money spent shortening the waiting lists. This isn't just commercial self-interest: fertility plummets from the mid-30s, and a wait of 12 to 18 months can badly lengthen the odds against successful conception.
For the same reason, Birdsall wants to see a loosening of eligibility criteria: couples with "unexplained" infertility must demonstrate they've been trying naturally for five years. Considering that a woman's chance of conception per IVF round plummet from 40% at age 35 to 23% at age 40, that seems a punitively long wait.
LAST WEEK Health Minister Tony Ryall said in a statement: "The government would like to do more, but at this stage we don't have the financial resources available". It's the identical response given to the Star-Times for an article in August last year. The ministry couldn't provide a national figure as funding is devolved to health boards but Birdsall says the government spends about $13 million on fertility per year, including IVF.
Although Birdsall is happy ASB is raising IVF awareness, she does have one major gripe: the fact that the lucky couple in the ad end up with triplets.
Implantation of multiple embryos increases the odds of at least one test-tube baby taking hold in the womb, but often leads to multiple births. This approach is falling out of favour, because multiple-baby pregnancies lead to riskier births and worse health outcomes for the babies.
"New Zealand clinics have led the southern hemisphere around moves to single-embryo transfers," says Birdsall, so when the ASB showed her a preview of the ad she was "horrified", and asked them if they'd consider refilming it, to no avail.
The bank, meanwhile, doesn't see a problem with its new ad. Deborah Simpson, brand communication manager, says the idea for "normalising" loans to pay for private fertility treatment came up during the recent rebranding exercise, when bank staff talked about their interactions with customers. Several staff reported customers seeking loans for IVF, and the ad is an amalgam of those reports.
A press release from ASB boasts the entire series of new ads, which are rolling out over the coming months, are "based on real-life personal stories'. So how real-life is this story? Was there a real customer who sold a vintage car to pay for IVF? Was there one who paid for a failed IVF cycle then succeeded after borrowing ASB money? Was there a customer who got triplets? No, no and, erm, no, says Simpson. The advertising company exercised its "creative licence".
So isn't this just, as Roger Gray believes, cynical exploitation of emotional pain to sell vulnerable people a new line of debt?
No, says Simpson. The ASB takes its relationship with customers seriously, and "this is something we want to help people with... we want to give people permission to come and talk to us about these things if they're not already."
If people follow the prompting of the ad they may indeed be taking on new debt, but if they need IVF and can't get the state funding and don't have the money up front, borrowing is an option. And without such a loan, says Simpson, "they can't do it at all".
She says there have been a "tiny" number of complaints to the bank about the ad, but those have been outnumbered by positive responses.
The subject of IVF is "very emotional", and the IVF story told in the ad is "beautiful", says Simpson.
"But certainly, we recognise that not all of them have happy endings".
THE INS AND OUTS OF IVF LOANS
What is an ASB IVF loan? ASB is offering unsecured loans for IVF at a rate of 13.95% rather than the usual rate of 17.95%, and a discounted application fee. Existing mortgage customers, however, will be better off to simply top up their mortgage. Do I get my money back if I don't have a baby? No, you still have to pay it back one day, regardless of outcome. The bank already lends money for IVF; the new ad seeks merely to "normalise" the idea. Where else can I get an IVF loan? Medical loans specialist Nova (www.nova.co.nz) offers unsecured loans at rates around 14.75% plus fees. Any bank should lend you money for anything you like, as long as you can cover repayments, but ASB is believed to be the only bank actively marketing around IVF.
Article: 27th November 2010 Sunday Star Times
Read more about IVF, sperm donation and co-parenting at www.prideangel.com