The role of Medicare policy in fertility treatment decisions: perceptions of Australians considering, undertaking or who have undertaken medically assisted reproduction treatment.

Objective Fertility treatments offer the only pathway to parenthood for many people, including those with infertility, single people and those in same-sex relationships. We aimed to explore how current Medicare policy affects Australians' fertility treatment decision-making. Methods Twenty-five people (22 females, 2 males, 1 agender/gender non-conforming) aged 26-54 who had used medically assisted reproduction treatments participated in semi-structured interviews. Data were analysed using reflexive thematic analysis. Results We developed three themes. Theme 1: For those eligible, Medicare enhances accessibility - describes how Medicare influences affordability and, in turn, increases accessibility. Theme 2: Medicare alters treatment plans - demonstrates how Medicare influences who undertakes treatment, what treatment, when and how often. Theme 3: Medicare enables more treatment for some people - discusses how Medicare enables people to undertake more treatment than they could otherwise afford. Conclusions For eligible people, the current Medicare policy enhanced treatment accessibility and allowed them to undertake more treatment than they could have without financial assistance. However, Medicare policy also contributed to people altering their treatment plans, including who received treatment, the type, timing, frequency and amount of treatment. Given Medicare's influence on fertility treatment decisions, our findings support calls for changes to Medicare eligibility to enable equitable access to fertility treatment and a pathway to parenthood for all Australians.