ONE PUBLICLY FUNDED IVF cycle will be available to those that meet access criteria from September.
Minister for Health Stephen Donnelly will today announce full funding for a cycle of IVF for eligible couples if they have availed of one privately funded cycle or have never availed of any.
Up to three cycles of IUI (Intrauterine Insemination Treatment) will be covered for those deemed clinically determined for such treatment under the new scheme.
Under Budget 2023, €10 million was allocated to start the roll-out of free infertility treatments from September.
The HSE advertised a tender for private clinics last month to provide the treatments with 12 different packages to be available to women and their partners who qualify.
It is understood that all clinics have applied to take part in the publicly funded scheme.
Private clinics are to be paid €6,143 for each IVF Cycle encompassing Fresh Embryo Transfer.
This will be the first time in the State that Assisted Human Reproduction (AHR) treatment is publicly-funded.
The HSE is finalising arrangements with private clinics, but it is understood that a number of access criteria are expected to be announced by the minister after the Cabinet has been updated on the plans today.
These include couples having a known clinical cause of infertility, limits on maximum age, body mass index (BMI), and the number of existing children a couple have.
It is understood these criteria were recommended by a working group of clinical experts, with access criteria forming part of public funding schemes in other jurisdictions.
Sources state Ireland has looked to the model in Scotland for guidance, where a couple is referred for IVF/ICSI treatment and where the intended birth mother is aged 39, the couple is unlikely to receive more than one NHS funded cycle.
If the intended birth mother is over the age of 42 years old, they are not eligible for any NHS funded treatment.
It is understood the Department of Health has written to all privately operated fertility clinics in Ireland, requesting that they share data on the the number of clients they treat, such as information on age profiles and the number of cycles carried out annually.
Private clinics are believed to have cooperated, sharing 2022 information with the department, though on the condition it is not shared publicly due to commercial sensitivity reasons.
It is understood the public funding is being commenced on a structured and phased basis.
One area which is likely to be a cause for criticism is that treatments involving the use of donated materials will not be funded in September.
A single person, same-sex couples, or hetrosexual couples who require donor eggs or sperm will not be eligible for the new funding scheme being rolled out in September.
It is understood that the service will become available as soon as possible after necessary legislation and regulation of the AHR bill is passed.
Labour Senator Marie Sherlock has said that while the news is welcome, there are “some causes for concern” around the criteria for the treatment.
Speaking on RTÉ’s Morning Ireland, Sherlock said the age limit and BMI criteria seem “rather crude”, but that she was most concerned about the exclusion of those with an unknown cause of infertility.
“We know that of the one-in-six couples who experience infertility in this country, about 25% have an unknown cause, and when we look to countries like the UK, the clinical guidelines there recommend that women with unexplained infertility who’ve not conceived after two years are eligible for publicly funded IVF,” she said.
“I don’t understand why that cannot be included here. I think that will be very unfair to those with unexplained fertility causes.
“I think as well, there are a number of people who will be listening this morning, particularly women who would hope to either go it alone and would rely on donated sperm or indeed couples who rely on donated eggs, and they’re excluded from the scheme.”
Sherlock also criticised the delivery of the scheme being provided by the private sector.
“There has been government commitment for over seven years now to developing publicly funded IVF programme, and yet the government has not got its’ act together to ensure that that can be provided through our public hospitals.”
While she expects the scheme will be rolled out in public hospitals eventually, Sherlock said the issue “goes into the wider health debate about relying on private agencies and private clinics to deliver what are essentially public services”.
In 2021, an investigation by Noteworthy - subsequently cited in the Dáil – found that a number of companies that own private fertility clinics reported profits in the millions as patients were left in debt.
Government aims to get the legislation to regulate the use of donor materials over the line by the end of the year, but it could take further months to put the regulations in place, meaning significant delays for that cohort of people waiting to avail of the publicly funded model.
Currently there is no public funding available for treatments – though drugs costs may be covered and tax relief claimed on medical expenses, with the state paying out €43 million last year on fertility drugs.
The minister has previously confirmed that first the National Advanced AHR Centre, delivering IVF and ICSI through a wholly public clinic, is scheduled to open in 2024.
Subject to the provision of additional funding in future, it is envisaged that additional National Advanced AHR Centres will be developed and become operational on a phased basis elsewhere in the country.
However, in the short to medium term it is anticipated the majority of services will need to be provided via the private sector whilst the HSE build up a network of public capacity.
With the scheme in its infancy, sources state it will be begin “cautiously” and under a phased approach in order to gauge the demand for the new service.
In gathering data from the private clinics, the HSE wished to gauge the potential demand on the new offering.
The number of treatment cycles per annum in Ireland grew the period 2009-2020, from 7,589 in 2009 to a peak of 11,359 in 2018.
There were fewer treatment cycles in 2019 and 2020, with a total of 9,878 recorded in 2020. The 10.6% drop in the number of treatment cycles between 2019 and 2020 may be the result of pandemic related disruption.
Additional reporting from Jane Moore
To embed this post, copy the code below on your site
have your say