WE LIVE IN a country where, when given a diagnosis of infertility, your ability to have children is entirely dictated by your ability to afford it.
If you are fortunate enough to have some money to engage in private IVF services, in the absence of public funding, your chances of becoming parents are much higher.
This is one of the greatest examples of inequality and access disparity that remains within our Irish healthcare system in 2021.
My husband and I found ourselves in this very situation at the beginning of 2020. We suddenly became members of an exclusive club that nobody wants to be part of where the registration fees were extortionate and none of the activities were enjoyable.
While we both felt we belonged to a minority group, the reality is that as many as one in six couples struggle to conceive in Ireland.
Many not given the ‘chance’
At the same time, there was a sense of relief that this opportunity was available to us, and despite a poor prognosis, there was still a great chance that we would get the opportunity that we so badly wanted – to become parents.
While there certainly was not an endless pot of money we could throw at this ‘chance’, there were so many other couples who received a similar diagnosis that were equally deserving to be parents but may never be afforded the ‘chance’.
How have we as a society accepted this and allowed it to prevail for so many years? Why have we allowed Ireland to be one of the last remaining countries in the EU to publicly fund IVF treatment?
We are a nation that has always fought for equal rights and for what we truly believe is right. We have set precedent for other countries in areas such as same-sex marriage, yet, the inequality of infertility in Ireland has fallen through the gaps despite a growing number of couples receiving this medical diagnosis.
A lucrative business
We were not long into our journey before we quickly realised that the IVF industry is a lucrative business and is, at times, financially exploiting vulnerable and desperate couples.
We were being charged almost five times the cost for a simple blood test that can be taken by a local GP but the clinic did not identify this as an option.
We were told that certain bloods required by the clinic would cost €300 for both of us. However, after communicating with my GP, these could be taken at a cost of €30 per person – a significant difference.
We, like many couples attending private IVF clinics have been offered ‘optional extras’ to allegedly boost chances of becoming pregnant. Noticeably the cost of these add-ons is prohibitive for many couples and their effectiveness is far from clear.
In the absence of appropriate regulation of IVF services in Ireland, they can profit by selling hope in the form of these extra ‘add-ons’.
Take the UK for example, the Human Fertilisation and Embryology Authority (HFEA) in the UK – a Government regulator responsible for making sure fertility clinics and research centres comply with the law – has produced a website for patients called treatment add-ons. Here they list some of the common services and use a traffic light system to rate them.
Red means no evidence, amber means the evidence is not conclusive so more research is required, and green means there is evidence that the add-ons are proven to boost success rates of treatment.
This affords transparency throughout the system and enables couples to make independent informed decisions about their treatments, instead of being consumed by the ‘what if we don’t do it’ guilt that haunts so many vulnerable couples. Yet, to date, we have no such equivalent in Ireland.
Significant wait for public funding
In 2017, the government announced that plans were afoot to provide public money for IVF. Four years on, very little progress has been made.
While this timeframe may not be significant to the Department of Health, four years can be detrimental to couples waiting for public funding to begin IVF journeys.
However, key phases of the infertility model will not be implemented until such a time that the Assisted Human Reproduction (AHR) legislation is commenced which was to happen in 2020 but is now due to be passed in 2021.
The finer details of the model are still kept in the dark, such as who will be eligible and what criteria has to be met. In the meantime, vulnerable couples are either left waiting with precious time slipping by, or turn to, if they can afford it, unregulated IVF services in Ireland.
While it is important to note that many couples get the outcome they have always hoped for and are treated by wonderful caring staff, the system as it stands remains accessible to only a few while those engaged in IVF services continue to spend thousands at the ‘chance’ of ever becoming parents.
Engaging in IVF services can lead many couples down a path of financial, physical and emotional stress, all of which are proven to be adversarial when going through infertility treatment.
These can all be alleviated by enactment of the Assisted Human Reproduction Bill and the implementation of a publicly funded infertility model of care that is accessible for all regardless of income and that is subjected to state regulation.
Given the current healthcare and economic landscape in the context of the global pandemic, and considering the very little progress that has been made in relation to enacting the Assisted Human Reproduction Bill, it would appear that Irish couples experiencing infertility will continue to be subjected to a painful, wasteful wait for a number of years before the Government takes action and effectively implements the model it describes.
In recent years, Ireland has witnessed some landslide changes to law in response to massive campaigns driven by people’s desire to fight for what they felt passionate about. Whether you were for or against the campaigns, you cannot deny the clear message that people were fighting for, that is, the right to choice.
We now need to reignite the flame, round up the troops and fight for the right for couples to become parents when faced with infertility and give couples the same equal chances as their European counterparts.
Emma Mc Dade is currently undergoing fertility treatment with her husband, and wants all couples to get the ‘chance’ to have children through the public health system.
FUNDING FERTILITY Investigation
Has the delay in publicly funding IVF destroyed people’s chance to have children?
Through Noteworthy, we want to do an in-depth investigation into the impact of the wait for public fertility funding and look at the potential obstacles to overcome in order to put IVF through the public system.
We want to compare fertility costs in Ireland to other EU countries and look into the type of state funding offered. We also want to investigate the supports offered to people who need fertility-related procedures or treatments due to health complications or illness.
Here’s how to help support this proposal>
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