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Explainer: When will IVF treatment be provided through the Irish public health service?

New fertility hubs will be open next year, with IVF available in 2021.

AFTER THE INITIAL government announcement two years ago that plans were afoot to provide public money for IVF treatment, Health Minister Simon Harris set out the details of his plans today.

Cabinet today approved €2 million in funding for IVF and fertility treatment and committed to funding a model of care for infertility as part of the public health system.

Ireland and Lithuania remain the only two EU countries not to offer state funding for assisted reproduction even though the World Health Organisation recognises infertility as a medical condition. 

What was announced today?

The Cabinet made a number of decisions today in terms of supporting people with fertility issues. 

It agreed that IVF will be publicly funded going into the future, and set out three models of care that will be funded through the initial €2 million fund. 

Under the new plan, couples will first go to their GP about their fertility issues, where an initial assessment and consultation will take place. 

Patients can also be referred on to one of six new fertility hubs which will be developed. There will be one fertility hub in each of Ireland’s maternity networks, with the first one being established in 2020 in Dublin and Cork.

Finally, the minister said two tertiary facilities will be identified where access to IVF through the public system will be made available.

Harris said that 50%-70% of people who present with fertility issues have their problems resolved in a hospital setting, without the need for IVF.

What about IVF, what did the government decide to do?

The Cabinet agreed to make IVF part of the public health service. The minister said the government will not be giving out a voucher or payment for patients to go to one of the private clinics that currently offers IVF.

Instead, the treatment will be made available in public hospitals.  

When can people start signing up for IVF through the public health system?

Here’s where the problem kicks in.

IVF is not actually regulated in Ireland. It is available privately, but not in any of the public hospitals at the moment.

This means that anyone that has wanted to get IVF in Ireland has had to go private and oftentimes had to pay at least between €4,000 and €4,500 for one course of IVF treatment. 

Harris said in order to offer IVF to patients, the government first needs to regulate it and set out who will be eligible and the criteria that will need to be met before someone can get the treatment through the public health system.

All this needs to be done through the Assisted Human Reproduction Bill, which was approved by Cabinet two years ago.

Pre-legislative scrutiny of the scheme, which covers areas including sperm, egg and embryo donation, surrogacy, pre-implantation genetic diagnosis of embryos, posthumous assisted reproduction as well as embryo and stem cell research, has taken place this year. 

However, a timeline for the passage of the Bill through the Houses of the Oireachtas is not certain.

The minister said today that he expects to publish the Bill at the start of 2020, and hopes to get the legislation passed by the end of the year.

He said the setting up of hubs will help people with fertility issues in the interim.

When will a couple realistically be able to get IVF through the new public system?

2021, if all goes to plan. 

Harris told TheJournal.ie today that he is “very conscious” that there are people waiting and wanting to know how all this will affect their life, and might be contemplating IVF and wondering what to do.

“If we’re being completely honest and frank here and I think we should, I think by any objective measure particularly with the stage we are with in the electoral cycle, I think it’s likely to take most of 2020 to pass and commence the legislation.

“So realistically I think you’re looking at 2021, in terms of IVF being available through the public health service and being publicly funded.

“But I would say to people today is there are obviously measures in the interim, seeing your GP, taking the advice from your GP being referred to regional fertility hubs, getting that advice, that access to diagnostics, and then either knowing from that perhaps, ‘may I need IVF now or in the future’, or indeed are there other options, so I’m hoping that these interim steps will provide some clarity and some assistance to people who are waiting while we pass the legislation,” he said.

Harris said the first of the regional fertility hubs should be up and running early in 2020.

What is the €2 million being spent on?

The funding will go towards hiring gynaecologists and diagnostic equipment for the regional fertility hubs, so that the infertility challenges can be determined, and how to resolve them.

One in seven have their fertility issues fully resolved without the need for IVF, and this can be done with the supports and diagnostics provided for through the new hubs.

The HSE will meet in the coming days to map out the resources needed for the new hubs.

“I think for far too long issues that have particularly pertained to pregnancy and the likes, we haven’t faced up to in this country, we haven’t provided for as part of the public health service and we’ve travelled a long road in that regard.

“I think dealing with fertility issues is really important. I think it should be a core component of our women and infants health program and indeed in our maternity services in general. So I think making that decision was important and also getting on with it now, establishing and expanding regional fertility hubs will provide a system for lots of people,” he said.

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    Mute Al Loveday
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    Jul 27th 2021, 9:33 PM

    Yo Malahide

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    Mute David Hughes
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    Jul 27th 2021, 10:20 PM

    Climate Change will affect everyone

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    Mute Pat Breen
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    Jul 27th 2021, 11:30 PM

    @David Hughes: it was worse 21 years ago

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    Mute kevin mc cormack
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    Jul 27th 2021, 11:32 PM

    @David Hughes: ye it’s really hot in the Sahara at the moment

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    Mute Verners Tess
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    Jul 27th 2021, 11:59 PM

    @David Hughes: If every weather event is now climate change, what was is 50,100,200 years ago?

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    Mute Sean Harmon
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    Jul 28th 2021, 12:14 AM

    @Verners Tess: 50,098,179 BC

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    Mute David Jordan
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    Jul 28th 2021, 12:25 AM

    @Verners Tess: 50.1 million years ago was during the tail end of the Early Eocene Climatic Optimum, it was a lot warmer than today.

    The warm climate caused by oceanic circulation and higher CO2 levels in the atmosphere. Antarctic continent wasn’t yet cut off from south America (Drakes passage hadn’t opened up yet) and Australia and Antarctica were still part of the same continent. Without a circumpolar ocean circulation, Antarctica did not act like a huge radiator like it does today.

    There was also the collision between India collided with Asia 50 million, the beginning of the Himalayas:

    https://www.nsf.gov/discoveries/disc_summ.jsp?cntn_id=298462&WT.mc_id=USNSF_1

    This collision increased physical rock erosion and weathering of rock, this resulted in the extraction of CO2 from the atmosphere, and in turn caused gradual climate cooling

    See: “Equatorial convergence of India and early Cenozoic
    climate trend”

    “The early Eocene (55 to 50Ma) was the warmest period during the Cenozoic. Various climatic indices suggest that tropical conditions extended 10 to 15 of latitude poleward of their present limits. Eocene tropical assemblages of foraminifera and coccoliths have been found in North Atlantic sediments (Haq et al., 1977). Vertebrate fossils of alligators and flying lemurs have been found from a site on Ellesmere Island, west of Greenland (Dawson et al., 1976).”

    https://www.global-climate-change.org.uk/5-2-2-3.php

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    Mute David Jordan
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    Jul 28th 2021, 12:34 AM

    @Verners Tess: Basically, the climate did change but the change was a very slow, over millions of years…

    https://www.global-climate-change.org.uk/wp-content/uploads/2019/02/Screenshot_26-1.jpg

    Continents moved by centimeters per year, ock weathering, CO2 extraction and changes in ocean circulation took place over 10 million years. Life was able to adapt e.g. evolution of horses, but we’re changing climate 25,000 to 50,000 times faster now. That is faster than life can adapt, that is catastrophic.

    Evolution of the Earliest Horses Driven by Climate Change in the Paleocene-Eocene Thermal Maximum – https://science.sciencemag.org/content/335/6071/959

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    Mute Anthony Doyle
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    Jul 28th 2021, 3:46 AM

    @Pat Breen: so what’s your point

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    Mute Anthony Doyle
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    Jul 28th 2021, 3:48 AM

    @Verners Tess: climate not changing

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    Mute Simon
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    Jul 28th 2021, 10:26 AM

    @David Jordan: doubt anyone who liked that comment read ur copy and paste wikipedia job.

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    Mute Bennett blaster
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    Jul 28th 2021, 11:20 AM

    @Simon: I did

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    Mute Cat Reid
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    Jul 28th 2021, 12:08 PM

    @David Jordan: thanks for the info!

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    Mute ed w
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    Jul 28th 2021, 2:48 PM

    @David Jordan: tldr so what you’re saying is we need two continents to bash into each other and problem solved.
    cant see why this hasn’t been done yet.

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    Mute David Jordan
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    Jul 28th 2021, 8:04 PM

    @Simon: I’m a geologist.

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