Funding welcomed for AHR and IVF treatment from September

by Rose Barrett
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Minister for Health, Stephen Donnelly today announced that fully publicly-funded assisted human reproduction (AHR) treatment will commence in September.

Eligible patients will be entitled to one full cycle of IVF (in-vitro fertilisation) or ICSI (Intracytoplasmic sperm injection) treatment, initially provided in HSE-approved private clinics of their choice ahead of the opening next year of the first public National Advanced AHR Centre.

The Minister has also set out details of eligibility criteria which sets parameters in respect of the ages of the intending parents, the female patient’s body mass index (BMI), the number of existing children and the number of previous IVF cycles accessed. Patients with known clinical causes of infertility and patients where there is no known clinical cause will be eligible for treatment.

Given the complex regulatory and clinical issues still to be addressed in respect of certain categories of AHR treatment, public funding of a number of specific services is being commenced on a structured and phased basis.

Therefore, treatment involving the use of donated gametes (sperm and eggs) will not be available in September for heterosexual or same-sex couples or single female patients. But it is hoped this treatment will become available soon.

Minister Donnelly said: “This Government recognises the difficult circumstances faced by so many people who long to have a child but who are unable to do so without clinical intervention. That is why a commitment to introduce a publicly-funded model of care for fertility treatment is included in the Programme for Government.

“The service we’re announcing is one that involves highly complex issues, and we are committed to ensuring that patient safety and regulation lie at the heart of service provision.”

Criteria too restrictive for some couples

Several commentators have said the age application (under 41 years) and other criteria are making the application process too restrictive. One woman who would like to benefit from the new funding for fertility services cannot avail as she is deemed to be slightly over weight as her BMI rates her as ‘obese’.

“BMI is an out of date methodology, it was designed 200 years ago by a mathematician – it’s ludicrous that this could rule me and others of availing of the new service!”

Same sex couples are also ruled out for the moment albeit the Minister has assured that more legislation is coming downstream to widen the access to infertility services.

She also questioned as to whether women who have unexplained and undiagnosed fertility issues, will they also be excluded from the new procedure?

Another woman who already has an embryo in storage – and underwent four rounds of IVF in a calendar year – will be ruled out under the conditions. Women who battle with PCOS is a very common hormone problem for women of childbearing age. Women who live with Polycystic Ovary Syndrome (PCOS) will experience hormonal imbalances, among them weight gain so it is a cruel twist of fate that a condition which prevents them from conceiving could also prevent them from availing of this new service.

There is very little reference to men, potential fathers within the condition brief.

(PCOS can prevent women from ovulating, experience high levels of androgens, and have many small cysts on the ovaries. PCOS can cause missed or irregular menstrual periods, excess hair growth, acne, infertility, and weight gain)

An IVF cycle costs anything from €3,5000 up to €8000, depending on the clinic. Many couples undergo several costy IVF treatments without achieving conception.

“Work is continuing on the Assisted Human Reproduction Bill which will ultimately allow us to improve accessibility to AHR treatments, while at the same time embedding safe and appropriate clinical practice and ensuring the cost-effective use of public resources,” said Minister Donnelly.

“I look forward to progressing this Bill and to ultimately expanding advanced AHR services to wider categories so that we can help more people to fulfil their wish of starting a family.”

Under the Model of Care for Fertility, people with fertility-related issues should be treated through the public health service at the lowest level of intervention necessary. In the first instance, people will present to their GP for a consultation and if appropriate they will be referred to their local Regional Fertility Hub, which provides a range of treatments and interventions for both males and females.

From September, where IVF, ICSI or IUI is clinically indicated, eligible patients will be referred by the Reproductive Medical Consultant in the Regional Fertility Hub for publicly-funded treatment in a HSE-approved private clinic of their choice.

Minister Donnelly concluded: “Today we are taking a significant first step and I would like to thank all involved in getting us to this stage. In particular, I would like to acknowledge the work of officials in my department, the HSE, clinicians and the private providers who agreed to provide the treatment in their facilities.”

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