Rose Conway-Walsh (Mayo, Sinn Fein)
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245. To ask the Minister for Health the options available to a couple (details supplied) seeking an IVF treatment that is not available in Ireland, and if there is any scheme that would assist them with costs [14345/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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The Model of Care for Fertility was developed by the Department of Health in conjunction with the HSE’s National Women & Infants Health Programme (NWIHP) in order to ensure that fertility-related issues are addressed through the public health system at the lowest level of clinical intervention necessary.

This Model of Care comprises three stages, starting in primary care (i.e., GPs) and extending into secondary care (i.e., the six Regional Fertility Hubs located across the country) and then, where necessary, AHR (assisted human reproduction) treatment (e.g., IVF (in-vitro fertilisation) and ICSI (intra-cytoplasmic sperm injection)), with patients being referred onwards through structured pathways.

Phase One of the roll-out of the Model of Care has involved the establishment, at secondary care level, of six Regional Fertility Hubs within maternity networks covering the entire country, in order to facilitate the management of a significant proportion of patients presenting with fertility-related issues at this level of intervention. Patients are referred by their GPs to their local Regional Fertility Hub, which provides a range of treatments and interventions.

Phase Two of the roll-out of the Model of Care relates to the introduction of AHR treatment, including IVF, provided through the public health system at tertiary level.

Appropriate funding is available to support access to AHR treatment via HSE-approved private providers. As well as IVF and ICSI, this allocation is also being used to provide IUI (intrauterine insemination), which can, for certain cohorts of patients, be a potentially effective, yet less complex and less intrusive form of treatment.

Referrals for publicly-funded, privately-provided AHR treatment commenced in September 2023. Criteria prospective patients should meet in order to access fully-funded AHR services were agreed by the Department and the HSE and subsequently approved by Government in July 2023.

The criteria were agreed following consultation with experts in the field of reproductive medicine and include limits in respect of the age of the intending birth mother, body mass index (BMI) and the number of children a couple already have. They are very much in keeping with those applied in other jurisdictions, even though in most European countries, for instance, such treatments are only partially funded and require often significant out-of-pocket payments by patients.

Following the consultation process, it was agreed that couples referred for IVF or ICSI will be offered a maximum of one IVF or ICSI cycle which comprises one episode of ovarian stimulation, egg retrieval, fertilisation and transfer of one fresh embryo (if appropriate, with single embryo transfer as standard), followed by the freezing of other suitable embryos and the subsequent publicly-funded transfer of such frozen embryos (provided the patient(s) still fulfil the access criteria) until depletion. At the same time, the publicly-funded AHR treatment scheme allows for a maximum of two cancelled IVF/ICSI cycles (instances where, based on clinical determination, the egg collection procedure did not proceed following ovarian stimulation). A publicly-funded cycle could also potentially include a Testicular Sperm Extraction (TESE) procedure, for instance.

More details on public fertility services, including information on the publicly-funded AHR treatment initiative, are available from the HSE at: www2.hse.ie/conditions/fertility-problems-treatments/fertility-treatment/

To date, over 2,000 couples have been referred by a Reproductive Specialist Consultant for AHR treatment following extensive investigations and/or secondary level treatment within the Regional Fertility Hubs. Furthermore, the Hubs have successfully and directly managed numerous patients presenting with fertility-related issues who have been referred by their GP. Not all couples experiencing fertility challenges actually require such advanced and invasive interventions as IVF.

Given the complex regulatory and clinical issues to be addressed in respect of certain categories of AHR treatment, including donor-assisted treatment, public funding of certain AHR services have been of necessity commenced on a structured and phased basis. Decisions in respect of any proposed changes to the access criteria and/or the range of services provided through the publicly-funded scheme require further extensive consultation between Department of Health officials, colleagues in the HSE and also with relevant specialists in the field of reproductive medicine.

I want to reassure you that my Department and the Government are focused, through the full implementation of the Model of Care for Fertility, on ensuring that patients receive care at the appropriate level of clinical intervention and then those requiring, and eligible for, advanced AHR treatment such as IVF will be able to access same through the public health system.