Donna McGettigan (Clare, Sinn Fein)
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766. To ask the Minister for Health the eligibility criteria for accessing publicly funded IVF treatment in cases where a woman seeks to use the preserved sperm of her deceased husband, where full written consent was given prior to his death; if there are any protocols in place to support widows in this situation; and if she will consider amending current policy to ensure fair access to treatment for individuals in such circumstances. [27546/25]

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) 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 elements, starting in primary care (i.e., GPs) and extending into secondary care (i.e., six Regional Fertility Hubs located across the country) and, 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 involved the establishment, at secondary care level, of six Regional Fertility Hubs within maternity networks covering the entire country. This means that a significant proportion of individuals presenting with fertility-related issues are managed 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. These Hubs have been fully operational for a number of years now.

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 has been made 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 people, 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.

More information is available on the HSE website in respect of the publicly-funded AHR treatment initiative at: www2.hse.ie/pregnancy-birth/trying-for-a-baby/your-fertility/getting-ivf-icsi-iui-hse/.

or on public fertility services more generally at: www2.hse.ie/conditions/fertility-problems-treatments/fertility-treatment/.

The Health (Assisted Human Reproduction) Act 2024 includes provisions which will introduce the regulation of posthumous assisted human reproduction (PAHR). PAHR is defined in the 2024 Act as AHR treatment involving the use of the gametes of a person, or of an embryo created by the use of such gametes, subsequent to the death of such person.

The 2024 Act was signed into law by the President last July 2nd 2024, having passed all stages in both Houses of the Oireachtas, and is yet to be commenced.

A key condition within the legislation for PAHR to be permitted is that the relevant AHR treatment should not begin prior to 12 months having passed from the death of the relevant deceased intending parent. This is to allow for an appropriate period of reflection and mourning for the surviving partner and space for her to be certain that she wishes to proceed with PAHR in the new circumstances of her life. It is the Department’s understanding that, in the few countries which specifically provide for PAHR, there is such a required post-death period.

There is also a requirement in the 2024 Act that the deceased person and the surviving partner would have received appropriate counselling and advice on issues in respect of succession rights, for instance, before providing their fully informed consent to PAHR, parentage of an as-yet-unborn child and the implications of same.

The provision of treatment related to PAHR is not part of the services currently funded through the publicly-funded AHR treatment initiative.

Moreover, there are other potentially highly sensitive and complex factors which arise here and these would need to be fully teased out, resolved and a firm decision agreed upon before it is decided whether, notwithstanding what is permitted in the relevant legislation, the State should fund this very distinct form of AHR treatment.

I want to reassure the Deputy 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.