Marie Sherlock (Dublin Central, Labour)
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821. To ask the Minister for Health her plans to extend the public fertility scheme to same-sex couples who are currently excluded from the scheme; the timeline for any such changes; and if she will make a statement on the matter. [65252/25]

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 to ensure that fertility-related issues are addressed through the public health system at the lowest level of clinical intervention necessary.

Referrals for publicly-funded, privately-provided assisted human reproduction (AHR) treatment commenced in September 2023, subject to patients meeting the criteria agreed by the Department and the HSE. The access criteria were developed by a multi-disciplinary group, with reproductive medicine expertise and followed consultation with experts in the field along with a review of the international evidence. These criteria are in keeping with those applied in other jurisdictions.

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/

Up to 21 November 2025, over 3,400 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 thousands more 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.

I was pleased to announce recently that, from 30 June 2025, an important criterion for accessing state-funded AHR treatment has been broadened. Couples with one existing child in their relationship, and who meet all the other current access criteria, can now access publicly-funded AHR treatment, including one full cycle of IVF or ICSI, if they are referred for same by a Reproductive Specialist Consultant within one of the Regional Fertility Hubs. Previously, couples with one child in their current relationship were not eligible to access publicly-funded AHR treatment.

There are complex regulatory and clinical issues to be considered in respect of certain categories of AHR treatment. In the case of treatment involving the use of donated gametes, while there is regulation at European level concerning the quality and safety of procedures involving donated gametes, and the Children and Family Relationships Act 2015 deals with matters relating to parentage and the right to identity of donor-conceived children arising from such procedures, there are a number of further clinical and regulatory requirements regarding the donation and use of donated gametes which are being considered.

The access criteria and the terms of the AHR treatment initiative are being kept under ongoing review. Further potential changes to the access criteria or expansion of the initiative requires continued extensive consultation between Department officials, colleagues in the HSE, and also with relevant specialists in the field of reproductive medicine. This will include consideration of additional funding requirements which may ensue from any proposed expansion of the initiative.

It should be noted that supports previously available to patients who access IVF, or other AHR treatment, privately, whereby tax relief on the costs involved can be claimed under the tax relief for medical expenses scheme, continues to be provided.

In addition, a defined list of fertility medicines needed for fertility treatment is covered under the High Tech Arrangements administered by the HSE. Medicines covered by the High Tech Arrangements must be prescribed by a consultant/specialist and authorised for supply to the client’s nominated community pharmacy by the High Tech Hub managed by the Primary Care Reimbursement Service. The cost of the medicines is then covered, as appropriate, under the client’s eligibility, i.e., Medical Card or Drugs Payment Scheme. The annual cost to the State of the financial support for these medicines is far from insignificant.

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 most effective deployment of finite public resources