Q&A: Am I eligible for publicly-funded fertility treatment?

In Ireland, eligible couples will be entitled to one cycle of IVF, one cycle of ICSI, and up to three cycles of IUI — if they meet clinical criteria. Picture: iStock

Publicly-funded fertility treatment is set to roll out in September following Cabinet approval on Tuesday.

Eligible couples will be entitled to one cycle of IVF, one cycle of ICSI, and up to three cycles of IUI — if they meet clinical criteria.

According to the World Health Organization, one in six adults around the world experience infertility and the costs associated with this creates a “medical poverty trap” for many.

In April, National Infertility Support and Information Group (NISIG) chairwoman Caitríona Fitzpatrick said people are relying loans from banks or credit unions to access medical treatment for infertility. In private clinics in Ireland, a round of IVF costs between €4,500 and €6,000. 

What is IVF?

In-vitro fertilisation is one of several procedures available that helps people with fertility problems to have a baby.

This process involves removing an egg from the woman's ovaries before it is fertilised by sperm in a laboratory. The fertilised egg then develops into an embryo before it is inserted back in the uterus to grow and develop. The process can use egg and sperm donors as well.

According to the HSE, one in every four IVF procedures is successful, resulting in a pregnancy. 

What is IUI?

Intrauterine insemination involves injecting sperm into a uterus during the time of ovulation. The sperm is injected using a small plastic tube. Sometimes, fertility medications could also be given before the procedure to help stimulate ovulation.

Donor sperm can also be used in this process if the woman's partner is not male, or if they have very few sperm, abnormal sperm, or no sperm, or if the partner has a serious infection. The sperm produced by the donor is usually stored in a sperm bank.

What is ICSI?

Intracytoplasmic sperm injection (ICSI) involves the injection of the sperm directly into an egg. This method is chosen if the man has a low sperm count, as only one sperm is needed. It is also used if the problem with getting pregnant is due to the sperm not being able to get inside the egg.

Any embryos as a result after fertilisation is then graded and one to two embryos can be transferred into the womb. Excess embryos may be suitable for freezing.

Do the treatments have complications and risks?

Some risks involved with these treatments include multiple pregnancies or even ectopic pregnancies (pregnancy in the fallopian tube), according to the HSE.

Ovarian hyperstimulation is also another risk where a number of cysts can be produced by you on your ovaries. This is caused by some of the medications used to stimulate ovulation, which can sometimes overstimulate your ovaries. When the cysts are produced, it can cause symptoms of nausea, bloated tummy, and vomiting. Stress has also been highlighted as another risk/complication with fertility treatments.

Who is eligible?

Patients that are eligble will be entitled to one full cycle of IVF or ICSI treatment that will be initially provided in HSE-approved private clincs of their choice ahead of the opening of the first public national advanced AHR (assisted human reproduction) centre next year. 

Following extensive clinical and expert consideration, the Government said some of the key criteria guidelines will include:

• The intended birth mother should be no older than 40 years and 364 days at the time of referral;  
• For males, it is 50 years and 364 days;  
• The intending mother should be between 18.5kg/m2 and 30.0kg/m2 in regards to BMI; 
• Couples should have no living children from the existing relationship or with at least one partner;  
• If the couple has previously undertaken one IVF cycle and all embryos were used from that cycle, they are eligible for the publicly-funded treatements;  
• Patients with known clinical causes of infertility and patients where there is no known clinical cause will be eligible. 

Can donor sperms or eggs be used?

The publicly-funded treatment cannot be used for donor sperms and donor eggs and will not be available for heterosexual or same-sex couples or single female patients who want to do so. 

However, this is expected to be made available as soon as possible.