secondary fertility

Currently only couples with no children are eligible for free fertility treatments.

COUPLES EXPERIENCING ‘SECONDARY infertility’, whereby they are having difficulty conceiving a second child, will soon be eligible to avail of free fertility treatment, such as IVF, under the government-funded scheme. 

While the Department of Health confirmed to The Journal that the plans are “currently being finalised”, it is understood the expansion of the scheme will be launched “imminently” and by the end of the month. 

Last October, the government said the scheme would be expanded to couples who already have children, however there have been criticisms about the delay in rolling out the expanded services. 

The expansion will mean the reversal of one element of the scheme’s current criteria which requires that a couple accessing publicly funded IVF or fertility treatments must have no living children together. 

The so-called ‘existing child limit’ had been criticised by GPs. 

500 referrals per month to fertility hubs

While many couples will welcome the news of the service expansion to include couples who have difficulty conceiving a second child, concerns have been raised about current delays with the service and whether enough resources are being given to fertility hubs tasked with handling the high number of referrals.

Nationally, the six regional fertility hubs receive approximately 500 referrals per month for fertility assessments. 

As of the end of May, the six regional fertility hubs have made 2,335 referrals to HSE authorised Assisted Human Reproduction providers for advanced fertility treatment, including IUI, IVF or ICSI.

Wait times to see a consultant following completion of required investigations are on average three months nationally, the department told The Journal.

Previously, Clinical Director of the HSE’s National Women’s and Infants Health Programme Dr Cliona Murphy told RTÉ that waiting time for patients who are due to attend a regional fertility hub for an initial appointment is approximately ten to 11 weeks while most are seeing a consultant within around six months.

Currently, a total of 45 staff work across the six fertility hubs, including consultants, fertility clinical nurse specialists, and administrative teams.

This figure includes 13 consultants who manage and provide fertility services as one of the duties and roles assigned to them while they also work as consultant obstetricians and gynaecologists in maternity and gynaecology services.

The remainder of the staff work full time in public fertility services.

Recently, Labour TD Marie Sherlock hit out at the false starts of the service, stating that some families have delayed adding to their family on the promise from government that this would be addressed.

Criteria

“It’s beyond cruel to treat women and families in this way,” she said. Sherlock also criticised the “very restrictive” criteria applied to scheme. 

Health Minister Jennifer Carroll MacNeill has confirmed that she hopes to be in a position “in the coming weeks” to make the  announcement to expand the government-funded scheme to ‘secondary infertility’,  but only “as long as, of course, they meet all the other existing criteria”.

There are commitments in the Programme for Government to both “expand eligibility to State-funded IVF” and establish the first public AHR treatment centre.

While the minister has said consideration of possible further expansion of the relevant criteria will continue, she has clarified that “it is highly unlikely that changes will be made to clinically-based criteria such as those in relation to BMI limits“. 

Decisions on further proposed changes to the access criteria or the scheme more broadly requires continued consultation between Department of Health officials, colleagues in the HSE and with specialists in the field of reproductive medicine, she said in a recent reply to a parliamentary question. 

Ireland’s first public AHR centre is scheduled to open in Cork later this year where it is anticipated service provision will commence in late 2025, with the facility fully operational by 2026. 

Currently, fertility treatments through the state-funded model, are largely outsourced to private operators.