A survey of 154 Irish GPs found almost two thirds believed the restriction on couples who already have a child together from accessing state-funded fertility treatment to be unfair.

The research, published in the European Journal of Obstetrics & Gynecology and Reproductive Biology, also found just 56% of surveyed GPs agreed with the exclusion of women with obesity from accessing free fertility treatment through the HSE.

However, 77% supported the age cut-off of 41 for women, which Minister for Health Stephen Donnelly last week told The Journal he would consider raising. 

Provision of one cycle of state-funded IVF for couples who meet access criteria was implemented last September, following years of government delays. The first baby conceived under the scheme has just been born.

Last week, Donnelly said he wants to expand the criteria to allow more people to avail of free fertility treatment.

Single people, same-sex couples and those who need to use donor eggs or sperm are also excluded from the scheme, as are couples who have been together for less than a year.

‘Having one child should not be a barrier’

The survey of GPs, conducted by researchers at the Merrion Fertility Clinic, National Maternity Hospital and UCD, found only 53% agreed with the age limit of 60 for men under the access criteria. Nine female GPs said the believed that the male age limit was too high and was disproportionate to the female age limit of 41 years.

GPs were asked about the fairness of several access criteria.

A number said they believed same-sex couples and those suffering from secondary infertility should also be included.

“I think having one living child should not be barrier,” one GP said.

“Secondary infertility is as devastating as primary infertility.”

Couples who already have a living child together cannot access state-funded fertility treatment. In addition, only one partner may have a living child.

Some believed the schemes’ weight criterion – a body mass index of less than 30, signalling that a person does not have obesity – to be too restrictive.

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One GP told the researchers: “‘More than half of Irish adults are overweight or obese.”

“It has an impact on fertility, obviously, but once again ‘others’ a group that has enough stigma.”

However, some GPs felt the access criteria were reasonable given limited resources, and that the female age criteria could be even more restrictive, given the impact of female age on the likelihood of success.

Education

The researchers added that GPs need better education on fertility. To obtain access to state-funded fertility treatment, couples must be referred by a GP or consultant.

While just over two thirds of GPs who responded to the survey had spent time working in obstetrics and gynaecology, 70% had not received any formal training in fertility. 

The study comprised an online questionaire completed between September 2023 and January 2024. The researchers noted that the sample size – comprising about 4% of practising GPs – was small, and possibly weighted towards those with an interest in fertility and women’s health.