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Wednesday 29 November 2023 Dublin: 1°C

Opinion The IVF funding scheme may be devastating for many, but it will also relieve some heartache

June Shannon is an award-winning medical journalist with a specialist interest in women’s health and the health of vulnerable groups.

IF THERE IS one thing that people struggling with fertility issues are good at it is waiting.

Waiting for the perfect time to have sex to optimise conception, waiting for that blue line to appear on a test, waiting for appointments, test results, and the outcomes of scans and treatments.

Waiting until you are safely home from yet another friend’s gender reveal party before dissolving into tears.

When you are undergoing fertility treatment, your whole life is put on hold while you wait.

The news yesterday that the Government was to provide public funding for IVF was another thing that people living with infertility have been waiting for.

They were told that Ireland was finally going to catch up with the rest of the EU and provide free fertility treatment. But unfortunately, like all things fertility related, it has turned out that it’s not that simple.

While the announcement was hugely welcome, like most things in life, the devil was in the detail.

The eligibility criteria announced yesterday contained a heavy blow for a lot of people. It was a blow for women over the age of 42, same-sex couples, and single people who yearn for a baby on their own.

It was also a crushing disappointment for people struggling with secondary infertility; who had their first baby naturally, but who struggle to provide that child with a long-dreamed-for sibling.

One cycle

The criteria announced by the Minister for Health yesterday were also devastating for people who have already started their IVF journey.

To qualify for free treatment, couples can only have undertaken one round or cycle of privately funded IVF and used all the embryos created as a result of that cycle.

People who have not had any IVF before and meet the other criteria are also eligible.

But the funding announced only provides for one cycle of IVF. Anyone who has undergone fertility treatment knows that it is rare to be successful the first time around.

In Britain, the NHS provides funding for up to three cycles. It usually takes several rounds or cycles of IVF treatment to get a positive pregnancy test, and sadly we also know that a positive test doesn’t always mean you will be bringing home a baby in nine months’ time.

The result is that funding for just one round of IVF, which would only provide funding to people who have never done a cycle or those who have been through just one, seems very unfair.

But then again, infertility isn’t fair. It is a devastating condition that affects one in six couples in Ireland.

Despite being categorised as a medical condition by the World Health Organization (WHO), it still carries a great deal of stigma and distress for those affected.

Confused reporting

According to the WHO’s definition, infertility is “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse”.

The WHO also states that infertility is classified as a disability, and that access to healthcare therefore “falls under the Convention on the Rights of Persons with Disability”.

Approximately a quarter of infertility cases are due to sperm problems; a quarter are female-related; another quarter are completely unexplained; and a further quarter would be as a result of several different issues, including male and female factors.

There was confusion in some reporting yesterday that people with a diagnosis of unexplained infertility would not be eligible for funding, as it was stipulated that couples needed to have a clinical diagnosis of infertility.

However, it is important to clarify that as unexplained infertility is a clinical diagnosis, they will be eligible under the new scheme.

So why were the criteria outlined by Government yesterday so limited?

My guess is that it comes down to the fact that there is a very limited budget available, with just €10 million ringfenced.

That’s a drop in the ocean when you consider that the annual health budget for 2023 was over €23 billion.

Therefore, to maximise the limited budget and ensure that as many people as possible attain the chance of having a longed-for child, restrictions had to be set.

I have sympathy for the experts who were faced with such a limited budget and charged with deciding who can and who can’t have a chance of having a family. It was a tough and unenviable task.

However, before yesterday’s announcement, there was no chance for those who could not afford IVF, and at least now there is a chance for an estimated 3,000 couples.

No guarantees

It is important to remember that there are no guarantees with fertility treatment. Anyone who has travelled that long lonely road knows that all too well.

I know it, and so does my husband. We underwent five cycles of IVF treatment before we finally got our happy ending in 2015 when our daughter was born following IVF with donor eggs.

We had one last attempt to give her a sibling in 2020, using our last remaining embryo. Sadly, that cycle failed.

Donor sperm and eggs are not covered by the funding announced yesterday, due to the failure to pass the long-awaited Assisted Human Reproduction Bill.

This legislative delay means that same-sex couples, single people and heterosexual couples who use donor eggs or sperm cannot receive publicly funded treatment.

We spent a total of €25,000 on IVF treatment, which was funded by loans, help from family and friends and inheritance.

Our daughter is seven years old now, and we are still paying off those loans.

I am painfully aware that we were one of the lucky ones, and I wouldn’t change a thing.

I am also aware that a lot of people in Ireland today are currently living through the very real heartbreak of infertility and my heart goes out to each and every one of them.

However, if yesterday’s announcement can relieve just a little of the huge financial pressure faced by people suffering from infertility, then it is to be welcomed.

And while the €10 million in funding to provide free fertility treatment, albeit for a limited number of people, is a welcome first step, it can only be seen as that: a first step.

I, along with lots of others, have long advocated for an equitable publicly funded fertility service.

And I believe it is incumbent on all of us to keep the pressure on the Government to ensure that free fertility treatment is available to everyone who needs it.

I can wait. I am good at that.

June Shannon is an award-winning medical journalist with a specialist interest in women’s health and the health of vulnerable groups.


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