State-funded IVF: What do we know?

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Head of Repromed Caitriona McPartlin sheds light on the unanswered questions surrounding the introduction of State-funded IVF

IVF: graphic with womb, pregnancy tests

Did you know that Ireland is the only country in the EU that does not offer any state funding for fertility treatment? Minister for Health Stephen Donnelly recently announced that State-funded IVF treatment will become a reality in 2023.

However, there is still a lot we don’t know about what a public system will look like here in Ireland. We sat down with Caitriona McPartlin, CEO of ReproMed, one of Ireland’s largest fertility clinics. She explained what the changes will mean for patients in Ireland.

Caitriona, Ireland is lagging behind when it comes to State-funded fertility treatment. Why has this taken so long?

We have absolutely no idea why it’s taken so long. Potentially because the government was waiting for legislation to be framed first, and probably for the regulator to be established as well. We’ve been crying out for this for an awfully long time. But we still don’t have a clear indicator even on a timeline. We’ve been told that it’s going to be next year, but even then it’s hard to know.

But what it means is more patients will be able to access treatment. Also, patients who were already accessing treatment might not have the same level of financial worries. If you can’t get pregnant it is very stressful. It consumes your mind. You don’t need financial worries on top of that.  

Can you give an idea of the current costs involved for patients?

It’s really specific depending on the individual and the reasons for their infertility. If you’re going to look at a cycle of IVF, you’re looking at just under €5000. But there’s also a lot of options available to patients to support them with that cost in the vacuum left by the lack of government funding.

A lot of health insurers are now covering sizable pieces of the cost, such as VHI. We also have Humm financing available now to patients, so they can pay for their treatment or their tests or whatever they need to have done on a monthly basis. Also, Revenue actually cover 20% of your medical expenses. So that’s another thing that people often forget. So while yes, it’s expensive for IVF, as I said, just under €5000 for one cycle, but there are a lot of options available to support patients.


Do we know what will be covered by the State, and to what extent?

We don’t really know how the government intends on funding it. It’s very hard to really understand how it’s going to affect individual clinics. What they may end up doing is having a certain amount available for each couple or each individual for fertility treatment, then it would be up to the clinic to decide what the best option may be. 

They could do something very binary where they fund a certain number of IUI cycles, which would be typically happening before IVF, and then they’ll fund a certain number of IVF cycles. And then if they’re finding that there’s a cohort of people who need to use donor gametes, perhaps they’ll fund part of that as well. Really, it’s unfortunate they’ve given us really no visibility on what they’re planning on doing. 

What does this mean for the industry?

A bit of prior warning from the government about what shape it’ll take will be great because we need to prepare first. It could easily be rolled out if the government utilizes the existing private clinic network and the government doesn’t decide to start from scratch and try to set up public fertility clinics. Fertility clinics, the technology that goes into them, the expertise in terms of staff and the set up involved takes so long. The investment would be huge. 

I’m working with the other clinics, key stakeholders and other fertility healthcare providers. We’re trying to position ourselves to petition the government on some of the really key issues that we have with the legislation particularly. But other than the engagement that we had with them originally back years ago when they were originally drafting this legislation, they haven’t engaged with us since then. And we’re hoping that they will. 

Do you expect that there could be waiting lists and delays in getting treatment?

I know from COVID that at ReproMed, we’re really dynamic. We’re able to change and adapt really, really quickly as things change. COVID really showed us that our staff were amazing. So I don’t have any doubt that if we have to deal with publicly funded cycles, we’d be more than capable of doing that.

A big thing to remember is not everyone who actually has fertility issues or subfertility issues needs IVF. Just because the government funding is there, it doesn’t mean that all of a sudden there’s going to be a massive influx of people demanding treatment. As long as the government funds it in a way that’s fair for patients and is cognizant of the treatment providers, I don’t have any doubt that the clinics already here will be able to service that demand.


Do you think these measures will result in less patients having to travel abroad for treatment?

It’s such an emotive topic because you know that adage, the Irish solution to the Irish problem is to send everything abroad. We saw that with abortions for so long. And so I certainly hope that having the publicly available services will result in fewer people going abroad. I suppose what patients don’t realize is that by the time you’ve gone abroad for treatment, you’ve had flights, accommodation, time off work and all of the other inconveniences that come with it. The cost savings are actually quite minimal in the overall scheme of things. I’m able to say that with confidence because ReproMed is part of a European group. So I know the costs that accumulate. I also have good visibility on the numbers of patients who are actually going abroad for treatment and the reasons behind it. I think the standards of practice in Ireland are really high here and the KPIs and success rates are good.

Should patients be concerned that a regulatory body is only being set up now?

I think the fact that there isn’t a dedicated regulatory body for this particular field is absolutely a concern. But I suppose the other thing is a patient should be aware that we’re actually quite stringently regulated already by the HPRA.

This is in addition to the fact that all of the doctors who work in the clinics in Ireland have to be IMB registered. It’s not like we have cowboys in taking care of patients. All of our doctors in Repromed are consultants. Some are even sub specialists in their fields and the training and the international expected standards for doctors, for nurses, for embryologists are all really, really high. Introducing a regulatory body won’t be a shock to the industry because the clinics themselves are ethical and the standards are high across the board.


Watch next: Q&A with fertility specialist, Dr Hans Arce