Guidelines for new IVF programme do not ‘reflect the reality of infertility in Ireland’

New IVF funding programme comes with ‘discriminatory’ and out-of-touch criteria, that excludes most seeking the treatment and leaves them asking, ‘What’s wrong with us?’, says Galway mother who has spent €24,000 on IVF cycles.

The guidelines of the fully publicly funded assisted human reproduction (AHR ) programme which sees eligible patients entitled to ‘one full cycle of IVF (in-vitro fertilisation ) or ICSI (Intracytoplasmic sperm injection ) treatment, initially provided in HSE-approved private clinics of their choice’, was announced on Tuesday, July 25, by Minister for Health, Stephen Donnelly and will commence in September.

The AHR programme received a Government green light in February this year, a move that was widely welcomed, medical experts, those who had pursued fertility treatments and the wider public, but the newly announced eligibility criteria that has been labelled as ‘out-of-touch’ or not reflective of the reality of infertility in Ireland by some. Only eligible for heterosexual couples who have no known clinical cause of infertility and require no ‘donor gametes’ (sperm or eggs ) can access the funding, provided they meet other outlined criteria.

Criteria

Introduced with stipulations on age (up to 41 for women but up to 60 for men ), body mass index (BMI ) of ‘18.5 kg/m2 to 30.0 kg/m2’, ‘donated gametes’ (sperm and eggs ), current family size, length of relationship, lifestyle choices down to units of alcohol consumed, and the number of ‘living children’ belonging to each partner, the accessibility of the long awaited AHR programme has been questioned by local mother, Katie Guinnane, who welcomed twin girls, Berry and Rudy with her partner, Rosy Kennedy, after four cycles of IVF costing €24,000.

Guinnane says the discrepancy of age criteria based on sex is ‘quite dangerous’ due to the fact that it ‘feeds into the idea that fertility issues tend to be linked to female’.

“This reinforces the idea that men can just keep having children forever, but recent studies that sperm does deteriorate with age and can cause issues with fertility. The BMI element has another element of exclusivity along with the ‘no donated material element’, which eliminates all couples that require donor material which is not only same sex couples, but sperm donation in heterosexual couples undergoing IVF is far more common than people think.

“If there was a clause where the guidelines said donated materials aren’t covered in the cost, but the IVF cycle is, that would make more sense but to be automatically excluded because of the donation factor is just hard to understand.”

Using one private support group Guinnane is a part of for parents who have undergone IVF, as an example - the criteria listed in the guidelines would exclude around nine out of 15 of members, some due to BMI being outside the guidelines, some for using donor sperm or eggs both within a relationship, or as single women.

“These people are a reflection of society and those who undergo IVF, we come from all walks of life, all backgrounds from all over the country with IVF being the only common link and a majority of us would not be eligible under those guidelines.

“The World Health Organisation have said that infertility is a disability. It is a real life issue and IVF is not luxury, it is not a handbag, it is a medical treatment that is incredibly difficult. IVF is a torturous journey and people do it because they are desperate to have a child and there is no other avenue. They are not doing this lightheartedly.”

‘What’s wrong with us?’

While the high levels of exclusion is evidently frustrating to Guinnane, she repeatedly says that she hopes that for those who are eligible, who can receive the aid in their journey to parenthood, the AHR programme helps them to achieve that goal.

“Stress is one of the biggest preventatives when trying to get pregnant and IVF is just one big ball of stress, so by removing the stress factor from the financial element it will be a huge positive for so many people and in that respect the scheme is really welcome and that is great, but the question is ‘who will be able to access the scheme?”

The fact that often people do not discover the challenges with their fertility until they have spent a number of years actively trying to conceive, or have experienced successive miscarriages. The average age of first-time mothers in Ireland was 33 in 2020, a figure that is increasing as issues with housing and finances are causing hopeful parents to delay having children until they are settled. In many reports those undergoing IVF often exceed the national average by more than a couple of years, meaning that having 41 as a cut off point is a very real threat for many women.

“There are all types of people in the Ireland using IVF and the one thing that we all have in common is that we all want to have a family, and we are all crippled by it financially.

“With no disrespect to anyone, but why should some be deemed as more worthy and be able to access funding, but others aren’t? It is unfair to validate people like that, based off their desire to have a family.”

 

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