Ireland's baby-making business: From egg freezing to IVF and everything in between

• Published date: 08 January 2022
• Author: Joanne Hunt
• Publication title: Irish Times: Web Edition Articles (Dublin, Ireland)

Of couples trying for a baby, about eight in 10 will get pregnant within a year. The one in six who will experience problems can find themselves alone. Ireland is the only state in the European Union not to offer publicly funded IVF. This leaves those struggling to conceive navigating the private fertility industry, spending years and potentially tens of thousands of euros on treatments. It's no wonder fertility is big business here

Not all of those wanting fertility treatment are heterosexual couples, of course. Many LGBTQ+ couples who want children, and single women wanting to get pregnant or freeze eggs for later use, need it too. But successive governments haven't kept pace with these social and demographic realities. Funnelled into the commercial fertility sector, those wanting to have a baby are left to make decisions on the dizzying array of sometimes gruelling treatments that may help, and "add-ons" that may not.

In October 2017, the cabinet approved the Assisted Human Reproduction (AHR) Bill, a piece of draft legislation that laid out regulations for AHR and the need for the establishment of a regulatory body. In 2019, the government committed to publicly funding infertility services. Then minister for health Simon Harris said he expected publicly funded IVF to be available in 2021. It still hasn't happened.

If you need help to have a baby in Ireland or you want to proactively preserve your fertility for a later date, you need money. This makes Ireland an outlier. In most other countries in the EU, fertility treatment is either whole or part funded or reimbursed by the public health system. Some 12 countries offer up to six funded cycles of intrauterine insemination (IUI), according to the European fertility atlas, a comparative map that grades countries on legal access to fertility treatments, as well as their funding and reimbursement. The index was published last in December by the charity Fertility Europe, along with the European Parliamentary Forum for Sexual and Reproductive Rights.

Three countries offer up to six fully funded cycles of IVF or intracytoplasmic sperm injection (ICSI), where an embryologist injects a single sperm into the egg to assist fertilisation, and 35 partially fund it. France has become one of the latest countries to give lesbian and single women the same rights to fertility treatment as heterosexual couples. Those rights include reimbursement for four IVF treatments and six IUIs.

Indeed Ireland ranks 40th out of 43 nations for access to fertility treatment, according to the atlas. Only Belarus, Ukraine and Turkey rank lower than us. Countries such as Belgium and the Netherlands are the gold standard, according to the atlas, scoring 86 per cent on the scale. In Belgium, public funding or partial funding is given for up to six IUIs and six IVF/ICSI treatments including insemination with donor sperm for heterosexual couples, single women and female couples. Treatment with egg donation is also funded for those groups and for male couples. France, Portugal, Finland, Norway, the UK and Spain all score between 70 and 80 per cent on this monitor. Ireland's score is just 27.

As early as 2008, the European Parliament called on member states to "ensure the right of couples to universal access to fertility treatment". Irish citizens are still waiting.

"Fertility specialists can help you to become pregnant. These treatments are available privately only. This means they are not provided by the public health service," the HSE website states. So if you are struggling to have a baby, that's on you. If you are struggling to conceive and don't have money, or don't have enough of it, your opportunities to have a child are less. Your chances to have a family will be limited by your funds. If you need fertility treatment, you better have substantial savings.

"As somebody involved in the provison of reproductive healthcare, this angers and frustrates me," says Dr Sorca O'Brien, Aspire Fellow in Fertility at the National Maternity Hospital and the not-for-profit Merrion Fertility Clinic. The WHO's recognition of infertility as a "medical disease" and a "disability" holds little currency here. "The creation of families in Ireland continues to be a luxury for those who can afford it or a financial burden for those who incur debt," says O'Brien.

Many coming through the door of fertility clinics aren't infertile but...