Dáil Éireann Debate, Thursday - 15 January 2026
536. Deputy Barry Heneghan asked the Minister for Health the current eligibility criteria for access to publicly funded in vitro fertilisation treatment, including the basis for any requirements related to marital or relationship status; whether her Department has undertaken, or plans to undertake, a review of the criteria to ensure they are fair, inclusive and reflective of modern family structures; and if she will make a statement on the matter. [3050/26]
View answerAs the Deputy is aware, the Health (Assisted Human Reproduction) Act 2024 was signed into law by the President in July 2024, having passed all stages in both Houses of the Oireachtas. Section 8(1) of the 2024 Act states that “there shall not be more than two intending parents of a child born as a result of AHR [assisted human reproduction] treatment and, in the case of two intending parents, they shall be spouses, civil partners or cohabitants of one another”. Such a requirement for intending parents who present as a couple to be spouses, civil parents or cohabitants of one another applies to both publicly-funded and privately-funded AHR treatment. A similar or identical requirement can be found in the Children and Family Relationships Act 2015 (e.g., section 5(1)) and also AHR legislation in other jurisdictions around the world. It is primarily based on issues related to the welfare of any children born as a result of AHR treatment in respect of the stability and durability of the parents’ relationship and hence of the family unit overall by seeking to ensure that intending parents presenting as a couple are in “an intimate and committed relationship” (the wording here taken from section 172(1) of the Civil Partnership and Certain Rights and Obligations of Cohabitants Act 2010). It also can assist an AHR treatment provider to satisfy itself that a couple have been trying for a sufficiently long period of time to conceive naturally.
However, it is important to emphasise that a single intending parent can be provided with AHR treatment under the provisions of both the 2024 Act and the 2015 Act.
The Model of Care for Fertility was developed by the Department of Health in conjunction with the HSE’s National Women & Infants Health Programme to ensure that fertility-related issues are addressed through the public health system at the lowest level of clinical intervention necessary.
Referrals for publicly-funded, privately-provided assisted human reproduction (AHR) treatment – including IVF (in-vitro fertilisation), ICSI (intra-cytoplasmic sperm injection) and IUI (intrauterine insemination) – commenced in September 2023, subject to patients meeting the criteria agreed by the Department and the HSE. The access criteria were developed by a multidisciplinary group, with reproductive medicine expertise and followed consultation with experts in the field along with a review of the international evidence. These criteria are in keeping with those applied in other jurisdictions and include, for example, restrictions in respect of maternal age, body mass index (BMI), and the number of previous IVF cycles / AHR procedures undertaken.
More information is available on the HSE website in respect of the publicly-funded AHR treatment initiative, including more details on the access criteria and specific services available, at: www2.hse.ie/pregnancy-birth/trying-for-a-baby/your-fertility/getting-ivf-icsi-iui-hse/, or on public fertility services more generally at: www2.hse.ie/conditions/fertility-problems-treatments/fertility-treatment/.
Up to the end of December 2025, over 3,600 couples have been referred by a Reproductive Specialist Consultant for AHR treatment, following extensive investigations and/or secondary level treatment within the Regional Fertility Hubs. Furthermore, the Hubs have successfully and directly managed thousands more patients presenting with fertility-related issues who have been referred by their GP. Not all couples experiencing fertility challenges actually require such advanced and invasive interventions as IVF.
AHR treatment involving the use of donated gametes – whether by opposite-sex couples, same-sex couples or single women – is not currently provided through the publicly-funded initiative. There are complex regulatory and clinical issues to be considered in respect of this and other categories of AHR treatment. In the case of treatment involving the use of donated gametes, there is regulation at European level concerning the quality and safety of procedures involving donated gametes. Furthermore, the Children and Family Relationships Act 2015 deals with matters relating to parentage and the right to identity of donor-conceived children arising from such procedures. Nevertheless, there are a number of further clinical and regulatory requirements regarding the donation of gametes and the use of such gametes which are being considered.
The access criteria and the terms of the AHR treatment initiative are being kept under ongoing review. Further potential changes to the access criteria or expansion of the initiative requires continued extensive consultation between Department officials, colleagues in the HSE, and also with relevant specialists in the field of reproductive medicine. This will include consideration of additional funding requirements which may ensue from any proposed expansion of the initiative.
It should be noted that supports previously available to patients who access IVF, or other AHR treatment, privately, whereby tax relief on the costs involved can be claimed under the tax relief for medical expenses scheme, continues to be provided.
In addition, a defined list of fertility medicines needed for fertility treatment is covered under the High Tech Arrangements administered by the HSE. Medicines covered by the High Tech Arrangements must be prescribed by a consultant/specialist and authorised for supply to the client’s nominated community pharmacy by the High Tech Hub managed by the Primary Care Reimbursement Service. The cost of the medicines is then covered, as appropriate, under the client’s eligibility, i.e., Medical Card or Drugs Payment Scheme. The annual cost to the State of the financial support for these medicines is far from insignificant.
I want to reassure the Deputy that my Department and the Government are focused, through the full implementation of the Model of Care for Fertility, on ensuring that patients receive care at the appropriate level of clinical intervention and then those requiring, and eligible for, advanced AHR treatment such as IVF will be able to access same through the most effective deployment of finite public resources.
