Assisted Human Reproduction

Thursday, 5 March 2026

Questions (524)

Peadar Tóibín

Question:

524. Deputy Peadar Tóibín asked the Minister for Health whether her Department has assessed the clinical effectiveness and cost-effectiveness of Restorative Reproductive Medicine (RRM) as a treatment for infertility; and whether consideration will be given to supporting or funding RRM as an alternative or complementary option to IVF, particularly for couples who cannot access IVF for religious or personal reasons. [17916/26]

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Written answers

Minister for Health

The Model of Care for Fertility was developed by the Department of Health in conjunction with the HSE’s National Women & Infants Health Programme. The key principle underlying this initiative is to ensure that fertility-related issues are addressed through the public health system at the lowest level of clinical intervention necessary. Under the Model of Care, referrals for publicly-funded, privately-provided assisted human reproduction (AHR) treatment are subject to patients meeting the access criteria agreed by the Department and the HSE. These access criteria were developed by a multi-disciplinary expert group together with a review of international evidence in the field. These criteria include, for example, restrictions in respect of maternal age, body mass index (BMI), and the number of previous AHR cycles/procedures undertaken. In respect of the latter, for instance, a couple must have had no more than one round of privately-funded IVF before and have no unused embryos still in storage to be eligible. The Model of Care comprises three stages of care. These begin in primary care (GPs), progress to secondary care through the six HSE-run Regional Fertility Hubs located across the country, and, where clinically indicated, advance to tertiary care, including IVF (in-vitro fertilisation) and ICSI (intra-cytoplasmic sperm injection). It should also be noted that IUI (intrauterine insemination) is also being provided and can, for certain cohorts of patients, be a potentially effective, yet less complex and less intrusive form of treatment. Public patients are referred through these structured pathways. Patients, following consultations in primary care, are referred by their GP to their designated Regional Fertility Hub for assessment and investigation. Before making a referral, the GP will provide appropriate advice and information on lifestyle factors, carry out relevant tests and examinations, and undertake any necessary initial interventions. The GP must also be satisfied that the couple has been trying to conceive naturally for an adequate period of time. The specific access criteria to avail of services provided at a Hub are less stringent than those required to be met in order to qualify for free AHR treatment. Patients must be clinically assessed by a Reproductive Specialist Consultant at a Regional Fertility Hub before they can be referred for IVF, ICSI, or IUI treatment. At the Hub, patients will undergo a comprehensive consultation and assessment. This may include a range of investigations, procedures, and interventions, as appropriate, such as: relevant blood tests, semen analysis, assessment of tubal patency, hysteroscopy, laparoscopy, fertility-related surgery, ovulation induction, and follicle tracking. Only where clinically indicated by the Specialist Consultant will a referral for IVF, ICSI, or IUI be made. A significant proportion of patients presenting with fertility challenges can be and are being successfully managed at Regional Fertility Hub-level and do not require progression to such invasive tertiary-level treatment as IVF.

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/ 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 only those requiring, and eligible for, advanced AHR treatment such as IVF can access same through the most effective deployment of finite public resources.