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.
This Model of Care comprises three elements, starting in primary care (i.e., GPs) and extending into secondary care (i.e., the six Regional Fertility Hubs located across the country) and, where necessary, the provision of AHR (assisted human reproduction) treatment (e.g., IVF (in-vitro fertilisation), ICSI (intra-cytoplasmic sperm injection) and IUI (intrauterine insemination)), with patients being referred onwards through structured pathways.
Referrals for publicly-funded, privately-provided AHR treatment commenced in September 2023, subject to patients meeting the criteria agreed by the Department and the HSE in order to avail of the fully-funded AHR services. These criteria are very much in keeping with those applied in other jurisdictions, even though in most European countries, for instance, such treatments are only partially funded and require often significant out-of-pocket payments by patients. An allocation of €30m has been provided on a full-year basis to fund this treatment.
More information is available on the HSE website in respect of the publicly-funded AHR treatment initiative 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 October 10th 2025, over 3,100 couples had been referred by a Reproductive Specialist Consultant for AHR treatment, following extensive investigations and/or secondary level treatment within the Regional Fertility Hubs. The number of couples being referred has been steadily increasing and currently averages over 160 per month. 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.
I was pleased to announce recently that, from June 30th 2025, an important criterion for accessing state-funded AHR treatment has been broadened. Couples with one existing child in their relationship, and who meet all the other current access criteria, can now access publicly-funded AHR treatment. including one full cycle of IVF or ICSI, if they are referred for same by a Reproductive Specialist Consultant within one of the six HSE-run Regional Fertility Hubs. Previously, couples with one child in their current relationship were not eligible to access publicly-funded AHR treatment.
As new evidence becomes available and an even greater understanding of how the service provision is working in practice emerges, the access criteria and the AHR treatment initiative generally are being kept under ongoing review. Further potential changes to the access criteria or 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 obviously 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 you 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.