3522. Deputy Ivana Bacik asked the Minister for Health her views on the need to include persons in a same-sex couple in the scheme for free IUI, IVF and ICSI; and if she will make a statement on the matter. [60380/26]

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.

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.

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 assisted human reproduction (AHR) treatment.

Referrals for publicly-funded, privately-provided 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 my Department and the HSE. The access criteria were developed by a multi-disciplinary 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.

The terms of the publicly-funded AHR treatment initiative are underpinned by the primary policy principle of supporting couples experiencing fertility issues and, most specifically, those who have been trying unsuccessfully to conceive naturally at the time in question.

As of the start of September 2026, just under 5,000 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. In this regard, it should be noted that IUI represents a significantly less invasive and less complex form of treatment which can prove to be very effective for certain cohorts of patients.

There are complex regulatory and clinical issues to be considered in respect of certain categories of AHR treatment. In the case of treatment involving the use of donated gametes – whether by heterosexual couples, same-sex couples, or single women – 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.

Extensive consultation between Department officials, colleagues in the HSE, and relevant specialists in the field of reproductive medicine on this matter is continuing, including in respect of examining the position in other jurisdictions regarding publicly funding such treatment and the consideration of additional funding requirements which may ensue from such an expansion of the initiative.

It should be noted that 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 assure 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 and ICSI will be able to access same through the most effective deployment of finite public resources.