A model of care for infertility, will see fertility issues addressed through the public health system at the lowest level of clinical intervention necessary, health minister Stephen Donnelly said in the Dáil this week. (28 September).

Responding to a question from Claire Kerrane TD, as to when legislation and supports for IVF and surrogacy will be made available, the minister said that the Bill being drafted on assisted human reproduction (AHR) is a comprehensive piece of legislation which will encompass the regulation of a very wide range of practices, including domestic altruistic surrogacy.

A model of care has been developed by the Department of Health, in conjunction with the HSE’s National Women and Infants Health Programme.

Donnelly said publication of the Bill is a priority.

“Officials in my Department and the Office of the Attorney General continue to prioritise the drafting of this complex legislation and will engage intensively over the next few months to finalise the Bill,” he said.

The model of care comprises three stages, starting in primary care (GPs) and extending into secondary care (regional fertility hubs) and then, where necessary, tertiary care (IVF and other advanced assisted human reproduction treatments).

Pathways

Structured referral pathways are being put in place and patients will be referred onwards for further investigations or treatment as required and as clinically appropriate, the minister said.

Phase One of the roll-out involves the establishment, at secondary care level, of regional fertility hubs within maternity networks in the six hospital groups across the country.

This will facilitate the management of a significant proportion of patients presenting with infertility issues.

Phase Two of the roll-out will see the introduction of tertiary infertility services, including IVF, in the public health system, but will not commence until infertility services at secondary level have been developed across the country, required resources have been allocated and the AHR legislation commenced.

“The underlying aim of the policy to provide a model of funding for AHR, within the broader AHR regulatory framework, is to improve accessibility to AHR treatments, while at the same time embedding safe and appropriate clinical practice and ensuring the cost-effective use of public resources,” the minister said.