Trying for a baby can be an exciting but stressful time for some couples. If you’ve been trying to conceive for a while, you might be starting to think about fertility tests and treatments to help you bring a little one into the world.
Healthy, fertile couples can often take up to a year to conceive, so don’t despair if you’ve been trying for a few months without any luck.
If, however, you’ve been trying for several months without becoming pregnant, it might be time to speak with a fertility specialist. The length of time you should try to conceive before seeking professional advice depends on your age and health status:
- Aged under 35 years: 12 months
- Aged 35-37 years: 9 months
- Aged 38+ years: 6 months
- History of endometriosis, chlamydia or other STI, pelvic surgery, or family history of early menopause: 3-6 months
If the time comes for you to see a fertility specialist, you are not alone. Around 1 in 6 couples in Ireland experience infertility problems, but 95% of couples will conceive after 2 years of regular unprotected sex. There are also numerous treatments that may be able to help you conceive naturally, as well as a choice of assisted conception methods.
Fertility can sometimes be a taboo subject, with limited information and education available to women in Ireland – so to help you explore your treatment options and understand how your health insurance provider can support you, we’ve outlined everything you need to know when you’re starting to think about fertility.
Fertility Testing
Usually, your first step will be to undertake a series of tests to identify any irregularities that could be stopping you from conceiving. In many cases, no issues will be found – but if your fertility specialist does identify a problem, they will support you to find the right treatment or solution.
For men, the most useful fertility test is semen analysis. This measures the amount of semen being produced, as well as the number and quality of sperm present. If any significant abnormalities are found, further testing may be required. For example, if a very low sperm count or the absence of sperm is identified, genetic testing may be conducted.
Women will be advised to have an up-to-date normal pregnancy smear, as well as an ultrasound scan. The ultrasound will give a lot of information about the uterus and ovaries, checking for cysts, polycystic ovaries, endometriosis, polyps, fibroids or swollen fallopian tubes. The scan will also show how many eggs are in the ovaries.
Along with an ultrasound scan, an Anti-Mullerian Hormone (AMH) blood test will be used to assess ovarian reserve and diagnose polycystic ovaries.
Surgical Treatments
Endometriosis affects 1 in every 10 women in Ireland. This common condition is where small pieces of the womb lining are found outside the womb, usually in the pelvis, fallopian tubes and ovaries.
If endometriosis is suspected, the only way to get a definite diagnosis is a laparoscopy. A small telescope is inserted through your belly button under general anaesthetic, and the image of your pelvis is transmitted onto a TV screen.
If your initial testing identifies fibroids – non cancerous swellings or growths in the muscle layer of the womb – you will be treated using a hysteroscopy. This involves inserting a small telescope through your vagina into your womb, and is carried out as a day procedure while you’re awake.
Assisted Conception
Should you, following thorough testing and any appropriate treatment, decide that assisted conception is the right path for you, you will need to be treated privately. There are a number of options available to you, but none of these are provided by the public health service:
- IUI (Intrauterine Insemination)
This technique involves inserting a man’s sperm into the woman’s womb during ovulation – the most fertile time for a woman to conceive. If your partner is male and his semen analysis results are within normal limits, his sperm can be used and will be produced by masturbation prior to the procedure.
If your partner has very few, abnormal or no sperm, or if your partner is not male, donor sperm can be used.
- IVF (In Vitro Fertilisation)
IVF is when the woman’s eggs are fertilised with a man’s sperm outside of the body.
A fertilised egg is known as an embryo. Any embryos produced are graded for quality, and one or two are chosen to transfer into the womb. Approximately 1 in every 4 IVF procedures is successful, but some remaining embryos may be suitable for freezing and can be used in subsequent cycles if the first is unsuccessful.
- ICSI (Intracytoplasmic Sperm Injection)
This method is chosen if you’re unable to get pregnant due to sperm not being able to get inside the egg, or if the man has a low sperm count.
ICSI is very similar to IVF, with the egg and sperm being collected from each partner or donor. However, fertilisation is achieved via a different method, with the sperm being inserted directly into an egg.
How Much Does Treatment Cost?
With fertility treatment unavailable through the public health service in Ireland, it’s often an expensive process. This can add significant financial strain on couples during an already difficult time, but there are numerous rebates available through tax relief or your health insurance. Typical costs include:
- Initial consultation: €150 - €200
- Semen analysis: €150
- His and hers fertility test: €300
- IVF: €4,500 per cycle
- ICSI: €4,500 - €5,000 per cycle
- Egg freezing: €3,000
Tax relief is given at the standard rate of 20% on most available fertility treatments, however you can’t claim tax relief on any expenses you’ve already reclaimed through your health insurance. Since fertility treatment in Ireland is so expensive, many couples travel abroad to receive treatment, for which you can also claim 20% tax relief.
You can also claim tax back on any drugs used in your fertility treatment, as they’re covered under the Drug Payment Scheme – so you won’t pay more than €114 each calendar month for approved prescription drugs, medicines and appliances.
Health Insurance: How Can it Help and What's the Best Plan?
Over recent years, all three of Ireland’s health insurance providers have added fertility cover to a number of their plans. There are a plethora of options to consider, with varying benefits, coverage and costs, so it’s important you select the right plan to suit your unique needs and preferences as a couple.
While we hope you won’t need to access fertility treatment, it may be worth considering coverage when you first start trying for a baby. Fertility cover is subject to a 52 week waiting period. As a result, delaying your insurance decision could prevent you from being able to claim back on these costs.
Here’s what’s on offer from the three providers:
Irish Life Health
Many of Irish Life Health’s plans offer fertility benefits, covering all fertility clinics in the Republic of Ireland. The level of cover will depend on which plan you select, but typically you can get contributions towards:
- His & Hers Fertility screening
- AMH (egg count) test
- Up to €2,000 towards IVF, IUI and ICSI
- 10% point of sale discount at Beacon Care Fertility
- International Second Opinion – Fertility
- Maternity Mental Health Support – Counselling sessions provided by Nurture for fertility issues and miscarriage support
- Egg freezing and Sperm Freezing
- Alternative therapies such as Nutritionist, Dietician and Acupuncturist
Laya Healthcare
Laya has two fertility programmes on offer. The first is available on many of their everyday plans, and has a 52 week waiting period before benefits become accessible. Benefits include:
- Up to €1,000 towards specific fertility treatment at approved centres
- €1,000 per lifetime towards egg freezing at approved centres
- €150 per lifetime for sperm freezing at approved centres
Their second fertility programme, ‘First Step Fertility Package’, has a two year waiting period but offers larger contributions toward treatment:
- Up to €3,550 for benefits towards specific fertility treatment and tests at approved fertility centres, payable twice per lifetime
- €1,500 per lifetime for egg freezing
- €200 per lifetime for sperm freezing at approved centres
Vhi
Many of Vhi’s plans include fertility cover, with participating fertility treatment centres: Repromed (Dublin, Louth and Kilkenny), Galway Fertility Clinic and Merrion Fertility Clinic. At these centres, you can access the following benefits with a Vhi policy:
- Money back toward semen analysis
- €1,000 towards egg freezing once per lifetime
- Up to €250 toward sperm freezing once per lifetime
- Benefit towards Preimplantation Genetic Testing
- Up to €1,000 towards two cycles of IUI, IVF or ICSI (female only)
- Frozen embryo transfer benefit – Up to €740 twice per lifetime
- Counselling from specially trained fertility counsellors
- Alternative therapists such as dieticians and acupuncturists
Find a Plan that Works for You
We understand all of this information can be overwhelming. Fertility issues can cause a lot of stress and anxiety, and there’s lots to learn and consider before decided your fertility care plan.
HCC’s health insurance experts are here to help you define a fertility plan that works for you and your partner. Choosing fertility treatment is very personal, and will depend on your preferences, needs, and health. We can help you weigh the options and explore which insurance provider and plan is the best fit.
Get started with a free quote today, and we'll be in touch. You can also contact us over the phone or via email to discuss your options, get advice and ask any questions.
Call: 01 498 0515
Email: support@hcc.ie