Israel Health Ministry Is Looking to Decrease Funding of IVF Treatments

17.05.2013

Israel's national health insurance program is unusual among Western nations in that it allows an unlimited number of IVF treatments before the births of up to two children for women up to age 45.

A professional advisory panel has recommended that the Health Ministry stop funding in vitro fertilizations for older women, whose chances of becoming pregnant are low.

The recommendations were prepared by the National Council of Midwives and Gynecologists at the ministry's request. As Haaretz reported last June, the ministry has been looking into funding IVF treatments for up to three children, rather than two as is currently done, but in return wanted to stop funding procedures for older women because there is a steep drop in the chances of women over 43 becoming pregnant.

Israel's national health insurance program is unusual among Western nations in that it allows an unlimited number of IVF treatments before the births of up to two children for women up to age 45. It also allows egg donations with public funding for up to two children for women between ages 45 and 54.

But according to Prof. Martha Direnfeld, head of the Israeli Fertility Association and director of the IVF clinic at Carmel Medical Center, "From age 44 to 45, the chances of getting pregnant from each cycle of treatment are 2 percent or less. When every treatment costs thousands of shekels, there's no reason not to enable women over 44 to undergo an egg donation, which multiplies the chances of pregnancy by 25."

The money saved by not financing IVF treatments for these women would free up funds to pay for their egg donations, thereby increasing the chances that they would actually have a child, Direnfeld maintained.

The cost of a child born through IVF to a women of 44 is estimated at over NIS 1 million.

Program requires nat'l IVF database

The council also proposed limiting women aged 42 to 44 to three state-funded IVF treatments. This would require setting up a national database for IVF treatments so clinics could see whether a woman has undergone such treatments before. Today, a woman could theoretically visit all 25 of Israel's IVF clinics in turn, and none would know that she had already been treated at another.

Finally, the council recommended that from age 39, women be referred directly for IVF treatments instead of first having to undergo three rounds of artificial insemination, and that women with a high chance of getting pregnant be allowed to have a third child through state-funded IVF.

The ministry said that director-general Prof. Roni Gamzu and Health Minister Yael German would discuss the proposal.

Meanwhile, a new ministry report showed that IVF treatments in Israel rose 11 percent in just a one-year period from 2010 to 2011. The report also showed a steady increase of such treatments over the past decade.

The newly released report shows that in 2011 there were 38,284 cycles of IVF treatments, compared to 34,538 such treatments in 2010. These figures include both treatment and transfer cycles. This figure has risen 83 percent from the 20,886 such treatments in 2002.

The chances of becoming pregnant from such treatments has remained the same: In 2011, 23 percent of women receiving IVF treatments became pregnant, resulting in 8,796 pregnancies; and 15 percent ended in deliveries with live births. All told in 2011 the IVF treatments led to 5,709 births and 6,901 babies. This is 4.1 percent of all the births in Israel that year, similar to the figures for the two previous years.

The percentage of IVF treatment rounds rose by 9 percent in 2011 from 2010 to 20.7 rounds of treatment per 1,000 women of childbearing age, 15 through 49.

In January 2013 Haaretz published the results of research on women who were members of Maccabi Health Services and who underwent IVF treatments from 2007 through 2010. The study showed that alongside the increase in the number of IVF treatments, there was a 21 percent drop in the success rates of those treatments. In addition, IVF success rates in the United States were 2.4 times higher than those in Israel for the same period. In 2007, the success rate for births after IVF treatments was 18.8 percent for 6,369 cycles of treatment for women insured by Maccabi, the study showed, while in 2010 the success rate was only 14.8 percent and the number of treatment cycles jumped 49.5 percent to 9,525.

A 2002 study of international IVF treatments conducted at McMaster University in Canada showed the rate of IVF treatments in Israel was the highest in the world, 1,657 cycles per million residents and significantly higher than in other Western nations. In France the figure was 610 per million; Britain, 441; Germany, 417; United States, 126 and Japan, 101 per million residents.

www.haaretz.com