Israel’s health ministry has used new medical guidelines, drawn up by a committee of 10 doctors, to limit access to in vitro fertilisation treatments guaranteed under the country’s national health insurance law. From now on, infertile women over age 45 will not be able to undergo treatment with their own ova, and those over 51 won’t be given donated ova.
Under the 1995 universal health insurance law, which provides a basket of health services to all residents, infertile women—whether married or single—are entitled to fertility treatment to produce their first two children paid for by their public health insurer.
The part of the law dealing with in vitro fertilisation had been one of the most liberal in the world, reflecting the high value placed by the Jewish state on childbearing and the perceived need to increase the population to keep pace with Israel’s more populous Arab neighbours.
In fact, Israel has the world’s highest rate of hospital based in vitro fertilisation centres—more than two dozen for a population of six million—which also perform a record number of fertility treatment cycles per patient. It costs from £9400 ($15000) to £12500 to produce a baby in a younger infertile woman; in an older woman it can cost three to five times as much, with much lower chances of success.
Professor Neri Laufer, the new director of gynaecology and obstetrics at Hadassah-University Hospital, Jerusalem, claimed that “the new limits are based solely on medical considerations—the chances for a pregnancy and delivery and the health of the mother and baby—and not on economic considerations.”
Drugs to stimulate ovulation could be harmful, and other risks of in vitro fertilisation included the dangers associated with general anaesthesia, and the possibility of haemorrhage, pelvic infection, and damage to internal organs, he explained.
Professor Laufer, who was a member of the committee that drew up the guidelines, added that even with the new limitations, “No other country in the world, even in Scandinavia, has a health services basket so generous regarding in vitro fertilisation.”
However, the fertility expert added that funds spent fruitlessly on trying to give older women babies should instead be channelled into giving those women who were under 51 another chance with donated ova.
Although a few hundred women in their 50s and 60s have managed to have children using donated ova, “the success rates are extremely low, and we don’t know much about safety and long term results,” Professor Laufer maintained.
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Israel tightens rules on fertility treatment