In Vitro Fertilization (IVF) (Right)

From All Rights (Kol-Zchut) (www.kolzchut.org.il)

Introduction:

In vitro fertilization (IVF) treatments are included in the healthcare basket for first and second children
For more information, see the Ministry of Health's English website
See information about eligibility in different health funds and additional information about IVF on the Ministry of Health's "Kol HaBriut" website.

In vitro fertilization (IVF) is a process in which ovum are fertilized by sperm outside the woman's body, and then transferred back into the woman's uterus.

Who is Eligible?

Eligibility for IVF as Part of the Healthcare Basket

  • According to the National Health Insurance Law, the following are entitled to IVF treatments provided as part of the healthcare basket:
    • Couples who do not have children from their current marriage. Couples are entitled to treatment so that they may have a child together even if they have children from a previous marriage(s).
    • Women without children who are interested in being a single parent or to birth a child from the sperm of a man who is not their partner.
    • Patients undergoing going the process of the process of pre-implantation genetic diagnosis PGD.
    • The prospective mother whose eggs are used for the treatment may not be over 45 years old (she is eligible until her 45th birthday). Egg donation recipients may be up to 54 years old.

Health Plan (Kupat Cholim) Supplementary Insurance Entitlement

  • Supplemental insurance arrangements through the health plans cover part of the fertility treatment costs not included as part of the healthcare basket, such as: treatment for a third child, certain costs involved in egg donation, fertility drugs not included in the healthcare basket and coverage of treatments in private hospitals or fertility units.
  • Most health plans divide the IVF process into three stages, according to which the co-payment and required payment obligation amounts are calculated :
    1. Stage A: Hormonal treatment to induce ovulation and relevant required testing
    2. Stage B: Treatment to retrieve eggs, fertilize them and transfer the fertilized eggs
    3. Stage C: Treatment for thawing a frozen embryo and transferring it to the uterus
  • The health plans require a qualification period (a period beginning from the time someone joins the supplemental insurance until the date s/he claims specific rights/services as part of the insurance), only after which is it possible to benefit from the services provided as part of the supplementary insurance. This period varies by health plan.
  • Fertility treatments are paid for by the woman's health plan even if the cause for the infertility is related to the man. The man will only be treated in his health plan if there is a need to treat the sperm. All other treatments are carried out through the woman's health plan.
  • For more information about relevant entitlements provided as part of the health plans' supplemental insurance options, see the English healthcare plan brochures on the Shira Pransky Project website or the following Hebrew resources:

How to Claim It?

  • A health plan doctor specializing in fertility must be contacted in order to obtain a referral for IVF treatments.
  • Approval from the health plan's fertility committee must be obtained. In most cases the required forms are submitted to the applicant's health plan branch. Additional information should be clarified with the health plan.
  • After receiving committee approval the applicant should contact an IVF unit at a public hospital with a payment voucher (Form 17) from the health plan.
  • By law, any medical action associated with IVF may only be performed after the physician in charge has explained the significance and potential consequences to all involved parties, and informed consent has been received from all of them separately.
  • Every medical action associated with IVF performed on a married woman may only be performed after receiving consent from her husband.
  • In cases where a woman undergoes IVF using the sperm of someone who is not her partner, and they are interested in shared parenting, a detailed agreement between them meeting all relevant legal requirements must first be prepared. For more information see Fertility treatments for women using donor sperm.

Number of Treatment Cycles

  • On 20.01.2014 Medical Administrative Circular No. 6/2014 was published regarding IVF treatment cycles included as part of the healthcare basket.
  • The circular details a number of recommendations related to IVF cycles:
    • Women age 39 and over may begin IVF treatments for medical reasons as an initial option .
    • Women age 42 and over cannot have more than three consecutive IVF cycles in which they did not reach the embryo transfer stage of the process. In the event that an embryo transfer does occur (even on the third cycle) this count begins again.
    • Treatment continuation hearing
      • Following four consecutive cycles that did not reach the embryo transfer stage, or after eight cycles with no clinical pregnancy, the treatment staff along with a social worker will hold a hearing where they will discuss the cause for the lack of success and recommendations for continuation of the treatment.
      • The unit in which the last treatment cycle took place is responsible for arranging the hearing.
      • The hearing will consider all of the treatments that the woman has undergone, the reasons for their failure, ovarian reserve, and recommendations regarding the continuation of treatment.
      • The hearing and its findings and recommendations will be included in the woman's medical file and will be sent on to her health plan.
      • Plans for continuation of treatment, including additional IVF treatments will be determined according to the hearing's conclusions.
  • Frequently Asked Questions on the Ministry of Health website.

Preimplantation Genetic Diagnosis

  • Preimplantation genetic diagnosis (PGD) that is done during the IVF process is now considered one of the practical options recommended to couples with increased risk of having a child with a chromosomal deficiency or genetic disease.
  • Through this process of pre-fetal genetic diagnosis it is possible to achieve a pregnancy with a healthy fetus and avoid the need to choose between termination of a pregnancy or giving birth to a sick baby.
  • To inquire about coverage of this process, the woman's health plan should be contacted.
  • For more information on the diagnosis process and the departments that are certified to perform it, see the Ministry of Health website.

Please Note

  • The recommended number of embryos to transfer as part of IVF treatments according to Ministry of Health guidelines:
    • In the first three treatments - Up to two embryos per treatment.
    • In the following cases, transfer of more than two embryos may be considered:
      1. After three IVF treatments in which two embryos were transferred without a pregnancy.
      2. When the woman is over 35 years old, after two embryo transfers without a pregnancy.
      3. When the woman is over 41 years old, from the first embryo transfer.
  • In no case may the number of embryos transferred exceed four at one time.

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