– The Comprehensive Reproductive Health Program in Poland for the years 2016-2020 financed primarily infertility diagnostics, not the treatment itself in the sense of insemination and in vitro fertilization. The cause of the problem was determined, and then, in principle, people said, “take care of yourself at your own expense” – says Dr. Marcin Mika, MD, a gynecologist dealing with infertility treatment.
- We talk about infertility when, despite systematic unprotected intercourse lasting at least a year, the couple does not become pregnant. It is estimated that about 1,5 million couples in Poland struggle with this problem
- Thanks to the program of the Ministry of Health “Treatment of infertility by in vitro fertilization for the years 2013-2016”, about 20 thousand children were born to the world. kids
- The subsequent Comprehensive Reproductive Health Program in Poland for 2016-2020 financed diagnostics, but not the treatment of infertility
- – Drugs preparing for the in vitro procedure will continue to be financed in the treatment of infertility. The National Health Fund will still finance a maximum of three such cycles – explains Marcin Mika, MD, PhD
- You can find more such stories on the Onet homepage.
obstetrician and gynecologist dealing with, among others diagnosis and treatment of infertility at the Superior Medical Center in Krakow.
Recently, there has been considerable interest in the information that infertility treatment has disappeared from the National Health Program for 2021-2025. So what is the current situation of couples struggling with infertility?
Dr. n. with Marcin Mika: First of all, it is worth paying attention to how it developed before. It is necessary to distinguish between the ministerial program, functioning in previous years, known as “Treatment of infertility by in vitro fertilization for the years 2013-2016”, from the 2016-2020 program. It was strictly a government infertility treatment program. I mean, first of all, that it was not only diagnostic, but also focused on treatment. I am talking about assisted reproduction, i.e. intrauterine insemination, in-vitro and other advanced treatment techniques. All this was done in the years 2013-2016, thanks to which about 20 were born in Poland. kids. It can therefore be said that it was a very spectacular and desirable program of the Polish government.
So what has changed in 2016-2020?
The program I was talking about was later replaced by the so-called Comprehensive Reproductive Health Program in Poland for 2016-2020, which financed primarily infertility diagnostics, and not the treatment itself in the sense of insemination and in vitro fertilization. This program was not called directly a diagnostic program, because it primarily assumed the financing of tests carried out, for example, by clinics operating at gynecological endocrinology clinics. Therefore, he financed research that allowed to find the source of infertility, for example, in men, sperm tests were performed, and in women, the patency of the fallopian tubes. As part of this program, it was also possible to perform diagnostic laparoscopy, but that was the end of the program.
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So you could say that this program helped the couple find the source of the problem, but it didn’t solve it in any way, right?
Yes, the cause of the problem was determined, and then basically said, “Just take care of yourself at your own expense.” The government called this a comprehensive program, but it was in fact truncated. It was just an excerpt from that earlier program. However, it must be honestly admitted that he also contributed to the increase in fertility. Of course, he did not help everyone, but some of the couples for sure. It’s hard to say how many people specifically, because in his case there was no reported effectiveness, it was after all a diagnostic program.
So what is the current program for 2021-2025?
In fact, you could say that we do not currently have a national fertility treatment program. Issues related to procreation and fertility have been deleted. It means, therefore, that the government has practically abandoned this type of social campaign financed from the state budget. Topics of fertility, preventive examinations, infertility treatment, education in the field of reproductive health – these topics will no longer be discussed in social campaigns. After all, not only the oncology program should be presented in the mass media. Fertility has become a kind of taboo subject and belongs to the canon of unanswered questions.
We, as gynecologists, take it with great sadness. This is also confirmed by the position of the Polish Society of Gynecologists and Obstetricians and the Polish Society of Reproductive Medicine and Embryology, which clearly oppose this approach. After all, one should remember that a healthy society is a society aware of its own reproductive health. To achieve this, however, funds are needed, and these have been taken from us. The aforementioned societies put emphasis above all on restoring the records that functioned in the past. We don’t even talk about IVF anymore, because it wasn’t on the last program anyway. We would like at least the social campaigns to be carried out unchanged.
What else won’t we find in the latest program until 2025?
In fact, the entire prevention and education in the field of proper lifestyle, assessment and prevention of fertility, possible behaviors during pregnancy and after childbirth. I suspect that there will be no diagnosis and treatment of infertility either, because this program, which was in force before, assumed, for example, the functioning of infertility treatment centers or clinics. This can now be cut down completely.
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I wonder how these words relate to the claims of the National Health Fund, whose representatives say that “as part of specialist outpatient care, services in the field of diagnosis and treatment of infertility are provided, as indicated in the regulation of the Minister of Health”. The average Kowalski may have a problem with such a diverse assessment of the situation …
The fact that we have funds for diagnostic procedures is true. But these are strictly operational procedures such as laparoscopy, hipsterolaparoscopy, etc. Therefore, we are talking about surgical diagnostics aimed at determining the causes of the lack of pregnancy. Sometimes it has no effect because the problem lies elsewhere, e.g. in ovulation disorders, metabolic syndrome, polycystic ovary syndrome or very low ovarian reserve, which translate into anovulation. In these cases, assisted reproductive techniques are the only treatment options.
This means, therefore, that the state actually deletes from the national health program not only any social campaigns, but also funds for treatment and fertility diagnostics that have been functioning so far. I am not talking about procedures that are possible in hospital treatment and are accounted for by the National Health Fund, because these are often laparoscopes, which are performed, for example, when removing various changes on the uterus or ovaries. I mean, for example, endometrial cysts or the diagnosis of endometriosis, which is one of the causes of infertility. The new program therefore funds hospital diagnostics, but nothing else. In such cases, we often have indications for IVF, because endometriosis is a serious problem, but at the same time we leave the couple alone with their problem and tell them that they have to cope without state aid.
- Infertility: causes, diagnosis and treatment
Okay, and what specific medical services will still be financed under the National Health Fund?
Medicines preparing for the in vitro procedure will continue to be financed in the treatment of infertility (the National Health Fund will still finance up to three such cycles). It is always some tangible financial benefit. Of course, I am talking about couples who meet the assumptions of the fund for reimbursement. This had been paid for in advance and luckily has been maintained. However, when it comes to financing treatment, and not the diagnosis itself and preparation for treatment, unfortunately this is not the case. Overall, all benefits have disappeared, except for drug reimbursement.
What can a couple struggling with infertility, who would like to take advantage of the state health care support system, count on?
In fact, for very little, i.e. for a limited diagnosis and a recommendation that they should rather seek help on their own, with their own financing. The in vitro procedure in Poland costs about PLN 10. PLN (one-time trial), but you also need to add the costs of drugs (not everyone has them reimbursed), frequent commuting, free holidays, etc. It should also be remembered that in vitro does not always end with one attempt, so these amounts should be multiplied accordingly . This makes a very large amount that not all patients are able to afford.
Do you want to know the cause of infertility? We recommend a mail-order genetic test to diagnose its cause, which is available on Medonet Market.
Is there anything else that should be noted about the current health program?
The position of the Polish Society of Gynecologists and Obstetricians and the Polish Society of Endocrinology and Development Medicine is interesting. In these circles, there was a valuable comment about couples struggling with infertility. It was noticed that the stress accompanying their struggle, exacerbated by the lack of state care, is comparable to the level of anxiety characteristic of people struggling with an oncological disease. It is estimated that about 1,5 million couples in Poland are subjected to such strong emotions, which also affects their mental health. Let that in itself remain an emphatic commentary on the events and plans we are talking about …
Read also:
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- Postpartum depression after IVF. Stress and hormones are an explosive mix
- Quintuplets are born once in 52 million births. What is conducive to multiple pregnancy and how does it happen?
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