Dr Lucia Hartigan: ‘Changed landscape’ in the Mid West for couples with fertility challenges

In this opinion piece, Dr Lucia Hartigan, Consultant Obstetrician and Gynaecologist and Clinical Lead for the UL Hospitals Group Regional Fertility Hub writes about fertility investigations and treatments which are available to public patients in the Mid West

Fertility investigations and treatments are available to public patients for the first time through the development of regional hubs such as the new Mid West service based at Nenagh Hospital

Approximately one in six heterosexual couples in Ireland have fertility problems.  Infertility can be a devastating diagnosis for men and women alike.  It can be socially isolating, lead to low self-esteem and have a negative impact on the couple’s relationship.  

Up until recently, Ireland was one of the few countries in Europe that did not offer any publicly-funded assisted human reproduction (AHR) treatments like in vitro fertilisation (IVF).

Thankfully, in recent times, the landscape has changed for couples who are challenged with their fertility with the rollout of six fertility hubs nationwide and the provision of public-funding for AHR treatments for eligible couples.

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Fertility services in the Mid West Region

The regional Fertility Hub services of the UL Hospitals Group launched in September 2023.  We provide comprehensive fertility investigations for couples across the Mid West.   Assessment and treatment requires specialised, skilled care by a team of doctors, an andrologist, specialist nurses and clinical specialist radiographer sonographers.

Ultrasound scans, phlebotomy, consultations, outpatient hysteroscopy and HyCosy (test of fallopian tube patency) all take place in the recently-renovated ambulatory gynaecology unit at Nenagh Hospital.   Semen analysis is currently performed at Waterstone’s clinic in Limerick although soon this investigation will also be available in Nenagh hospital.

Our hub currently receives approximately 60 new referrals per month.

Referral pathway

In order to be investigated for infertility, patients must be referred by the female partner’s GP.  They must be 42 years or under (women) or 59 or under (men) and have a BMI between 18.5 and 35.

To be eligible for referral for AHR treatments such as IUI (intrauterine insemination), IVF and ICSI (intracytoplasmic sperm injection), the female partner must be aged 41 or under and have a BMI of between 18.5 and 30.  Both partners must be non-smokers.

What patients can expect when they are referred to our hub

When couples are seen in our Regional Fertility Hub, they can expect to avail of a wide range of investigations and interventions including: relevant blood tests, semen analysis, fertility-related surgeries and medical management of ovulatory problems eg. ovulation induction with follicle tracking.

If furthermore advanced treatment is recommended by a Reproductive Medical Consultant and the patients meet the access criteria, the hubs will refer patients to HSE-approved private provider of their choosing. There is no cost to patients for the recommended treatment through the private providers.

This service is initially being provided by approved private clinics on behalf of the HSE, while the HSE builds up the capacity to, in due course, deliver the service directly within the public health system.

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