Growth in Irish fertility services

The HSE Fertility Services Report 2025 highlights how the field has developed, along with emerging challenges. Paul Mulholland reports  

In 2022, the then Minister for Health Stephen Donnelly announced a €30 million budget to facilitate the provision of publicly funded assisted human reproduction (AHR) services for the first time in the State’s history.

The Model of Care for Fertility was developed by the Department of Health in collaboration with the HSE National Women and Infants Health Programme (NWIHP). The new service commenced in September 2023 and now supports almost 6,000 couples annually.

The recently published HSE Fertility Services Report 2025 provides an insight into how provision evolved last year.

Data

In 2025, a total of 5,818 referrals were accepted across the six regional fertility hubs (RFHs), representing approximately 11,636 individuals accessing public fertility services.

The six RFHs are located at: the Rotunda Hospital; the National Maternity Hospital; Coombe Women and Infants University Hospital, all in Dublin; Nenagh Hospital, Tipperary; Galway University Hospital; and Cork University Maternity Hospital.

Some 1,996 patients were referred onward for AHR treatment with a private provider of their choice. According to the report, this reflects “the continued progression of patients through structured care pathways”.

“The number of patients being referred has grown month on month as patients continue to move through the six regional fertility hubs and exhaust treatment options available at secondary level care,” the report stated.

Over the course of 2025, the average number of AHR referrals per month was 166.

This rate has “grown substantially” from the previous year’s activity where the average monthly referral was 122.

The NWIHP expects referrals to “plateau” at approximately 180 per month with the current access criteria, now that patient pathways have been established and processes embedded.

Choice

“The ability for patients to choose their preferred AHR provider is a key principle of the patient pathway,” noted the report.

“Under the service agreements in place, the chosen provider must provide their initial consultation with the patient within six weeks of receipt of referral. As such, there are no waiting lists held with the AHR providers to be seen for the initial consultation.”

Patients aged 36 to 40 years represented the largest cohort referred by RFHs to an AHR private provider, accounting for 45 per cent of all referrals. Patients aged 41 years and older comprised 6 per cent of referrals, while those aged 18 to 30 years accounted for 11 per cent. These findings are consistent with previously identified trends.

At secondary care level, 435 clinical pregnancies were recorded, “demonstrating that a meaningful proportion of couples can achieve pregnancy without requiring advanced reproductive interventions.”

“This underscores the value of the hub model in delivering timely, appropriate, and less invasive interventions, while reserving advanced reproductive treatments for those who require them.”

At AHR level, treatment activity has increased “significantly”. Last year, 712 in vitro fertilisation (IVF) cycles, 1,020 intra-cytoplasmic sperm injection (ICSI) cycles, 1,319 frozen embryo transfer (FET) cycles, and 594 intrauterine insemination cycles were initiated.

The overall activity figures reflect “both the maturation of the service and the increasing number of patients progressing to advanced treatment”.

Combined success rates for IVF, ICSI and FET show an overall clinical pregnancy rate of approximately 30 per cent, consistent with comparable international data.

A total of 664 clinical pregnancies were recorded in 2025.

“While challenges remain in relation to data completeness and outcome tracking, particularly in capturing live birth outcomes, the data in this report is robust, and shows an effective service.

“Ongoing enhancements in data capture and standardised reporting processes are expected to significantly strengthen the completeness of future datasets.”

The report stated that such enhancements will help achieve a more comprehensive evaluation of clinical outcomes and inform service planning.

“The HSE will continue to work closely with colleagues across the HSE and the Department of Health to further develop and refine the service, ensuring its continued evolution as a high-quality, equitable, and patient-centred model of care,” according to the report.

Access

The report noted that demand for the AHR service has continued to grow since it commenced in September 2023.

It acknowledged, however, that there are “some challenges emerging regarding access times” for the RFHs.

These pressures were highlighted in a recent HSE response to a parliamentary question submitted by Sinn Féin Deputy Louise O’Reilly.

The response, which was issued by Ms Davinia O’Donnell, NWIHP General Manager, in January 2026, showed significant variation in waiting times for an appointment with a reproductive medicine consultant across the six hubs.

Patients referred to the Coombe Women and Infants University Hospital faced the longest average wait at 27 weeks, followed by the Rotunda Hospital at 26 weeks.

Average waiting times were 24 weeks at both the National Maternity Hospital and Galway University Hospital, 13 weeks at Cork University Maternity Hospital, and 10 weeks at Nenagh Hospital.

Overall, the HSE said patients were being seen within an average of five months of referral.

“The NWIHP works closely with the RFHs to identify measures that can improve patient access and reduce waiting times,” a HSE spokesperson told the Medical Independent.

“This work includes ongoing review of service activity, workforce requirements, clinic capacity, and patient pathways to ensure services operate as efficiently as possible and are appropriately funded.”