Fertility treatments and assisted human reproduction in Ireland

Getting pregnant can be a challenge for some people. There are several things that can cause fertility problems. Some of these problems can be treated. In 20% of infertility cases, no cause is ever found. Talk to your GP if you are worried about your fertility. They can offer advice, examine you and arrange specialist fertility tests.

There are fertility treatments available to help you to become a parent. The best option for you depends on the cause of your fertility problem. For example, medications may be used if you need help to ovulate. Surgery may be necessary to unblock fallopian tubes or treat endometriosis. Donor sperm or eggs may be necessary if you are not producing eggs or sperm of your own.

The most common fertility treatments currently available are:

Ovulation induction (OII)

Medications are used to stimulate the development of one or more mature follicles in a woman’s ovaries. Tests help reveal when the woman is most fertile.

Intrauterine insemination (IUI)

Healthy sperm is collected and inserted directly into the woman's uterus when she is ovulating.

In vitro fertilization (IVF)

A woman's eggs are taken from her ovaries and fertilized by sperm in a laboratory, where they develop into embryos. The embryos are transferred back to the uterus a few days later.

IVF with intracytoplasmic sperm injection (ICSI)

Sperm is injected directly into an egg to assist contraception. The embryos are then transferred back to the womb.

If you or your partner has an infertility problem, you may be able to get eggs or sperm from a donor to help you conceive.

In Irish law, Donor-Assisted Human Reproduction (DAHR) is any procedure where the aim of the procedure is for an embryo to be implanted in the womb of a woman and one or both of the gametes (the sperm or the egg) has been provided by a donor.

The donor (or donors) do not intend to be the legal parents of any children born as a result of the treatment.

Donor sperm might be used if:

• Your partner is not male
• Your partner has very few sperm, abnormal sperm or no sperm
• Your partner has a serious infection, or there is a high risk of passing on an inherited disease or condition

Donor eggs might be used if:

• The woman is infertile as a result of treatment for another medical condition, for example, following chemotherapy for cancer
• The woman stops producing eggs due to early menopause
• There is a high risk of passing on an inherited disease or condition
• IVF has been unsuccessful

From 25 September 2023, you can get free assisted conception treatment from a HSE-approved private clinic of your choice. Read more about HSE Assisted Human Reproduction services, what is available and how you apply.

Alternatively, your family doctor (GP) may refer you to a private specialist or clinic, or you may be able to contact a clinic directly for an appointment.

You may be able to claim tax relief on the costs involved in IVF treatment as part of the tax relief for medical expenses scheme. Drugs used as part of fertility treatment are covered under the Drugs Payment Scheme.

The legal framework for donor-assisted human reproduction is complex.

Children and Family Relationships Act 2015

The Children and Family Relationships Act 2015 contains provisions on many aspects of family law in Ireland such as adoption, guardianship and custody. However, its main focus is the legal framework for donor-assisted human reproduction in Ireland. It gives clarity on the rights and responsibilities of the intending parents, donor-conceived children, donors and those involved in delivering fertility services.

The Children and Family Relationships Act 2015 only applies to couples where a female partner is to be the birth mother, that is, heterosexual and lesbian couples.

Registering a birth after donor-assisted reproduction

The provisions set out in Parts 2 and 3 of the Children and Family Relationships Act 2015 provide a legal framework for the donor-assisted human reproduction process including registering the births of children who are born in the State as a result of assisted human reproduction involving donated eggs or sperm or embryos. These provisions came into effect on 4 May 2020.

From 4 May 2020, the birth mother and the intending parent (the mother's spouse, civil partner or cohabitant) of a donor-conceived child (born as a result of a donor assisted human reproduction procedure) can now register with the Registrar for Births, Deaths and Marriages, as parents.

The regulations provide for two different scenarios depending on the date of conception (the date the DAHR procedure is performed), not the date of the birth of the child.

Registering the birth of a child conceived after 4 May 2020

The DAHR procedure must have been undertaken in a DAHR facility in Ireland using a traceable sperm donor. Both parents can be registered as the parents with the Registrar for Births, Deaths and Marriages as normal. The clinic will need to provide a certificate confirming the details of the procedure.

Registering the birth of a child conceived before 4 May 2020

The DAHR procedure must have been undertaken in a DAHR facility in Ireland or abroad using an anonymous or traceable sperm donor. In this case, only the birth mother will be registered as the parent. A Declaration of Parentage is required from the District Court to enable the intending parent (the person intending to be the other parent) to be registered on the child’s birth certificate at re-registration. An application can be made to the Circuit Court by an individual to get a Declaration of Parentage where parents are no longer in a relationship.

Health (Assisted Human Reproduction) Bill 2022

Initially, the Children and Family Relationships Act 2015 was also meant to deal with surrogacy arrangements. However, it was ultimately decided to deal with these issues in a separate piece of legislation.

The Health (Assisted Human Reproduction) Bill 2022 is not yet passed into law but it will cover the regulation of a wide range of assisted human reproduction practices undertaken in Ireland, including:

• Gamete and embryo donation for assisted human reproduction (AHR) and research
• Domestic altruistic surrogacy
• Pre-implantation genetic testing of embryos
• Posthumous assisted human reproduction and
• Embryo and stem-cell research

The regulation of international surrogacy, and the recognition of parentage of domestic and international surrogacy arrangements that have already taken place, are also included in the Bill.

The Health Services Executive (HSE) has information on types of fertility problems and what you should do if you are worried.

The National Infertility Information and Support Group (NISIG) provide information and support for anyone experiencing fertility problems. It operates a 24-hour helpline and holds support group meetings for both members and non-members.

LGBT Ireland and FLAC have published detailed FAQs on family rights for LGBTI+ parents and those planning parenthood (pdf) in relation to the Children and Family Relationships Act 2015.