Country

ART
(no. of cycles per year)

Reimbursement
status

Austria

5,000 ART

Since 1.1.2000: 70% of treatment and drug costs for IVF/ICSI reimbursed by IVF-fund in specific indications (female <40, male <50, tubal factor, male factor).
Non fund patients have to pay 100%.
 

In Belgium: HMG 75% reimbursed.
In Luxembourg: all medications reimbursed up to 80%, including r-hFSH.
NB: In Belgium r-hFSH reimbursed only from the third IVF cycle. Metrodin HP is only reimbursed for PCOS.
 

8,000 ART cycles

3 cycles reimbursed, but only in public clinics.
Drugs are reimbursed as follows:
0-74 USD 0 % reimbursed
74-177 USD 50 % reimbursed
177-415 USD 75 % reimbursed
-> 415 USD 85 % reimbursed
 

5,500 ART cycles

Patients have to pay for the medication up to a total of 3,300 FIM/year.

~45,000 IVF/ICSI
~115,000 OI/IUI

Number of cycles not limited, both in public and private clinics (in the latter, covers only the same amount as in a public clinic & patient pays the difference).
However it is recommended to limit the number of IVF/ICSI with embryo transfer to 4 attempts and to limit the number of OI and IUI to 6 attempts if no pregnancy is obtained.
 

52,000 IVF/ICSI ~ 60,000 OI / IUI

4 IVF or IVF/ICSI cycles or 2 GIFT are reimbursed by the statutory health insurance companies (Krankenkassen) in patients up to 40 years of age. Additional attempts require permission of the sick fund. OI and IUI cycles reimbursed up to 6 (with gonadotropin) or 8 (without gonadotropin) attempts.
 

~13,000 IVF/ICSI
~22,000 OI/IUI

IVF treatment costs are reimbursed if performed in a public hospital. Otherwise patients may be reimbursed a set amount per ART cycle for up to 3 cycles, however difficult to obtain. Metrodin HP is the only gonadotropin reimbursed, but only for 75% of the prescription cost.
 

35,000 IVF & ICSI
50,000 OI, IUI

Full reimbursement of all gonadotrophins. r.FSH, FSH & hMG are under MOH prescribing restriction (only authorized centers can perform diagnosis and prescribe a therapeutic plan). Procedures partially reimbursed only in public hospitals or clinics operating within the national health service.
 

13,000 ART cycles

In average maximum of 3 IVF treatment cycles reimbursed, no limit on OI/IUI. Medication always reimbursed. GIFT, ZIFT and ICSI treatment (technique) not reimbursed. MESE and TESA prohibited, only allowed in a few centers.

5,000 ART 3 cycles

reimbursed in public clinics. No reimbursement in private clinics.

3,350 IVF/ICSI
3,000 OI/IUI

ART procedures 100% reimbursed if practiced in a state Hospital. Drugs only 40% reimbursed.

In a private setting, ART procedures are not reimbursed. Drugs however are 40% reimbursed.

24,000 ICSI/IVF/
GIFT

Public centers 100% reimbursed.

7,500 ART cycles

Public healthcare system usually reimburses 3 cycles, but not in all counties.
Participation of patients in medication, both in public and private settings.

ART not reimbursed. OI reimbursed up to 6 cycles.

No national policy. Is left up to each Health Authority -> level of provision varies enormously -> many patients seek private treatment and have to pay for it.

Country

ART
(no. of cycles per year)

Reimbursement
status

Canada

13,000 OI/IUI and IVF/ICSI

No reimbursement except clomiphene in one province. Most patients privately insured.
Ontario: IVF procedure paid for if required due to bilateral tubal occlusion.
Quebec: 2000 taxation – individuals who resort to medical techniques can claim a refundable tax credit for expenses relating to artificial insemination or in vitro fertiliz. This refundable tax credit for the treatment of fertility is equal to 25% of the total allowable expenses, to a maximum of $15,000, paid in the year by an individual in order to become a parent, or by the person who is the individual’s spouse at the time expenses are paid.
Quebec: Taxation year 2001. The rate of the tax credit will be raised from 25% to 30%. The amount of expenses giving entitlement to each of the tax credits will be raised by $5000, to a ceiling of $20 000.
 

USA

77,013 Total ART (1998)
61,650 Fresh Cycles
(24,660 w/ICSI)
10,058 Frozen Cycles
5,305 Donor Cycles

No Federal law yet to regulate reimbursement, however bills have been introduced in Congress. Within individual states, most insurance companies and employers are not mandated by law to reimburse for fertility services. Steps are being taken to increase mandated coverage. Currently most patients pay themselves.

Country

ART
(no. of cycles per year)

Reimbursement
status

Japan

54,000 IVF/ICSI
81,000 OI/IUI

Not reimbursed. Medical costs for OI/IUI are reimbursed 70-80%.

Country

ART
(no. of cycles per year)

Reimbursement
status

Latin America

16,000-18,000 ART
~ 50,000 OI

Brazil, Venezuela, Colombia: No reimbursement.
Argentina: No reimbursement of ART. Some reimbursement of OI.

Country

ART
(no. of cycles per year)

Reimbursement
status

Australia

15,222 Egg pick ups
3,751 OI

As of 1 November 2000, the six cycle limit will be removed, couples will then be allowed unlimited access to IVF.