Fertility treatment: Family form decides on funding

There are anxious minutes before your gaze wanders to the pregnancy test: not pregnant. Not every childless woman can get pregnant naturally – for a variety of reasons. According to one, a quarter of all childless women and men between the ages of 20 and 50 are unintentionally without children. If your dream of having your own child just doesn’t come true, it’s not just a physical or mental strain – it’s also a financial one.

Although there are now many options in reproductive medicine, the costs are only partially covered by the statutory health insurance companies and the assumption of costs is subject to strict requirements. Lesbian couples who would need donor sperm for fertility treatment, for example, have to pay for fertility treatment themselves. Because: The statutory health insurance companies only cover part of the costs for married, heterosexual couples. Even unmarried, heterosexual couples and single people with an unfulfilled desire to have children do not get such treatment paid for by health insurance.

Further requirements for heterosexual, married couples from the health insurance company: The woman must be older than 25 and younger than 40 years old, men must be older than 25 and younger than 50 years old. In addition, only the couple’s egg and sperm cells may be used. In addition, couples must prove that fertility treatment has a chance of success and infertility must have been diagnosed by a doctor. And the insurance usually only pays for three attempts at artificial insemination.

Fertility treatment: Family form decides on funding

In addition to the benefits of the health insurance company, there is also state funding from the federal and state governments in twelve of the 16 federal states. are available for heterosexual, married and unmarried couples. Here, too, there is an age limit and only those who use the partner’s egg and sperm cells are eligible. The financial burden of fertility treatment varies depending on the life model and personal requirements.

Only couples who correspond to the classic idea of ​​a family are considered: “I don’t think it’s our place to make a judgment about the right type of family. It is discriminatory that only married, heterosexual couples are supported,” says Dr. Saskia Porta, fertility doctor at TFP Kinder Wunsch Wiesbaden, in conversation with the star. In addition, the problem begins for some couples at the point of marriage: “For couples who got married abroad and whose marriage is not recognized here, the costs are not covered even though they are married.” Depending on the treatment methods and how many attempts are necessary, the cost of fertility treatment can vary. The age of the woman also plays a role, because the probability of pregnancy decreases with increasing age, says the fertility doctor.

Many groups of people have to bear the high costs of artificial insemination themselves

There are different methods for artificial insemination. During insemination, the egg cell is fertilized in the woman’s body with medical help. The probability of pregnancy per cycle and treatment is around 25 percent for a 25-year-old and less than ten percent for a 40-year-old, the doctor explains. Benefit couples here Sperm donations can cost up to 250 euros just for the transport of the sperm donation. Insemination costs between 500 and 700 euros per cycle. If a part of the costs for married, heterosexual couples are covered by health insurance, they still have to pay an average of 375 euros for an insemination themselves.

If the IVF or ICSI procedures are used, it becomes significantly more expensive. In artificial insemination using the IVF method, individual egg cells are brought together with prepared sperm in a test tube so that spontaneous fertilization occurs. With ICSI, on the other hand, each individual sperm is injected directly into the egg cell. “The costs here are upwards of 5,000 euros,” explains Saskia Porta.

This means extremely high costs for many unintentionally childless people. dr Sarah Ponti is policy officer at the Lesbian and Gay Association (LSVD). She describes: “Founding a family is increasingly a natural part of life planning for LGBTIQ* families. However, due to illness, many couples remain unintentionally childless and are dependent on medical support. Luckily, opposite-sex couples can count on part of the costs for fertility treatment being covered. Rainbow families who are exposed to numerous disadvantages due to the applicable law of descent anyway, usually have to bear the entire cost of medical treatment themselves.”

Place of residence determines funding opportunities

It is not known how many couples and singles in Germany who are not entitled to have the costs of fertility treatment covered and therefore cannot afford it, says fertility doctor Saskia Porta. In the so-called IVF register, however, all therapies of artificial insemination in Germany are recorded. A look at the numbers reveals that in 2020, 2.8 percent of artificial inseminations using the ICSI procedure used donor sperm. However, the figures are not broken down according to whether the treatments were used by opposite or same-sex couples or single people. “Of the 66,650 treatments in 2021, we know that 2.4 percent of the treatments fall into the category of missing male part or homosexuality,” says Saskia Porta.

In addition to funding from the federal government and the assumption of costs by the health insurance company, there are also funding options in the federal states for the unintentionally childless. It also depends on where the unintentionally childless person lives. Of the twelve federal states that offer a subsidy option, only half receive financial support for both heterosexual couples and lesbian couples. Lesbian couples receive grants from the state in , , , the , and . In , where one person is trans*, also in Bremen, transgender and intersex as well as non-binary persons are taken into account in the guidelines. “It is sometimes very difficult for those who do not want to have children to understand what the situation is and what support is available for which groups of people,” says the doctor.

Sarah Ponti explains that even in these federal states, the funding for queer couples lags behind the funding for heterosexual couples because they receive additional money from federal funds.

Federal government wants to make artificial insemination non-discriminatory

The current federal government wants to change that: in 2021, it agreed in its coalition agreement that the unintentionally childless should be given more support. Literally it says there: “Artificial insemination will also be eligible for non-discriminatory insemination, regardless of medical indication, marital status and sexual identity. We will review the restrictions on age and treatment cycles. The federal government will assume 25 percent of the costs regardless of state participation.”

This means that financial support should no longer only be given to artificial insemination of heterosexual couples. In addition, those who want to use sperm donations for artificial insemination should also be financially supported. However, it is not yet clear when the project will be implemented. The Ministry of Family Affairs says when asked by the star: That it is a particular concern of the federal government to offer the support they need to those who do not want to have children. A spokeswoman said: “Therefore, the departmental group is currently examining intensively how the coalition’s mandate for better, non-discriminatory support for those who do not want to have children can be implemented in the best possible way.”

Sarah Ponti speaks about the federal government’s plans when asked by the star: “Non-discriminatory financial support when starting a family is an important step towards the legal recognition of rainbow families and important support for those affected. The legal regulations on the assumption of costs stem from outdated ideas of family.” It is high time that the regulations also correspond to the realities of life and that reproductive medicine is open to everyone under federal law, regardless of marital status, gender identity and sexual orientation. “People are still being rejected by fertility clinics because they are lesbian or single,” says Sarah Ponti, describing the status quo.

The fertility doctor Saskia Porta is positively surprised by the plans of the federal government. However: “I cannot imagine that everything that was agreed in the coalition agreement will also be implemented. I very much hope that we will soon have non-discriminatory fertility treatment in Germany through the legal framework.” As a doctor, she wishes that she could do more for the involuntarily childless. “Some couples have to stop treatment after the second or third attempt for financial reasons and I’m very sorry about that.”