Infertility screening and related healthcare services – specialist consultations, investigations, reimbursable medicines, etc. – are funded by the state.
Medically assisted reproduction is covered for women up to the age of 40 (inclusive) (this service was available for women up to the age of 37 (inclusive) until 2022). This means that a patient, for example, aged 40 years and two months, has the right to start state-funded ovarian stimulation with medication and continue it until embryo transfer.
Diagnosing Infertility
The first step is to undergo tests to identify the causes of infertility and establish a diagnosis. If the patient wants to undergo tests paid by the state, it is necessary to a doctor who has contractual relations with the state (a contract with the National Health Service). Women should consult a gynaecologist and men should consult a urologist. The gynaecologist is a specialist of direct access, so no referral is required. A referral from the general practitioner is required when seeing a urologist. For information on medical facilities where you can get state-funded consultations with gynaecologists and urologists, visit www.rindapiearsta.lv.
During the appointment, the doctor will examine the patient and, after assessing the patient's health state, will identify the tests required to determine the causes of infertility and confirm the diagnosis of infertility. The doctor determines whether diagnostic tests are sufficient for the woman only, or whether additional tests for the man are also required.
The following tests may be carried out to detect infertility:
- gynaecological examination;
- testing for sexually transmitted infections;
- hormonal examination;
- ultrasound investigation (patient’s co-payment – 4.00 EUR);
- checking uterine tubes patency (patient’s co-payment – depending on the method applied).
The following tests may be carried out to detect infertility in men:
- testing for sexually transmitted infections;
- spermogram.
State-funded medical assisted reproduction service (in specialised medical facility) includes:
When infertility is diagnosed:
- consultation of a gynaecologist, during which the specialist can prescribe IVF and place the patient on a centralised waiting list for the service (patient’s co-payment 4.00 EUR).
A woman whose turn it is gets an invitation to receive the service by the National Health Service to her personal e-mail address.
Upon receipt of the invitation letter:
- consultation of a gynaecologist before the service (patient’s co-payment 4.00 EUR);
- medicines for ovarian stimulation (see the List of Reimbursable Medicines);
- ovarian puncture for egg aspiration (including all gynaecological consultations required for the patient, ultrasound investigations, consultation of an anaesthesiologist, daycare facility and costs of anaesthesia) (patient’s co-payment 21.00 EUR);
- testicular biopsy (including consultation of a urologist and ultrasound) (patient’s co-payment 21.00 EUR);
- intracytoplasmic sperm injection with incubation period (embryo culture up to day 5) or egg insemination with sperm with incubation period (embryo culture up to day 5);
- freezing of embryos (up to five test tubes) and embryo unfreezing;
- embyo transfer (patient’s co-payment 21.00 EUR);
- consultation of a gynaecologist after the service (patient’s co-payment 4.00 EUR);
- ultrasound investigation 4-6 weeks after embryo transfer.
The state does not pay for the long-term storage of frozen embryos.
According to the terms of the agreement with the healthcare facilities, the healthcare facilities do not have the right to accept additional payments or to request payment from patients or third parties (employers, insurers, etc.) for healthcare services included in the scope of state-funded medical assistance provided under the agreement, except for the patient co-payment stipulated in the regulatory acts.
To find healthcare facilities providing state-funded medically assisted reproduction, please contact the National Health Service Customer Service Centre at nvd@nvd.gov.lv or call the information line 80001234. Telephone number for international calls +37167045005.
How to I find out my number in the waiting list?
To find out your waiting list number, women can:
- contact the NHS by e-mail; you can find the link to the NHS e-mail address here. Detailed information how to create an e-mail address can be found here;
- by sending an application signed by safe electronic signature by e-mail to the NHS (nvd@vmnvd.gov.lv);
- apply in person to the NHS (with an identity document) at the Client Service Centre (Riga, 31 Cēsu Street, k-3, entrance 6) or at one of the territorial units;
- If a woman is unable to obtain and use secure electronic identification tools (ID card or eParaksts mobile) to contact with the National Health Service by using the official e-mail address, applications submitted on the Latvija.lv portal using the e-service “Submission of a proposal, complaint, question or request" will be accepted in exceptional cases.
What should be kept in mind?
Patients are excluded from the waiting list if:
- a woman has reached the age of 41 years;
- a woman has refused medically assisted reproduction;
- a woman has not contacted a healthcare facility for medically assisted reproduction within six months since the invitation was sent;
- medically assisted reproduction is not necessary or is not possible due to medical indications.
Medically assisted reproduction will not be covered:
- if two unsuccessful medically assisted reproduction procedures have already been funded by the state budget (no clinically confirmed pregnancy occurred after embryo transfer);
- women over 40 years of age, unless medical egg stimulation started before that age has been successful and medical insemination is continued until embryo transfer without embryo freezing.