Assisted reproduction, regions in no particular order on treatments with the SSN
Since January, heterosexual married or cohabiting couples diagnosed with infertility have been able to access treatment with a co-pay of between 100 and 300 euros
by Silvia Pasqualotto
2' min read
2' min read
Medically assisted procreation free throughout Italy. Or rather not. Twenty-one years after Law 40 came into force, medically assisted procreation has entered the essential levels of care (lea). From 1 January 2025, heterosexual married or cohabiting couples with a diagnosis of infertility can access treatment under the national health service, paying a co-pay of between EUR 100 and EUR 300. For homologous treatment there are uniform fees, while for heterologous treatment the costs may vary according to the regional agreements concluded for the purchase of gametes from abroad.
This long-awaited step promises to make access to fertility techniques fairer. But what will make the difference will be the choices of the regions, now called upon to strengthen the public network or enter into agreements with private centres. The aim is to reduce health mobility, one of the most critical nodes of the system, as emerges from the latest report to Parliament on PMA.
There are 333 active centres in Italy, but the distribution is uneven: 52% are concentrated in only four regions. Lombardy, Latium, Tuscany, Campania and Emilia-Romagna carry out almost 70% of the cycles. According to the data, in 2022 more than a third of patients travelled outside their region to receive treatment, a percentage that rises to more than 38% for techniques using donated gametes. A phenomenon that increases the disparities between those who can afford to travel and those who are excluded.
In order to prevent inclusion in the LEAs from remaining only on paper, some regions have begun to take action, seeking to expand the network of approved centres, particularly in the South, where supply is often entrusted to the private sector. Apulia and Sicily, for example, are considering the accreditation of new facilities in order to bring back to the territory a growing quota of patients who today move around. But the need for private accreditation also concerns regions where there are many centres. This is the case in Veneto, where out of 19 private facilities only one is accredited: a fact that signals the urgency of adapting to a demand that is destined to grow. This is also the direction taken by Lazio, which has set up a regional network dedicated to pma and approved new accreditation criteria.
After all, pma was already growing steadily before the entry into the lea. Since 2005, the number of treatments initiated has increased by 118%, with an average annual increase of 7%. In 2022, 109,755 were performed, up from 108,067 the previous year. There were 16,718 live births, compared to over 87,192 couples treated, or 4.3% of the total number of births in Italy. The average age of patients is also on the rise, reaching 36.7 years in 2022, exceeding the European average (35 years in 2019), with more than a third of women over 40.
