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''Assisted Reproduction Fund'' Center

“Assisted Reproduction Fund” Center is a specialized formation of Ministry of health, which financially helps bulgarian citizens carry out activities on assisted reproduction within individuals struggling with infertility, treatable primarily with the methods of ART and in particular by in vitro fertilization. The activity of the fund begins in April 2009. Invitro Clinic “SOFIA” has signed a contract with “Assisted Reproduction Fund” Center.

What does the Center fund?

The center finances the following assisted reproduction activities:

  1. controlled ovarian (hyper) stimulation (COX) with one or more of the following medicinal products (by groups):
    а) gonadotropin analogues (agonists or antagonists);
    b) gonadotropic hormones (urinary or recombinant);
    c) others (for luteal maintenance) – steroids and / or chorionic gonadotropin;
  2. Control of the stimulation process through:
    а) documented ultrasound examinations;
    b) hormonal tests;
  3. ART methods (in vitro methods):
    а) follicular puncture under ultrasound control;
    b) classical in vitro fertilization;
    c) fertilization by the so-called ICSI;
    d) (amended, SG No. 4/2018, effective 01.01.2018) transfer of fresh embryos;
    e) (suppl. – SG, iss. 4 in 2018, in force from 01.01.2018) cryopreservation of pre-implantation embryos or of ova (in the cases of art. 26, para 1, item 6);
    f) (New, SG No. 4/2018, effective 01.01.2018) transfer of thawed embryos that have been cryopreserved with funds from the center – the necessary ultrasound examinations, thawing of the embryos, cultivation if necessary and embryo transfer ;
    g) (New, SG No. 4/2018, effective 01.01.2018) assisted reproduction of a spontaneous cycle – the necessary ultrasound examinations
  4. Follicular punctures under ultrasound control, fertilization, freezing and thawing of embryos, cultivation if necessary, the required number of embryo transfer (s).
    (2) The medicinal products, financed with funds from the center, shall be included in the Positive medicinal list and shall be provided by the order of art. 207, para. 1, item 5a of the Law on Medicinal Products in Human Medicine.

What is not funded by the Center?

The center does not provide funding outside para. 1 and 2, including:

  1. Initial tests to diagnose and decide on ART by in vitro fertilization;
  2. The examinations necessary at least according to Ordinance № 28 of 2007 for assisted reproduction activities (SG, issue 55 of 2007), as follows:
    (a) microbiological;
    b) sperm analysis;
    c) for transmissible infections;
    d) blood group affiliation and rhesus factor;
    e) hormonal – before COHS;
    (f) blood counts, biochemistry and haemostasis;
    (g) other specific tests (genetic, immunological, etc.);
  3. Examinations other than those specified in Ordinance № 28 of 2007 for assisted reproduction activities, regardless of the moment of their performance;
  4. Induction of ovulation and / or COX with clomiphene citrate, etc. SERM;
  5. Inseminations by the partner or donor;
  6. Embryo reduction;
  7. Pre-implantation genetic diagnosis or screening (PGD / PGS);
  8. In vitro maturation (IVM);
  9. Oocyte donation;
  10. Embryo donation;
  11. GIFT, ZIFT, etc. similar;
  12. Testicular and / or epididymal biopsy (TеSE, PESA, МESA).

Indications for financing

The Center finances the indicated in individuals struggling with infertility, treatable primarily with the methods of ART and in particular by in vitro fertilization in the presence of the following indications:

  1. Tubular sterility in women (МКБ-X: N97.1):
    a) lack of fallopian tubes bilaterally (surgically removed);
    b) unilateral absence with contralateral obstruction or stenosis;
    c) bilateral obstruction of the fallopian tubes (including after sterilization);
    d) unilateral obstruction with contralateral stenosis;
    e) bilateral interstitial or isthmic stenosis;
    (f) post-plastic condition of the fallopian tubes for at least 12 months after plastic surgery, provided that no intrauterine pregnancy has occurred;
    g) (amended, SG No. 58/2011) proven severe endometriosis (III and IV class according to AFS), as well as milder, but affecting the integrity of the fallopian tubes;
    male factor infertility (ICD-X: N97.4):
    a) (amended, SG No. 58/2011, amended, SG No. 4/2018, effective 01.01.2018) azoospermia, with histological data on the presence of spermatogenesis;
    (b) oligo- and / or astheno- and / or teratozoospermia requiring ART by IVF or ICSI with at least two of the following parameters:
    aa) ejaculate volume <1.0 ml;
    bb) sperm concentration <20 million / ml;
    cc) sperm with good motility <40% (grade 1 – 2);
    dd) sperm with good morphology <30% (according to WHO) or <15% (according to Kruger);
    ee) presence of sperm antibodies in the man and / or woman;
  2. female infertility associated with lack of ovulation due to LUFS;
  3. infertility with etiology not clarified by conventional diagnostic methods;
  4. (New, SG No. 4/2018, effective 01.01.2018) a proven monogenic genetic disease or a proven balanced chromosomal mutation in at least one of the partners;
  5. (New, SG No. 4/2018, effective 01.01.2018) a proven oncological disease in women.

What does the amount financed by the Center cover?

Prices for assisted reproduction activities
  1. For fresh embryo transfer activities (up to BGN 5,000.00) :
    – ultrasound examinations – up to 6 pieces – BGN 30.00 / piece.
    – hormonal tests – up to 10 pieces – BGN 18.00 / piece.
    – follicular puncture under ultrasound control – BGN 400.00.
    – Classic in vitro fertilization – BGN 1300.00.
    – Fertilization through the so-called ICSI – BGN 1600.00.
    – Embryo transfer – BGN 340.00.
    – Cryopreservation of preimplantation embryos – BGN 200.00.
    – Medicinal products in classic in vitro – up to BGN 2400.00.
    – Medicinal products for fertilization by ICSI – up to BGN 2,100.00.
  2. For activities on transfer of thawed embryos (up to BGN 500.00) :
    – Ultrasound examinations – BGN 30.00.
    – Thawing of embryos – BGN 100.00.
    – Cultivation – BGN 30.00.
    – Transfer of thawed embryos – BGN 340.00.
  3. For activities on assisted reproduction of a spontaneous cycle (up to BGN 5,000.00):
    – Ultrasound examinations – up to 12 times – BGN 30 / piece.
    – Follicular puncture under ultrasound control – 4 pieces – BGN 400.00 / piece.
    – Fertilization – BGN 1600.00.
    – Freezing of embryos – up to 4 pieces – BGN 200.00 / piece.
    – Thawing of embryos – BGN 250.00.
    – Cultivation – BGN 50.00.
    – Transfer of thawed embryos – BGN 340.00.
  4. In assisted reproduction activities to preserve the fertility of women with cancer (up to BGN 2,500.00):
    – Ultrasound examinations – up to 6 pieces – BGN 30.00 / piece.
    – Hormonal tests – up to 10 pcs. – BGN 18.00 / pc.
    – Follicular puncture under ultrasound control – BGN 400.00.
    – Freezing of ova – BGN 200.00.
    – Medicinal products – up to BGN 1,540.00.
  5. For assisted reproduction activities of women with cancer (up to BGN 2,500.00):
    – Thawing of eggs – up to 2 pcs. – BGN 280.00 / item.
    – Fertilization – BGN 1600.00.
    – Transfer of embryos – BGN 340.00.