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In vitro fertilization at the expense of the state
Since December 2022, the Republic Fund of Health Insurance has been financing an unlimited number of in vitro fertilization procedures, for couples who do not have children together, and when the woman is not older than 45 years.
Somewhat different rules apply to women without a partner and those who already have a child, which you can find out about at https://rfzo.rs/index.php/osiguranalica/vto.
The couple does not have to be married, and if they are not, they need to attach a declaration of cohabitation.
Conditions for IVF at the expense of the state
The indication for the in vitro fertilization procedure will be set by your doctor, but here are some of the criteria that must be met according to the decision of the Ministry of Health of the Republic of Serbia:
- that other possibilities for assisted pregnancy have been exhausted;
- that the woman is under 45 years old who fulfilled conditions proposed by Ministry of Health;
- if there are no spermatozoa in the ejaculate, frozen spermatozoa are obtained by one of the surgical techniques (micro TESE , TESE, TESA , PESA );
- adequate ovarian function;
- body mass index below 30.
The IVF process through the Serbian Republic Fund of Health Insurance in the Gyn-Fertility Clinic Milenković
The Gyn-Fertility Clinic Milenković has a successful cooperation with the Gynecology Hospital Jevremova, and if you want to go through in vitro fertilization with the team of the Gyn. Fertility Clinic Milenković, when choosing the institution, select Jevremova.
After receiving the invitation from Jevremova, the further implementation of the procedure will be in cooperation with this institution and our Clinic, and the nurses will coordinate all examinations and interventions.
Step 1: Consultation at the Gyn-Fertility Clinic Milenković
So the first step is a consultation in our Clinic.
Both partners come to the first consultation. It is preferable that the couple already have AMH analyses and a semen analysis.
Step 2: Consent from the Ministry of Health
After that, it is necessary that the Ministry of Health issues the final approval for the implementation of the procedure.
To submit the request, you will need certain documentation, as well as mandatory analyses for both partners.
Analyses for IVF
The chosen gynecologist from the competent health center (for a woman) or the chosen general practitioner (for a man) will give you the necessary referrals.
They will first check whether you meet all the conditions prescribed by the Ministry of Health and, if you wish, they will refer you to the required tests.
You can also do all the preparation outside the state health institutions.
For women, it is necessary to do:
- cervical and vaginal swab;
- test for chlamydia and bacterial vaginosis;
- Hepatitis B, hepatitis C, human immunodeficiency virus (HIV) and syphilis Rubella, Toxoplasma gondii;
- PAP test and colposcopy;
- ultrasound examination;
- hormonal status from the 2nd to the 4th day of menstruation (FSH, LH, E2, PGT, TSH, fT3, fT4, Prolactin, AMH)
then, due to the upcoming anesthesia:
- blood type
- urine
- basic biochemistry
- hemostasis tests
- ECG and examination by an internist (not necessary at the very beginning).
The following tests are required for the male partner:
- swabs of the urethra for bacteria and chlamydia;
- Hepatitis B, hepatitis C, human immunodeficiency virus (HIV) and syphilis;
- semen analysis;
- semen microbiology test.
Step 3: Permission for IVF
With the collected analyses, the woman once again reports to the gynecologist and the man to the general practitioner, in the competent health centers - in order to receive three referrals for the commission for biomedically assisted fertilization. They are:
- Referral for the biomedically assisted fertilization commission in one of the institutions from the health institutions network plan: (https://www.rfzo.rs/download/IVF/Spisak%20ustanova.pdf).
- For a woman - referral for an ultrasound examination performed as part of the biomedically assisted fertilization commission's examination (the referral should be addressed to the institution where the commission is located).
- For a man - a referral for a semen analysis performed as part of the examination of the commission for biomedically assisted fertilization (the referral should be addressed to the institution where the commission is located).
With the referrals, a commission examination is scheduled.
- If you live in Belgrade, you can choose between two clinics (Clinical Center of Serbia and Gynecological Clinic Narodni front);
- If your place of residence is different, check the website of the Ministry of Health which clinic you need to contact;
- If you do not live in the territory of the institution to which you are referred, you should first contact the main branch of the RFZO/ Republic Fund of Health Insurance/. There, all the referrals will be verified and the OLK-1 form will be issued.
- Phone numbers for scheduling the examination of the commission for BMPO (https://rfzo.rs/download/vto/Brojevi%20telefona%20BMPO.pdf ).
- The commission in Vojvodina is scheduled through the competent health center, electronically.
You need to go together, as a couple.
During the commission examination, you will fill out several forms:
- Statement on the choice of the health institution where the procedure will be performed (form BMPO-1)
- Statement that you have no children from the existing union, and/or that you have one child (form BMPO-2)
- Statement that you agree to freeze embryos if possible (form BMPO-6).
On this occasion, you will also attach:
- birth certificate for the first child (if you have a child);
- certificate of frozen material (for men with azoospermia);
- form BMPO-7 (only if you were issued form BMPO-6 for the previous procedure) from the institution where you were previously referred to for the in vitro fertilization procedure.
If you want to do the in vitro fertilization procedure in cooperation with the Gyn-Fertility Clinic Milenković, at this moment you need to select the Gynecology Hospital Jevremova (BMPO-1).
Check if you have the required documentation with you:
- medical analyses and reports;
- referrals for the commission received from a gynecologist, and/or a general practitioner;
- copy of discharge list (from previous procedures);
- all discharge lists related to infertility treatment;
- your personal documentation if you have or have had any condition, medical procedure and/or disease relevant to the reproductive system (photocopies).
The medical commission will confirm the diagnosis and the indication for the in vitro fertilization procedure, based on all the analyses performed, and if necessary, an ultrasound examination will be performed (for women) and a semen analysis for men and you will receive a certificate of fulfillment of the conditions for the stimulated BMPO procedure/ (form BMPO-3).
This certificate is valid for one procedure only and lasts for 12 months.
Step 4: After the Commission
It takes some time to finalize the communication between the Republic Fund of Health Insurance and the institutions where IVF is performed.
If you have opted for the Gyn-Fertility Clinic Milenković, that is, the Gynecology Hospital Jevremova, expect a phone call from this hospital.
The idea of the call is to specify the date of the first consultation. At the same time, you will be asked which doctor you want to have the procedure with.
At this moment, you select the team of Dr Milenković
The hospital will send feedback to the fund with the date of your scheduled consultation, and soon after, an official invitation letter will arrive at the address of the Republic Fund of Health Insurance.
If it happens that the letter does not arrive on time, before your scheduled consultation in Jevremova, you need to pick it up in person at the competent Republic Fund of Health Insurance branch.
On that occasion, you will take the other necessary documentation, which you will take with you to the first consultation.
Step 5: Consultation at the IVF clinic
Before the first consultation, with the invitation letter, you have to go to the health center one more time for new referrals, this time two of them:
- The referral for inpatient treatment for a woman should be addressed to the institution where you will perform the IVF.
- Referral for a specialist examination for the male partner - a referral for a specialist examination, also addressed to the institution where you will perform the IVF.
With the invitation letter and referrals from the health center, you need to go to the main branch of Republic Fund of Health Insurance (so-called social welfare institution) to verify the referrals and take the OLK-12 form.
See you at Jevremova Hospital.
Expert advice: frequently asked questions
Answered by: Nikola Matavulj, MD
How long are the analyses valid for the IVF?
Hepatitis B, hepatitis C, human immunodeficiency virus (HIV) and syphilis tests are valid for one year. Hormonal status (FSH, H, E2, PGT, T, Prl, AMH, TSH, T3 and T4) is valid for 6 months. Microbiological tests (cervical, vaginal smear and bacterial vaginosis test, chlamydia and gonococcus) are valid for 6 months. PAP test and colposcopy are valid for one year. Toxoplasma and Rubella are valid for 12 months. For men – hepatitis B, hepatitis C, human immunodeficiency virus (HIV) and syphilis (valid for one year), urethral bacteriological smear and chlamydia smear are valid for 6 months. Semen analysis and sperm culture are valid for one year.
Do the analyses for IVF have to be done only in state institutions?
No, it is only important that they are not older than the specified deadlines.
How long does the process of in vitro fertilization take at the expense of the state?
From the moment the commission is scheduled, it can take from one month to three months.
How many attempts are couples entitled to?
If the couple does not have children, Republic Fund of Health Insurance finances an unlimited number of attempts until the wife is 45 years old.
Is it possible to freeze eggs at the expense of Republic Fund of Health Insurance?
In certain situations, such as for example malignancy therapy, the Republic Fund of Health Insurance finances the preservation of egg cells, embryos and ovarian tissue.
What are all the costs related to IVF treatment covered by the fund?
Republic Fund of Health Insurance covers the costs of stimulation, (medications, ultrasound examinations and possible blood sampling for determining hormones), the costs of aspiration and of the embryo transfer. In case there are conditions for embryo freezing, this service is also covered.
If you have additional questions, please feel free to contact us.
You can expect an answer during office hours, from Monday to Friday, between 9 a.m. and 7 p.m.
