Cryopreservation – costs and who is entitled?
In the future, statutory health insurances will cover the costs of cryopreserving sperm (and egg cells in women) – under certain conditions. After a treatment that damages the sperm cells, men should still be able to fulfill a possible wish to have children and become fathers themselves. In principle, cryopreservation can be used in the following cases:
- operational Removal of the gonads
- radiotherapyin which damage to the gonads is to be expected
- Application potentially fertility-damaging drugs, such as chemotherapy
The decision as to whether a treatment is potentially harmful to germ cells and whether those affected are entitled to cryopreservation rests with a specialist.
Cryopreservation – up to what age?
The basis for assuming the costs of cryopreservation is the Appointment Service and Supply Act (TSVG). The Federal Joint Committee (G‑BA) has described the requirement for the cryopreservation of germ cells and germ cell tissue for later fertility treatment in more detail in a guideline. Have a right to cryopreservation:
- Men up to 50 years (women up to 40 years)
- Children and adolescents (there is no lower age limit)
So that those affected can make use of the cryopreservation as quickly as possible, the G‑BA a two-stage procedure is established:
- Step one includes regulations for the cryopreservation of egg and sperm cells, including testicular sperm extraction (TESE) – these procedures are considered to be established and standardized.
- At the second step the experts advise the cryopreservation of germ cell tissue – here the state of knowledge is not yet certain, according to the G‑BA.
The costs of cryopreservation are composed as follows, but can vary between institutions and laboratories:
- consultation: The G ‑ BA guideline provides that those affected should seek comprehensive advice. For men, a specialist doctor with additional training in andrology is the right contact. He must offer all measures that are named in the directive.
- treatment – Collection of the sperm
- Laboratory costs cryopreservation including the technology required for it
- Long-term storage of the germ cell depot
The cost of cryopreservation and storage for one year is approximately 500 euros. Storage for each additional year costs around 300 euros.
Transitional regulation until the law comes into force
There is a transitional arrangement for those affected who have already had cryopreservation carried out or have already started due to an illness and treatment. From the day on which the remuneration regulations come into force, there is a right to cryopreservation and the associated medical measures.
The decision of the G‑BA namely only comes into force if the Federal Ministry of Health has not objected to it and published it in the Federal Gazette. Doctors can provide the services after the evaluation committee has regulated the amount of the remuneration.