[THE EFFECT OF THE ISRAELI AUTHORITY PLAN TO DIVERT PRIVATE TO PUBLIC FUNDING ON THE RESULTS OF IN VITRO FERTILIZATION TREATMENT OUTCOME].

Introduction: Israel's public funding policy for in vitro fertilization (IVF) is unique globally, with only minor restrictions. In late 2017, a program was launched to shift IVF treatments from private to public funding in an attempt to reduce waiting times, allowing IVF treatment in both public and private centers within the health basket.

Objectives: The study aimed to analyze the impact of this program on IVF treatment outcomes using data from the Clalit-Dan district.

Methods: Data from the Clalit-Dan District Health Insurance Fund (2014-2021) were analyzed, comparing IVF outcomes cumulative live birth rates (using Kaplan-Meier curves) in public and private centers.

Results: Between the years 2014 and 2021, 14,509 IVF treatment cycles were performed within the health basket in the Dan District. After implementing the 2017 aforementioned programe, IVF cycles in private centers increased, with no change in public centers. Live birth rates were slightly higher in public centers compared to private centers (10.02% vs. 9.04%), but without statistical significance (p=0.13). A noticeable decline in live birth rates was observed after 2018, especially in fresh cycles. No significant differences were found between public and private centers for women aged 20-39 years, but for those aged 40-45 years, public centers had significantly higher live birth rates, particularly in fresh cycles.

Conclusions: The 2017 program to shift IVF activity from private to public funding increased the burden on private centers and led to a decline in live birth rates, particularly for women over 40 years of age. The Ministry of Health, being entrusted, among other things, with the supervision and control of the IVF units in Israel, must examine and provide an adequate response to the issues raised above.