Fertility treatment in Latviathe state programme, clinics and costs

The National Health Service states that testing comes first, to establish the causes of infertility and reach a diagnosis. State-funded tests can be obtained from any doctor contracted with the National Health Service.

Latvia provides state-funded diagnosis of infertility and the related services: specialist consultations, investigations and reimbursed medicines.

Assessment of the male factor starts with semen analysis, which in Latvia is handled by an andrologist.

• Six years of medical study and a doctor's degree, at RSU or the University of Latvia.
• Residency in obstetrics and gynaecology, or the andrology additional specialty for male infertility.
• Reproductive medicine is not a separately certified specialty in Latvia, so a clinic doctor's qualification appears in the register under their base specialty.

• Certificates are valid for 5 years, and register entries must be renewed every 5 years.

• NVD contract. For state-funded treatment, the clinic must hold a contract with the National Health Service.
• The waiting list. The NVD invitation letter is valid for six months, so act promptly once it arrives.
• Donor programmes. If donor eggs or sperm are needed, ask whether the clinic runs its own donor programme.
• Male factor. If male infertility is the cause, a clinic with an andrology centre and sperm laboratory is more convenient.
• Extra payments. Establish in advance what the state-funded service includes and what the clinic will charge for.

• Testing comes first, to establish the cause and reach a diagnosis. Without a diagnosis the state programme is not available.
• Bring all earlier test results, investigation reports and details of previous treatment attempts.
• Assessing the male partner requires semen analysis, and the clinic will give the preparation rules.
• Once the diagnosis is made, the doctor explains the treatment options and whether the case qualifies for state funding.
• If it does, the clinic registers the patient on the waiting list, and the National Health Service governs what happens next.

Within the state-funded programme the patient pays only the set co-payments. Providers may not demand extra payments for services already included in the state-funded service.

• Outpatient visitPrice EUR: 4.00Source: NVD
• Egg collectionPrice EUR: 21.00Source: NVD
• Embryo transferPrice EUR: 21.00Source: NVD
• Testicular biopsyPrice EUR: 21.00Source: NVD
• Consultation after the servicePrice EUR: 4.00Source: NVD
• Embryo freezing up to five straws, and thawingPrice EUR: included in the programmeSource: NVD
• Long-term storage of frozen embryosPrice EUR: not fundedSource: NVD
• Private IVF outside the programmePrice EUR: per clinic price listSource: My Clinic Riga

The National Health Service states that providers may not demand extra payments for services already included in the state-funded assisted reproduction service, beyond the set patient co-payments. If a provider does ask for extra payments, the Service invites patients to submit a complaint to the National Health Service, which will assess the case and whether the charges were justified.

Gynaecologists are represented by the Latvian Association of Gynaecologists and Obstetricians, and andrology by the Latvian Society of Andrologists. Certificates are issued by the Certification Council of the Latvian Medical Association. The sector regulator is the Health Inspectorate.

If you have doubts about the quality of care, raise them first with the provider's management. If that does not resolve it, a written submission goes to the Health Inspectorate no later than two years after the alleged infringement, and is reviewed within 30 days, extendable to four months in complex cases. The procedure is set out on the Health Inspectorate site. Where the problem is extra charges within a state-funded service, the National Health Service is the body to approach.