Situación y evolución de la reproducción humana asistida en la sanidad pública ante la promulgación de la nueva cartera de servicios comunes del Sistema Nacional de Salud

Prior to the publication of the new procedure regulating assisted reproduction in the National Health System (Order SSI/2065/2014), a questionnaire was sent to the 376 assisted reproduction centres accredited up to 12/31/2012 by the Spanish Ministry of Health and Consumer Affairs, of which 94 were publicly owned. A response was obtained from 73 of these public centres, representing a participation of 77.66%. In these centres, a total of 17,757 cycles were performed with homologous artificial insemination and 2421 with donor semen. In 35 centres, 16,584 in vitro fertilization - intracytoplasmic injection cycles were performed, which taking into account the Spanish population it represented a number of cycles started in public centres of 356/1,000000 inhabitants during 2014, a value significantly lower than the European mean (1,269 cycles/1,000,000 inhabitants). Oocyte donation was carried out in only 5 Autonomous Communities, while male and female preservation took place in 10. Only the study and diagnosis of sterile couples was carried out in 9 of the centres. In addition, the Castilla-León, Castilla la Mancha, Cantabria, and the Canaries Islands Communities lacked a biological risk laboratory. Pre-implantation diagnosis was not carried out in Asturias, Balearic Islands, Castilla La Mancha, Extremadura, or Navarra. There was a program of embryo donation in 7 centres in 6 Autonomous Communities.

In conclusion, there is a wide heterogeneity in the clinical practice between the different Autonomous Communities, and conflicts between health resources and the demand of users. It is intended to solve these problems with the implementation of this basic portfolio.

A shorter questionnaire will be used in the same centres within two years, asking for any changes in their centres after the incorporation of the new order.