Portugal ranks 5th in Europe for fertility treatment policies, according to a new European report. The report assessed 43 countries regarding legislation, reimbursement, and user opinion.

Promoted by Fertility Europe, which brings together infertility patient organisations, and the European Forum for Sexuality and Reproductive Rights, made up of members of parliaments across Europe, the report - also known as an "atlas" - aims to encourage political leaders to recognise the right to try for a child as a universal right across Europe, to guarantee access "to equal, fair and safe fertility treatments for the entire population".

It also aims to make public funding available for all fertility treatment options and to implement communication campaigns to combat the stigma associated with infertility.

The criteria chosen by the patient group were legislation, reimbursement, and user opinion, leaving out waiting times for access to Medically Assisted Procreation (MAS) techniques.

"Our country is doing very well in the parameters that were chosen, but some other practical parameters were not measured, namely for us the worst of all: the waiting lists in the public sector," said Portuguese expert and physician Carlos Calhaz Jorge to Lusa news agency. Calhaz Jorge published the review article on the state of European countries that served as basis for the Atlas.

"Accessibility is our Achilles' heel, because in all the other legislative aspects, including financing, we are in 5th place", after Belgium, Israel, the Netherlands and France.

Within the country itself, there are inequalities in access to treatment. In the North, there are more public centres for MAS and the waiting time is shorter - in some cases, it can reach a year.

In the South, where the number of centres and their capacity is not adequate for needs, the wait exceeds one year, and in the "worst case scenario", one-and-a-half-years. However, it is not the waiting list itself that is responsible for these times, but the difficulty of getting into an initial infertility consultation.

"A couple who want to reproduce and who meet the criteria to be accepted for an infertility consultation have a few months to wait before they can register" and only after the consultation and the exams do they enter the waiting list for treatments, which, in total, will result in "completely unacceptable waiting times", Calhaz Jorge explained.

According to Calhaz Jorge, there will only be an increase in the response capacity when there is more equipment that justifies having more specialists.

Questioned whether the new beneficiaries of MAS techniques (woman-woman couples or single women) have increased the demand for treatments in the SNS, he said no. "Unfortunately there are no national donors, near or far, that have caused very significant activity in this area".

"That is why we are so well placed in the Atlas. There is possibility of access, and in practice, it almost only takes place in the private sector because private centres import gametes from international banks, something that the SNS does not have the ability to do," he lamented.

He stressed, however, that "Portugal is not exactly far from where it should be. What is missing now is the implementation of plans to improve accessibility in the public sector".

The Atlas concludes that "most countries have legislation dedicated to MAS techniques, but with a clear tendency to support heterosexual couples, discriminating against homosexual and LGBT couples" and that only 12 countries provide up to six intrauterine insemination cycles and treatments, and three provide six in-vitro fertilisation cycles.

Patient organisations are only consulted on fertility policies in 13 countries.

An estimated 25 million citizens in the European Union have infertility problems.