Armenia Offers Free IVF to Tackle Population Decline

Friday, 3 February, 2023

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Gayane Markosyan

Yerevan-based journalist

When Marine Muradyan and her husband decided to start a family, they had no idea they would be embarking on a traumatic, expensive process that would nearly bankrupt them.

“We went to doctors, they sent us to do various tests, prescribed many expensive medicines,” said the now 35-year-old woman from Tavush, a border village in north-eastern Armenia. “Nothing worked and they could not find the reason [why we could not have a child]. The thought that we were spending so much money in vain brought us to a nervous breakdown.”

Over five years, the family spent about ten million drams (25,400 US dollars) in their attempts to have a baby, culminating with in-vitro fertilisation (IVF) in 2015. They took a bank loan to afford the 1.7 million drams price tag (4,400 US dollars), and in 2017 Muradyan gave birth to a daughter.

However, she had to experience new parenthood alone as her husband had to migrate for work to Russia to cover the loan costs.

Those experiencing similar troubles conceiving will be given new hope by the Armenian government’s January announcement it was substantially expanding the IVF support programme, allocating it 917 million drams (2.32 million dollars) in 2023, an increase of 40 per cent from 2022.

Health minister Anahit Avanesyan said that the decision was intended “to overcome infertility and include new groups of beneficiaries”.  

The scheme will benefit all women aged 20-42 who have been unable to conceive in the previous two years as well as women aged 20-35 living in border areas who already have one child. The ministry plans to also expand the reach to make the procedure available in cities other than the capital Yerevan.

Statistics indicate that one in every seven Armenian women experiences fertility-related issues. In 2021, the country’s infertility rate was 16.8 per cent, according to quantitative research funded by the UN Population Fund (UNFPA). The World Health Organisation defines a 15 per cent infertility rate as critical.

In 2015, the Armenian government decided to cover IVF costs for a selected group of candidates in a programme that has been amended over the years to expand the beneficiaries. The last amendments in 2020 included couples who had lost their sons in the war against Azerbaijan over the Nagorny Karabakh region; residents of border areas, military personnel, people with disabilities and citizens receiving family benefits.

Eduard Hambardzumyan is the founding director of the Fertility Centre of Armenia, a specialised clinic which works closely with the ministry of health and has been advocating for years for programmes to address the country’s low birth rate.

“Better late than never,” he said in response to the latest announcement, adding, “Since 2015, I have been trying to promote this issue… [Politicians] changed regularly, but all of them had the same approach: this is an expensive service, we cannot cover these costs from the state budget, we have more important problems...but what can be more important in such dire demographic situation?”

"Such programmes are very important for small countries.”

Demographics have long been a concern for Armenia. In 2021 it had a population of 2.791 million, down from the nearly 3.6 million that it had when it became independent in 1991. According to Anna Hovhannisyan, Armenia’s UNFPA head, the downward trend is due to continue with the population reaching 2.6 million by 2050, due to a high rate of infertility and migration due to socio-economic hurdles.

Hambartzumyan, who also leads the Association for Reproductive Medicine, maintained that delays in government support were partly to be blamed for the shrinking population.

“Over the years, many women have lost their chance; this could have been prevented, if we had launched such programme five, ten, 15 years ago… Now, this programme is a huge step forward. We are taking the first steps on a significant road. Such programmes are very important for small countries,” he noted.

Narine Beglaryan, who coordinates the sexual and reproductive health programme at the UNFPA office in Yerevan, said that the government now needed to promote the scheme.

“More large-scale awareness activities should be carried out so that the information is more accessible to the population,” she said.

Prime minister Nikol Pashinan stressed that the programme’s goal was two-fold: improving the country’s demographic situation and supporting couples in their desire to form a family.

“Many people could not afford these medical services because they were expensive,” he said during a government meeting.

Fertility treatments cost between one and 2.5 million Armenian drams (2,530 and 6,340 dollars), out of reach for many in a country where the average monthly wage is about 248,000 drams (627 dollars) and the minimum is 75,000 drams (190 dollars).

Statistics about the effectiveness of the early stages of the programme are unavailable and its funding has been irregular. In 2017, 78 couples benefited from it, then in 2018 it was suspended due to lack of state financing. Since 2019 the number of couple benefitting from the programme steadily increased: from 364 in 2019 to 874 in 2022, with 2021 marking a peak of 910 as a result of the 2020 war.

Avanesyan stated that between 2020 and 2022, 251 children were born as a result of the scheme, but it is difficult to evaluate the programme’s effectiveness.

“There are patients who, for various reasons, did not finish the treatment cycle that started two or even three years ago,” Vardanush Grigoryan, the general secretary of the ministry of health, told IWPR. “However, from preliminary calculations the effectiveness of IVF from 2019 is 33.7 per cent, which is a rather high figure.”
 

He added that the number of beneficiaries in 2023 will depend on the number and needs of beneficiaries who have gone through a certain stage of paid treatment and are now applying to the programme.

The Muradyans paid back their debt when their daughter was two years old. Marine’s husband returned from Russia and they thought of having a second child, but financially it was not feasible. The new scheme has given them hope: as they live in a border village, they meet the requirement to apply for the procedure.

Referring to her now six-year-old daughter’s dream to have a sibling, Muradyan said, “She told me, mother, I want a little sister, to pass on all my outgrown clothes to her.