We are happy to share a success story from one of our members that can be a source of inspiration for others in the same situation. Sometimes, change begins with one person refusing to accept a negative. Check JSIS reimbursement sheets for instructions on how to challenge non-reimbursement or check the other options available [1]: sometimes insistence pays off! If you get stuck, we’re here for you!
It all started when I read an article on the Generation 2004 website about the [Joint Sickness Insurance Scheme’s] outdated and limiting policy on fertility, including egg freezing reimbursements [2], which discriminates against women over 36 [in comparison with Member State provision]. After discussion with a legally trained Generation 2004 colleague, I decided to file an appeal (Art 90 (2) complaint) with the responsible [institution] services, challenging a decision that I received. It denied the reimbursement of my egg-freezing procedure simply because I am a woman over 36, even though I had a very well documented pathology of infertility’. [‘proven medical necessity’ in the table below]
Maternal birthday deadlines: beware of prerequisites [bold is not present in original]
| Maternal birthday deadline | Text from Commission Decision C(2007)3195 [3] | Text from staff matters>Fertility treatment [4] |
| 36 (in the absence of a medical indication) | 3.3(d) Outside IVF, even where there is no medical indication: retrieval of spermatocytes, including the costs of analyses and tests, and long-term conservation of selected spermatocytes subject to a ceiling corresponding to category B1 surgical operations; stimulation and retrieval of oocytes, including the costs of analyses and tests, and long-term conservation of selected oocytes subject to a ceiling corresponding to category B1 surgical operations. The reimbursement is subject to the condition that the collection takes place before the 36th birthday. | stimulation and retrieval of oocytes, including the costs of analyses and tests, and long-term conservation of selected oocytes subject to a ceiling corresponding to category B1 surgical operations. The reimbursement is subject to the condition that the collection takes place before the 36th birthday
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| Beyond 36 (In the event of proven medical necessity) | In the event of proven medical necessity, after the age of 36, an egg retrieval remains reimbursable, subject to a prior authorisation, on the basis of a medical report from the specialist.
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| 40 | 3.3(c) Up to the age of 40, the reimbursement of the costs of the first IVF can only be granted after exhaustion of the six attempts of intra-uterine insemination. Exceptions to this rule can be granted subject to prior authorisation when there are medical reasons justifying that intrauterine sperm insemination has no or very limited chance of success. | |
| 45 | 3.3(c) At least the first IVF attempt must take place before the beneficiary’s 45th birthday. This condition shall not apply to persons who will reach their 45th birthday within 18 months of the date of taking effect of this point 3. | The first attempt must have taken place before the age of 45. |
| 48 | 3.3(c) IVF attempts between the 45th and 48th birthdays may be reimbursed
subject to prior authorisation.
3.5 Medical treatments related to fertility and reproduction shall not be reimbursed under the JSIS beyond the age of 48. |
The maximum number of IVF or ICSI attempts allowed is 8 attempts until the future mother is 48 years old (depending on the case, a request for prior authorisation is required). |
‘Following a re-examination of my file, in which all medical data was taken into account, the decision was revised.
and I WON!
The [JSIS] has reimbursed my expenses (80-85% as normal) following my appeal without providing any justification for changing its opinion. This outcome proves a simple but powerful truth: when we stand up for our rights, when we challenge unfairness, justice can prevail.
This is not just my victory. It is a step forward for all women working within the EU institutions, many of whom face the same dilemma: balancing professional commitment with the natural limits of fertility.
Nevertheless, work remains to be done to reflect the advances in the field of fertility assistance in the last 18 years and to ensure that the JSIS ensures an equivalent level of provision as Member States. Of course, this individual success does not erase the larger issue in the meantime: that countless would-be mothers will continue to be excluded on the grounds of age under the current rules. Here’s a rough and unrelated rough estimate of the costs involved [5] for reference, without JSIS reimbursement the treatment is out of reach for many would-be parents. Systemic change remains urgent. The JSIS must update its policy so that women are not forced to fight lengthy battles against the clock for what is fair and medically justified.
The existing policy dates from 2007 [3] and fails to reflect the current reality, updates in science, and greater equality between those working inside the institutions and those working outside. But through persistence, we can show that it can be challenged, and that outdated practices do not have to stand unopposed.
We call on the Joint Sickness Insurance Scheme to:
- Extend the reimbursement age limit for egg freezing up to 45, in line with medical guidelines and legal precedents set in Belgium and Denmark.
- Ensure that elective egg freezing, not only medically indicated cases, is reimbursed fairly for all women, especially younger and lower-paid staff.
- Provide accessible fertility awareness and counselling services to help women make informed choices early.
- Treat this issue not only as a health policy, but as a matter of gender equality, fairness, and demographic sustainability.
But let this case serve as proof: challenging a refusal can lead to concrete results. Progress often starts with a single appeal, a single voice refusing to remain silent.
We should never stop fighting for our rights. Because every victory – however small it may seem – pushes the system closer to justice, equality, and respect for all.’
We fully agree with our member’s statements and are pleased that justice was done. Generation 2004 will keep on informing you on your rights and fight injustice.
As always, we would love to hear from you. Please do not hesitate to get in touch with us [6] or leave a comment below.
If you appreciate our work, please consider becoming a member of Generation 2004 [7].