# Israeli Fertility Guide

> Guide to fertility treatments in Israel including IVF coverage, health basket entitlements, surrogacy law, egg freezing, and navigating kupat cholim fertility services. Use when a user needs information about IVF funding through the national health system, understanding SHABAN supplementary insurance for fertility, the legal framework for surrogacy and sperm donation, or cost breakdowns for ferti…

- **Type:** Skill
- **Install:** `agentstack add skill-skills-il-health-services-israeli-fertility-guide`
- **Verified:** Yes — security-reviewed for prompt injection and unsafe behavior
- **Seller:** [skills-il](https://agentstack.voostack.com/s/skills-il)
- **Installs:** 0
- **Category:** [Agent Skills](https://agentstack.voostack.com/c/agent-skills)
- **Latest version:** 0.1.0
- **License:** MIT
- **Upstream author:** [skills-il](https://github.com/skills-il)
- **Source:** https://github.com/skills-il/health-services/tree/master/israeli-fertility-guide

## Install

```sh
agentstack add skill-skills-il-health-services-israeli-fertility-guide
```

Requires the [AgentStack CLI](https://agentstack.voostack.com/docs/cli). Works with Claude Code, Cursor, and any MCP-compatible agent.

## About

# Israeli Fertility Treatment Guide

## Instructions

### Step 1: Israel's Fertility Treatment Landscape

Israel is a world leader in IVF (in vitro fertilization, הפריה חוץ גופית) per capita. The national health system provides among the most generous fertility coverage in the world.

| Fact | Detail |
|------|--------|
| IVF per capita | Israel leads the world in IVF cycles per capita |
| Public funding | Full IVF coverage for first 2 live births through kupat cholim |
| Age limit | Coverage available for women up to age 45 |
| Governing law | National Health Insurance Law (chok bituach briut mamlachti, חוק ביטוח בריאות ממלכתי) |
| Health basket | Annual committee (vaadot sal briut, ועדת סל בריאות) evaluates new treatments for inclusion |
| Fertility clinics | Located in major hospitals and some independent licensed centers |

Types of fertility treatments covered:

| Treatment | Hebrew Name | Covered by Basic Insurance |
|-----------|-------------|---------------------------|
| IVF (in vitro fertilization) | הפריה חוץ גופית (IVF) | Yes, up to 2 live births |
| IUI (intrauterine insemination) | הזרעה תוך רחמית (IUI) | Yes |
| Ovulation induction | השריית ביוץ | Yes |
| ICSI (intracytoplasmic sperm injection) | הזרקת זרע תוך ביצית (ICSI) | Yes |
| Egg freezing (medical reasons) | הקפאת ביציות (סיבות רפואיות) | Yes, up to age 39 (see Step 5) |
| Egg freezing (elective) | הקפאת ביציות אלקטיבית | No, not in basic basket (see Step 5) |
| Sperm donation | תרומת זרע | Yes (see Step 5) |
| PGT for BRCA1/BRCA2 and Lynch syndrome carriers | PGT לנשאיות BRCA / לינץ' | Yes (added in 2026 basket) |

### Step 2: Health Basket Coverage for Fertility

The health basket (sal briut, סל בריאות) defines what is covered under the National Health Insurance Law.

| Coverage Rule | Details |
|---------------|---------|
| Eligibility | All Israeli residents registered with a kupat cholim |
| Live birth limit | Funding covers treatment until 2 live births from the current relationship |
| Age limit for women | Up to age 45 (some treatments may have lower age limits) |
| No cycle limit | There is no hard limit on the number of IVF cycles, only the 2-live-birth cap |
| Single women (single mother by choice, em yechidanit) | Eligible for the same IVF and sperm-donation coverage as couples; no partner is required for a woman's own 2-child entitlement |
| Same-sex couples (women) | Eligible for IVF and sperm donation coverage. A March 2024 Supreme Court ruling requires the state to register both women as mothers on the birth certificate for children born via sperm donation (alongside a judicial parenthood order, tzav horut), without a lengthy adoption process |
| Relationship change | If a woman starts a new relationship, the 2-live-birth count may reset (consult kupat cholim) |

What the health basket covers for each IVF cycle:

| Component | Covered |
|-----------|---------|
| Hormonal stimulation medications | Yes |
| Egg retrieval procedure | Yes |
| Laboratory fertilization | Yes |
| Embryo transfer | Yes |
| Monitoring ultrasounds and blood tests | Yes |
| Anesthesia during egg retrieval | Yes |
| Embryo freezing (for future use) | Yes |
| Frozen embryo transfer (FET) | Yes |

The Health Basket Committee (vaadot sal briut) meets annually to evaluate new treatments and technologies for inclusion. The 2026 health basket (approved in early 2026 with a NIS 650M budget) added PGT (preimplantation genetic testing) coverage for women carrying high-cancer-risk mutations (BRCA1/BRCA2 and Lynch syndrome) as part of their IVF cycle.

### Step 3: The IVF Process Through Kupat Cholim

Navigating IVF through the public system involves several steps.

| Step | Action | Details |
|------|--------|---------|
| 1 | Referral | Obtain a referral from your gynecologist or family doctor |
| 2 | Choose a fertility clinic | Select from approved clinics (yechidot poryut, יחידות פוריות) in hospitals or licensed centers |
| 3 | Initial consultation | Meet with a fertility specialist (rofe poryut, רופא פוריות) for evaluation |
| 4 | Diagnostic tests | Blood tests (hormonal panel), ultrasound, semen analysis, hysterosalpingography (HSG) |
| 5 | Treatment plan | Doctor creates a personalized protocol based on diagnosis |
| 6 | Hormonal stimulation | Daily injections for approximately 10-14 days with monitoring |
| 7 | Egg retrieval | Minor procedure under light sedation (aspiratzia, אספירציה) |
| 8 | Fertilization | Eggs fertilized with sperm in the lab (IVF or ICSI) |
| 9 | Embryo transfer | One or two embryos transferred to the uterus (hachzarat ubarim, החזרת עוברים) |
| 10 | Two-week wait | Wait approximately 14 days for pregnancy test |

Choosing a fertility clinic:
- Each kupat cholim has agreements with specific fertility units
- Major hospital fertility units include: Sheba, Ichilov, Hadassah, Rambam, Soroka, Assuta
- You may choose a different clinic from your kupat cholim's default, but verify coverage first
- Wait times vary; some clinics have shorter queues than others
- Private fertility clinics (like Assuta) may have shorter wait times but higher out-of-pocket costs unless covered by your kupat cholim agreement

### Step 4: Supplementary Insurance (SHABAN) for Additional Coverage

Supplementary health insurance (shaban, שב"ן, ביטוח משלים) extends fertility coverage beyond the basic health basket.

| Kupat Cholim | SHABAN Plan Names | Fertility Benefits |
|-------------|-------------------|-------------------|
| Clalit (כללית) | Clalit Mushlam, Clalit Platinum | Additional IVF cycles, faster access, choice of doctor |
| Maccabi (מכבי) | Maccabi Sheli, Maccabi Zahav | Extended coverage, premium clinics |
| Meuhedet (מאוחדת) | Meuhedet Adif, Meuhedet Sheli | Additional treatments, specialist access |
| Leumit (לאומית) | Leumit Silver, Leumit Gold | Supplementary coverage for fertility |

What SHABAN may add:

| Benefit | Details |
|---------|---------|
| Coverage beyond 2 live births | Some SHABAN plans cover additional IVF cycles for third or more children |
| Choice of specific doctor | Basic coverage assigns a doctor; SHABAN may allow choosing |
| Reduced wait times | Access to private or semi-private fertility units |
| Additional genetic testing | PGT (preimplantation genetic testing) may be covered |
| Extended medication coverage | Some premium medications not in the basic basket |

Important: Without SHABAN, treatment costs for a third child or beyond are fully out-of-pocket. SHABAN plans have waiting periods (typically 6-12 months for fertility benefits), so it is advisable to enroll before starting treatment.

### Step 5: Egg Freezing, Sperm Donation, and Surrogacy

Israel has specific legal frameworks for advanced reproductive options.

**Egg Freezing (hakpaat bitziot, הקפאת ביציות):**

| Aspect | Details |
|--------|---------|
| Medical egg freezing | Covered by health basket up to age 39 for women at risk of early menopause, cancer patients before chemo/radiation, people undergoing gender-affirming treatment, or other clear medical indications |
| Elective egg freezing | NOT covered in the basic health basket. Out-of-pocket for healthy women ages 30-41 who want to preserve fertility for non-medical reasons |
| Supplementary coverage | As of 2025-2026 the SHABAN plans of Clalit (Mushlam Platinum), Maccabi, and Meuhedet subsidize elective egg freezing (roughly ages 30-38, around 3,500 NIS copay per cycle). Leumit is currently the only kupat cholim that does NOT subsidize elective freezing. Verify exact ages and copays with your kupat cholim, since these benefits changed recently |
| Cycle/egg cap (medical, basket) | Standard medical indication: up to 4 retrieval cycles or 20 eggs, whichever comes first. A higher cap of up to 6 cycles or 40 eggs applies to specific genetic indications such as fragile-X premutation carriers (nasaiot pre-mutatzia le-X shavir). (The 25-35 egg figures sometimes quoted are private SHABAN limits, not the basic basket.) |
| Storage costs | Annual storage fee applies (varies by clinic, approximately 1,000-2,000 NIS/year), and is typically NOT covered even when retrieval is funded |
| Usage | Frozen eggs can be used for IVF when the woman is ready, subject to the 2-live-birth IVF cap and age 45 limit at thaw |

**Sperm Donation (trumat zera, תרומת זרע):**

| Aspect | Details |
|--------|---------|
| Legal status | Legal and regulated in Israel |
| Who can use | Single women, married couples with male infertility, same-sex female couples |
| Coverage | Covered by health basket for eligible recipients |
| Donor selection | Through licensed sperm banks (bank zera, בנק זרע) |
| Anonymity | Donors are anonymous; limited non-identifying information provided |
| Known donors | Not permitted under current regulations for most cases |
| Pending reform | A public committee chaired by Prof. Shlomo Mor-Yosef (convened 2025) is examining an identified / open-identity donation track. No change is in force yet, but anonymity rules may change |

**Egg Donation (trumat bitziot, תרומת ביציות):**

| Aspect | Details |
|--------|---------|
| Legal status | Legal and regulated under the Egg Donation Law 2010 (chok trumat bitziot, חוק תרומת ביציות) |
| Who can use | Women who cannot use their own eggs (premature ovarian insufficiency, repeated IVF failure with poor egg quality, genetic risk, or age-related decline) |
| Recipient coverage | Funded by the health basket for eligible recipients within the standard age window (roughly 18-54), subject to the 2-live-birth IVF entitlement |
| Donors | Egg donors are compensated (around 20,000 NIS per cycle); donations are coordinated through licensed units |
| In surrogacy | A surrogate may never also be the egg donor (a legal requirement that keeps all Israeli surrogacy gestational, not traditional) |

**Surrogacy (pundakaut, פונדקאות):**

| Aspect | Details |
|--------|---------|
| Legal status | Legal under the Embryo Carrying Agreements Law 1996 (chok hapundakaut, חוק הפונדקאות) |
| Who can use | Couples (married or cohabiting) and single individuals (men and women). A reform that took effect January 2022 expanded eligibility to include single men and same-sex couples (following a High Court ruling) |
| Approval process | Requires approval from a special committee (vaada le'ishur heskemei pundakaut, ועדה לאישור הסכמי פונדקאות) |
| Surrogate requirements | Must be Israeli resident, age 22-39, has given birth before, not genetically related to the intended parents |
| Cost | Significant out-of-pocket costs (compensation, legal, medical), typically 150,000-250,000 NIS total |
| Religious considerations | The committee historically considered religious compatibility between surrogate and intended parents; this requirement was loosened as part of the 2022 reform |

### Step 6: Costs Breakdown

Understanding what is covered vs. out-of-pocket helps with financial planning.

| Item | Covered by Health Basket | Approximate Out-of-Pocket Cost |
|------|------------------------|-------------------------------|
| IVF cycle (first 2 live births) | Yes | Minimal copays (parking, some medications) |
| IVF cycle (third child+, no SHABAN) | No | 15,000-25,000 NIS per cycle |
| IUI cycle | Yes | Minimal copays |
| Fertility medications (basic) | Yes | Small copay per prescription |
| Fertility medications (premium) | Partial | 500-2,000 NIS per cycle depending on protocol |
| Genetic testing (PGT-A) | Sometimes (depends on indication) | 5,000-10,000 NIS if not covered |
| Egg freezing (medical indication, age <=39) | Yes (per cap) | Storage fees: 1,000-2,000 NIS/year (typically not covered) |
| Egg freezing (elective, no medical indication) | No | 10,000-15,000 NIS per cycle + 1,000-2,000 NIS/year storage |
| Sperm donation | Yes (for eligible recipients) | Minimal |
| Egg donation (recipient) | Yes (for eligible recipients within the IVF entitlement) | Minimal copays; donor compensation is funded, not paid by recipient |
| Surrogacy | No (medical costs may be partially covered) | 150,000-250,000 NIS total |
| Private fertility clinic (full cycle) | No (unless SHABAN agreement) | 20,000-40,000 NIS per cycle |

Financial assistance options:
- Some non-profits assist with fertility treatment costs
- Municipal grants may be available in certain cities
- Tax credits may apply for large documented medical expenses (consult a tax advisor for the current threshold and eligibility)
- SHABAN enrollment before treatment can significantly reduce costs for additional children

### Step 7: Work Rights During Fertility Treatment

Fertility treatment is demanding and time-consuming, so Israeli labor law protects employees who undergo it.

| Right | Details |
|-------|---------|
| Paid absence for treatment | Under the Women's Employment Regulations (Absence for Fertility and IVF Treatments) 1990, an employee may be absent for treatment and count it against accrued sick days: up to 16 days per IVF cycle on a 5-day work week (20 days on a 6-day week), for up to 4 cycles per year |
| Who is covered | Applies to women undergoing treatment, and (for the prescribed shorter periods) to men undergoing fertility treatment. The employee must notify the employer in advance and provide medical confirmation |
| Anti-dismissal protection | Under the Women's Employment Law, an employer may not dismiss an employee during fertility treatments (for a first or second child) nor during the 150 days following the absence, without a permit from the Ministry of Labor |
| Practical step | Tell HR before you start a cycle, submit the doctor's confirmation (ishur refui), and keep copies. If you are dismissed during the protected window, contact the Ministry of Labor or a labor-rights organization |

These are statutory rights and do not depend on which kupat cholim or SHABAN plan you hold.

### Step 8: Emotional Support Resources During Fertility Treatment

Fertility treatment can be emotionally challenging. Israel offers several support resources.

| Resource | Description | Contact |
|----------|-------------|---------|
| Kupat cholim support groups | Free group sessions through your health fund | Contact your kupat cholim's fertility unit |
| Chen (חן) | Fertility support organization (Amutat Chen) offering counseling and peer groups | amotatchen.org (tel. 03-5050345) |
| Social workers at fertility clinics | Every licensed fertility unit has a social worker available | Ask at your clinic |
| Yad Sarah (יד שרה) | Provides medical equipment lending and support | 02-6444444 |
| Online forums | Hebrew-language fertility forums for peer support | Various Israeli fertility communities |

Tips for emotional wellbeing during treatment:
- Fertility units are required to have a social worker (oveid sotsiali, עובד סוציאלי) on staff who can provide counseling at no additional cost
- Consider joining a support group; many kupot cholim offer these through their fertility departments
- Communicate with your partner about expectations, timelines, and boundaries
- Take breaks between cycles if needed; there is no medical disadvantage to pausing
- Mental health support through kupat cholim (see Israeli Mental Health Navigator skill) is available and recommended

## Examples

### Example 1: Starting IVF for the First Time
User says: "My wife and I have been trying for a year with no success. How do we start IVF through our kupat cholim?"

Actions:
1. Visit your gynecologist or family doctor and describe the situation (typically 12 months of trying is the threshold for referral)
2. Obtain a referral to a fertility specialist (rofe poryut)
3. Both partners will undergo diagnostic tests: hormonal blood panel and ultrasound for the woman, semen analysis for the man
4. The fertility specialist will recommend a treatment plan (may start with IUI before IVF)
5. If IVF is indicated, select a fertility clinic from your kupat cholim's approved list
6. Treatment is fully covered under the health basket for the first 2 live births

Result: The couple enters th

…

## Source & license

This open-source skill is cataloged on AgentStack and links to its original source — we do not rehost the code.

- **Author:** [skills-il](https://github.com/skills-il)
- **Source:** [skills-il/health-services](https://github.com/skills-il/health-services)
- **License:** MIT

Install and usage instructions live in the source repository linked above.

## Pricing

- **Free** — Free

## Security capabilities

Automated source analysis of v0.1.0 — what this tool can access:

- **Network access:** no
- **Filesystem access:** no
- **Shell / process execution:** no
- **Environment & secrets:** no
- **Dynamic code execution:** no

*"Yes" means the capability is present in the source — more access means more to trust, not that it is unsafe.*


## Versions

- **0.1.0** — security scan: passed — Imported from the upstream source.

## Links

- Listing page: https://agentstack.voostack.com/l/skill-skills-il-health-services-israeli-fertility-guide
- Seller: https://agentstack.voostack.com/s/skills-il
- Browse the marketplace: https://agentstack.voostack.com/browse

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