Egg Freezing in Israel: Criteria, Process, and Coverage Guide

Last Updated on:

June 25, 2023

Over the last 10 years, egg freezing has become increasingly popular as a means of fertility preservation for women. Women or couples with medical indications are entitled to egg freezing with coverage from their HMOs (Kupat Cholim). Since 2011, women between the ages of 30-41 have had the option to undergo egg freezing at their own expense. This guide will help you understand the criteria for egg freezing, the process within the Kupat Cholim, and more.
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Medical Egg Freezing

Women or couples with medical indications are entitled to freeze their eggs with coverage from their HMO (Kupat Cholim) until age 39. Women ages 39 - 41 with medical indications may freeze their eggs, but it will be at their own expense and not be covered by the Kupah.
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Medical Indications for Coverage of Egg Freezing Include:

‍As part of the fertility treatment process:
- Severe disorders of sperm count or quality
- Inability for the man to give sperm on the day of retrieval
- Severe endometriosis in the woman
- Women with a low response to treatments

‍Women at risk for early menopause:
- Fragile X syndrome
- Signs of early menopause (low AMH, other indicators)
- Autoimmune disorders
- Chromosome abnormalities

‍Women or girls about to start chemotherapy or radiation
Women undergoing surgery that will impact fertility:
- Preventive oophorectomy (ovarian removal) for BRCA carriers
- Surgery that may involve ovarian removal

Important to Note:

Women undergoing medical egg freezing are eligible for up to 4 cycles or until 20 eggs are obtained.
Women with fragile-X syndrome are entitled to up to 6 cycles or 40 eggs.
To receive coverage for medical egg freezing, the cycle must begin before a woman’s 39th birthday. Once the cycle is completed (after the woman turned 39), subsequent egg freezings will not be covered.
Women who have begun treatment before turning 41 are entitled to continue until reaching the maximum number of treatments. You can not begin egg freezing after the age of 41 under any circumstances.

Process of Receiving Coverage:

Proof of diagnosis
Blood test including AMH, FSH, and [insert] levels
Referral from a fertility specialist (including all of the above information)
Submit all of the above documents to the medical secretary, and wait for official approval.
Once you are approved you will receive coverage for medications, and a Hitchayvut (Tofes 17) for relevant procedures in hospitals.
For the process of egg freezing, see below.
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Non-Medical Egg Freezing

Women between the ages of 30-41 are entitled to freeze their own eggs at their own expense.

Women freezing eggs for non-medical purposes (fertility preservation) should also start by scheduling an appointment with a fertility specialist and doing relevant tests.
In the case of non-medical egg freezing, blood tests such as AMH testing will not be covered.
Medications and other treatments will also need to be paid for out of pocket.
The average cost for 1 cycle of egg freezing is approximately 10,000 NIS, although this varies by hospital, and the amount of medication needed.
Women who have begun treatment before turning 41 are entitled to continue until reaching the maximum number of treatments. You can not begin egg freezing after the age of 41 under any circumstances.

Important to Note:

Egg freezing is limited to up to 6 extractions or procurement of 25 eggs (ages 30-25) or 35 eggs (ages 35-40).
Currently, Meuhedet C is the only kupah supplemental insurance that offers coverage for non medical egg freezing. It is important to be mindful of the wait times and take advantage of this great benefit.
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Process of Egg Freezing

Appointment with a Fertility Specialist

You can schedule an appointment with any fertility specialist on your Kupah.
A referral may or may not be required depending on your Kupah.
You can make use of supplemental insurance and see a private specialist for an initial consultation. For more on supplemental insurance, click here.

Initial Blood Tests

General Blood Panel
AMH, and full fertility blood panel
Referral is required, can receive a referral from a GP, gyno, or fertility specialist.
In the case where a blood test is being done outside the Kupah, a Hitchayvut (tofes 17) is required.
For non-medical egg freezing, general blood tests will be covered by the Kupah with a referral. Specialized blood tests will not be covered, and can be done privately for a few hundred NIS.

Breast Exam

Breast exams are required before starting injectable hormonal medications for egg freezing. You can make an appointment with a breast surgeon or general surgeon, depending on your Kupah.
Learn more about breast cancer prevention in Israel, click here

Approval from the Kupah

Submit the above tests and referral from the fertility specialist for approval to start treatments for egg freezing.

Prescription for Medications

In the case of injectable fertility medications, a prescription must be given by a fertility specialist.
For those getting coverage for medical egg freezing, the prescription must be filled at the Kupah pharmacy in order toreceive the discount.
Those who are paying out of pocket can fill the prescription at any pharmacy.
There is sometimes a shortage of certain medications. We recommend calling various pharmacies and crowdsourcing to see where medications are available.
In the case where a woman is seeing a private specialist, the prescription will need to be transferred to a Kupah prescription to receive coverage. In this case the prescription can be transferred by a GP/family doctor, but you will need to get permission to use the GP’s prescription (along with the private fertility specialist). Speak to your medical secretary for assistance.

Follicle Tracking (מעקב זקיקים)

Once treatment has started, you will be sent regularly for follicle tracking. This is a transvaginal ultrasound to determine the size, number, and development of follicles.
A referral is required. One referral can be used for multiple ultrasounds throughout the cycle.
Generally Kupot offer walk-in hours early in the morning in women’s health clinics for those who need regular follicle tracking. In some cases, an appointment is required.
You will be in touch with a fertility nurse and/or your doctor to determine the next steps after the results of each ultrasound.

Extraction

Once your doctor has determined you are ready, you will be scheduled for an extraction appointment.
This is done in the hospital and a hafnaya and hitchayvut are required.
This is an out-patient procedure (you are released the same day), and is generally done under anesthesia.
Some women request to undergo the extraction without anesthesia. This is usually done in cases when they are only extracting 1-2 eggs.

Freezing eggs

Once the procedure is complete, healthy eggs will be frozen.
Frozen eggs are kept for 5 years, and there is an annual fee for keeping frozen eggs.
After 5 years, the clinic will notify you. If you do not inform them that you want to continue preservation within 60 days of this notification, they are permitted to stop preservation (with MoH approval).
Be proactive- make it clear to the clinic that you would like to continue preservation, make sure payment plans are up todate.
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Importing Frozen Eggs from Abroad

Those who have done egg or embryo freezing abroad can import their eggs or embryos from abroad. However, it is a complex and expensive process, and close coordination between the Israeli clinic and clinic abroad is required.