Sperm freezing Health insurance companies do not pay

Sperm freezing for artificial insemination: health insurance companies do not pay.
In the case of imminent infertility, men can freeze and store their sperm cells in order to fulfill their desire to have children later on. However, those affected should not expect a reimbursement by their health insurance. Because as the Federal Social Court (BSG) in Kassel has now decided, the insurance companies are generally not obliged to participate in the costs incurred.

Cryopreservation is „Personal responsibility of the insured“At the beginning of the year, the BSG had ruled (Az .: B 1 KR 10/09 R) that in women before cancer therapy ovarian tissue is removed and frozen in order to later reimplantation to restore the ability to conceive, the health insurance companies are committed to reimbursement. For men, however, this is not the case, according to the current verdict of the BSG, because the freezing and storage of sperm, the so-called cryopreservation, is basically in the „Personal responsibility of the insured“ (Az .: B 1 KR 26/09 R).

Infertility due to chemotherapy and radiation therapy
In the case in question, a 42-year-old man from Koblenz, who had been diagnosed with rectal cancer, accepted the advice of his doctor and had his sperm cryopreserved because of the infertility threatened by chemotherapy and radiation therapy. Chemotherapy and radiation therapies can lead to sperm death and azoospermia (complete absence of spermatozoa in the ejaculate). The consequence: infertility (infertility). It is difficult to say how great the risk of infertility is, for example through chemotherapy. Experts speak of 20 - 50 percent. The cytostatic agents used for chemotherapy are a high risk of damage to the spermatozoa, because most substances are directly involved in cell division. Not only tumor cells but also other tissues, especially tissue based on rapid cell division, are damaged. In men, the sperm cells are often affected. The risk is particularly high when using so-called alkylating substances, the platinum compounds and the frequently used method of combination chemotherapies.

Cryopreservation to save family planning
Cryopreservation is a process for storing cells by freezing in liquid nitrogen. The biological system is put into the state of aggregation of a solid and the vitality of the cells can be maintained almost indefinitely. After thawing, the cells can resume their normal physiological processes at any time. For example, men can have their sperm kept in order to fulfill their desire to have children, even after chemotherapy.

Health insurance does not cover costs
However, the costs of freezing and storing the sperm in a so-called cryobank are quite high and so the plaintiff wanted to have these reimbursed by his health insurance company, the Bamer GEK. It refused to cover the cost of 687.25 euros for the first 12 months of cryopreservation. Therefore, the person affected, after he had already lost the process at various lower courts, to the BSG in Kassel. But the judges did not want to follow his argument here either.

Lawyer sees unequal treatment of man and woman
„His bad luck is that he has to store his genetic material outside the body“, The man's lawyer commented on the current verdict of the BSG. Because for him it makes no difference if a woman before a cancer therapy remove ovarian tissue and freeze or a man cryoconserve his sperm. However, the judges at the BSG see this differently, because the statutory health insurance must only pay for a concrete artificial insemination and for treatments that enable a natural pregnancy again. Both are not present in the now treated case of precautionary course to the seed bank, because a concrete date for the artificial insemination does not exist and the restoration of the natural fertility is not given, so the verdict of the senate. (fp, 30.09.2010)

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Health insurance companies do not pay for sperm bank

Picture credits: Johannes Höntsch