IVF in North Macedonia: state voucher 6.000 denars, couples face extra costs

Parenthood is often said to be priceless — but in North Macedonia the route to it carries a clear price tag. The state presents an in vitro voucher of 6.000 denars as the official contribution for eligible patients, yet many couples say that sum only opens the door to a longer, costlier process.

Instead of covering the whole treatment, the voucher frequently acts as an entry fee to private clinics where additional expenses pile up. Couples report extra bills for medication and hormone therapy, embryo freezing and long‑term storage, and further analyses and diagnostic tests that are not always included in public funding — costs that can run into thousands of euros.

The government has recently approved three additional IVF attempts on the public plan, raising the maximum number of attempts charged to the Fund to six. Still, the system is conditional: there are eligibility rules and administrative steps that leave many patients facing uncertainty and possible surprise charges.

What patients actually pay

Beyond the 6.000 denars voucher, the most common extra items reported by couples are hormonal medication around the time of stimulation and transfer, laboratory procedures tied to embryo freezing, and monthly fees for storing frozen embryos. Clinics also sometimes request additional genetic or hormonal tests before proceeding, which are not always fully reimbursed.

Healthcare advocates and patient groups argue that the current model shifts the financial burden from the Fund to couples at a vulnerable moment, while clinics and suppliers profit from ancillary services. At the same time, couples say they are left navigating between hope and limited budgets, forced to decide whether to proceed, borrow, or stop treatment.

Poll: "Should the state fully cover the costs of additional tests, embryo freezing and storage, and hormone therapy after transfer?" Yes / No

Photo: press material from the event