Ombudsman Diana Kovacheva sent a recommendation to the Acting Minister of Health Dr. Asen Medzhidiev, to the Acting Director of the National Health Insurance Fund (NHIF) Dr. Yordanka Penkova and to the Chairman of the Bulgarian Medical Association Dr. Ivan Madjarov, recommending that annual fertility tests be included in the package of health activities covered by the Fund's budget – for women this means an ovarian reserve evaluation, and for men this involves a sperm analysis.

Ombudsman Diana Kovacheva sent a recommendation to the Acting Minister of Health Dr. Asen Medzhidiev, to the Acting Director of the National Health Insurance Fund (NHIF) Dr. Yordanka Penkova and to the Chairman of the Bulgarian Medical Association Dr. Ivan Madjarov, recommending that annual fertility tests be included in the package of health activities covered by the Fund's budget – for women this means an ovarian reserve evaluation, and for men this involves a sperm analysis.

The reason for this recommendation is a signal from Iskam Bebe (I want a baby) Foundation, which warns that more and more young people aged 25-35 in the country find themselves with a seriously impaired reproductive function.

According to the Foundation, this is due to the lack of conducting ovarian reserve tests at young age, and they point out that if the test was carried out annually on women aged over 18, it would give a clear picture of their reproductive status and would enable them to plan the birth of a child in accordance with their health status.

Therefore, Iskam Bebe Foundation suggests that in the package of health activities guaranteed by the NHIF budget, “every woman aged 18 to 35 should be subject to a hormone test for ovarian reserve evaluation (AMH)”, specifying that currently the average price of testing for this hormone is BGN 50, and for men of the same age the sperm analysis costs BGN 70.

“Regarding the issue raised, I would like to point out that the Ombudsman is committed to finding solutions to the problems related to reproductive health and assisted reproduction. In this regard, I believe that timely prevention and timely detection of reproductive problems for women and for men is important, so that they can have information about their health status at a much earlier stage and can take the necessary measures with a view to pregnancy planning and giving birth to a healthy child,” writes Prof. Kovacheva.  

She also drew attention to the fact that currently there is no data and no statistics is kept on how many women and men at young age have reproductive problems, since the ovarian reserve test is most often carried out only when applying for funding assisted reproduction activities. Thus women find out about them too late, with the resulting expenditure of public and personal funds, and sometimes even the impossibility of having children, and men also find themselves in the same situation of late detection of reproductive problems.

“I believe that in the current demographic crisis and the ageing population in the country, the public authorities must do more to find solutions and take measures aimed at promoting health and preventing fertility-related diseases”, said the Ombudsman.

In her recommendation, Diana Kovacheva also emphasized that the role of general practitioners was extremely important – they must inform citizens and refer them to perform reproductive health preventive tests.