Health insurance plans are obliged to pay for the egg cryopreservation procedure for cancer patients, as a preventative measure against the risk of infertility

Recently, the Third Panel of the Superior Court of Justice (STJ) made an extremely important unanimous decision, ruling that health insurance companies are obliged to pay for the procedure of cryopreserving the eggs of cancer patients.

The decision was based on the understanding that if the health insurance company covers chemotherapy to treat cancer, it must also pay for preventive measures, such as cryopreservation, in order to prevent foreseeable adverse effects, such as infertility. This is a significant milestone, ensuring the full rehabilitation of the beneficiary at the end of treatment.



The case that led to this decision involved a woman with breast cancer who sought in court the right to have her egg cryopreservation procedure paid for by her health insurance company. The lower courts agreed with the claim, ordering the operator to reimburse the plaintiff approximately R$18,000.



At the heart of the appeal to the STJ, the operator claimed that the contract explicitly excluded in vitro fertilization and artificial insemination techniques, among other assisted reproduction methods. However, the rapporteur of the case, Justice Nancy Andrighi, highlighted the differentiation between the treatment of infertility and the prevention of infertility as an adverse effect of chemotherapy.

Based on current legislation, the Justice emphasized that the collection of gametes is a permitted stage of the assisted reproduction procedure. She also emphasized the duty of health insurance companies to prevent illnesses, including infertility resulting from medical treatment.



The decision respects the principle of primum, non nocere (first, do no harm), implying the duty to prevent foreseeable and avoidable damage resulting from the prescribed medical treatment. Thus, infertility, considered a foreseeable adverse effect of chemotherapy, can and should be prevented.



The solution proposed by Justice Nancy Andrighi balances the expectations of the consumer and the operator. The operator's obligation to pay for egg cryopreservation is limited to the date of discharge from chemotherapy treatment. From that point onwards, the beneficiary assumes the costs of the service.



This decision not only sets an important legal precedent, but also highlights the importance of finding balanced solutions that meet the needs of all parties involved. We will be keeping a close eye on future developments and bringing you more insights into legal issues of relevance in the health area.



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