MEDICAL ASPECTS
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? No; For women not living in a heterosexual couple? NA
b. Risk of transmission of a disease
For a heterosexual couple? No; For women not living in a heterosexual couple? NA
There are no restrictions in the access to medically assisted procreation neither to heterosexual couples nor to single women
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? Yes; For women not living in a heterosexual couple? Yes
b. Risk of transmission of a disease
For a heterosexual couple? Yes; For women not living in a heterosexual couple? Yes
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes. Both, the Law on Health Care and draft Law on Reproductive Health and Reproductive Rights in principle permit donation of gametes and embryo.
However, the Law on Health Care does not include specific provisions on this issue. It includes only a general provision saying donor’s gamete(s) or embryo could be used for MAP.
The draft Law on Reproductive Health and Reproductive Rights is more specific. It includes a separate chapter on gamete donation, which defines conditions and procedures for gamete donation.
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No. LHC: No; DL-RHRR: No; According to the article 20 of DR-RHRR “there is no reimbursement for gamete donation. A donor shall be reimbursed for time spent and other expenses incurred by donorship” (e.g. time, transport, absence from office, etc.).
8. Are there specific criteria for donation of sperm/oocytes/embryos?
LHC: No DL-RHRR: Yes
DL-RHRR:
A gamete donor must be a legally competent man or woman above 18 years of age, who has none of the diseases defined by law.
The fusion of the sperm or ovum of genetic relatives for medically assisted reproductive technologies is prohibited.
The gamete can be retrieved from a deceased male person, only if he has given an advanced directive for taking his gametes after his death for homological artificial insemination, or for in vitro fertilization of the ovum of his spouse, married under the rules defined by the legislation of Georgia. On the other hand, taking ovum or an ovary from a deceased woman for the implementation of medically assisted reproductive technologies is prohibited.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP?
LHC: No
DL-RHRR: Yes
According to the draft Law on Reproductive Health and Reproductive Rights a couple or a single woman have the right to choose a donor on the basis of the donor’s age, appearance, ethnic background, and health condition. However, information on the identity of a sperm donor is confidential.
10. Are there special measures for the prevention of consanguinity?
LHC: No
DL-RHRR: Yes
The following two principles are introduced in the draft law (DL-RHRR) to avoid consanguinity:
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? Yes; For women not living in a heterosexual couple? Yes
b. Risk of transmission of a disease
For a heterosexual couple? Yes; For women not living in a heterosexual couple? Yes
On the basis of Section 3a(2) of the Embryo Protection Act a pre-implantation genetic diagnosis is exceptionally permitted where the genetic predisposition of the woman from whom the egg cell was collected, or that of the man producing the sperm cell, or both, suggest that their offspring will be highly likely to have a serious genetic illness or to identify an abnormality that would be highly likely to lead to still-birth or miscarriage. With regard to the further requirements for a pre-implantation genetic diagnosis, reference is made to Section 3a(2) and (3) of the Embryo Protection Act. The execution of the MAP, in these cases, depends on the result of the pre-implantation genetic diagnosis.
c. Other
Pursuant to Section 6(2) of the Tissues and Cells Regulation of the Transplantation Act, the use of sperm cells for heterologous fertilisation, as a medically assisted procreation technique requires that the sperm donor is medically assessed as suitable for sperm donation, regarding his age, state of health and medical history and that the use of the donated sperm will not pose any health risks to others. Sperm donors are selected according to the criteria and laboratory tests laid down in Annex 4 Numbers 2 und 3 of the Tissues and Cells Regulation of the Transplantation Act. Annex 4 has implemented the selection criteria and laboratory tests for donors of reproductive cells laid down in Annex III of the Directive 2006/17/EC of 8 February 2006 as regards certain technical requirements for the donation, procurement and testing of human tissues and cells in national law. For this purpose, in particular, the donors’ serum or plasma samples must be tested and found negative for HIV 1 and 2, HCV, HBV and syphilis. Furthermore, urine samples of sperm donors must be tested and found negative for chlamydia by the nucleic acid amplification technique (NAT).
Additional aspects are set out in the Guidelines of the German Medical Association, paragraph 2.7.
3. Are MAP procedures covered by the social security system? No. Due to the general difficult economic conditions in Georgia, the Health and Social Security System is not able to cover such high technology procedures as MAP.
4. Are there specific criteria for such coverage? NA
5. Is the financial coverage limited to a number of MAP procedures? NA. The same reasons as question 3 connected with economic situation in the country.
19. Is there an important current debate in your country on these or related issues? Yes. Legislation pertaining to assisted human reproduction (AHR) is currently being developed. The draft General Scheme of legislative provisions has been completed and submitted to the relevant parliamentary committee which published the report of its review in July 2019, making recommendations which include proposals related to both broad policy objectives and more technical amendments. Its recommendations are being considered during the ongoing process of drafting this the AHR Bill. Until the enactment of the Children and Family Relationships Act 2015, the provision on assisted human reproduction treatment was largely unregulated. There has been and will continue to be widespread stakeholder engagement and national debate on these sensitive and complex matters.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law.
Roche -v- Roche & ors (2009)
Supreme Court unanimously dismissed an appeal by a separated mother requesting to have three frozen embryos implanted in her womb against the wishes of her estranged husband.
The appeal was brought on the following grounds:
Judgment
Legally Enforceable Agreement:
During their treatment the parties signed four consent forms as required by the clinic. As consent forms, they were found not to contain the necessary criteria for legal contracts.
None of the consent forms dealt with the three surplus frozen embryos, therefore, there was no evidence that the respondent gave his consent to their implantation.
Constitutional Protection:
Article 40.3.3 of the Irish Constitution protects the right to life of the unborn “with due regard to the equal right to life of the mother”. The Court interpreted this provision as meaning there must be a physical link between the unborn and the mother i.e. implantation in the womb.
The Court decided that the purpose of the 8th Amendment to the Constitution (1983 Referendum) was to prevent the de-criminalisation of abortion and that issues relating to IVF were not considered or foreseen.
A number of the Judgments stated that if respect for an embryo were carried to the point of equating it to the “unborn” a situation might arise where some methods of contraception e.g. morning after pill would be outlawed.
High Court Ruling: http://www.courts.ie/Judgments.nsf/bce24a8184816f1580256ef30048ca50/e5617d292b7b6b268025724800329992?OpenDocument
Supreme Court Ruling: http://www.courts.ie/Judgments.nsf/0/0973CBD1FD5204028025768D003D60F7
MR and Anor – v- An tArd Chlaraitheoir & Ors [2014]
This case concerned an arrangement whereby a woman agreed to act as a surrogate for her sister and brother-in-law (the commissioning couple). The commissioning couple provided the genetic material (egg and sperm), which ultimately resulted in the birth of twins. The commissioning couple sought to have the birth register altered so that both the commissioning couple were registered as the legal parents. The Registrar refused to do so, on the principle that he woman who has given birth to a child is always regarded as the legal mother. That refusal was challenged in the High Court.
In his judgment of 5th March 2013, Judge Abbott found in favour of the commissioning couple. He held that the genetic mother, and not the birth mother, was the mother, and that the person with the genetic/blood link was entitled to be registered as the parent on the birth certificate.
In February 2014, the State appealed Judge Abbott’s decision on the grounds that: it could create uncertainty regarding the parentage and parental rights of children born as a result of egg donation; demean the role of birth mother; lead to an opinion that commercial surrogacy is not unlawful; and result in the Registrar requiring genetic proof of maternity for every birth.
In November 2014 the Supreme Court overturned the High Court decision on the basis that the case had raised important, complex and social issues which are best addressed by the Oireachtas rather than the judiciary.
High Court Ruling: http://www.courts.ie/Judgments.nsf/bce24a8184816f1580256ef30048ca50/e3f0dc917872554c80257b250052dab3?OpenDocument
Supreme Court Ruling: http://www.courts.ie/Judgments.nsf/0/E238E39A6E756AB480257D890054DCB6
Children and Family Relationships Act 2015 – Parts 2 and 3 deals with parentage matters arising from donor assisted human reproduction. It is available at http://www.irishstatutebook.ie/eli/2015/act/9/enacted/en/html
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes. Under the Children and Family Relationships Act 2015, gamete and embryo donation are permitted on a non-anonymous basis. In addition, this legislation provides for the establishment of a National Donor-Conceived Person Register, which will allow donor-conceived children to access certain information regarding the gamete/embryo donor involved in procedures leading to their conception. It is intended that the proposed legislation pertaining to assisted human reproduction will deal with the broader issues relating to donor conception (e.g. age limits, screening, storage periods, the avoidance of consanguinity and donation for research purposes).
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? Yes. Under the Children and Family Relationships Act 2015, commercial gamete and embryo donation is prohibited. Gamete and Embryo donation may only operate on an altruistic basis and the reimbursement of reasonable expenses incurred as part of the donation process will be permitted. Reasonable expenses, for the purposes of the Act means: travel costs, medical expenses and any legal or counselling costs incurred by the donor.
8. Are there specific criteria for donation of sperm/oocytes/embryos? Yes. The Children and Family Relationships Act 2015, sets out a number of criteria in relation to the consent of gamete/embryo donors. For instance, a donor must be over 18 and must give consent in writing, having confirmed that s/he has been informed that s/he will not be the parent of a child born through the donation. The consent must be witnessed. The donor must agree, when consenting, to the inclusion of information about him/her on the National Donor-Conceived Person Register. The consent must also indicate that the donor understands that a donor-conceived child may seek to contact her/him. Assisted human reproduction clinics should be satisfied that where donated gametes/embryos are being imported from another jurisdiction, the consent process in the other jurisdiction is in line with the stipulations set out above. Under the proposed assisted human reproduction legislation, donors will undergo medical screening in accordance with requirements set out under SI No. 158/2006 European Communities (Quality and Safety of Human Tissues and Cells) Regulations 2006
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? No
10. Are there special measures for the prevention of consanguinity? Ireland has a relatively small population size, which could increase the risks of inadvertent consanguinity between individuals conceived using gametes from the same donor. It is proposed that the assisted human reproduction legislation will place a maximum limit of four families to which gametes/embryos from the same donor can be donated.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? Yes.
Under the Children and Family Relationships Act 2015, the parents of a donor-conceived child who is born as a result of a donor assisted human reproduction procedure are
(a) the mother, and
(b) the husband, civil partner or cohabitant, as the case may be, of the mother.
The Act of 2015 does not encompass surrogacy.
19. Is there an important current debate in your country on these or related issues? Yes. As previously stated, a debate has been ongoing on the necessity of revising the law on artificial insemination, specifically with regards to issues pertaining to embryonic stem cell research.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. NA
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples?
b. possible for women not living in a heterosexual couple?
Based on the principles of equality and non-discrimination, it is proposed that the legislation will provide that assisted human reproduction services should be available to people irrespective of their gender, marital status or sexual orientation subject to consideration of the welfare of any future children.
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? Yes; For women not living in a heterosexual couple No?
b. Risk of transmission of a disease
For a heterosexual couple? Yes (HIV); For women not living in a heterosexual couple? No
c. Other NA