Access to medically assisted procreation - Search
Georgia - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues?
Debates took place about the draft Law on Reproductive Health and Reproductive Rights among the representatives of various professionals, especially medical professionals, representatives of church and religious groups, representatives of Ministry of Health and Social Affairs, etc.
As the above draft Law is more specific than the Law on Health Care it will change existing legal situation (details are already specified throughout the questionnaire).
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law.
English versions of the following legislation related to MAP are presented in the Addendum:
- Law on Health Care (Relevant articles from Chapter XXIII Family Planning) [see Addendum];
- Draft Law on Reproductive Health and Reproductive Rights [see Addendum].
Germany - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? No
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. See section I above for links to the updated versions of German laws
Switzerland - Legal regulation or practice and access to MAP
- Title of the law: Federal Act on Medically Assisted Reproduction (Reproductive Medicine Act, RMA), Reproductive Medicine Ordinance (RMO)
- Date of adoption and entry into force RMA: 18.12.1989 / 1.1.2001 and RMO: 4.12.2000 / 1.1.2001
- Published in: https://www.admin.ch/opc/fr/classified-compilation/20001938/index.html , and
- https://www.admin.ch/opc/fr/classified-compilation/20002342/index.html
- Revision: June 5th,2016, popular vote on the revision of the RMA regarding the regulation of Preimplantation Genetic Screening (PGS) and Preimplantation Genetic Diagnosis (PGD) (prohibited until now)
France - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. Medically assisted procreation is considered a health care activity. Law N°2021-1017 of August 2nd 2021 provides for the possibility of reimbursement of MAP by social security under the same conditions for unmarried single women, female couples and heterosexual couples. The MAP procedure is covered by national solidarity. The beneficiaries are exempt from the co-payment.
4. Are there specific criteria for such coverage? Yes. The law of August 2, 2021 removed the criterion of infertility, MPA procedures are covered at 100% by the Assurance Maladie for a maximum of : - 6 inseminations (only one artificial insemination per cycle) to obtain a pregnancy; - 4 in vitro fertilization attempts to achieve a pregnancy. This coverage is the same for everyone (heterosexual couple, couple made up of 2 women, unmarried woman) Knowing that, for the retrieval or the collection in a project of AMP, there are conditions of ages: - oocyte retrieval can be performed in women up to their 43rd birthday; - Sperm collection can be performed in men up to their 60th birthday; And for the performance of MPA: - until her 45th birthday for the woman, unmarried or within the couple, who will carry the child; - until his 60th birthday for the person in the couple who will not carry the child.
5. Is the financial coverage limited to a number of MAP procedures? Yes. The health insurance system will cover six inseminations and four complete cycles, i.e. concluded by embryo transfer. Any IVF cycle broken off before embryo transfer, irrespective of the stage at which it is abandoned, will not be counted by the health insurance system. Reimbursement is subject to a preliminary agreement procedure.
Should pregnancy and delivery occur, the count restarts from zero, and coverage is provided for four new attempts. This does not apply to miscarriages or extrauterine pregnancies.
Georgia - Medical aspects
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? LHC: Yes, DL-RHRR: Yes;
For women not living in a heterosexual couple? LHC: No, DL-RHRR: Yes
2bi
LHC: Yes
“Risk of transmission of a genetic disease”
DL-RHRR: Yes
a) “Proven likelihood of the transmission of a serious genetic disease to a naturally conceived child from a woman or man, that may result in a child’s severe disability and/or premature death.”
b) “Proven likelihood that a child from natural insemination will be born with a non-genetic disease that may result in grave disability and/or premature death.”
b. Risk of transmission of a disease
For a heterosexual couple?; LHC: Yes “Risk of transmission of a genetic disease” DL-RHRR: Yes
a) “Proven likelihood of the transmission of a serious genetic disease to a naturally conceived child from a woman or man, that may result in a child’s severe disability and/or premature death.”
b) “Proven likelihood that a child from natural insemination will be born with a non-genetic disease that may result in grave disability and/or premature death.”
For women not living in a heterosexual couple? LHC: No, DL-RHRR: Yes
a) “Proven likelihood of the transmission of a serious genetic disease to a naturally conceived child from a woman or man, that may result in a child’s severe disability and/or premature death.”
b) “Proven likelihood that a child from natural insemination will be born with a non-genetic disease that may result in grave disability and/or premature death.”
Accordingly, the draft law of Georgia on Reproductive Health and Reproductive Rights permits access to medically assisted reproductive technologies for heterosexual couples or single women only if at least one of the conditions listed below are met:
- A woman and/or man of reproductive age is infertile, other alternatives available in the country for treating infertility have proved ineffective; or such treatment hasn’t yet been carried out, but there is a reason to assume that it will be ineffective, as attested by a duly authorised state medical institution;
- There is a proven likelihood of the transmission of a serious genetic disease to a naturally conceived child from a woman or man, which may result in a child’s severe disability and/or premature death;
- There is a proven likelihood, that a child from natural insemination will be born with a non-genetic disease, that may result in grave disability and/or premature death;
- A woman carries a disease due to which the pregnancy may endanger the woman’s life and/or health.
c. Other There is one more medical criterion, but only for accessing surrogacy: existence of a disease due to which the pregnancy may endanger the woman’s life and/or health.
Georgia - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples?
LHC: Insemination-No; IVF-Yes
a) At present the law gives access to artificial insemination to heterosexual couples as well as to single women.
b) However in vitro fertilization (IVF) is accessible only to couples.
DL-RHRR: No. Draft law gives access to medically assisted procreation (artificial insemination as well as in vitro fertilization procedures) to heterosexual couples as well as to single women.
b. possible for women not living in a heterosexual couple?
LHC: Insemination-Yes; IVF-No
a) Law gives access to artificial insemination to single women. However, the Law does not specify whether women should be living in heterosexual couple or not.
b) IVF is not accessible for single women.
DL-RHRR: Yes. Draft law gives access to medically assisted procreation (artificial insemination as well as in vitro fertilization procedures) to single women.
Lithuania - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. The compensation is available to people who have entered into a marriage or registered partnership agreement in accordance with the law and have been diagnosed with infertility (female, male or both). The woman must be at least 42 years old.The compensation is available to people who have entered into a marriage or registered partnership agreement in accordance with the law and have been diagnosed with infertility (female, male or both). The woman must be at least 42 years old.
4. Are there specific criteria for such coverage? Yes. When the woman is 42 yearl old and the partners are infertile
5. Is the financial coverage limited to a number of MAP procedures? Yes. A maximum of 2 treatment cycles per couple is reimbursed
Lithuania - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? Yes
b. possible for women not living in a heterosexual couple? No
Italy - Réglementation ou pratique et accès à la PMA
- Titre de la législation : Règles en matière de procréation médicalement assistée.
- Date de l’adoption et de l’entrée en vigueur 19 février 2004 n°40
- Publiée dans : Gazzetta Ufficiale della Repubblica Italiana (publication officielle contenant les éléments des nouvelles lois).
- Indiquer si une révision est en cours et, dans vos réponses, fournir des informations sur les dispositions du projet de loi :
Le 12 juin 2005 a eu lieu un référendum populaire pour modifier plusieurs dispositions de cette loi. L’abrogation de ces dispositions a été rejetée, le taux d’abstention ayant été de 74 % (51 % de votes favorables auraient été nécessaires pour changer la loi).
Résumé
1. Protection des désirs de maternité/paternité et règles d’exercice des droits découlant de la loi n° 40/2004.
L’accès aux techniques de procréation assistée est réservé à des couples hétérosexuels majeurs, mariés ou menant une vie commune, dont les membres sont tous deux vivants et en âge de procréer.
Il est interdit aux personnes célibataires et aux homosexuels.
Le couple qui demande un accès aux techniques de procréation (médicalement) assistée doit produire un certificat médical attestant l’existence d’une stérilité ou d’une infertilité pour lesquelles il n’existe aucune autre solution possible.
Le consentement, écrit et librement révocable jusqu’au moment de la fécondation in vitro de l’ovocyte, est obligatoirement précédé d’une information sur le plan technique, juridique, et éthique ainsi que sur le coût des procédures et sur les conséquences possibles des techniques de procréation assistée pour l’enfant à naître.
Lors de l’entretien avec le responsable du centre médical, les couples sont également informés des possibilités d’adopter un enfant ou de devenir famille d’accueil d’un enfant en vue de son adoption (loi n° 184 du 4 mai 1983).
Un délai de réflexion de sept jours doit être respecté avant le début des procédures de procréation assistée.
Ces techniques sont appliquées de manière progressive en commençant par les moins invasives afin d’éviter de recourir à des interventions dont le caractère invasif, au plan technique et psychologique, les rend plus pénibles pour les personnes concernées.
Le médecin responsable du centre médical est en droit de prendre la décision de ne pas recourir aux techniques de procréation assistée, exclusivement pour des raisons médicales ou de santé.
La cryoconservation des gamètes masculins et féminins est autorisée, à condition que les personnes concernées aient été informées et y aient donné leur consentement écrit.
La loi, dans sa formulation d’origine, interdisait le recours à des techniques de type hétérologue (avec don de gamètes d’un tiers extérieur au couple). L’intervention de la Cour constitutionnelle (arrêt n° 162 de 2014) a supprimé cette interdiction.
2.Protection de l’enfant à naître
Le statut juridique de l’enfant né par techniques de procréation assistée est celui d’un enfant légitime ou reconnu par le couple. Le désaveu de paternité est exclu en cas de fécondation hétérologue. Le donneur de gamètes n’acquiert aucun lien juridique de parenté avec l’enfant né (aucun droit ni devoir).
La mère ne peut plus, au moment de l’accouchement, déclarer sa volonté de ne pas être connue, comme cela est autorisé pour la conception naturelle (Décret du Président de la République n° 396 du 3 novembre 2000).
3.Protection de l’embryon
Il est interdit de procéder à la cryoconservation ou à la suppression d’embryons, sous réserve des dispositions de la loi n° 194 du 22 mai 1978 (loi sur l’interruption volontaire de grossesse).
La loi, dans sa formulation d’origine, disposait que les techniques de production d’embryons, compte tenu de l’évolution technique et scientifique et de ce qui pourra être établi à l’avenir par des orientations juridiques du ministre de la Santé, ne peuvent conduire à la création d’un nombre d’embryons supérieur à celui strictement nécessaire à la réalisation d’un transfert unique et simultané, ce nombre ne pouvant en aucun cas être supérieur à trois.
Lorsque le transfert des embryons dans l’utérus se révèle impossible pour raison majeure grave et prouvée, ayant trait à l’état de santé de la femme et non prévisible au moment de la fécondation, la cryoconservation des embryons est autorisée jusqu’à la date du transfert, qui sera effectué aussitôt que possible. Depuis la décision n° 151/2009 de la Cour constitutionnelle, la détermination du nombre d’embryons à créer et à transférer dans le cadre d’une procédure d’implantation reste à l’appréciation du médecin qui tient compte de l’état de santé de la femme. Il ne doit pas être supérieur au nombre strictement nécessaire à la procréation.
En vertu de la loi sur la procréation médicalement assistée, il est interdit de procéder à la réduction embryonnaire de grossesses multiples, sauf dans les cas prévus par la loi n° 194 du 22 mai 1978 (loi sur l’interruption volontaire de grossesse).
Les sujets visés à l’article 5 sont informés du nombre et, s’ils le demandent, de l’évaluation des embryons produits à transférer dans l’utérus.
À la suite de la décision n° 96 du 5 juin 2015, la Cour constitutionnelle a levé l’interdiction qui était faite aux couples fertiles porteurs connus de maladies génétiques graves de recourir au diagnostic génétique préimplantatoire. Les maladies en question doivent répondre aux critères de gravité énoncés à l’article 6, paragraphe 1, lettre b) de la Loi n° 194 du 22 mai 1978 et être détectées par les prestataires publics de soins de santé compétents. Il appartient au Parlement de définir les critères d’agrément de ces structures.
Toute expérimentation sur l’embryon humain est interdite.
La recherche clinique et expérimentale sur l’embryon humain est autorisée à condition que les buts en soient exclusivement thérapeutiques et diagnostiques, en vue de la protection de la santé et du développement de l’embryon.
Sont interdites :
(a) la production d’embryons humains aux fins de recherche ou d’expérimentation ou à toutes fins autres que celles prévues par la loi. Interdiction des dons d’embryon à des fins de recherche : dans l’arrêt Parrillo c. Italie (requête n°46470/11) du 27 août 2015, la Cour européenne des droits de l’homme a reconnu que l’interdiction faite à une femme de donner à la recherche scientifique des embryons résultants d’une fécondation in vitro n’était pas contraire à son droit au respect de sa vie privée (il n’y avait pas de violation de l’article 8 (droit au respect de la vie privée) de la Convention européenne des droits de l’homme). Elle a également affirmé que les embryons humains ne sauraient être réduits à des « biens ». La Cour a considéré qu’il convenait de reconnaître à l’Italie une large marge d’appréciation dans cette affaire, qui mettait en jeu des questions morales et éthiques sensibles, d’autant plus qu’il n’y avait pas de consensus européen sur la question délicate du don d’embryons non destinés à l’implantation. La Cour constitutionnelle a rejeté un recours récent sur ces questions, affirmant qu’il appartenait au législateur de modifier la loi.
(b) toute forme de sélection dans un but eugénique, des embryons et des gamètes, ou des interventions qui, au moyen de techniques de sélection, de manipulation, ou par des procédés artificiels, visent à altérer le patrimoine génétique de l’embryon ou du gamète, ou à en prédéterminer les caractéristiques génétiques, à l’exception des interventions à des fins diagnostiques et thérapeutiques. Cela dit, l’arrêt n° 229/2015 de la Cour constitutionnelle n’a supprimé l’interdiction de la sélection d’embryons que dans des circonstances particulières, considérant qu’il ne s’agissait pas d’une infraction lorsqu’elle vise à prévenir l’implantation d’embryons nés de couples présentant un risque de transmission de maladies génétiques graves, conformément à l’article 6, 1 B de la loi 194 (relative à l’interruption de grossesse) dans des structures publiques désignées. Une question de constitutionnalité concernant l’article 13 (paragraphes 3, alinéa b) et 4) de la Loi n° 40/2004 a été soulevée. Le jugement rendu est conforme à l’arrêt précité.
Il souligne toutefois la protection nécessaire a conférer à l’embryon humain à la protection nécessaire, rappelant que « l’enjeu est ici la nécessité de protéger la dignité de l’embryon, à laquelle aucune autre réponse que la cryoconservation ne peut actuellement être apportée. Un embryon, quel que soit le statut juridique plus ou moins déterminé associé au début de la vie, ne saurait être réduit à un simple matériau biologique ».
(c) des interventions de clonage par transfert de noyau ou de scission précoce de l’embryon ou d’ectogenèse, à des fins de procréation ou de recherche ;
(d) la fécondation d’un gamète humain par un gamète d’espèce différente et la production d’hybrides ou de chimères.
4. Sanctions
Le texte de la loi 40/2004 prévoit différentes sanctions progressives en cas de violation de la loi, qui s’appliquent aux médecins et aux Centres autorisés mettant en œuvre les techniques de procréation assistée.
L’homme ou la femme auxquels sont appliquées les techniques ne peuvent être sanctionnés que s’ils n’ont pas suivi les procédures prévues. La sanction pour insémination hétérologue a été supprimée. Les sanctions qui restent en vigueur sont définies à l’article 12 de la Loi n° 40/2004.
5. Autorisations
Un système d’autorisation régionale des structures jugées adéquates est prévu, sur la base :
(a) des données techniques, scientifiques et d’organisation de ces structures ;
(b) des qualifications du personnel.
Les conditions requises sont établies par actes des Régions.
Il existe un Registre obligatoire des structures autorisées, établi et tenu par l’Institut supérieur de la santé, qui suit l’application des techniques de procréation médicalement assistée, les embryons formés et les enfants nés à la suite de l’application de ces techniques.
L’Institut supérieur de la santé prépare le rapport annuel à présenter au Parlement.
Après la décision n° 162/2014, le ministère de la Santé a approuvé les Lignes directrices pour l’application des techniques de reproduction hétérologues au couple qui reçoit le gamète. En ce qui concerne le don de gamètes, l’Italie adoptera la Directive UE 2006/17, ALL.III, PAR.3,4 et ses modifications ultérieures. Le texte sera approuvé dans le système normatif (sous la forme d’un décret gouvernemental). L’un des éléments fondamentaux issus du système juridique Italien est le principe selon lequel le don de sperme et d’ovocyte doit être un acte volontaire, altruiste et non rémunéré.
Ireland - Legal regulation or practice and access to MAP
Until recently in Ireland the provision of assisted human reproduction (AHR) services was largely unregulated. However, in April 2015 Parliament passed the Children and Family Relationships Act which deals with the limited topic of parentage in the case of donor assisted human reproduction. 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 register of gamete/embryo donors, recipients and donor-conceived children (the 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.
Moreover, although AHR services are not currently regulated by any specific health legislation, in February 2015, the Minister for Health received Government approval to draft a General Scheme of legislative provisions which would deal with a wide range of issues from the beginning to the end of the AHR process. Following the completion of the General Scheme, the Government approved its publication and the drafting of a Bill on assisted human reproduction based on this General Scheme. The drafting of this Bill is currently ongoing.
Under the proposed legislation, a number of practices will be regulated, including gamete and embryo donation, surrogacy and the assignment of parentage in such cases, pre-implantation genetic screening/diagnosis, sex selection for medical purposes, and posthumous assisted reproduction as well as associated research. It is also proposed that the legislation will establish a regulator to promote patient safety and good clinical practice in the area of assisted human reproduction. The regulator will maintain the National Donor-Conceived Person Register, establish the National Surrogacy Register and maintain records of all assisted human reproduction activities and services.
In January 2018 the General Scheme was submitted to the relevant parliamentary committee for review as part of the pre-legislative scrutiny process. This committee 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 the AHR Bill.
Norvège - Legal regulation or practice and access to MAP
- Title of the law: The act relating to the application of biotechnology in human medicine etc
- Adopted 5 December 2003, partly into force from 1 January 2004, 1 September 2004 and 1 January 2005. Limited use of PGD was allowed (only in cases of X-linked diseases), and research on surplus embryos was banned. An amendment in force from September 2004 allowed PGD also in cases of serious hereditary diseases for which no treatment is available. New regulations regarding PGD and research on surplus embryos entered into force in July 2008; allowing research on surplus embryos under certain conditions, and PGD or PGD/HLA in situations of serious hereditary disease. New regulations regarding access to MAP for lesbian couples entered into force in January 2009. In 2013 the act was amended to allow MAP to otherwise fertile couples, where one person has a serious and chronic sexually transmitted infection. In 2020 single women who live alone were given access to MAP, and from 2021 oocyte donation is allowed. Egg donation is accessible only to couples able to use their own sperm. Same-sex female couples can donate oocytes to each other (partner donation) and use sperm from a donor.
Iceland - Legal regulation or practice and access to MAP
- Title of the law: Artificial Fertilisation Act N° 55/1996
- Date of adoption and entry into force: 1 June 1996
- Published in: http://eng.heilbrigdisraduneyti.is/laws-and -regulations/nr/685
- Indicate if process of revision is ongoing and, in your answers, provide information on provision in the draft law: No process of revision has yet been embarked upon, a parliamentary resolution on the necessity of a revision, specifically with regards to issues pertaining to embryonic stem cell research, is being discussed.
Lithuania - Legal regulation or practice and access to MAP
- Title of the law: The Law on the Assisted Reproduction of the Republic of Lithuania
- Date of adoption: 14th September 2016 (amended 24th May 2022, 30th May 2019 and 17th January 2017)
- Entry into force: 1st January 2017
- Published in: the Lithuanian Register of Legal Acts
In the last revision of the Law entered into force on the 1st of July 2022, the requirement to store embryos for the unlimited period of time was abolished. This requirement was replaced by a requirement to store embryos for 10 years after the assisted reproduction procedure.
Andorra - Financial aspects
3. Are MAP procedures covered by teh social secutiy system? NA
4. Are there specific criteria for such coverage? NA
5. Is the financial coverage limited to a number of MAP procedures? NA
Andorra - Right to know about his or her biological origin for children born after MAP
16. Are donation of the sperm/oocytes/embryos anonymous?
Yes, specify the legal provisions. Law 12/2019, of the 15th February, described as techniques of assisted reproduction
17. Is it possible to obtain information about the biological origin of a child bornn after gametes or embryo donation for the child/for the parents/for the court?
Yes for the child
No for the parents
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions?
No
Andorra - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? If so, what might the implications be?
NA
20. Particular cases encountered in your country, and expecially, their case-law
NA
Azerbaijan - Medical aspects
2. Are there specific criteria for access to MAP?
- Medical reasons:
a. Infertility
i. for a heterosexual couple? Yes
ii. for women not living in a heterosexual couple? Yes
b. Risk of transmission of a disease (please specify the risk and/or disease)
i. for a heterosexual couple? Yes
ii. for women not living in a heterosexual couple? Yes
Azerbaijan - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? Yes
b. possible for women nnot living in a heterosexual couple? Yes
Cyprus - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? There is no indication for the practice followed by several clinical centers, due to the non-existence of relevant legislation
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation? There are no legal provisions. There is no indication for the practices followed by the IVF centers, due to the non-existence of relevant legislation.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? NA
Cyprus - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? The drafting of a law regulating MAP and IVF is currently under consideration. For this purpose a Steering Committee has been established by the Ministry of Health. The Committee is composed of representatives from Services and interested groups on MAP issues.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. There is no case-law up-to-date.
Denmark - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. The Region must provide cost-free treatment for MAP to single women who do not have children, and couples who do not have children together.
4. Are there specific criteria for such coverage? Yes. Women over 45 year of age cannot receive treatment.
5. Is the financial coverage limited to a number of MAP procedures? Yes. Practice: 3 procedures with IVF and more if there are one or more spare, frozen embryos from the woman.
Denmark - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? No
b. possible for women not living in a heterosexual couple? Yes
There are no restrictions in the access to medically assisted procreation neither to hetero couples nor single women.
Ireland - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? No. As previously indicated, under the Children and Family Relationships Act gamete and embryo donation is permitted on a non-anonymous basis. Gamete and embryo donors will be required to provide name; place and date of birth; nationality, place and date on which s/he provided the donation; and contact details. Once a donor-conceived child has attained the age of 18 years s/he may request the name, date of birth and contacts details of the relevant donor, as recorded in the National Donor-Conceived Person Register.
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court NA
According to the Children and Family Relationships Act 2015, a donor-conceived child who has attained the age of 18 years, or the parent of a donor-conceived child who has not attained the age of 18 years, may request the following information from the Register:
(a) information other than the relevant donor’s name, date of birth and contact details, that is recorded on the Register in respect of the relevant donor;
(b) the number of persons who have been born as a result of the use in a donor-assisted human reproduction procedure of a gamete donated by the relevant donor, and the sex and year of birth of each of them.
In addition, the Act provides that, a donor-conceived child who has attained the age of 18 years may request the name, date of birth and contacts details of a relevant donor, as recorded in the Register. The donor must be issued with a notice informing him or her that a request has been made by the donor-conceived child. The requested information may be released 12 weeks from the date on which on which the notice is sent (with very restrictive exceptions).
a. Identity of the donor(s)
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court NA
See answer to previous question
b. Certain health information concerning the donor(s)
i. For the child him or herself; ii. For the parents; iii. For a court
Under the proposed assisted human reproduction legislation, medical information relating to the donor may be released to a medical practitioner in order to avoid an imminent and serious risk to the health of a person or to enable the medical practitioner to provide medical advice to a person regarding the existence of a genetic or hereditary condition.
c. Other information
i. For the child him or herself; ii. For the parents; iii. For a court NA
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? Yes/No.
According to the Irish Constitution, the woman who has given birth to a child is always regarded as the legal mother. This assertion was challenged in the Irish Courts, but it was upheld in the Supreme Court in 2014 in the MR and Anor – v- An tArd Chlaraitheoir & Ors (Surrogacy) case.
According to the Children and Family Relationships Act 2015, the parents of a donor-conceived child are the mother and her husband, civil partner or cohabitant as the case may be. A donor of a gamete or embryo is not regarded as the parent of a donor-conceived child.
Iceland - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? sperm Yes/oocytes Yes/embryos -
See art.18 reg.568/1997 (If a donor wishes to remain anonymous, health workers are obliged to ensure that this is respected. In this case, the donor may neither receive information about the couple receiving the donated gamete or the child, nor the couple or the child receive information about the donor. If a donor does not wish to remain anonymous, the institution shall preserve information about him in a special file. If the donation of gamete leads to the birth of a child, information about the child and the couple who received the gamete shall be kept in the same file. A child born on account of a gamete donation where the donor does not wish to remain anonymous can at the age of 18 gain access to a file pursuant to paragraph 2 for the purpose of obtaining information about the identity of the donor. If a child receives information about the gamete donor at the institution, the said institution shall as soon as possible inform the donor that the information has been given.)
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No
The child cannot obtain information if the donor has wished to remain anonymous, See art.18 reg.568/1997.
a. Identity of the donor(s)
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No
The child cannot obtain information if the donor has wished to remain anonymous, See art.18 reg.568/1997.
b. Certain health information concerning the donor(s)
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No
The child cannot obtain information if the donor has wished to remain anonymous, See art.18 reg.568/1997.
c. Other information
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No
The child cannot obtain information if the donor has wished to remain anonymous, See art.18 reg.568/1997.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? No. See art.6, Act in respect of Children, no. 76/2003 (A man who has agreed that his wife be artificially inseminated according to the Act on is deemed to be the father of a child so conceived. The same applies to a man and a woman who have registered their cohabitation with the National Registry. A man who donates sperm for the purpose of it being used in artificial insemination of a woman other than his wife or cohabiting spouse, cf. paragraph 1, according to the provisions of the Act on Artificial Insemination will not be deemed to be the father of a child conceived with his sperm. -A man who donates sperm for another purpose than stipulated in paragraph 2 is deemed to be the father of a child conceived with his sperm unless the sperm is used without his knowledge or after his decease.)
Luxembourg - Financial aspects
3. Are MAP procedures covered by the social security system? Yes
4. Are there specific criteria for such coverage? Yes. Age limit of woman – 40 years old.
5. Is the financial coverage limited to a number of MAP procedures? Yes. Four attempts.
Luxembourg - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? No
b. possible for women not living in a heterosexual couple? Yes. Selection on the basis of a psychologist’s opinion and following the recommendations formulated by the National Ethics Commission.
Luxembourg - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? Yes. This depends on the legislation of the countries from which the donations originate.
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself; ii. For the parents; iii. For a court NA
a. Identity of the donor(s)
i. For the child him or herself; ii. For the parents; iii. For a court NA
b. Certain health information concerning the donor(s)
i. For the child him or herself; ii. For the parents; iii. For a court NA
c. Other information
i. For the child him or herself; ii. For the parents; iii. For a court
This depends on the legislation of the countries from which the donations originate.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? No. See Art.312 of the Civil Code cited in the section I – relevant instruments or draft instruments.
Malta - Legal regulation or practice and access to MAP
- Title of the law: Embryo Protection Act 2018
- Date of adoption and entry into force: 2018
- Published in: Laws of Malta; Government Gazette
Malta - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? No
b. possible for women not living in a heterosexual couple? Yes
Surrogacy is not allowed but donation of sperm is allowed and therefore homosexual female couples can use sperm donation or adoption of frozen embryos
Norvège - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous?
sperm No / oocytes No / embryos NA. Sperm or oocyte donors cannot be anonymous.
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No. Children born after sperm donation have the right to know the identity of their donor when they (the children) reach the age of 15 (or 18 for those born from sperm donated before 2021).
a. Identity of the donor(s)
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No.
b. Certain health information concerning the donor(s)
i. For the child him or herself No; ii. For the parents No; iii. For a court No. For donors recruited in Norway, the parents will be familiar with the general criteria for selection of a donor (good physical and mental health, no serious inheritable disease; as well as the test regimes) but will not have any other information about the donor. Norway allows import of sperm or oocytes from banks established outside of Norway, but only if they can provide sperm/oocytes from open donors, and in conformity with the relevant EC directives. Oocytes can only be imported from other Nordic countries.
c. Other information
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No. At the age of 15 (or 18, se previous text), the child can obtain information about the identity of the donor (name and address according to the registry and if necessary, date of birth and national identity number). This is the only information that will be provided.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? Yes.
- a child or a parent, as well as a third person who claims paternity of a child with another legal father may contest paternity in front of a court. There is no exception for children or parents of children born after MAP, but a sperm donor cannot contest paternity of a child born after MAP procedures using donated sperm.
- the donor has no legal responsibility for the child, and has no right to any information about children that have been born using his sperm (except for the maximum number).
- according to Norwegian family law provisions, the legal father of a child conceived after MAP is the one the mother is married to at birth (“pater est”). If the woman is not married, the legal father will be the man who acknowledge paternity for the child.
according to family law the woman who gave birth to a child is the child's mother.
Türkiye - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? No
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No
8. Are there specific criteria for donation of sperm/oocytes/embryos? Oocyte and embryo donation are prohibited.
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? Yes. Sperm, oocyte and embryo donation is forbidden.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No
Türkiye - Financial aspects
3. Are MAP procedures covered by the social security system? Yes
4. Are there specific criteria for such coverage? Yes. Married, infertile couples, older than 23, younger than 40 years old can benefit from assisted reproduction (IVF) techniques
5. Is the financial coverage limited to a number of MAP procedures? No
Türkiye - Medical aspects
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 No?; For women not living in a heterosexual couple? No
c. Other N/A
Spain - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous?
sperm Yes / oocytes Yes / embryos Yes
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court Yes
a. Identity of the donor(s)
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court Yes
b. Certain health information concerning the donor(s)
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court Yes
c. Other information
i. For the child him or herself No; ii. For the parents No; iii. For a court No
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? No
Spain - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. Where permitted by law: infertility, therapeutic or preventive purposes.
4. Are there specific criteria for such coverage? Yes.
Medically assisted procreation (MAP) is applied in the National Health System to people who meet the following criteria or situations including:
1. Women will be over 18 and under 40 and men over 18 and under 55 years at the time the infertility was taken into consideration.
2. People without any child, prior and healthy. In case of couples, no common, prior and healthy child.
3. The woman did not present any pathology in which pregnancy may have caused a serious and uncontrollable risk, both for their health and for their potential offspring.
5. Is the financial coverage limited to a number of MAP procedures? Yes.
The financial coverage limited to:
Three IVF procedures only
Artificial insemination with sperm from the couple: maximum number of cycles, four
Artificial insemination with donor gamete: maximum number of cycles, six.
Spain - Legal aspects
1. Is access to medically assisted procreation (MAP) (artificial insemination, in vitro fertilization procedures (IVF)
- restricted to heterosexual couples? Yes
- possible for women not living in a heterosexual couple? Yes
Every woman over 18 years with full capacity to act may be a recipient or user of the techniques regulated by this Law, provided that he has given his written consent. The woman may be user or recipient of the techniques covered in this law regardless of their marital status and sexual orientation.
Spain - Medical aspects
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
c. Other N/A
Hungary - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? Updating of the national regulation is intended in the next future.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. In 2015 a case has been concluded by the Hungarian supreme court (Kúria) where paternity was contested after MAP based on the exception if the husband had not consented to the MAP intervention.
The married couple separated shortly after the birth of the child. The couple had agreed about procreating a child with MAP intervention. The separated husband contested his paternity because a genetic DNA test excluded his biological parentship while supported that of the mother. The court has accepted the action of the ex-husband not to be the father based on the fact that he consented to generate a child with MAP but did not consent to the actual intervention; the document of consent did not contain that the sperm might come from a foreign donor. Not the fact that he could not be the biological father but the lack of a legally valid declaration of consent served as the base of the judgement. (Case EBH2015 P.8.)
Sweden - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? sperm Yes /oocytes Yes /embryos No
Sperm and oocyte donation are allowed. Embryo donation will be allowed from the 1st January 2019, if a couple or a single female consent in writing, they have children of their own, one of them is genetically linked to the embryo, and they are informed of the consequence of the donation; that their children may have genetic siblings in another family and will have the right to know of their origin. Any third party donor must consent specifically to embryo donation only if they donated before the law was amended, i.e. before the 1st January 2019.
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? -
8. Are there specific criteria for donation of sperm/oocytes/embryos? sperm Yes /oocytes Yes /embryos -
The donor is assessed on numerous conditions. The donor has to be in good health, physically and mentally. He/she must understand the consequences; He/she has no authority over the conceived child, he/she should not have regrets and it is preferred that he/she has a social network to cope with any possible thoughts, and the donor has to accept the possibility that children may in the future ask for his identity and make contact, as donation by Swedish law is not anonymous. The donor must be above 18 and his/her maturity is assessed in line with the above conditions. The donor must give written consent and has the option to withdraw the consent before the oocyte is fertilized.
The donor must be alive at the time of fertilization.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes. The responsible physician shall choose a matching appearance.
10. Are there special measures for the prevention of consanguinity? Yes. It is not recommended that a donor conceives more than 12 children (2 children in 6 families). There is no national register.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? Yes. Adoption is possible.
Sweden - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues?
In the recent publication on the 24th February 2016 “Olika vägar till föräldraskap (SOU 2016:11)” a government inquiry had been issued to consider different ways to increase the possibilities for involuntarily childless people to become parents. One legal change to occur on April 1st is that single women can now receive MAP. The inquiry has proposed that one should no longer demand a genetic link between the child and one of the parents, which might mean that embryo donation will become possible. The inquiry also included considering whether to permit altruistic surrogacy, if any, in Sweden. The inquiry’s conclusion was that commercial surrogacy should not be permitted, nor should altruistic surrogacy, and that society should also counter that type of surrogacy. The final report has been submitted to a large number of stakeholders, organisations and authorities, for comments by the 23rd June 2016.
In a new government inquiry followed by a law proposal by the government on the 15th March 2018 “Modernare regler om assisterad befruktning och föräldraskap (proposition 2017/18:155)” which will entered into force on January 1st, 2019, the legislator has made embryo donation possible. A couple or a single female may donate fertilized eggs if they already have children of their own and if the egg is genetically linked to one of them (or to the single female). The children born from embryo donation shall have a right to enter their personal information into the special registry to be kept about the donation for 70 years, for any possible genetic siblings to be retrieved upon request.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. -
Sweden - Legal aspects
1. Is access to medically assisted procreation (MAP) (artificial insemination, in vitro fertilization procedures (IVF)
- restricted to heterosexual couples? No
- possible for women not living in a heterosexual couple? Yes. As from 1/4/2016 single females gain access.
Switzerland - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? sperm Yes /oocytes No /embryos No
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No
8. Are there specific criteria for donation of sperm/oocytes/embryos? sperm Yes /oocytes - /embryos -
Medical criteria (good health).
Oocyte and embryo donation are prohibited.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes. Matching appearance of donor to recipient (including blood type)
10. Are there special measures for the prevention of consanguinity? Yes. 8 children only
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? Yes. This has nothing to do with MAP.
Switzerland - Financial aspects
3. Are MAP procedures covered by the social security system? IUI (intrauterine insemination) YES, IVF NO.
4. Are there specific criteria for such coverage? Yes. Only married couples have access to IUI.
5. Is the financial coverage limited to a number of MAP procedures? Yes. IUI: a maximum of 3 IUI cycles
Switzerland - Legal aspects
1. Is access to medically assisted procreation (MAP) (artificial insemination, in vitro fertilization procedures (IVF)
- restricted to heterosexual couples? No
- possible for women not living in a heterosexual couple? Yes
Switzerland - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? Yes. Recently, Parliament has decided that oocyte donation should be permitted. As a result, the Federal Council (government) has to prepare a corresponding draft law.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. -
Denmark - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes
In general, all men can donate sperm and all women can donate oocytes if this does not involve any known serious genetic or infectious risk. The establishments in charge of testing, processing, preservation, storage or distribution of human tissues and cells have the responsibility to ensure the quality of sperm and oocytes. Donation of embryo is only permitted for research purposes, not for assisted reproduction.
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No. It is not allowed to sell or otherwise assist in the sale of unfertilized or fertilized oocytes. The compensation to the donor for donation of oocytes is, therefore limited to expenses actually incurred and disadvantages that are directly related to the donation.
8. Are there specific criteria for donation of sperm/oocytes/embryos? Yes. In general, all men can donate sperm and all women under the age of 35 years can donate oocytes if this does not involve any known serious genetic or infectious risk. The establishments in charge of testing, processing, preservation, storage or distribution of human tissues and cells have the responsibility to ensure the quality of sperm and oocytes. Donation of embryos is only possible for research purposes, not for assisted reproduction.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes
10. Are there special measures for the prevention of consanguinity? Yes. A sperm donor cannot have more than twelve offsprings.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? Yes.
By December 2013 the Children Act was amended with rules on co-maternity. Co-maternity can be established when the mother has been treated with assisted reproduction and has a female spouse or partner who has agreed to the treatment.
In other cases, homosexual couples have the same rights to adoption as heterosexual couples, which also include the possibility for stepchild adoption.
Finland - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? No.
Donations are coded. The competent authority keeps a donation register on the donations of gametes and embryos for the purposes of MAP.
If a child born using MAP wishes to know the donor’s identity, he or she will have access to the information after having turned 18 years of age.
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court No
If a child born using MAP wishes to know the donor’s identity, he or she will have access to the information after having turned 18 years of age.
When MAP has been provided for a woman not living in marriage or in a relationship comparable to marriage with a partner of the opposite sex (after 1 April 2019: a woman not living in marriage, registered partnership or in a relationship comparable to them, regardless of whether the partner is same sex or opposite sex) and the donor has given his consent to being confirmed as the father of the child, the mother and the child are entitled to learn from the service provider the donor’s code and, by providing the donation register with the code, the identity of the donor. According to the Code of Judicial Procedure, the court does not have access to sensitive health care data unless the person in whose benefit the secrecy obligation has been provided consents to it or he or she is deceased and if very important reasons require it. Exception to this rule is a case where the prosecutor has brought charges for an offence for which the maximum sentence is imprisonment for at least six years.
a. Identity of the donor(s)
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court No. See answer to previous question.
b. Certain health information concerning the donor(s)
i. For the child him or herself No; ii. For the parents No; iii. For a court No
c. Other information
i. For the child him or herself No; ii. For the parents No; iii. For a court No. Only limited information may be registered. Donors undergo a health examination in order to rule out serious diseases that may constitute a health risk to a future child. No specific health information concerning the donor is recorded.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? Yes. According to Paternity Act (isyyslaki; 11/2015) the man having consented to MAP will be the father of the child born through MAP. According to Maternity Act (entering into force 1 April 2019) the same applies to a woman in a female couple concerning her maternity. If sperm is used to provide MAP to a single mother, the donor can consent to potentially be declared as the father of a future child. If the sperm donor has consented only to fertility treatments and not to paternity, he cannot be declared the father of the child.
Finland - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? Yes. Surrogacy-related issues are debated every now and then.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law.
Paternity Act (isyyslaki; 11/2015): unofficial English translation available at: <http://www.finlex.fi/en/laki/kaannokset/2015/en20150011.pdf>.
Act on Assisted Fertility Treatments (laki hedelmöityshoidosta; 1237/2006) unofficial English translation available at:
<http://www.finlex.fi/fi/laki/kaannokset/2006/en20061237.pdf> NB: This translation does not include the latest updates.
Maternity Act (äitiyslaki; 253/2018): unofficial English translation available at: <https://www.finlex.fi/en/laki/kaannokset/2018/20180253>
Lithuania - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? Yes. A child born as a result of assisted reproduction using the donor's gametes, as well as a donor of gametes, may, with the permission of the court, be provided with information about the relevant donor of gametes, or the child born as a result of the use of the donor's gametes, if this information is necessary for the child's or the gamete donor's health or for other compelling reasons.
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No
a. Identity of the donor(s)
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No
b. Certain health information concerning the donor(s)
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No
c. Other information
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No. A child born as a result of assisted reproduction using the donor's gametes, as well as a donor of gametes, may, with the permission of the court, be provided with information about the relevant donor of gametes, or the child born as a result of the use of the donor's gametes, if this information is necessary for the child's or the gamete donor's health or for other compelling reasons.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? No. Persons who have signed an informed consent to assisted reproduction are considered the legal parents of the child born after assisted reproduction.
Austria - Sperm/oocyte/embryo donation
6. Are sperm, oocytes or embryos donation permitted in your country?
It is permitted to donate sperme and oocytes, but not embryos.
7. Are there specific compensation arrangements for such donations(s)?
No
8. Are there sepcific criteria for sperm, oocytes and embryos donation?
Yes, for sperm and oocyte donation, No for embryos donation.
Written consent of the donor is required. Donation can only be done to a specifically authorized hospital. Age limit for egg donation: 30 years (donor), 45 years (recipient)
9. Are there specific non-medical criteria for selection of gametes/embryo to be used for MAP?
No
10. Are there special measures for the prevention of consanguinity?
Yes, sperm and eggs of a donor may only be used in favour of three couples. The donation by a certain donor is permitted only to one single hospital.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of his or her legal parent?
Yes, the legal mother's partner is automatically the other parent of the child if that partner has given written consent for the PMA with a sperm donation.
Bosnia and Herzegovina - Current debate and specific situations
19. Is there and important current debate in your country on these or related issues?
Yes. As stated above, the issue of MAP is very high on political and public agenda in B&H, however no specific legislation has been approved so far, explicitly due to the opposition of conservative parties and influence of church. The main debate and controversy are around granting the rights to MAP to single women, as well as the issues of heterologous procreation (sperm/oocyte donation).
20. Delegations are invited to provide information on particular cases encountered in their country. NA
Bosnia and Herzegovina - Financial aspects
3. Are MAP procedures covered by the social secutiry system?
Yes, currently only for 2 procedures in the entities Federation BiH, Republika Srpska and Brcko district.
4. Are there specific criteria for such coverage?
Yes, Infertility, age limitation (37 in FBIH, 41 in RS).
5. Is the financial coverage limited to a number of MAP procedures?
Yes, 2 procedures
Finland - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? Yes. The expenses borne by the patient, a possible loss of income and any other inconvenience caused by the MAP may be compensated. For ovum donation, a maximum amount of 250 euros may be reimbursed due to inconvenience. Other types of remunerations and payments are forbidden.
8. Are there specific criteria for donation of sperm/oocytes/embryos? Yes.
Sperm and oocytes - Act on Assisted Fertility Treatments (laki hedelmöityshoidoista; 1237/2006) requires the donor to be 18 years old. In medical practice, maximum age limits have been set up by clinics and may vary between them. Donation of gametes should not pose a health hazard to the donor and donors should have no serious hereditary diseases or any communicable diseases, which may cause a serious illness to the woman receiving assisted fertility treatment or to the child. This is ensured by means of a health examination of the donor. Informed consent is required. A donor may specifically consent to the use of sperm for MAP of single women.
Embryos - Only surplus embryos resulting from MAP may be donated with informed consent from both donors.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes. When using donated gametes, Section 5 of Act on Assisted Fertility Treatments (laki hedelmöityshoidoista; 1237/2006) requires the attending physician to select gametes whose donor resembles in appearance the parent of the child to be born, unless otherwise requested by the person receiving treatment.
10. Are there special measures for the prevention of consanguinity? Yes. When the gametes of a donor have provided progeny to five MAP recipients, gametes donated by the said donor may no longer be used in MAP provided to others.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? Yes. If partners living in a same-sex relationship are married or have registered their partnership, a partner may adopt the other partner’s child. According to the new Maternity Act which entered into force on 1 April 2019, the maternity of a partner in a female same sex couple can be recognised on the basis of valid consent to fertility treatments.
Finland - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. Public health services include MAP procedures. Pursuant to the Health Insurance Act (sairausvakuutuslaki; 1224/2004), health insurance covers the cost of necessary medical care when infertility is caused by an illness. Infertility is in addition paralleled to illness in cases of permanent relationships where the pregnancy does not start within one year. Also men are covered.
4. Are there specific criteria for such coverage? Yes. Pursuant to the practice instructions of the Socio-medical Advisory Board of the Social Insurance Institution of Finland, MAP-procedures are available within the public health care to women until the age of 40. Also women over 40 years are treated if the prognosis is good. The costs are reimbursed by the health insurance scheme until the age of 43 years. In case of older women, the health insurance coverage is assessed on a case-by-case basis in the light of the medical data of the woman concerned.
5. Is the financial coverage limited to a number of MAP procedures? Yes.
The financial coverage has not been limited by law. The number of MAP procedures has however been limited to three attempts in the practice of the Social Insurance Institution of Finland, because according to statistics, the prospect of a successful procedure is known to decrease thereafter.
Infertility related to a decrease in the amount of gametes caused by aging is not considered an illness and is thus not covered as necessary medical care by the health insurance. MAP procedures are usually not covered after sterilization either. Possible costs borne by a cell donor are not covered, because they are unrelated to the treatment of the donor’s disease.
The insurance coverage of MAP procedures for an applicant over 43-years of age is decided upon on a case-by-case basis. An application for reimbursement is made with the Social Insurance Institution of Finland for both the medicines and the procedure itself. A statement by the doctor providing treatment must be attached to the application.
Estonia - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? Yes
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself Yes, ii. For the parents No, iii. For a court No
a. Identity of the donor(s)
i. For the child him or herself No, ii. For the parents No, iii. For a court No
b. Certain health information concerning the donor(s)
i. For the child him or herself Yes, ii. For the parents Yes, iii. For a court Yes
c. Other information
i. For the child him or herself No, ii. For the parents No, iii. For a court No
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? No
Finland - Medical aspects
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? Yes/No; For women not living in a heterosexual couple? Yes/No
Medical grounds are used as the criteria for accessing MAP in the public health care. In practice however the reasons for infertility are not always known and this has not prevented public sector clinics from providing treatment in particular to heterosexual couples (i.e., provision of treatment has not always been based on a diagnosed medical condition). Another reason for not providing MAP for same-sex female couples and single women has been the lack of available donated gametes. These criteria are, however, not provided for in the legislation.
b. Risk of transmission of a disease
For a heterosexual couple? Yes; For women not living in a heterosexual couple? Yes
MAP cannot be provided if the pregnancy would pose a substantial risk to the health of the woman or of the child due to the age or health of the woman. The donor cannot donate gametes if he has a serious hereditary disease or any communicable disease that may cause a serious illness to the woman receiving assisted fertility treatment or to the child who may be born as a result of the assisted fertility treatment.
c. Other NA
Estonia - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? No
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. NA
Pays-Bas - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous?
sperm No / oocytes No / embryos No. The law requires professionals who carry out the MAP, to provide data about the donor(s) to a national registration.
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself Yes; ii. For the parents No; iii. For a court Yes
a. Identity of the donor(s)
i. For the child him or herself Yes; ii. For the parents No; iii. For a court Yes
b. Certain health information concerning the donor(s)
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court Yes
c. Other information
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court Yes
Parents can obtain information about physical characteristics, education and profession and medical issues.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? No
Türkiye - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous?
Sperm, oocyte and embryo donation is forbidden.
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation? Sperm, oocyte and embryo donation is forbidden.
i. For the child him or herself No; ii. For the parents No; iii. For a court NA
a. Identity of the donor(s)
i. For the child him or herself NA; ii. For the parents NA; iii. For a court NA
b. Certain health information concerning the donor(s)
i. For the child him or herself NA; ii. For the parents NA; iii. For a court NA
c. Other information
i. For the child him or herself; ii. For the parents; iii. For a court
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? Yes. DNA tests.
Türkiye - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? Yes
b. possible for women not living in a heterosexual couple? No
Andorra - Sperm/oocyte/embryo donation
6. Are donation of the sperm/oocytes/embryos permitted? Yes, permitted for sperm and embryos.
7. Are there specific compensation arrangements for such donations?
Donation is never in its nature profitable or commercial. Nevertheless, financial compensation is possible strictly in order to compensate the physical inconveniences as well as work and travel expenses resulting from the donation. Such compensation cannot constitute an economic incentive. The conditions [for its allocation] must be set through regulation.
8. Are there specific criteria for donationn of the sperm/oocytes/embryos?
The donors of female and masculine gametes must be over 18 years and no older than 37 for the female donors and 45 for the male ones. In addition, they must be in good health. The maximum authorised number of children born to Andorran nationals or residents of Andorra of the same gamete donated, is limited to 1, unless this concerns the reproductive process of the same recipient.
9. Are there specific non-medical criteria for selection of gametes/embryo to be used for MAP?
Yes, major phenotypic and immunological similarity, [made] possible by the medical team.
10. Are there special measures for the prevention of consanguinity?
Yes, a register for assisted human reproduction.
11. In a homosexual couple, is a legal relationship possible betweenn a child and the partner of the legal parent?
Yes, surrogate mothers
Azerbaijan - Right to know about his or her biological origin for children born after MAP
16. Is donation of the sperm/oocytes/embryos anonymous? Yes for sperm
17. Is it possible to obtain information about the biological origin of a child bornn after gametes or embryo donnation?
i. For the child him or herself NA
ii. For the parents NA
iii. For a court NA
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which connditions (family law provisions)?
No
Azerbaijan - Sperm/oocyte/embryo donation
6. Are donation of the sperm/oocyte/embryos permitted in your country? Yes for sperm/oocyte/embryos
7. Are there specific compensation arrangements for such donations? Yes
8. Are there specific criteria for donation of sperm, oocytes, embryos? Yes, for sperm
9. Are there specific non-medical criteria for selection of gametes/embryo to be used for MAP? No
10. Are there special measures for the prevention of consanguinity? No
Consanguinity (between cousins) is very widespread in Azerbaijan and these marriages are not forbidden.
11. In a homosexual couple, is a legal relationship possble between a child and the partner of the legal partner? No
Estonia - Legal regulation or practice and access to MAP
- Title of the law: Artificial Insemination and Embryo Protection Act
- Date of adoption and entry into force: 11 July 1997
- Amended: 01/01/2018
- Published in: State Gazette 1997, Nr. 51. Art 824
United Kingdom - Legal regulation or practice and access to MAP
- Titre de la législation : Human Fertilisation and Embryology Act 2008; Human Fertilisation and Embryology Act 1990 (as amended)
- Date of adoption and entry into force:
Human Fertilisation & Embryology Act 1990 date of adoption and entry into force: 1 August 1991
HFEA Act 2008 received Royal assent on 13 November 2008.The HFE Act 2008 came into force in three stages:
Phase one: On April 6 2009 part 2 of the Act, the revised definitions of parenthood, took effect.
Phase two: In October 2009 the amendments to the 1990 legislation take effect. Examples of these amendments include research on human admixed embryos, and removal of the ‘need for a father’.
Phase three: In April 2010 people in same sex relationships and unmarried couples are able to apply for authorisation allowing them to be treated as parents of children born using a surrogate.
Phase four: In January 2019 single people are able to apply for authorisation allowing them to be treated as parents of children born using a surrogate.
Malta - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? sperm No / oocytes No / embryos Yes. Articles 6 though to 9 of the Act
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself No; ii. For the parents No; iii. For a court No
a. Identity of the donor(s)
i. For the child him or herself No; ii. For the parents No; iii. For a court No
b. Certain health information concerning the donor(s)
i. For the child him or herself No; ii. For the parents No; iii. For a court No
c. Other information
i. For the child him or herself No; ii. For the parents No; iii. For a court No
Article 19 has two provisions:
19(1): That any child born of any medically assisted procreation, including cases where the child was born from donated germ line cells or a donated embryo, shall be considered as the child of the prospective parent(s) who has/have expressed their consent to the procedure. It also states that for all intents and purposes of the law, the child will be considered to have been ‘naturally born of the same prospective parent or prospective parents’. The child will be registered in any act of civil status as the direct descendant of such prospective parent(s), who then have the rights and duties under the law in respect of the child.
19(2) states explicitly that there shall be no link of filiation between the child born from donated germ line cells or adopted embryos and the persons from whom donated germ line cells or adopted embryos originated.
Note : (Interestingly, in a scientific sense, this also acknowledges that the Gestational mother is more important that the Genetic mother under these circumstances)
The law does not explicitly mention the cases ticked ‘NO’ above, but Article 22 of the Act does oblige the licensee who performs MAP to ‘keep a confidential register with full details of every medically assisted procreation procedure, germ line donation, cryo-preservation of germ line cells and cryo-preservation of embryos in terms of this Act and to pass on this information to the Authority without delay’
Note: Presumably therefore, the Authority may in certain circumstances, e.g. for health reasons, give permission to reveal identities. This is not however explicitly stated, but keeping the register mean implicitly having a safety net.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? See comments in point 19
Luxembourg - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues?
Opinion issued by the National Ethics Commission.
General debate in Parliament expected.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law.
It is important to note that MAP is currently not regulated in Luxembourg, except that
- Article 312 of the Civil Code states that a paternity suit is non-admissible by the husband of the mother “if it is established, by all means of proof, that the child has been conceived by means of artificial insemination, either by the husband or by a third party with the written consent of the husband”.
- the national hospital plan adopted in 2001 through regulation, envisages the creation of a service of MAP in a general hospital containing an obstetrics department.
In the meantime, the creation of a MAP department has effectively been authorised to the Hospital Centre of Luxembourg. This department is in place. The data supplied to the questionnaire reflects the practices of this department.
There exists a legal proposal, of which a bill is before parliament, with regard to MAP. Parliament had anticipated holding a large debate but as yet this debate has not yet taken place.
The National Ethics Commission has produced a very complete opinion on all aspects of MAP.
Malta - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. Infertility treatment is of course a disease when biological; however social infertility presumably allowed by law due to equal rights for married couples.
4. Are there specific criteria for such coverage? Yes. Depends on the Authority for MAP
5. Is the financial coverage limited to a number of MAP procedures? Yes
Bulgaria - Legal aspects
1. Is access to medically assisted procteation (MAP
a. restricted to heterosexual couples? NA
b. possible for women not living in a heterosexual couple? NA
Denmark - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm Yes and no/oocytes Yes and no/embryos anonymous Yes? Donor of oocytes can be anonymous or non-anonymous. Donor of sperm can be anonymous or non-anonymous.
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself, Yes. It’s only possible to obtain information if the sperm donor or oocyters donor is non-anonymous. Identity of the donor can be obtained when the child are 18 years or older. ii. For the parents No, iii. For a court No
a. Identity of the donor(s)
i. For the child him or herself Yes, ii. For the parents No, iii. For a court No
b. Certain health information concerning the donor(s)
i. For the child him or herselfn No, ii. For the parents No, iii. For a court No
c. Other information
i. For the child him or herselfn No, ii. For the parents No, iii. For a court No
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? Yes. A father or a co-mother can contest paternity or co-maternity if he or she believes that the child is not conceived by the MAP he or she gave consent to, but instead is conceived by a sexual relationship.
Czech Republic - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes. Sperm/oocytes/embryos can be donated only if the person concerned agrees with it.
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? Yes. Financial compensation of expenses and loss of income.
8. Are there specific criteria for donation of sperm/oocytes/embryos? Yes. Age limit, health status, informed consent.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? No. But usually the blood group and appearance are matched, if possible.
10. Are there special measures for the prevention of consanguinity? Yes. Limited number of donations, but this is a recommendation, not a law.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No. But this was breached last week (half of May 2018). A gay couple who brought a child from surrogacy in the USA, was recognized by the Supreme Court as a full-fledged fathers. The reason was the best interest of the child. Nevertheless, in December 2020, a proposal to amend the wording of the law allowing adoption by homosexual couples was rejected.
Czech Republic - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? Yes. The debate is steady and intense, considering single person and homosexual couples guaranteed by the state access to MAR, explicit legal regulation of surrogate motherhood, increasing the number of IVF cycles covered by HI, changes in the age for MAR access.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. NA
Estonia - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? Yes
8. Are there specific criteria for donation of sperm/oocytes/embryos? Yes
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes
10. Are there special measures for the prevention of consanguinity? Yes
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No
Denmark - Medical aspects
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
Czech Republic - Medical aspects
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/AIDS, Hepatitis etc. For women not living in a heterosexual couple? Yes