16. Is donation of sperm/oocytes/embryos anonymous?

sperm Yes / oocytes Yes / embryos -

Art. 18 specifies the rules of confidentiality regarding both the couples receiving MAP and the gamete donors.

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 Yes

Art. 18: The child may request medically important information about the donor after reaching 15 years of age, provided that he/she is mentally competent. The child’s legal representative may be given such information only with a permission issued by court, in cases of exceptionally important medical reasons.

The child’s physician has the right to access information in the donors’ registry for health reasons.

The court and administrative body have a right to access information in the registry if that is absolutely necessary for carrying out their official duties under this law.

a. Identity of the donor(s)

i. For the child him or herself No; ii. For the parents No; iii. For a court Yes. See comment to first table answer 17.

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. See comment to first table answer 17.

c. Other information

i. For the child him or herself No; ii. For the parents No; iii. For a court Yes. See comment to first table answer 17.

18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? 

In principle, no.

• Art. 41: Maternity cannot be contested if the mother had consented to the MAP procedure. When  a donated egg is used, the donor cannot claim maternity for the child, nor can biological maternity be determined in the interest of other parties. 
• Art. 42: Paternity may not be contested, unless it is claimed that the child had in fact not been conceived with a MAP procedure. In that case articles 96-99 of the Marriage and family relations Act apply.

When donated sperm is used, the donor cannot claim paternity for the child, nor can biological paternity be determined in the interest of other parties.

3. Are MAP procedures covered by the social security system? Yes. 

This may differ between counties but normally MAP is covered up to a limited number of attempts, presently most state owned/contracted clinics offer three attempts by national recommendation (by the Swedish Association of Local Authorities and Regions, SKL).

MAP is considered part of health care.

4. Are there specific criteria for such coverage? By national recommendations: If the couple/female is approved by above mentioned criteria she will receive up to three attempts. Females above 40 will however normally not be approved for treatment, unless embryos were frozen before she turned 40, in which case the embryos may be used before she turns 45. This applies regardless of financial coverage. The other parent must not be above 56 years old.

5. Is the financial coverage limited to a number of MAP procedures? Yes. Up to three attempts are normally covered.

16. Is donation of sperm/oocytes/embryos anonymous?

sperm No / oocytes No / embryos N/A

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. Yes, by request to the clinic which has a special registry about the donors (to be saved for 70 years). For embryo donor children it will be possible to find genetic siblings who have requested to be entered into the register.;

ii. For the parents No;

iii. For a court No. Unlikely, but potentially if court rules it necessary. 

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, if relevant and noted in the donor registry; ii. For the parents No; iii. For a court No

c. Other information

i. For the child him or herself Yes, 

Contact info and any other info provided in the medical file

A donor child has the right to, at a “mature age” (interpreted as appx 18) and upon request, find out the identity and contact information of their donor. This information is to be kept for 70 years in a special donor registry. The parents are encouraged to inform their child about the donation;

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. 

Paternity is regulated in the Parental Code.

Paternity can be contested if, having regard to all the circumstances, it is not probable that the child was conceived by insemination or IVF.

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

Female married couples have access to sperm donation even if there is no infertility in the medical sense.

b. Risk of transmission of a disease

For a heterosexual couple Yes?; For women not living in a heterosexual couple? Yes

Female married couples have access to sperm donation and pre-implantation genetic diagnosis if there is a risk of transmitting a predisposition to a serious disease.

c. Other N/A

19. Is there an important current debate in your country on these or related issues? These issues are currently being discussed in medical faculties, medical doctors' councils and among lawyers.

20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. -

Are there specific criteria for access to MAP?

Yes, Access permitted for heterosexual and homosexual couples, no access for single women. Access in case of high risk of transmission of a serious disease, e.g. HIV.

6. Is donation of sperm/oocyte/embryos permitted in your country? 

No

7. Are there specific compensation arrangements for such donations? 

NA

8. Are there specific criteria for donation of sperm/oocytes/embryos? 

NA

9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? 

NA

10. Are there special measures for teh prevention of consanguinity? 

NA

11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? MAP legal only for heterosexual couples

6. Is donation of sperm/oocytes/embryos permitted in your country? NA

7. Are there specific compensation arrangements for such donation? NA

8. Are there specific criteria for donation of sperm/oocytes/embryos? NA

9. Are there specific non-medical criteria for selection of gametes/embryo to be used for MAP? NA

10. Are there special measures for the prevention of consanguinithy? NA

11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal partner? NA

3. Are MAP procedures covered by the social security system? NA

4. Are there specific criteria for such coverage? NA

5. Is the financial coverage limited to a number of MAP procedures? NA

2. Are there specific criteria for access to MAP? NA

2. Are there specific criteria for access to MAP? 

Medical reasons:

a. Infertility:

For a heterosexual couple?; For women not living in a heterosexual couple? NA

b. Risk of transmission of a disease

For a heterosexual couple?; For women not living in a heterosexual couple? NA

c. Other

• Title of the law: There are no general laws or regulations on medically assisted procreation in Poland
• If no legal instrument please describe the practice: In view of the lack of specific legal provisions, MAP may be practised under the general rules of medical law and in particular those governing the practice of medicine (duty to inform patients of the medical and legal consequences, confidentiality with regard to the MAP itself and the identity of the donor of the gametes, due care in the choice of the donor and examination of the genetic material to be used, the duty to obtain free and informed consent, etc), the corresponding rights of patients, the general laws on families, descent and registration, and the Medical Code of Ethics (which does not address this issue specifically). Some questions are addressed in the Opinion of the Polish Association of Obstetricians concerning the MAP techniques used in the treatment of infertility, and others by the internal regulations of the clinics practising MAP (practice may therefore vary from one place or establishment to another).

It is note-worthy that MAP is not currently regulated in Luxembourg, except that:

• Article 312 of the Civil Code states that a repudiation of paternity by the husband of the mother is non-admissible “if it established by all proven means that the child has been conceived by means of artificial insemination, whether by the husband or by a third party with the written consent of the husband.
• The national hospital plan, adopted in 2001 by regulation, provides for the creation of a MAP department in a general hospital with an obstetrics department.

Indicate if process of revision is ongoing and, in your answers, provide information on provision in the draft law: There is a proposed law, in fact a draft law initiated by Parliament, concerning MAP.  Parliament had planned a large general debate but this has not yet taken place.

If no legal instrument please describe the practice There is no law regulating in particular assisted reproduction techniques, but these methods are generally permitted. As for the insurance, basic problems of MAP are partially solved by the Sanitary Order Law / the definitions of indications, contra – indications for reimbursement of MAP are: more than 38 years of age, tubal sterility or previous interruption for social or personal reasons. Only for 2 cycles of MAP can be reimbursed.

• Title of the law: Law on biomedically assisted procreation
• Date of adoption and entry into force: adoption 25 April 2017; entry into force 5 May 2017, 
• Published in: "Official Gazette of the Republic of Serbia ", No. 40/2017 and 113/2017
• Indicate if process of revision is ongoing and, in your answers, provide information on provision in the draft law: At the moment, new law is in the process of adoption by the Serbian Parliament. Public debate is finished, and the new law is correlated with EU Directives

• Title of the law Law: 17/2016 Enlarges those who can benefit from ART (June 20, 2016). Creation of human embryos for for research purposes remains prohibited under the provisions of Law 32/2006, which regulates the use of Medically Assisted Reproduction (MAR) techniques.
• Date of adoption and entry into force: August 1, 2017
• Published in: Diário da República, Iª série – Nº 116 , pp 1903-1904, June 20, 2016

6. Is donation of sperm/oocytes/embryos permitted in your country? sperm Yes /oocytes Yes /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 Yes /embryos Yes. In fact there is neither a collection nor a bank in Luxembourg.  The service functions in collaboration with a foreign bank.

9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes. Five classic characteristics (blood group, complexion, eyes, colour of hair, height).

10. Are there special measures for the prevention of consanguinity? No. The straws of sperm come from abroad.

11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No. Currently no legislation.

3. Are MAP procedures covered by the social security system? Yes. 

MAP procedures are covered by the National Health care system and by co-payments. The (outpatient) clinic where the MAP procedure is conducted is financed as follows:

• Fee-for-service reimbursement from the National Insurance Scheme based on the treatments of IVF and intracytoplasmic sperm injection (ICSI) procedures
• en bloc subsidies from the state
• Co-payments from the patients, the woman/couple pays maximum NOK 18800 to cover some medicines and treatment costs for IVF/ICSI. The couples are usually offered three treatment cycles (three IVF or ICSI procedures, or a combination) per child.

4. Are there specific criteria for such coverage? Yes. 

All couples that are offered MAP have a right to partial coverage of the medicines and treatment costs for IVF/ICSI treatment, limited to three attempts per child.

As a first step in the process, the woman/couple will consult their family physician. Based on a medical and psychosocial evaluation of the woman/couple the physician will decide whether to recommend the couple to one of the clinics offering MAP. The physician at the clinic decides whether or not the woman/couple will be offered MAP. According to the Biotechnology Act, a clinic offering MAP needs authorisation or approval from the Directorate of Health.

To have access to MAP through the clinics financed by the national health care system, an evaluation of the presumed cost-effectiveness of the treatment for the woman/couple is carried out, 

Many clinics have established guidelines for evaluation of couples asking for medically assisted procreation. 

Women/couples may also choose to pay for treatment in private clinics, this may provide shorter waiting time, and these clinics are not bound by the same principles of cost-efficiency.

A woman cannot be older than 46 at the time of insemination or implantation of embryo.

5. Is the financial coverage limited to a number of MAP procedures? Yes. Financial coverage is limited to three MAP procedures (three IVF or ICSI procedures - or a combination, where a procedure includes the retrieval of ova). Implantation of stored embryos (FER) is not counted as a “MAP procedure”.

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?; For women not living in a heterosexual couple? No

c. Other Yes

Criteria for access to IVF is infertility or that the woman is affected by or carrier of serious hereditary disease.

Lesbian couples and single women have access to MAP by insemination or IVF. Criteria for assisted procreation by insemination to heterosexual couples is infertility or that the man has or is carrier of serious hereditary disease. :

• the woman is a carrier of serious X-linked diseases. In such cases, the act allows that procedures for selection of sperm can be used to ensure a female offspring. Such procedures can only be accepted after thorough scientific evaluation, and must be approved by the Directorate for Health and Social affairs.
• the husband/spouse is affected by or carrier of a serious inheritable disorder
• if there is a risk of transmission of a serious and chronic sexually transmissible disease.

The act does not specify a right to treatment in cases where there is a risk of transmission of diseases such between the woman and her husband/spouse.

Regarding situation where one or both partners have a serious and chronic sexually transmitted infection: Where the woman is infected, an evaluation of the risk of transmitting the virus to the child must be made in each case before it is decided to proceed.

A woman cannot be older than 46 at the time of insemination or implantation of embryo.

The criteria for infertility for access to IVF does not apply in cases where same-sex couple have treatment using partner donation (one of the women donates her egg to the other who carries the child).

2.b.X linked diseases

                        Other known genetic disorders

16. Is donation of sperm/oocytes/embryos anonymous? Yes. 

Lack of specific legal provisions on the subject.

Anonymity of donations is a matter of medical confidentiality. The Opinion of the Polish Association of Obstetricians recommends double anonymity (of both the donor and the receiver). Clinics’ internal regulations may provide otherwise.

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. 

There are no specific legal provisions on the subject.

Doctors are therefore bound by medical confidentiality in respect of both the donor and the receiver of the gametes. Information concerning the donor may be revealed only on medical grounds, when the life or health of the child is threatened.

a. Identity of the donor(s)

i. For the child him or herself No; ii. For the parents No; iii. For a court No. See above comment

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. See above comment

c. Other information

i. For the child him or herself No; ii. For the parents No; iii. For a court No. See above comment

18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? NA

There is no specific legal provisions on the subject.

Under the general laws governing descent, it is not possible to contest paternity in the event of homologous insemination within a married couple.

In cases of heterologous insemination, however, paternity may be contested, but only if the spouse of the inseminated woman did not consent to insemination with another man’s sperm.

Relevant provisions:

Presumption of paternity:

Art. 62 of the Code of the Family and Guardianship:

“1. A child born in wedlock or within three-hundred days of the dissolution or annulment of the marriage shall be presumed to be the child of the mother’s husband.

2. A child born within three-hundred days of the dissolution or annulment of the marriage, but after the mother has remarried, shall be presumed to be the child of the second husband.

3. These presumptions may be rebutted only through action to disclaim paternity.” 

Art. 63 of the Code of the Family and Guardianship:

“The husband of the mother may take action to disclaim paternity within six months of learning of the birth.”

Art. 85 of the Code of the Family and Guardianship:

“1. The man who had intercourse with the mother of the child between three-hundred days and one-hundred-and-eighty-one days before its birth shall be presumed to be its father.

2. The fact that, during that period, the mother also had intercourse with another man shall rebut this presumption only if, under the circumstances, the other man appears more likely to be the father."

Abuse of rights and public policy:

Art. 5 of the Civil Code:

“No person shall use their rights in a manner contrary to the social and economic purpose of those rights or the rules of life in society. Abuse or abusive non-use of a right shall not be considered as exercise of that right, or enjoy the protection of the law.”

Art. 58 para. 2 of the Civil Code:

“Any legal act contrary to the rules of life in society shall be null and void.”