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? 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

Provision of treatment on the National Health Service (NHS) varies across the UK with different local clinical commissioning groups (CCGs) or health boards having differing levels of provision and different eligibility criteria. The National Institute of Clinical Health and Excellence (NICE) is the NHS body who developed the overarching guidelines which CCGs then apply locally. Guidelines can be viewed here: https://www.nice.org.uk/guidance/cg156. Private fee-paying (non-National Health Service) patients can have treatment for purely non-medical reasons if they wish.

As the UK’s regulator for assisted reproduction, the HFEA requires licensed fertility clinics to follow screening requirements to avoid the transmission of diseases. Donors have to be screened for infectious diseases such as HIV, Hepatitis B and C and Cytomegalovirus (CMV). Among the criteria to be considered is the patient’s age, health and ability to provide for the needs of a child/children. Further information on screening requirements can be viewed in the HFEA’s code of practice: http://www.hfea.gov.uk/498.html

Clinics ultimately must decide fairly whether to offer or refuse treatment. Further information on guidance to treating people fairly when receiving fertility treatment is included in the HFEA code of practice: https://www.hfea.gov.uk/media/2793/2019-01-03-code-of-practice-9th-edition-v2.pdf

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. The Human Fertilisation & Embryology Act 1990 (HFE Act) does not prohibit treatment for same sex couples or single women

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

sperm No / oocytes No / embryos No

Due to amendments to the Human Fertilisation and Embryology Act – the law overseeing the use of fertility treatment in the UK – donor conceived people born after 1 April 2005 can request identifying information about their donor from the HFEA once they reach 18 years old. This, however, means that there are different information access rights depending on when the donor conceived person was conceived. These are set out below.

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

The HFE Act 1990 (as amended) allows donor conceived people to apply for non- identifying information about the donor, if available, such as family medical history, hair/eye colour and interests, when they reach 16. If they were conceived after 1 April 2005, when the donor conceived person reaches 18 years old, they may apply to the HFEA to receive identifying information about their donor.

Parents of children conceived through donor conception can access non identifying information about the donor from the HFEA.

Section 34 of the HFE Act 1990 permits the Authority to make disclosure where it is necessary for the purposes of instituting proceedings under the Congenital Disabilities Act.

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

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

Whether patients’ own gametes are used in assisted fertility treatment or whether donor gametes are used, where the couple is either married or in a civil partnership, both parents will be the legal parents of any child born from the treatment from the date of birth of the child. The law endeavours to put couples who have had assisted fertility treatment in a similar position to couples who conceive naturally as regards legal parenthood and parental responsibility. It is however possible for the father or second parent (in the case of a female same sex couple who are in a civil partnership) to resist legal parenthood but only where the person can demonstrate that he or she did not consent to their partner’s treatment (see section 35(1) and section 42(1) of the HFE Act 2008).

When donor gametes are used in treatment, and where the couple having treatment is neither married nor in a civil partnership, the second parent (i.e. not the birth mother) can acquire legal parentage if the agreed parenthood conditions are met (see section 37 and 44 of the HFE Act 2008). In cases where the agreed parenthood conditions are not met, parenthood will be in question and in order to establish legal parenthood, the couple would need to seek a declaration of parenthood from Court.

Further information on legal parenthood can be found on these pages of the HFEA website:

https://www.hfea.gov.uk/treatments/explore-all-treatments/becoming-the-legal-parents-of-your-child/

Definitions of mother and father in accordance to (HFE) Act 2008 are as follows:

Meaning of "mother"

(1) The woman who is carrying or has carried a child as a result of the placing in her of an embryo or of sperm and eggs, and no other woman, is to be treated as the mother of the child.

(2) Subsection (1) does not apply to any child to the extent that the child is treated by virtue of adoption as not being the woman’s child.

(3) Subsection (1) applies whether the woman was in the United Kingdom or elsewhere at the time of the placing in her of the embryo or the sperm and eggs.

Meaning of "father"

35 Women married at time of treatment

(1) If -

(a) at the time of the placing in her of the embryo or of the sperm and eggs or of her artificial insemination, the woman was a party to a marriage, and

(b) the creation of the embryo carried by her was not brought about with the sperm of the other party to the marriage, then, subject to section 38(2) to (4), the other party to the marriage is to be treated as the father of the child unless it is shown that he did not consent to the placing in her of the embryo or the sperm and eggs or to her artificial insemination (as the case may be).

(2) This section applies whether the woman was in the United Kingdom or elsewhere at the time mentioned in subsection (1)(a)

19. Is there an important current debate in your country on these or related issues? As referred to at 18 above, in cases where the agreed parenthood conditions of the HFE Act 2008 have not been met, legal parenthood does not automatically follow for the second parent. In such cases one of the only remedies for the second parent to seek a declaration of legal parenthood from the Court. See for example the recent case (Neutral Citation Number: [2015] EWHC 2602 (Fam) which can be found here: https://www.judiciary.gov.uk/wp-content/uploads/2015/09/parentage.pdf

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

R (TT) v Registrar General for England and Wales & Ors ((2019) EWHC 2384 (Fam))

The case concerns a transgender man (TT) who has a gender recognition certificate (GRC) confirming that he is male for all legal purposes except the limited exceptions set out in the Gender Recognition Act 2004 (GRA).  TT had artificial insemination using donor sperm in a licenced fertility clinic, fell pregnant as a result, gave birth to a child, in 2017.  He tried to register the birth as the father but was refused by the Registrar General (RG) who was only able to register the birth with TT as the mother.  The birth has remained unregistered.

The judgement was handed down on 25 September 2019. The judge supported the Government’s position that a person who gives birth to a child (i.e. including a trans man such as TT) will be the child’s mother. The Government’s view is that the judgment has no effect on the availability of regulated fertility treatment in the UK. The Government considers that regulated fertility treatment is currently, and will remain, equally available to all (trans) women and (trans) men under the Human Fertilisation and Embryology Acts.

3. Are MAP procedures covered by the social security system? Yes. Infertility is classified as a medical condition.

4. Are there specific criteria for such coverage? Yes. As public funding for medical services has to cover priorities within a set budget, there are conditions for access to National Health Service (NHS) funded treatment. The UK’s National Institute for Clinical Excellence (NICE) has provided guidance on access to NHS funded treatment which can be found on this page: https://www.nice.org.uk/guidance/cg156

5. Is the financial coverage limited to a number of MAP procedures? No. Although guidelines exist on access to NHS funded treatment for IVF and IUI, it is for local clinical commissioning groups (CCGs) or health boards to decide the appropriate health care services to fund for their communities. Patients who pay for their own treatment are not limited in the number of procedures they can have.

• 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.

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 HFEA permits UK licensed clinics to compensate egg donors up to the fixed amount of £750 per cycle of donation and up to £35 per clinic visit for sperm donors. Guidance is provided to clinics in the HFEA’s Code of practice (https://www.hfea.gov.uk/media/2793/2019-01-03-code-of-practice-9th-edition-v2.pdf) and HFEA General Directions (http://ifqtesting.blob.core.windows.net/umbraco-website/1547/2017-04-03-general-direction-0001-version-4-final.pdf).

The HFEA also permits benefits in kind, such as egg sharing. Egg sharing arrangements where a woman who needs IVF treatment agrees to share her eggs with another woman needing donated eggs, in return for free or reduced rate treatment. Again guidance is contained in the HFEA code of practice: https://www.hfea.gov.uk/media/2793/2019-01-03-code-of-practice-9th-edition-v2.pdf

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

a) The HFEA provides guidance to UK licensed clinics in its Code of Practice: https://www.hfea.gov.uk/media/2793/2019-01-03-code-of-practice-9th-edition-v2.pdf

Clinics should refer to the relevant professional body guidelines on age limits before accepting gametes for the treatment of others. Gametes for the treatment of others should not be taken from anyone under the age of 18. A donor must not be selected because they are known to have a particular gene, chromosome or mitochondrial abnormality that, if inherited by any child born as a result of the donation, may result in that child having or developing:

a) serious physical or mental disability

b) A serious illness

c) Any other serious medical condition

The use of gametes from donor known to have an abnormality as described above, should be subject to consideration of the welfare of any resulting child and should normally have approval from a clinical ethics committee.

9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes. Centres are not expected to match the ethnic background of the recipient to that of the donor. Where a prospective recipient is happy to accept a donor from a different ethnic background, the centre can offer treatment, subject to the normal welfare of the child assessment.

10. Are there special measures for the prevention of consanguinity? Yes. The HFEA maintains a register of all donors and patients who have had a child using donor gametes. Children born following donor conception who intend to enter into an intimate physical relationship can submit a joint application to the HFEA to establish whether they are genetically related. Also, anyone who intends to marry, or enter into a civil partnership may submit a joint application to establish whether they are genetically related. A single donor can contribute to a maximum of 10 families. After this limit is reached the donor can no longer be used, one reason for this being to reduce the risk of consanguinity.

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

The legal provisions on who can be a child’s legal parent and what conditions must be met is set out in the HFEA Act.

Where a woman in a civil partnership is seeking treatment using donor sperm, or embryos created using donor sperm, the woman’s civil partner will be treated as the legal parent of any resulting child unless, at the time of placing the embryo or sperm and eggs in the woman, or of her insemination:

a) A separation order was in force, or

b) It is shown that the civil partner did not consent to the placing in her of the sperm and eggs, or embryos, or to the insemination

Where a woman is being treatment together with a female partner (not a civil partner) using donor sperm, or embryos created with donor sperm, the female partner will be the other legal parent of any resulting child if, at the time the eggs and sperm, or embryos, are placed in the woman or she is inseminated, all the following conditions apply:

a) Both the woman and her female partner have given a written, signed notice (subject to the exemption for illness, injury or physical disability) to the centre consenting to the female partner being treated as the parent of any resulting child

b) Neither consent was withdrawn (or superseded with a subsequent written note) before insemination/transfer, and

c) The patient and the female partner are not close relatives (within prohibited degrees of relationship to each other as defined in section 58(2), part 2, HFE Act 2008)