Access to medically assisted procreation - Search
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Ireland
3. Are MAP procedures covered by the social security system? No. Although in vitro fertilisation (IVF) treatment is not provided by the Irish public health service, there is some support available in that patients who access IVF treatment privately may claim tax relief on the costs involved under the tax relief for medical expenses scheme. In addition, a defined list of fertility medicines needed for fertility treatment is covered under the High Tech Scheme administered by the Health Service Executive (HSE). Medicines covered by the High Tech Scheme must be prescribed by a consultant/specialist and approved by HSE ‘High Tech Liaison Officers’. The cost of the medicines is then covered, as appropriate, under the Medical Card or Drugs Payment Scheme.
4. Are there specific criteria for such coverage? Assisted human reproduction is provided for in the private sector and at present there are no standard limits relating to age or infertility. However, most providers of assisted human reproduction services adhere to the guidelines produced by the Irish Fertility Society.
5. Is the financial coverage limited to a number of MAP procedures? No
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?
b. Risk of transmission of a disease
For a heterosexual couple?; For women not living in a heterosexual couple?
c. Other
As previously mentioned, it is proposed that legislation will permit assisted human reproduction services to be available to people irrespective of gender, marital status or sexual orientation. However, in the interests of any child to be born as a result of assisted human reproduction (or any existing children in families wishing to avail of assisted human reproduction), the legislation will provide for child welfare assessments which will afford a way of assessing whether intending parents are suitable for assisted human reproduction treatment. The purpose of these assessments will be used to assess intending parents’ age, health and ability to provide a stable and healthy environment for a child/children.
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.
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.
19. Is there an important current debate in your country on these or related issues? Yes. Legislation pertaining to assisted human reproduction (AHR) is currently being developed. The draft General Scheme of legislative provisions has been completed and submitted to the relevant parliamentary committee which published the report of its review in July 2019, making recommendations which include proposals related to both broad policy objectives and more technical amendments. Its recommendations are being considered during the ongoing process of drafting this the AHR Bill. Until the enactment of the Children and Family Relationships Act 2015, the provision on assisted human reproduction treatment was largely unregulated. There has been and will continue to be widespread stakeholder engagement and national debate on these sensitive and complex matters.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law.
Roche -v- Roche & ors (2009)
Supreme Court unanimously dismissed an appeal by a separated mother requesting to have three frozen embryos implanted in her womb against the wishes of her estranged husband.
The appeal was brought on the following grounds:
Judgment
Legally Enforceable Agreement:
During their treatment the parties signed four consent forms as required by the clinic. As consent forms, they were found not to contain the necessary criteria for legal contracts.
None of the consent forms dealt with the three surplus frozen embryos, therefore, there was no evidence that the respondent gave his consent to their implantation.
Constitutional Protection:
Article 40.3.3 of the Irish Constitution protects the right to life of the unborn “with due regard to the equal right to life of the mother”. The Court interpreted this provision as meaning there must be a physical link between the unborn and the mother i.e. implantation in the womb.
The Court decided that the purpose of the 8th Amendment to the Constitution (1983 Referendum) was to prevent the de-criminalisation of abortion and that issues relating to IVF were not considered or foreseen.
A number of the Judgments stated that if respect for an embryo were carried to the point of equating it to the “unborn” a situation might arise where some methods of contraception e.g. morning after pill would be outlawed.
High Court Ruling: http://www.courts.ie/Judgments.nsf/bce24a8184816f1580256ef30048ca50/e5617d292b7b6b268025724800329992?OpenDocument
Supreme Court Ruling: http://www.courts.ie/Judgments.nsf/0/0973CBD1FD5204028025768D003D60F7
MR and Anor – v- An tArd Chlaraitheoir & Ors [2014]
This case concerned an arrangement whereby a woman agreed to act as a surrogate for her sister and brother-in-law (the commissioning couple). The commissioning couple provided the genetic material (egg and sperm), which ultimately resulted in the birth of twins. The commissioning couple sought to have the birth register altered so that both the commissioning couple were registered as the legal parents. The Registrar refused to do so, on the principle that he woman who has given birth to a child is always regarded as the legal mother. That refusal was challenged in the High Court.
In his judgment of 5th March 2013, Judge Abbott found in favour of the commissioning couple. He held that the genetic mother, and not the birth mother, was the mother, and that the person with the genetic/blood link was entitled to be registered as the parent on the birth certificate.
In February 2014, the State appealed Judge Abbott’s decision on the grounds that: it could create uncertainty regarding the parentage and parental rights of children born as a result of egg donation; demean the role of birth mother; lead to an opinion that commercial surrogacy is not unlawful; and result in the Registrar requiring genetic proof of maternity for every birth.
In November 2014 the Supreme Court overturned the High Court decision on the basis that the case had raised important, complex and social issues which are best addressed by the Oireachtas rather than the judiciary.
High Court Ruling: http://www.courts.ie/Judgments.nsf/bce24a8184816f1580256ef30048ca50/e3f0dc917872554c80257b250052dab3?OpenDocument
Supreme Court Ruling: http://www.courts.ie/Judgments.nsf/0/E238E39A6E756AB480257D890054DCB6
Children and Family Relationships Act 2015 – Parts 2 and 3 deals with parentage matters arising from donor assisted human reproduction. It is available at http://www.irishstatutebook.ie/eli/2015/act/9/enacted/en/html
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes. Under the Children and Family Relationships Act 2015, gamete and embryo donation are permitted on a non-anonymous basis. In addition, this legislation provides for the establishment of a National Donor-Conceived Person Register, which will allow donor-conceived children to access certain information regarding the gamete/embryo donor involved in procedures leading to their conception. It is intended that the proposed legislation pertaining to assisted human reproduction will deal with the broader issues relating to donor conception (e.g. age limits, screening, storage periods, the avoidance of consanguinity and donation for research purposes).
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? Yes. Under the Children and Family Relationships Act 2015, commercial gamete and embryo donation is prohibited. Gamete and Embryo donation may only operate on an altruistic basis and the reimbursement of reasonable expenses incurred as part of the donation process will be permitted. Reasonable expenses, for the purposes of the Act means: travel costs, medical expenses and any legal or counselling costs incurred by the donor.
8. Are there specific criteria for donation of sperm/oocytes/embryos? Yes. The Children and Family Relationships Act 2015, sets out a number of criteria in relation to the consent of gamete/embryo donors. For instance, a donor must be over 18 and must give consent in writing, having confirmed that s/he has been informed that s/he will not be the parent of a child born through the donation. The consent must be witnessed. The donor must agree, when consenting, to the inclusion of information about him/her on the National Donor-Conceived Person Register. The consent must also indicate that the donor understands that a donor-conceived child may seek to contact her/him. Assisted human reproduction clinics should be satisfied that where donated gametes/embryos are being imported from another jurisdiction, the consent process in the other jurisdiction is in line with the stipulations set out above. Under the proposed assisted human reproduction legislation, donors will undergo medical screening in accordance with requirements set out under SI No. 158/2006 European Communities (Quality and Safety of Human Tissues and Cells) Regulations 2006
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? No
10. Are there special measures for the prevention of consanguinity? Ireland has a relatively small population size, which could increase the risks of inadvertent consanguinity between individuals conceived using gametes from the same donor. It is proposed that the assisted human reproduction legislation will place a maximum limit of four families to which gametes/embryos from the same donor can be donated.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? Yes.
Under the Children and Family Relationships Act 2015, the parents of a donor-conceived child who is born as a result of a donor assisted human reproduction procedure are
(a) the mother, and
(b) the husband, civil partner or cohabitant, as the case may be, of the mother.
The Act of 2015 does not encompass surrogacy.
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples?
b. possible for women not living in a heterosexual couple?
Based on the principles of equality and non-discrimination, it is proposed that the legislation will provide that assisted human reproduction services should be available to people irrespective of their gender, marital status or sexual orientation subject to consideration of the welfare of any future children.