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
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
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.
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.
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
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
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
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
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.
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
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
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
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
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.
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
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.
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
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
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.
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.
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
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
MEDICAL ASPECTS
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? No; For women not living in a heterosexual couple? NA
b. Risk of transmission of a disease
For a heterosexual couple? No; For women not living in a heterosexual couple? NA
There are no restrictions in the access to medically assisted procreation neither to heterosexual couples nor to single women
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? Yes; For women not living in a heterosexual couple? 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
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
3. Are MAP procedures covered by the social security system? No. Due to the small budget for social security.
4. Are there specific criteria for such coverage? No
5. Is the financial coverage limited to a number of MAP procedures? No
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 No; ii. For the parents No; iii. For a court Yes
a. Identity of the donor(s)
i. For the child him or herself NA; ii. For the parents NA; iii. For a court Yes
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 Yes
c. Other information
i. For the child him or herself No; ii. For the parents No; iii. For a court Yes
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? Yes
Title of the law:
Date of adoption and entry into force: Embryos Act: 20 June 2002 - Act on special medical operations 24 October 1997.
Published in: Staatsblad van het Koninkrijk der Nederlanden
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes. It is possible to make cryoembryo transfer.
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No
8. Are there specific criteria for donation of sperm/oocytes/embryos? No. All donors investigated for TORCH (toxoplasmosis, syphilis, rubeola, cytomegalovirus (CMV), herpes simplex virus (HSV)) infection, genetical and medical tests.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes. We take into account phonotypical characteristics of donors and recipient.
10. Are there special measures for the prevention of consanguinity? Yes. Very strict measures.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No
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. Basic principle is to have no difference in access for single or lesbian women. However, some IVF-centers apply a stricter selecting policy then others.
Are MAP procedures covered by the social secutiry system?
Yes. The patient is not liable for the costs arising from all the laboratory work entailed in IVF/ICSI insemination of eggs if she is not more than 43 years old, with a maximum of 6 attempts per woman (Royal Decree of 25 April 2002 concerning the setting and liquidation of the budget for the financial resources of hospitals, Art. 74bis ). The logic behind this rule is that after the age of 43, MAP has very little chance of success.
Since 2008 (Royal Decree of 6 October 2008 introducing a flat-rate reimbursement for female infertility treatments), sickness and invalidity insurance has also provided a flat-rate reimbursement for pharmaceutical specialities prescribed by a gynaecologist and delivered in a hospital, which are used in the context of intra-uterine insemination or ovarian stimulation. The woman must be not more than 43 years old, however, and reimbursement is available for a maximum of 6 cycles/completed treatments per woman. Patients have to pay a share of the cost.
As regards other services in connection with MAP, these are partially covered by sickness and invalidity insurance (e.g. embryo implantation after in vitro fertilisation): the patient has to pay a share of the costs.
Are there specific criteria for such coverage?
Yes. Age of the woman = 42 maximum because very little chance of success after that.
Is the financial coverage limited to a number of MAP procedures?
Maximum of 6 attempts
The issue of surrogate mothers regularly crops up in Parliament. A number of proposals have been made, some of which deal only with surrogacy in the context of MAP.
The issues of surrogate mothers (absence of specific legislation) & donor anonymity (provided for in the 2007 Act on medically assisted procreation and Destination of Supernumerary Embryos and Gametes) are subject to ongoing debate within society (especially the issue of donor anonymity) and are regularly reported upon by the media. Also the issue of donor anonymity is subject of law proposals of political parties.
19. Is there an important current debate in your country on these or related issues?
The main principles introduced by the first bioethics law of 1994 have been confirmed by subsequent laws.
Bioethical issues are the subject of ongoing societal debates (notably via the Estates General on Bioethics) and are regularly covered by the media. We can mention the opening of MAP to couples of women and unmarried women (achieved by the aforementioned law n°2021-1017 of 2 August 2021), post-mortem MAP, and surrogate motherhood.
The ban on the latter two techniques has been maintained.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law.
Public health code
Articles L. 1244-1 to L. 1244-9
Articles L. 2141-1 to L. 2143-9
Civil code
Article 16-7
Criminal code
Articles 511-6, 511-9 to 511-13 and 511-22 to 511-25-1
3. Are MAP procedures covered by the social security system? No. Due to the general difficult economic conditions in Georgia, the Health and Social Security System is not able to cover such high technology procedures as MAP.
4. Are there specific criteria for such coverage? NA
5. Is the financial coverage limited to a number of MAP procedures? NA. The same reasons as question 3 connected with economic situation in the country.
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 - No; ii. For the parents - No; iii. For a court - Yes
a. Identity of the donor(s)
i. For the child him or herself - No; 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 - 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 conditions? No
19. Is there an important current debate in your country on these or related issues? Yes. There was a great discussion in Saeima about surrogate motherhood. A conclusion has not yet been reached.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. NA
2. Are there specific criteria for access to MAP?
a. Infertility
i. for a heterosexual couple? Yes. Access to MAP have heterosexual couples
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. Access to MAP for single women when there is a risk of transmission of severe hereditary disease
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
16. Is donation of sperm/oocytes /embryos anonymous? sperm No/oocytes - /embryos No
With regard to the question of whether sperm donations for MAP purposes may remain anonymous, recourse is made to the ruling of the Federal Constitutional Court which states that the general right of personality (Article 2(1) in conjunction with Article 1(1) of the Basic Law [Grundgesetz – GG]) also applies to the child’s knowledge of his/her parentage and protects against the withholding of obtainable information about one’s parentage (consistent past decisions since the Federal Constitutional Court decision of 31 January 1989 – 1 BvL 17/87 - BVerfGE 79, 256). Therefore, the Sperm Donor Register Act provides that the physician who oversees the sperm donation must ensure that the child will later on be able to find out who his/her father is. Anonymising the sperm donation or the use of pooled sperm for artificial fertilisation is not permissible. According to the Model Guidelines of the German Medical Association on the performance of assisted reproduction, the physician must inform the sperm donor that he/she is required to disclose the name of the donor to the child on request and cannot, in this regard, invoke medical confidentiality.
In January 2015, the Federal Court of Justice (Judgment of 28 January 2015 – XII ZR 201/13, BGHZ 204, 54) ruled that children have the right to ask the treating reproductive health physician or sperm bank to disclose the name of the sperm donor from the medical treatment agreement between the parents and the clinic.
These principles were implemented in the Sperm Donor Register Act.
The same rules apply for the donation of embryos, as far as permitted under the Health Law. The coalition agreement provides for the opportunity to submit information about embryo donations to the Sperm Donor Register, this is subject to ongoing legislation.
Regarding oocytes, German Law does not permit any oocyte donation. Therefore, there is no rule in place to identify the genetic mother of a child born by another woman. Section 1591 of the Civil Code determines legal motherhood in terms of gestation only, the woman who gestates is the mother of the child. Whether a court can require a mother to inform the child about his or her genetic mother has not been tested yet in jurisprudence.
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
Pursuant to Section 10(1) of the Sperm Donor Register Act a person who assumes to have been conceived through sperm donation has the right to information from the sperm donor register (limited to the child seeking information or his or her parents as legal representatives of the child underage).
a. Identity of the donor(s)
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No
See response to question 17.
Unlike the child, the legal parents are not entitled to learn the identity of the sperm donor. Pursuant to the data protection provisions under the Transplantation Act, the sperm donor and the legal parents are to remain anonymous to one another.
In case of litigation, courts have to decide on the above-mentioned rights; however, the courts themselves are not intrinsically entitled to request information about the parentage of a child.
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
Pursuant to Section 2(3) of the Sperm Donor Register Act voluntary information about the sperm donor can be recorded in the sperm donor register. Unless the Donor withdraws his consent to store and use this data, the child is entitled to receive respective information upon request.
c. Other information
i. For the child him or herself No; ii. For the parents No; iii. For a court No
See response to question 17b.
In case of litigation, courts have to decide on the above-mentioned rights; however, the courts themselves are not intrinsically entitled to request information about the parentage of a child.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions?
German law does not provide for maternity to be challenged. A child’s mother is – also where MAP has been used – the woman who has given birth to him/her (Section 1591 of the Civil Code). In rare cases the woman registered as the mother is in fact not the biological mother of the child; in those cases, however, the correction of the birth register (to replace this woman by the woman who has borne this child) is carried out by the civil status authority outside a contestation proceeding.
In contrast, it is in principle possible to challenge the paternity of children born as a result of assisted reproduction (Sections 1599 et seqq. of the Civil Code). The persons entitled to do so are the legal father, the man who declares in lieu of an oath that he had sexual intercourse with the mother of the child during the period of conception, the mother and the child (Section 1600 (1) of the Civil Code). However, any challenge to paternity by the father and the mother is excluded if they have both agreed to the artificial fertilisation (Section 1600(4) of the Civil Code). A challenge to paternity by the sperm donor fails because he cannot affirm on oath that he has had sexual intercourse with the mother. The child, however, is entitled to challenge paternity if donor-assisted MAP has taken place.
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes. Both, the Law on Health Care and draft Law on Reproductive Health and Reproductive Rights in principle permit donation of gametes and embryo.
However, the Law on Health Care does not include specific provisions on this issue. It includes only a general provision saying donor’s gamete(s) or embryo could be used for MAP.
The draft Law on Reproductive Health and Reproductive Rights is more specific. It includes a separate chapter on gamete donation, which defines conditions and procedures for gamete donation.
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No. LHC: No; DL-RHRR: No; According to the article 20 of DR-RHRR “there is no reimbursement for gamete donation. A donor shall be reimbursed for time spent and other expenses incurred by donorship” (e.g. time, transport, absence from office, etc.).
8. Are there specific criteria for donation of sperm/oocytes/embryos?
LHC: No DL-RHRR: Yes
DL-RHRR:
A gamete donor must be a legally competent man or woman above 18 years of age, who has none of the diseases defined by law.
The fusion of the sperm or ovum of genetic relatives for medically assisted reproductive technologies is prohibited.
The gamete can be retrieved from a deceased male person, only if he has given an advanced directive for taking his gametes after his death for homological artificial insemination, or for in vitro fertilization of the ovum of his spouse, married under the rules defined by the legislation of Georgia. On the other hand, taking ovum or an ovary from a deceased woman for the implementation of medically assisted reproductive technologies is prohibited.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP?
LHC: No
DL-RHRR: Yes
According to the draft Law on Reproductive Health and Reproductive Rights a couple or a single woman have the right to choose a donor on the basis of the donor’s age, appearance, ethnic background, and health condition. However, information on the identity of a sperm donor is confidential.
10. Are there special measures for the prevention of consanguinity?
LHC: No
DL-RHRR: Yes
The following two principles are introduced in the draft law (DL-RHRR) to avoid consanguinity:
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? Yes; For women not living in a heterosexual couple? Yes
b. Risk of transmission of a disease
For a heterosexual couple? Yes; For women not living in a heterosexual couple? Yes
On the basis of Section 3a(2) of the Embryo Protection Act a pre-implantation genetic diagnosis is exceptionally permitted where the genetic predisposition of the woman from whom the egg cell was collected, or that of the man producing the sperm cell, or both, suggest that their offspring will be highly likely to have a serious genetic illness or to identify an abnormality that would be highly likely to lead to still-birth or miscarriage. With regard to the further requirements for a pre-implantation genetic diagnosis, reference is made to Section 3a(2) and (3) of the Embryo Protection Act. The execution of the MAP, in these cases, depends on the result of the pre-implantation genetic diagnosis.
c. Other
Pursuant to Section 6(2) of the Tissues and Cells Regulation of the Transplantation Act, the use of sperm cells for heterologous fertilisation, as a medically assisted procreation technique requires that the sperm donor is medically assessed as suitable for sperm donation, regarding his age, state of health and medical history and that the use of the donated sperm will not pose any health risks to others. Sperm donors are selected according to the criteria and laboratory tests laid down in Annex 4 Numbers 2 und 3 of the Tissues and Cells Regulation of the Transplantation Act. Annex 4 has implemented the selection criteria and laboratory tests for donors of reproductive cells laid down in Annex III of the Directive 2006/17/EC of 8 February 2006 as regards certain technical requirements for the donation, procurement and testing of human tissues and cells in national law. For this purpose, in particular, the donors’ serum or plasma samples must be tested and found negative for HIV 1 and 2, HCV, HBV and syphilis. Furthermore, urine samples of sperm donors must be tested and found negative for chlamydia by the nucleic acid amplification technique (NAT).
Additional aspects are set out in the Guidelines of the German Medical Association, paragraph 2.7.
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. Lesbian couples have had access to MAP since 2009. Single women who live alone have access to MAP since 2021.
16. Is donation of sperm/oocytes/embryos anonymous?
sperm Yes / oocytes Yes / embryos Yes. Most of Portuguese bioethicists – including the Portuguese National Bioethical Council – have defended that anonymous donation should finish, as in the UK, in order to protect the child rights to identity, information and health
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
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 NA
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? NA
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes. Sperm and oocyte donation are anonymous
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? Yes
8. Are there specific criteria for donation of sperm/oocytes/embryos? No
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes. Matching appearance of donor and future parent(s)
10. Are there special measures for the prevention of consanguinity? Yes. Limited number of donations
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? Yes. Homosexual marriage, adoption and co adoption are legal in Portugal
1. Is access to medically assisted procreation (MAP) NA. See comments on legal instruments.
a. restricted to heterosexual couples?
b. possible for women not living in a heterosexual couple?
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No
8. Are there specific criteria for donation of sperm/oocytes/embryos? Yes.
For sperm donation – health, state.
For oocytes donation and for embryos donation – parents, age.
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. Limited number of donations
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No
3. Are MAP procedures covered by the social security system? Yes. Infertility is considered as a disease.
4. Are there specific criteria for such coverage? Yes
5. Is the financial coverage limited to a number of MAP procedures? Yes. Only two.
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
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes. Double gamete donation has been permitted since 2 August 2021.
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No. As stated in the Public Health Code, no payment, whatever its form, may be granted to the person who lend themselves to the removal of elements of their body or to the collection of their products. The full costs associated with removal or collection are nevertheless covered by the health care institution responsible for carrying it out. Oocyte donors benefit from an exemption from co-payment for 6 months for all care and treatment related to the donation.
8. Are there specific criteria for donation of sperm/oocytes/embryos? Yes.
Donor recruitment takes account of age, general state of health, personal and family history, results of health tests, and findings from sperm characteristics or gynaecological examination (in particular assessment of ovarian function).
A psychological interview is held.
A full and documented study of the genealogical tree of the gamete donor is made in order to identify risk factors for transmission of a genetic anomaly to the child. Any suspected anomaly is an indication to complete the work-up. A karyotype is performed.
The age limits set by the decree on good practices in MAP are 18 to 45 years for male donors and 18 to 37 years for female donors.
Since the law n°2021-1017 of 2 August 2021 on bioethics, the donor must expressly consent in advance to the communication of his non-identifying data (age, general state, physical characteristics, family and professional situation, country of birth, motivation for the donation) and his identity to the person resulting from his donation (at the latter's request). In the event of refusal, those wishing to donate cannot proceed with the donation.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes. Matching on phenotypic criteria (physical characteristics, blood type) between the recipient couple and the donor(s) is possible. It is optional and offered to applicants.
10. Are there special measures for the prevention of consanguinity? Yes. A maximum of ten children may be born from the use of gametes originating from the same donor. This control is exercised by the Agence de la biomédecine.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? Yes.
Since the law n°2021-1017 of 2 August 2021 relating to bioethics, in the context of a MAP with a third-party donor, filiation with regard to the partner of the woman who gave birth to the child may be established by means of an anticipated joint acknowledgement (for MAPs carried out after the law came into force) or by a joint acknowledgement (transitional arrangement applicable to couples of women who had recourse to MAP abroad before the publication of the said law). These joint acknowledgements are made before a notary. The partner of the legal parent may also adopt (simple or full adoption) the child of his/her spouse, partner linked by a civil solidarity pact or cohabitant. Law No 2022-219 of 21 February 2022 aimed at reforming adoption has opened up adoption to unmarried couples. - The couple must, in this context, be married. However, a bill currently being discussed in Parliament intends to open adoption to all couples, even unmarried ones.