Access to medically assisted procreation - Search
Poland - Medical aspects
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? Yes; For women not living in a heterosexual couple? NA
b. Risk of transmission of a disease
For a heterosexual couple Yes?; For women not living in a heterosexual couple? NA
c. Other N/A
Poland - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? Yes
b. possible for women not living in a heterosexual couple? No.
There is no specific legislation on the subject. In practice only heterosexual couples are concerned.
Serbia - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous?
sperm Yes / oocytes Yes / embryos Yes
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court Yes
a. Identity of the donor(s)
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court Yes
b. Certain health information concerning the donor(s)
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court Yes
c. Other information
i. For the child him or herself 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? NA
United Kingdom - Financial aspects
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.
Serbia - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues?
We have for many years very vivid discussions about surrogacy in whole media and public debates.
The case of women (newspapers and TV): after accidental death of her partner the medical and law authorities didn’t allow her to use their freeze embryos for MAP. The case is on the Court.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. NA
Serbia - Medical aspects
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? Yes; For women not living in a heterosexual couple? Yes
b. Risk of transmission of a disease
For a heterosexual couple Yes?; For women not living in a heterosexual couple? Yes
c. Other N/A
Latvia - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No
8. Are there specific criteria for donation of sperm/oocytes/embryos? Yes.
For sperm age limit 18-45.
For oocytes 18-35.
If checking on sexually transmitted disease STD, Hepatitis B, C are positive.
If General health are not in good condition.
If in anamnesis have genetic diseases.
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. No more than three children can be born from one donor, furthermore, special means are taken if the children born from donor have genetically hereditary disease.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No
Latvia - Legal regulation or practice and access to MAP
Title of the law “Law on reproductive and sexual Health”
Date of adoption 31 January 2002 and entry into force 01 July 2002
Published in 19 February 2002
San Marino - Sperm/oocyte/embryo donation
16. Is donation of sperm/oocytes/embryos anonymous? Na
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself ; ii. For the parents; iii. For a court NA
a. Identity of the donor(s)
i. For the child him or herself ; ii. For the parents; iii. For a court NA
b. Certain health information concerning the donor(s)
i. For the child him or herself ; ii. For the parents; iii. For a court NA
c. Other information
i. For the child him or herself ; ii. For the parents; iii. For a court NA
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? NA
San Marino - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? See comment on relevant legal instruments
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? 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 the prevention of consanguinity? NA
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? NA
Ukraine - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? It is necessary to renew Decree of the Ministry of Health.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. NA
Ukraine - Financial aspects
3. Are MAP procedures covered by the social security system? No. First step is made to cover one cycle in case of bilateral tubectomy.
4. Are there specific criteria for such coverage? Yes.
- Only tubal factor of infertility.
- Age up 35 years.
5. Is the financial coverage limited to a number of MAP procedures? Yes. Only one IVF procedure.
Pays-Bas - Medical aspects
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? Yes; For women not living in a heterosexual couple? Yes
b. Risk of transmission of a disease
For a heterosexual couple Yes?; For women not living in a heterosexual couple? Yes
c. Other Yes
There is a screening on sexually transmitted diseases.
Slovenia - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. Indeed, infertility is considered a medical condition of the couple.
4. Are there specific criteria for such coverage? Yes. The criteria are the same as those entitling the couple to MAP. These include infertility not treatable in other ways, age appropriate for pregnancy (the upper age limit for the woman is 43 years) and parenthood, the need to avoid transmission of a serious genetic disorder.
5. Is the financial coverage limited to a number of MAP procedures? Yes. Up to four IVF procedures are covered. The rate of pregnancies achieved is among the highest in Europe, in spite of the fact that since 1999, a maximum of two embryos is transferred in a single MAP procedure.
Slovenia - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? Yes. Art. 5: MAP is available to heterosexual couples living in marriage or in extra-marital relationship, which must exist at the time the procedure is performed.
b. possible for women not living in a heterosexual couple? No
Slovenia - Medical aspects
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? Yes; For women not living in a heterosexual couple? N/A
b. Risk of transmission of a disease
For a heterosexual couple Yes?; For women not living in a heterosexual couple? N/A
Risk of transmission of serious genetically determined disease (Art. 5).
c. Other N/A
Malta - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes.
Regarding ‘embryos’ this is when the couple do not use the remaining frozen embryos; government can then take custody through the Authority set up by the Embryo protection Act and give them up for adoption.
Donation of gametes is only possible by a ‘confidential agreement between the donor and the licensee:’
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.
No age limit stated
The Embryo Protection authority ensure high standards. In the case of adoption of embryos a medical practitioner must declare the prospective parent physically fit.
See also 6 above.
Donation of embryos remains confidential and anonymity of the biological parents is entrenched into the law. Besides, all parental and filial rights are relinquished. That is to say, for example, the donated embryo would have no right to inherit the biological parents who gave up the embryo. Conversely the former would have no right on the latter.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? No
10. Are there special measures for the prevention of consanguinity? Yes. There is an official register kept by the Authority. Article 4, Section 3 states that ‘the Authority shall make all reasonable efforts to match prospective adoptive parents with the embryos who require an adoption placement’.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? Yes
North Macedonia - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? No. There is no legal regulation in the country therefore no gamete banks aiming to this are functioning.
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No
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 the prevention of consanguinity? With the exception of the occasional donations for inseminations with fresh sperm which may be done outside of any control, other donor procedures have not been performed in the country.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No. No legal regulations.
North Macedonia - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? Some debates have just started in many professional organisations - obstetricians/gynaecologists.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law.
Current healthcare law predates the era of MAP. No updates concerning MAP have been made.
In family law there are standard articles addressing the contesting of the paternity but not in relation to MAP.
North Macedonia - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? Yes
b. possible for women not living in a heterosexual couple? No
Poland - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? NA
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law.
Homologous insemination in a married couple has no legal incidence: the mother’s spouse becomes the child’s biological father; the means of conception (natural or artificial) has no legal incidence, nor does consent or the lack of it.
Heterologous insemination, on the other hand, raises legal questions concerning filiation. The donor of the sperm is certainly the child’s biological father, but it is impossible to prove legal paternity as the identity of the donor is in principle unknown to the mother and the doctor is sworn to secrecy. Furthermore, no action to prove paternity may be opened in this case as Article 85 para. 1 of the Code of the Family and Guardianship makes sexual intercourse a prerequisite of such action.
The question of the legal paternity of the child thus remains open. In the case of an unmarried woman, action to prove paternity should be excluded, as the donor has the right to remain anonymous. However, if the child is born in wedlock or within 300 days of the marriage being dissolved or annulled, the mother’s husband is presumed to be the legal father. He may take action to contest his paternity within six months of finding out about the birth (art. 63). This is a peremptory time limit, after which only the public prosecutor may institute such proceedings.
The situation is more complex in the event of heterologous insemination carried out with the husband’s consent. As there are no specific legal provisions in the matter, the husband has the right to contest his paternity even though he did give his consent. Theoretically he only needs to prove that the birth was the result of MAP. However, according to a decision of the Court of Cassation on 27 October 1983: “Action by the spouse of the mother contesting paternity of a child born following MAP performed, with said spouse’s consent, with the sperm of another man may be considered contrary to public policy.” In stating its reasons, the Court stressed the importance of the child’s welfare, arguing that if it were to accept an action contesting the father’s paternity of a child born following MAP carried out with his consent using another man’s sperm, the child would, to all intents and purposes, be fatherless; it would be virtually impossible to prove the paternity of the donor because of the rules protecting his anonymity. And the donor has no interest in proving his paternity. This interpretation also takes into account the interests of the family formed subsequent to the couple’s decision to have recourse to MAP.
San Marino - Financial aspects
3. Are MAP procedures covered by the social security system? Infertility is followed free of charge, the healthcare system covering 2 pharmacological treatment cycles and the pre and post implantation. The gametes extraction techniques, fertilisation, implantation and embryo storage at Italian specialised structures are the responsibility of the couple as well as any subsequent treatment cycles to the two provided free of charge.
4. Are there specific criteria for such coverage? No. See comments on relative legal instruments.
5. Is the financial coverage limited to a number of MAP procedures? Yes. See comment to question 3.
Portugal - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? No
b. possible for women not living in a heterosexual couple? Yes
Any women – even being single and without any sexual relationship, and without infertility can go to a specific ART centre and ask for artificial insemination
Poland - Financial aspects
3. Are MAP procedures covered by the social security system? No
4. Are there specific criteria for such coverage? NA
5. Is the financial coverage limited to a number of MAP procedures? Na
Serbia - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? Yes
b. possible for women not living in a heterosexual couple? Yes
United Kingdom - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous?
sperm No / oocytes No / embryos No
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)
United Kingdom - Current debate and specific situations
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.
Bosnia and Herzegovina - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous?
NA
17. Is it possible to obtain information about the biological origin of a child born after gametes or embryo donation?
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?
NA
Azerbaijan - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? NA
20. Particular cases encountered in your country, and especially your case-law, in relation to the questions appearing in Sections I and II above
The law on reproductive health is being elaborated. Many aspects of MAP were included during discussions on the draft law.
Greece - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? Yes.
The law adopts the principle of anonymity regarding any donation, therefore, the identity of the donor cannot be revealed under any circumstances.
According to Art 8, para 6 of the new law, medical information that concerns the donor are kept in an anonymous codified form in the Cryopreservation Bank and in the National Registry of Donors and Receivers.
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court Yes
The child and his legal representative may have access only to medical data which are kept in secrecy and in a codified form in Cryopreservation Banks.
Law 2472/1997 on the “Protection of individuals with regard to the processing of personal data” qualifies health data as “sensitive” kind of information and stipulates special permission of the Data Protection Authority (Article 7).
According to Art 20, para 3 of Law 3305, access to the National Registry of Donors and Receivers is permitted only to the child and for reasons related to his health, with the permission of the Data Protection Authority and as long as the conditions of Law 2472/1997 regarding protection of personal data are fulfilled. The parents may have access to information only when they act as representatives of the child. The Court may order access.
a. Identity of the donor(s)
i. For the child him or herself No; ii. For the parents No; iii. For a court No
The law adopts the principle of anonymity regarding any donation, therefore, the identity of the donor cannot be revealed under any circumstances. The child and his legal representative may have access only to medical data which are kept in secrecy and in a codified form in Cryopreservation Banks.
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
The child or the parents (acting as representatives of the child) can have access to health information which are kept in secrecy and in a codified form in Cryopreservation Banks but not to the identity of the donor. The Court also may authorize access to health information.
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? Yes.
Contestation of maternity and paternity: contestation of paternity is not allowed when the father has provided consent at the beginning of the treatment.
Also, according to Law 3089/02, consent before a notary public of a man and a woman living in a free union takes place in order to guarantee their affiliation with the child to be born. As a result of that, contestation of the voluntary affiliation is forbidden.
In the case of surrogate motherhood, according to the law, the woman to whom the Court’s approval has been given is considered to be the legal mother of the child. Exceptionally, either the commissioning, or the surrogate mother, may contest this in Court, under conditions provided for by the law.
Greece - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? No process of revision is currently foreseen for this Law.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. NA
Austria - Right to know about their origin for children born after MAP
16. Is donation of sperm, oocytes and embryos anonymous?
No
17. Is it possible to obtain information about the biological origin of a child born after gametes or embryo donation? For the child? For the parents? For a court?
Yes
In particular: identity of the donors for the child, for the parents, for a court?
Yes
Certain health information concerning the donor(s), for the child, for the parents, for a court?
Yes, details in § 20 Law on Medical Assisted Procreation “Fortpflanzungsmedizingesetz”.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions (family law provisions)?
Yes, under Austrian law, the mother is the woman who gave birth to the child. The father is the husband of the mother, or the man who recognized paternity or whose fatherhood was imposed by the court. The donor of sperm/eggs is excluded by law from fatherhood/motherhood.
Regulations see § 144 and §145 Austrian Civil Code “Allgemeines Bürgerliches Gesetzbuch”
Finland - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? No
b. possible for women not living in a heterosexual couple? Yes
The national legislation is based on the concepts of a “couple” (that is, a woman and a man living together in marriage or in a relationship comparable to marriage or two women living together in marriage, registered partnership or in a relationship comparable to marriage) and a “person receiving treatment” (a couple or a woman not living in a marriage, registered partnership or a relationship comparable to marriage). The provisions in certain sections of the Act vary depending on whether the treatment is provided to a couple or to a single woman.
Clinics in the public sector have declined to provide MAP to female couples and single women, on the grounds that these services are provided only on the basis of medical indications. Female couples and single women have for this reason sought services from the private sector.
Denmark - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? No
Estonia - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? Yes
b. possible for women not living in a heterosexual couple? Yes
Italy - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? sperm Yes/oocytes Yes/embryos No
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 NA; ii. For the parents NA; 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 Yes; ii. For the parents Yes; iii. For a court NA
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. In the case of reproduction using a heterologous donor - even if prevented by law - the donor cannot disown the child (Art 9). The mother of the child after MAP cannot declare her wish not to be entered in the birth registers as provided for by dpr no 396 (2000).
Belgium - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? No
b. possible for women not living in a heterosexual couple? No
The 2007 Act makes no mention of such a restriction. Each centre is free to accept or refuse requests from homosexual couples.
Latvia - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? No
b. possible for women not living in a heterosexual couple? Yes
France - Legal regulation or practice and access to MAP
- Laws and regulations
Law n°2021-1017 of 2 August 2021 on bioethics
Order n°2008-480 of 22 May 2008 transposing Directive 2004/23/EC of the European Parliament and of the Council of 31 March 2004 on gamete donation and medically assisted procreation
Decree n° 2021-1243 of 28 September 2021 setting the conditions for the organisation and management of medically assisted procreation procedures
Decree n° 2021-1933 of 30 December 2021 setting the conditions for authorising gamete self-preservation activities for non-medical reasons in application of article L. 2141-12 of the public health code and carrying various adaptations to the regulatory part of the same code with regard to the provisions of law n° 2021-1017 of 2 August 2021 relating to bioethics
Date of adoption and entry into force
First bioethics laws adopted in 1994, last revision: Law No. 2011-814 of 7 July 2011, which entered into force on 9 July 2011
Ordinance No. 2008-480 of 22 May 2008, which entered into force on 24 May 2008.
French Bioethics Law n°2021-1017 of 2 August 2021 on bioethics, entered into force on 4 August 2021.
Adoption on 29 June by the National Assembly and promulgation on 2 August 2021
Staggered entry into force according to the implementing texts.
- Published in: Official Journal of the French Republic (Journal officiel de la République française https://www.legifrance.gouv.fr/jorf/id/JORFTEXT000043884384)
- Next revision: 2028 maximum, (review within a maximum of 7 years from the promulgation of the law of 2 August 2021)
Lithuania - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No
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? No
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
Belgium - Legal regulation or practice and access to MAP
Title of the law: Medically Assisted Procreation and Destination of Supernumerary Embryos and Gametes Act of 6 July 2007
Entry into force 27 July 2007
Published in: the Moniteur belge [Official Gazette] on 17 July 2007, p.38575
Articles 26 and 55, paragraph 2, of the Act, inserted by a law of 10 April 2014 and entered into force on 10 May 2014 provides that if the two authors of the parental project are two women, they are considered as a single woman, when counting the maximum of six women who can give birth to children from gametes or surplus embryos from one donor or donor couple.
Croatia - Legal regulation or practice and access to MAP
- Title of the law: Act on Medically Assisted Fertilisation
- Date of adoption and entry into force: Adopted on 18th July 2012.
- Entered into force: 4th August 2012.
- Published in: Official Gazette No 86 from 27th July 2012
- Indicate if process of revision is ongoing and, in your answers, provide information on provision in the draft law: Revision of the Act is planned for the last quarter of the 2016. Revision will be primarily focused on the technical aspects, i.e. harmonisation with acquis communautaire in this field (EU tissues and cells directives).
Denmark - Legal regulation or practice and access to MAP
- Title of the law: Act on medically assisted procreation in connection with medical treatment, diagnosis and research etc. (Loi no. 460/1997)
- Date of adoption and entry into force: 1 October 1997
- Published in Danish Law Journal
- Indicate if process of revision is ongoing and, in your answers, provide information on provision in the draft law: The law was last recently amended in January 2021.
Lithuania - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? Yes. Surrogacy is widely discussed in Lithuania
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. NA
Cyprus - Legal regulation or practice and access to MAP
- Title of the law: Not Applicable
Croatia - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? No. After reaching the age of 18 a person born from the MAP procedure is allowed to have access to data on identity of biological parent(s).
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
After reaching the age of 18, every person born from a MAP procedure is allowed to have access to data on identity of biological parent(s).
Parents do have a right to access the donor data in the case of medical indication.
Both, child and parents should require data access from the MAP Registry.
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 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 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. Contest is regulated within the Family Law. It is possible to contest maternity or paternity only in the cases when MAP procedure was performed without consent.
Cyprus - Financial aspects
3. Are MAP procedures covered by the social security system? No. The Ministry of Finance covers the cost of MAP procedures.
4. Are there specific criteria for such coverage? Yes. Specific criteria for such coverage are: (1) infertility (2) for women under 40 years old.
5. Is the financial coverage limited to a number of MAP procedures? Yes. The financial coverage is limited to only one (1) MAP procedure
Germany - Sperm/oocyte/embryo donation
6. Is donation of sperm Yes/oocytes No/embryos* permitted in your country? Yes.
*Embryo donation per se is not regulated by law. However, the Embryo Protection Act provides that an oocyte may only be artificially fertilised for the purpose of bringing about a pregnancy in the same woman from whom the oocyte has been obtained (Section 1(1) number 2 of the Embryo Protection Act) and that it is prohibited to remove an embryo from a woman before its nidation is completed, in order to transfer it to another woman (Section 1(1) number 6 Embryo Protection Act). In addition, the Embryo Protection Act incorporates provisions aimed to prevent the creation of supernumerary embryos in the course of artificial fertilisation (especially the ban on the artificial fertilisation of more oocytes than can be inserted into a woman within one cycle – Section 1(1) number 5 Embryo Protection Act). Consequently, permissible embryo donation is only conceivable in exceptional instances where an artificially created embryo can unexpectedly no longer be transferred to the woman from whom the oocyte originated.
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No
8. Are there specific criteria for donation of sperm Yes/oocytes/embryos?
Gametes may be used for medically assisted procreation only after full medical assessment and if their use is medically indicated and the protection of the recipient’s and the child’s health is guaranteed (Section 6(1) of the Tissues and Cells Regulation of the Transplantation Act). The use of sperm cells for heterologous fertilisation as a medically assisted procreation technique furthermore requires that the sperm donor is medically assessed as suitable for sperm donation with regard to his age, state of health and medical history and that the use of the donated sperm will not pose any health risks to others. The necessary donor information must be collected by questionnaire and by means of a subsequent personal interview with the donor by the physician.
An age limit exists for eligibility to cost coverage by the health insurance funds (see response to question 4).
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? No. As part of a voluntary commitment physicians, sperm banks and laboratories have limited the number of offspring from a sperm donation to 15 (Richtlinien des Arbeitskreises für Donogene Insemination zur Qualitätssicherung der Behandlung mit Spendersamen in Deutschland).
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? Yes.
German law includes the following provisions governing the legal relationship between the child and the spouse of the legal parent:
- Authority of the spouse/registered partner of a parent who has the sole parental care (decision-making authority) about the child to have a say in matters of daily life (so-called “small care” – Section 1687b(1) of the Civil Code, Section 9(1)of the Act on Registered Life Partnership). In case of imminent danger, the spouse/registered partner is also entitled to perform all acts necessary for the child's welfare (Section 1687b(2) of the Civil Code, Section 9(2) of the Act on Registered Life Partnership).
- Right of contact with the child, if a “family-like social relationship” has evolved between the parent’s spouse and the child (Section 1685(2) of the Civil Code),
- In case the child has been living in one household with one parent who dies or is no longer able to exercise parental care or whose parental care has been suspended, the court may deny the other parent’s request to give the child to him or her and order that the child should stay with the spouse/registered partner of the first parent (ex officio or by request of that spouse), provided the child has been living in that household for a longer time (Section 1682 sentence 2 of the Civil Code). Similar rules apply for staying with the partner of a deceased parent or a parent who cannot exercise his or her parental care.
Pursuant to Section 1741(2) sentence 4 of the Civil Code/Section 9(7) sentence 1 of the Act on Registered Life Partnership, a spouse/registered partner is entitled to adopt his or her spouse’s/registered partner’s biological child. According to Section 1742 of the Civil Code/Section 9(7) sentence 2 of the Act on Registered Life Partnership, a spouse/registered partner may also adopt the child adopted by his or her spouse/registered partner. There is no longer a distinction between heterosexual and homosexual married couples, registered partners or between married and unmarried stable couples in case they want to adopt the child of their partner (Section 1766a of the Civil Code). In addition, married couples regardless of the sex of the spouses may adopt any other child as common parents, whereas unmarried couples and registered partners do not have this option to become common parents of the child simultaneously. They have to adopt the child successively.
Germany - Financial aspects
3. Are MAP procedures covered by the social security system? Yes
MAP is a medical therapy under Section 27a of Book V of the Social Code.
The medical services covered by the statutory health insurance also include medical interventions aimed to induce a pregnancy. MAP measures must be medically diagnosed as necessary and have reasonable chances of success.
The Statutory Health Insurance Modernisation Act [GKV-Modernisierungsgesetz] reasonably restricted the entitlement to MAP measures from 1 January 2004 onwards. Since then Section 27a of Book V of the Social Code specifies that 50% of the costs are covered by the health insurance fund, so that the insured equally share in the costs of MAP interventions with a co-payment of 50%.
To reduce the financial burden caused by the 2004 cutback in costs covered by the statutory health insurance fund, in 2012 the Federal Ministry for Family Affairs launched the federal initiative “Hilfe und Unterstützung bei ungewollter Kinderlosigkeit” (assistance and support for involuntary childlessness). The funds are paid from both the federal budget and the budget of the Länder in which the couples concerned have their principal residence. Currently, twelve of the sixteen Länder participate in the initiative. Federal funding is generally provided for the first four treatment cycles of in-vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI). Couples can be reimbursed up to 25 per cent of the share they have to pay in addition to the costs covered by the health insurance fund.
Until 2015, only married couples were entitled to additional federal financial assistance. Today, also unmarried couples living in a non-marital long-term relationship can receive federal financial assistance under the amended federal guidelines on financial assistance for assisted reproduction procedures (Richtlinie über die Gewährung von Zuwendungen zur Förderung von Maßnahmen der assistierten Reproduktion), which took effect on 7 January 2016. However, pursuant to Section 27a of Book V of the Social Code, entitlement to benefits from the statutory health insurance fund is still restricted to married couples only.
4. Are there specific criteria for such coverage? Yes.
The criteria included in Section 27a of Book V of the Social Code:
Coverage of part of the costs by the statutory health insurance funds is subject to the following requirements:
- the measures must be medically diagnosed as necessary
- according to medical diagnosis, the intervention must be reasonably likely to induce a pregnancy
- the procedure may be performed up to three times
- only married couples are eligible (non-married couples are not)
- only the spouses’ egg and sperm cells may be used (homologous system)
- prior to treatment, the spouses must have themselves thoroughly informed about the medical and psychosocial aspects involved by a physician other than the one who will perform the treatment
- MAP may only be performed by physicians or facilities that are suitably qualified and have obtained an appropriate licence from the authority responsible under the law of the federal Land
Any method other than homologous fertilisation is excluded from the mandatory package of benefits and services of the statutory health insurance system.
The restriction of eligibility to married couples is in accordance with the German Constitution (cf. Judgment of 28 February 2007 – 1 BvL 5/03, BVerfGE 117, 316).
Eligibility is subject to age limits of between 25 and 40 years for women and between 25 and 50 years for men.
Although unmarried heterosexual couples are not entitled to benefits from the statutory health insurance fund pursuant to Section 27a of Book V of the Social Code, they can receive the voluntary financial assistance offered through the federal initiative “Hilfe und Unterstützung bei ungewollter Kinderlosigkeit”.
5. Is the financial coverage limited to a number of MAP procedures? Yes. Pursuant to Section 27a of Book V of the Social Code three attempts to induce a pregnancy are partially covered by the health insurance funds. The payment of expenses by the health insurance funds has been limited to 50% of the costs approved along with the treatment schedule.
Georgia - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous?
LHC: no specific provisions are included in the LHC on this issue.
*DL-RHRR:
Donation of gametes and embryo is not anonymous; however information on the identity of a gamete donor is confidential. Also, any personal data collected about a couple or single women applying for MAP is confidential.
United Register of Gamete Donors will include data about the identity of gamete donors as well as of couple.
These data are confidential. However, the law may make exceptions for specific cases; e.g. “when the disclosure of information on the donor’s genetic characteristics is necessary for the health purposes of the child, born as a result of medically assisted reproductive technologies”.
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself; ii. For the parents; iii. For a court Yes. LHC: no specific provisions are included in the LHC on this issue. The answers given to question 17 are based on DL-RHRR.
a. Identity of the donor(s)
i. For the child him or herself; ii. For the parents; iii. For a court No
b. Certain health information concerning the donor(s)
i. For the child him or herself; ii. For the parents; iii. For a court Yes. Health data of the gamete donor, particularly information about the donor’s genetic characteristics, could be disclosed from the register of gamete donors if this is necessary for the health purposes of the child, born as a result of MAP.
c. Other information
i. For the child him or herself NA; ii. For the parents; Yes. A couple or a single woman has the right to request and receive information on the donor’s age, appearance, ethnic background, and health condition.
- Obligation of gamete donor to provide information about his/her health:
According to the DL-RHRR gamete donors are obligated “to give the medical personnel complete and comprehensive information on his/her health condition prior to gamete donation.”
- Right of the gamete donor to receive information about his/her health:
According to the DL-RHRR gamete donors are entitled to receive “information concerning his/her own health, which may be discovered as a result of monitoring the child born after utilizing assisted reproductive technologies.”
iii. For a court NA
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? There are no specific provisions on this subject in family law at present.
Georgia - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues?
Debates took place about the draft Law on Reproductive Health and Reproductive Rights among the representatives of various professionals, especially medical professionals, representatives of church and religious groups, representatives of Ministry of Health and Social Affairs, etc.
As the above draft Law is more specific than the Law on Health Care it will change existing legal situation (details are already specified throughout the questionnaire).
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law.
English versions of the following legislation related to MAP are presented in the Addendum:
- Law on Health Care (Relevant articles from Chapter XXIII Family Planning) [see Addendum];
- Draft Law on Reproductive Health and Reproductive Rights [see Addendum].
Germany - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? No
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. See section I above for links to the updated versions of German laws
Switzerland - Legal regulation or practice and access to MAP
- Title of the law: Federal Act on Medically Assisted Reproduction (Reproductive Medicine Act, RMA), Reproductive Medicine Ordinance (RMO)
- Date of adoption and entry into force RMA: 18.12.1989 / 1.1.2001 and RMO: 4.12.2000 / 1.1.2001
- Published in: https://www.admin.ch/opc/fr/classified-compilation/20001938/index.html , and
- https://www.admin.ch/opc/fr/classified-compilation/20002342/index.html
- Revision: June 5th,2016, popular vote on the revision of the RMA regarding the regulation of Preimplantation Genetic Screening (PGS) and Preimplantation Genetic Diagnosis (PGD) (prohibited until now)
France - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. Medically assisted procreation is considered a health care activity. Law N°2021-1017 of August 2nd 2021 provides for the possibility of reimbursement of MAP by social security under the same conditions for unmarried single women, female couples and heterosexual couples. The MAP procedure is covered by national solidarity. The beneficiaries are exempt from the co-payment.
4. Are there specific criteria for such coverage? Yes. The law of August 2, 2021 removed the criterion of infertility, MPA procedures are covered at 100% by the Assurance Maladie for a maximum of : - 6 inseminations (only one artificial insemination per cycle) to obtain a pregnancy; - 4 in vitro fertilization attempts to achieve a pregnancy. This coverage is the same for everyone (heterosexual couple, couple made up of 2 women, unmarried woman) Knowing that, for the retrieval or the collection in a project of AMP, there are conditions of ages: - oocyte retrieval can be performed in women up to their 43rd birthday; - Sperm collection can be performed in men up to their 60th birthday; And for the performance of MPA: - until her 45th birthday for the woman, unmarried or within the couple, who will carry the child; - until his 60th birthday for the person in the couple who will not carry the child.
5. Is the financial coverage limited to a number of MAP procedures? Yes. The health insurance system will cover six inseminations and four complete cycles, i.e. concluded by embryo transfer. Any IVF cycle broken off before embryo transfer, irrespective of the stage at which it is abandoned, will not be counted by the health insurance system. Reimbursement is subject to a preliminary agreement procedure.
Should pregnancy and delivery occur, the count restarts from zero, and coverage is provided for four new attempts. This does not apply to miscarriages or extrauterine pregnancies.
Georgia - Medical aspects
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? LHC: Yes, DL-RHRR: Yes;
For women not living in a heterosexual couple? LHC: No, DL-RHRR: Yes
2bi
LHC: Yes
“Risk of transmission of a genetic disease”
DL-RHRR: Yes
a) “Proven likelihood of the transmission of a serious genetic disease to a naturally conceived child from a woman or man, that may result in a child’s severe disability and/or premature death.”
b) “Proven likelihood that a child from natural insemination will be born with a non-genetic disease that may result in grave disability and/or premature death.”
b. Risk of transmission of a disease
For a heterosexual couple?; LHC: Yes “Risk of transmission of a genetic disease” DL-RHRR: Yes
a) “Proven likelihood of the transmission of a serious genetic disease to a naturally conceived child from a woman or man, that may result in a child’s severe disability and/or premature death.”
b) “Proven likelihood that a child from natural insemination will be born with a non-genetic disease that may result in grave disability and/or premature death.”
For women not living in a heterosexual couple? LHC: No, DL-RHRR: Yes
a) “Proven likelihood of the transmission of a serious genetic disease to a naturally conceived child from a woman or man, that may result in a child’s severe disability and/or premature death.”
b) “Proven likelihood that a child from natural insemination will be born with a non-genetic disease that may result in grave disability and/or premature death.”
Accordingly, the draft law of Georgia on Reproductive Health and Reproductive Rights permits access to medically assisted reproductive technologies for heterosexual couples or single women only if at least one of the conditions listed below are met:
- A woman and/or man of reproductive age is infertile, other alternatives available in the country for treating infertility have proved ineffective; or such treatment hasn’t yet been carried out, but there is a reason to assume that it will be ineffective, as attested by a duly authorised state medical institution;
- There is a proven likelihood of the transmission of a serious genetic disease to a naturally conceived child from a woman or man, which may result in a child’s severe disability and/or premature death;
- There is a proven likelihood, that a child from natural insemination will be born with a non-genetic disease, that may result in grave disability and/or premature death;
- A woman carries a disease due to which the pregnancy may endanger the woman’s life and/or health.
c. Other There is one more medical criterion, but only for accessing surrogacy: existence of a disease due to which the pregnancy may endanger the woman’s life and/or health.
Georgia - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples?
LHC: Insemination-No; IVF-Yes
a) At present the law gives access to artificial insemination to heterosexual couples as well as to single women.
b) However in vitro fertilization (IVF) is accessible only to couples.
DL-RHRR: No. Draft law gives access to medically assisted procreation (artificial insemination as well as in vitro fertilization procedures) to heterosexual couples as well as to single women.
b. possible for women not living in a heterosexual couple?
LHC: Insemination-Yes; IVF-No
a) Law gives access to artificial insemination to single women. However, the Law does not specify whether women should be living in heterosexual couple or not.
b) IVF is not accessible for single women.
DL-RHRR: Yes. Draft law gives access to medically assisted procreation (artificial insemination as well as in vitro fertilization procedures) to single women.
Lithuania - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. The compensation is available to people who have entered into a marriage or registered partnership agreement in accordance with the law and have been diagnosed with infertility (female, male or both). The woman must be at least 42 years old.The compensation is available to people who have entered into a marriage or registered partnership agreement in accordance with the law and have been diagnosed with infertility (female, male or both). The woman must be at least 42 years old.
4. Are there specific criteria for such coverage? Yes. When the woman is 42 yearl old and the partners are infertile
5. Is the financial coverage limited to a number of MAP procedures? Yes. A maximum of 2 treatment cycles per couple is reimbursed
Lithuania - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? Yes
b. possible for women not living in a heterosexual couple? No
Italy - Réglementation ou pratique et accès à la PMA
- Titre de la législation : Règles en matière de procréation médicalement assistée.
- Date de l’adoption et de l’entrée en vigueur 19 février 2004 n°40
- Publiée dans : Gazzetta Ufficiale della Repubblica Italiana (publication officielle contenant les éléments des nouvelles lois).
- Indiquer si une révision est en cours et, dans vos réponses, fournir des informations sur les dispositions du projet de loi :
Le 12 juin 2005 a eu lieu un référendum populaire pour modifier plusieurs dispositions de cette loi. L’abrogation de ces dispositions a été rejetée, le taux d’abstention ayant été de 74 % (51 % de votes favorables auraient été nécessaires pour changer la loi).
Résumé
1. Protection des désirs de maternité/paternité et règles d’exercice des droits découlant de la loi n° 40/2004.
L’accès aux techniques de procréation assistée est réservé à des couples hétérosexuels majeurs, mariés ou menant une vie commune, dont les membres sont tous deux vivants et en âge de procréer.
Il est interdit aux personnes célibataires et aux homosexuels.
Le couple qui demande un accès aux techniques de procréation (médicalement) assistée doit produire un certificat médical attestant l’existence d’une stérilité ou d’une infertilité pour lesquelles il n’existe aucune autre solution possible.
Le consentement, écrit et librement révocable jusqu’au moment de la fécondation in vitro de l’ovocyte, est obligatoirement précédé d’une information sur le plan technique, juridique, et éthique ainsi que sur le coût des procédures et sur les conséquences possibles des techniques de procréation assistée pour l’enfant à naître.
Lors de l’entretien avec le responsable du centre médical, les couples sont également informés des possibilités d’adopter un enfant ou de devenir famille d’accueil d’un enfant en vue de son adoption (loi n° 184 du 4 mai 1983).
Un délai de réflexion de sept jours doit être respecté avant le début des procédures de procréation assistée.
Ces techniques sont appliquées de manière progressive en commençant par les moins invasives afin d’éviter de recourir à des interventions dont le caractère invasif, au plan technique et psychologique, les rend plus pénibles pour les personnes concernées.
Le médecin responsable du centre médical est en droit de prendre la décision de ne pas recourir aux techniques de procréation assistée, exclusivement pour des raisons médicales ou de santé.
La cryoconservation des gamètes masculins et féminins est autorisée, à condition que les personnes concernées aient été informées et y aient donné leur consentement écrit.
La loi, dans sa formulation d’origine, interdisait le recours à des techniques de type hétérologue (avec don de gamètes d’un tiers extérieur au couple). L’intervention de la Cour constitutionnelle (arrêt n° 162 de 2014) a supprimé cette interdiction.
2.Protection de l’enfant à naître
Le statut juridique de l’enfant né par techniques de procréation assistée est celui d’un enfant légitime ou reconnu par le couple. Le désaveu de paternité est exclu en cas de fécondation hétérologue. Le donneur de gamètes n’acquiert aucun lien juridique de parenté avec l’enfant né (aucun droit ni devoir).
La mère ne peut plus, au moment de l’accouchement, déclarer sa volonté de ne pas être connue, comme cela est autorisé pour la conception naturelle (Décret du Président de la République n° 396 du 3 novembre 2000).
3.Protection de l’embryon
Il est interdit de procéder à la cryoconservation ou à la suppression d’embryons, sous réserve des dispositions de la loi n° 194 du 22 mai 1978 (loi sur l’interruption volontaire de grossesse).
La loi, dans sa formulation d’origine, disposait que les techniques de production d’embryons, compte tenu de l’évolution technique et scientifique et de ce qui pourra être établi à l’avenir par des orientations juridiques du ministre de la Santé, ne peuvent conduire à la création d’un nombre d’embryons supérieur à celui strictement nécessaire à la réalisation d’un transfert unique et simultané, ce nombre ne pouvant en aucun cas être supérieur à trois.
Lorsque le transfert des embryons dans l’utérus se révèle impossible pour raison majeure grave et prouvée, ayant trait à l’état de santé de la femme et non prévisible au moment de la fécondation, la cryoconservation des embryons est autorisée jusqu’à la date du transfert, qui sera effectué aussitôt que possible. Depuis la décision n° 151/2009 de la Cour constitutionnelle, la détermination du nombre d’embryons à créer et à transférer dans le cadre d’une procédure d’implantation reste à l’appréciation du médecin qui tient compte de l’état de santé de la femme. Il ne doit pas être supérieur au nombre strictement nécessaire à la procréation.
En vertu de la loi sur la procréation médicalement assistée, il est interdit de procéder à la réduction embryonnaire de grossesses multiples, sauf dans les cas prévus par la loi n° 194 du 22 mai 1978 (loi sur l’interruption volontaire de grossesse).
Les sujets visés à l’article 5 sont informés du nombre et, s’ils le demandent, de l’évaluation des embryons produits à transférer dans l’utérus.
À la suite de la décision n° 96 du 5 juin 2015, la Cour constitutionnelle a levé l’interdiction qui était faite aux couples fertiles porteurs connus de maladies génétiques graves de recourir au diagnostic génétique préimplantatoire. Les maladies en question doivent répondre aux critères de gravité énoncés à l’article 6, paragraphe 1, lettre b) de la Loi n° 194 du 22 mai 1978 et être détectées par les prestataires publics de soins de santé compétents. Il appartient au Parlement de définir les critères d’agrément de ces structures.
Toute expérimentation sur l’embryon humain est interdite.
La recherche clinique et expérimentale sur l’embryon humain est autorisée à condition que les buts en soient exclusivement thérapeutiques et diagnostiques, en vue de la protection de la santé et du développement de l’embryon.
Sont interdites :
(a) la production d’embryons humains aux fins de recherche ou d’expérimentation ou à toutes fins autres que celles prévues par la loi. Interdiction des dons d’embryon à des fins de recherche : dans l’arrêt Parrillo c. Italie (requête n°46470/11) du 27 août 2015, la Cour européenne des droits de l’homme a reconnu que l’interdiction faite à une femme de donner à la recherche scientifique des embryons résultants d’une fécondation in vitro n’était pas contraire à son droit au respect de sa vie privée (il n’y avait pas de violation de l’article 8 (droit au respect de la vie privée) de la Convention européenne des droits de l’homme). Elle a également affirmé que les embryons humains ne sauraient être réduits à des « biens ». La Cour a considéré qu’il convenait de reconnaître à l’Italie une large marge d’appréciation dans cette affaire, qui mettait en jeu des questions morales et éthiques sensibles, d’autant plus qu’il n’y avait pas de consensus européen sur la question délicate du don d’embryons non destinés à l’implantation. La Cour constitutionnelle a rejeté un recours récent sur ces questions, affirmant qu’il appartenait au législateur de modifier la loi.
(b) toute forme de sélection dans un but eugénique, des embryons et des gamètes, ou des interventions qui, au moyen de techniques de sélection, de manipulation, ou par des procédés artificiels, visent à altérer le patrimoine génétique de l’embryon ou du gamète, ou à en prédéterminer les caractéristiques génétiques, à l’exception des interventions à des fins diagnostiques et thérapeutiques. Cela dit, l’arrêt n° 229/2015 de la Cour constitutionnelle n’a supprimé l’interdiction de la sélection d’embryons que dans des circonstances particulières, considérant qu’il ne s’agissait pas d’une infraction lorsqu’elle vise à prévenir l’implantation d’embryons nés de couples présentant un risque de transmission de maladies génétiques graves, conformément à l’article 6, 1 B de la loi 194 (relative à l’interruption de grossesse) dans des structures publiques désignées. Une question de constitutionnalité concernant l’article 13 (paragraphes 3, alinéa b) et 4) de la Loi n° 40/2004 a été soulevée. Le jugement rendu est conforme à l’arrêt précité.
Il souligne toutefois la protection nécessaire a conférer à l’embryon humain à la protection nécessaire, rappelant que « l’enjeu est ici la nécessité de protéger la dignité de l’embryon, à laquelle aucune autre réponse que la cryoconservation ne peut actuellement être apportée. Un embryon, quel que soit le statut juridique plus ou moins déterminé associé au début de la vie, ne saurait être réduit à un simple matériau biologique ».
(c) des interventions de clonage par transfert de noyau ou de scission précoce de l’embryon ou d’ectogenèse, à des fins de procréation ou de recherche ;
(d) la fécondation d’un gamète humain par un gamète d’espèce différente et la production d’hybrides ou de chimères.
4. Sanctions
Le texte de la loi 40/2004 prévoit différentes sanctions progressives en cas de violation de la loi, qui s’appliquent aux médecins et aux Centres autorisés mettant en œuvre les techniques de procréation assistée.
L’homme ou la femme auxquels sont appliquées les techniques ne peuvent être sanctionnés que s’ils n’ont pas suivi les procédures prévues. La sanction pour insémination hétérologue a été supprimée. Les sanctions qui restent en vigueur sont définies à l’article 12 de la Loi n° 40/2004.
5. Autorisations
Un système d’autorisation régionale des structures jugées adéquates est prévu, sur la base :
(a) des données techniques, scientifiques et d’organisation de ces structures ;
(b) des qualifications du personnel.
Les conditions requises sont établies par actes des Régions.
Il existe un Registre obligatoire des structures autorisées, établi et tenu par l’Institut supérieur de la santé, qui suit l’application des techniques de procréation médicalement assistée, les embryons formés et les enfants nés à la suite de l’application de ces techniques.
L’Institut supérieur de la santé prépare le rapport annuel à présenter au Parlement.
Après la décision n° 162/2014, le ministère de la Santé a approuvé les Lignes directrices pour l’application des techniques de reproduction hétérologues au couple qui reçoit le gamète. En ce qui concerne le don de gamètes, l’Italie adoptera la Directive UE 2006/17, ALL.III, PAR.3,4 et ses modifications ultérieures. Le texte sera approuvé dans le système normatif (sous la forme d’un décret gouvernemental). L’un des éléments fondamentaux issus du système juridique Italien est le principe selon lequel le don de sperme et d’ovocyte doit être un acte volontaire, altruiste et non rémunéré.
Ireland - Legal regulation or practice and access to MAP
Until recently in Ireland the provision of assisted human reproduction (AHR) services was largely unregulated. However, in April 2015 Parliament passed the Children and Family Relationships Act which deals with the limited topic of parentage in the case of donor assisted human reproduction. Under the Children and Family Relationships Act 2015, gamete and embryo donation are permitted on a non-anonymous basis. In addition, this legislation provides for the establishment of a national register of gamete/embryo donors, recipients and donor-conceived children (the National Donor-Conceived Person Register), which will allow donor-conceived children to access certain information regarding the gamete/embryo donor involved in procedures leading to their conception.
Moreover, although AHR services are not currently regulated by any specific health legislation, in February 2015, the Minister for Health received Government approval to draft a General Scheme of legislative provisions which would deal with a wide range of issues from the beginning to the end of the AHR process. Following the completion of the General Scheme, the Government approved its publication and the drafting of a Bill on assisted human reproduction based on this General Scheme. The drafting of this Bill is currently ongoing.
Under the proposed legislation, a number of practices will be regulated, including gamete and embryo donation, surrogacy and the assignment of parentage in such cases, pre-implantation genetic screening/diagnosis, sex selection for medical purposes, and posthumous assisted reproduction as well as associated research. It is also proposed that the legislation will establish a regulator to promote patient safety and good clinical practice in the area of assisted human reproduction. The regulator will maintain the National Donor-Conceived Person Register, establish the National Surrogacy Register and maintain records of all assisted human reproduction activities and services.
In January 2018 the General Scheme was submitted to the relevant parliamentary committee for review as part of the pre-legislative scrutiny process. This committee published the report of its review in July 2019, making recommendations which include proposals related to both broad policy objectives and more technical amendments. Its recommendations are being considered during the ongoing process of drafting the AHR Bill.
Norvège - Legal regulation or practice and access to MAP
- Title of the law: The act relating to the application of biotechnology in human medicine etc
- Adopted 5 December 2003, partly into force from 1 January 2004, 1 September 2004 and 1 January 2005. Limited use of PGD was allowed (only in cases of X-linked diseases), and research on surplus embryos was banned. An amendment in force from September 2004 allowed PGD also in cases of serious hereditary diseases for which no treatment is available. New regulations regarding PGD and research on surplus embryos entered into force in July 2008; allowing research on surplus embryos under certain conditions, and PGD or PGD/HLA in situations of serious hereditary disease. New regulations regarding access to MAP for lesbian couples entered into force in January 2009. In 2013 the act was amended to allow MAP to otherwise fertile couples, where one person has a serious and chronic sexually transmitted infection. In 2020 single women who live alone were given access to MAP, and from 2021 oocyte donation is allowed. Egg donation is accessible only to couples able to use their own sperm. Same-sex female couples can donate oocytes to each other (partner donation) and use sperm from a donor.
Iceland - Legal regulation or practice and access to MAP
- Title of the law: Artificial Fertilisation Act N° 55/1996
- Date of adoption and entry into force: 1 June 1996
- Published in: http://eng.heilbrigdisraduneyti.is/laws-and -regulations/nr/685
- Indicate if process of revision is ongoing and, in your answers, provide information on provision in the draft law: No process of revision has yet been embarked upon, a parliamentary resolution on the necessity of a revision, specifically with regards to issues pertaining to embryonic stem cell research, is being discussed.
Lithuania - Legal regulation or practice and access to MAP
- Title of the law: The Law on the Assisted Reproduction of the Republic of Lithuania
- Date of adoption: 14th September 2016 (amended 24th May 2022, 30th May 2019 and 17th January 2017)
- Entry into force: 1st January 2017
- Published in: the Lithuanian Register of Legal Acts
In the last revision of the Law entered into force on the 1st of July 2022, the requirement to store embryos for the unlimited period of time was abolished. This requirement was replaced by a requirement to store embryos for 10 years after the assisted reproduction procedure.
Andorra - Financial aspects
3. Are MAP procedures covered by teh social secutiy system? NA
4. Are there specific criteria for such coverage? NA
5. Is the financial coverage limited to a number of MAP procedures? NA
Andorra - Right to know about his or her biological origin for children born after MAP
16. Are donation of the sperm/oocytes/embryos anonymous?
Yes, specify the legal provisions. Law 12/2019, of the 15th February, described as techniques of assisted reproduction
17. Is it possible to obtain information about the biological origin of a child bornn after gametes or embryo donation for the child/for the parents/for the court?
Yes for the child
No for the parents
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions?
No
Andorra - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? If so, what might the implications be?
NA
20. Particular cases encountered in your country, and expecially, their case-law
NA
Azerbaijan - Medical aspects
2. Are there specific criteria for access to MAP?
- Medical reasons:
a. Infertility
i. for a heterosexual couple? Yes
ii. for women not living in a heterosexual couple? Yes
b. Risk of transmission of a disease (please specify the risk and/or disease)
i. for a heterosexual couple? Yes
ii. for women not living in a heterosexual couple? Yes
Azerbaijan - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? Yes
b. possible for women nnot living in a heterosexual couple? Yes
Cyprus - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? There is no indication for the practice followed by several clinical centers, due to the non-existence of relevant legislation
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation? There are no legal provisions. There is no indication for the practices followed by the IVF centers, due to the non-existence of relevant legislation.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? NA
Cyprus - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? The drafting of a law regulating MAP and IVF is currently under consideration. For this purpose a Steering Committee has been established by the Ministry of Health. The Committee is composed of representatives from Services and interested groups on MAP issues.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. There is no case-law up-to-date.
Denmark - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. The Region must provide cost-free treatment for MAP to single women who do not have children, and couples who do not have children together.
4. Are there specific criteria for such coverage? Yes. Women over 45 year of age cannot receive treatment.
5. Is the financial coverage limited to a number of MAP procedures? Yes. Practice: 3 procedures with IVF and more if there are one or more spare, frozen embryos from the woman.
Denmark - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? No
b. possible for women not living in a heterosexual couple? Yes
There are no restrictions in the access to medically assisted procreation neither to hetero couples nor single women.
Ireland - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? No. As previously indicated, under the Children and Family Relationships Act gamete and embryo donation is permitted on a non-anonymous basis. Gamete and embryo donors will be required to provide name; place and date of birth; nationality, place and date on which s/he provided the donation; and contact details. Once a donor-conceived child has attained the age of 18 years s/he may request the name, date of birth and contacts details of the relevant donor, as recorded in the National Donor-Conceived Person Register.
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court NA
According to the Children and Family Relationships Act 2015, a donor-conceived child who has attained the age of 18 years, or the parent of a donor-conceived child who has not attained the age of 18 years, may request the following information from the Register:
(a) information other than the relevant donor’s name, date of birth and contact details, that is recorded on the Register in respect of the relevant donor;
(b) the number of persons who have been born as a result of the use in a donor-assisted human reproduction procedure of a gamete donated by the relevant donor, and the sex and year of birth of each of them.
In addition, the Act provides that, a donor-conceived child who has attained the age of 18 years may request the name, date of birth and contacts details of a relevant donor, as recorded in the Register. The donor must be issued with a notice informing him or her that a request has been made by the donor-conceived child. The requested information may be released 12 weeks from the date on which on which the notice is sent (with very restrictive exceptions).
a. Identity of the donor(s)
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court NA
See answer to previous question
b. Certain health information concerning the donor(s)
i. For the child him or herself; ii. For the parents; iii. For a court
Under the proposed assisted human reproduction legislation, medical information relating to the donor may be released to a medical practitioner in order to avoid an imminent and serious risk to the health of a person or to enable the medical practitioner to provide medical advice to a person regarding the existence of a genetic or hereditary condition.
c. Other information
i. For the child him or herself; ii. For the parents; iii. For a court NA
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? Yes/No.
According to the Irish Constitution, the woman who has given birth to a child is always regarded as the legal mother. This assertion was challenged in the Irish Courts, but it was upheld in the Supreme Court in 2014 in the MR and Anor – v- An tArd Chlaraitheoir & Ors (Surrogacy) case.
According to the Children and Family Relationships Act 2015, the parents of a donor-conceived child are the mother and her husband, civil partner or cohabitant as the case may be. A donor of a gamete or embryo is not regarded as the parent of a donor-conceived child.
Iceland - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? sperm Yes/oocytes Yes/embryos -
See art.18 reg.568/1997 (If a donor wishes to remain anonymous, health workers are obliged to ensure that this is respected. In this case, the donor may neither receive information about the couple receiving the donated gamete or the child, nor the couple or the child receive information about the donor. If a donor does not wish to remain anonymous, the institution shall preserve information about him in a special file. If the donation of gamete leads to the birth of a child, information about the child and the couple who received the gamete shall be kept in the same file. A child born on account of a gamete donation where the donor does not wish to remain anonymous can at the age of 18 gain access to a file pursuant to paragraph 2 for the purpose of obtaining information about the identity of the donor. If a child receives information about the gamete donor at the institution, the said institution shall as soon as possible inform the donor that the information has been given.)
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No
The child cannot obtain information if the donor has wished to remain anonymous, See art.18 reg.568/1997.
a. Identity of the donor(s)
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No
The child cannot obtain information if the donor has wished to remain anonymous, See art.18 reg.568/1997.
b. Certain health information concerning the donor(s)
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No
The child cannot obtain information if the donor has wished to remain anonymous, See art.18 reg.568/1997.
c. Other information
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No
The child cannot obtain information if the donor has wished to remain anonymous, See art.18 reg.568/1997.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? No. See art.6, Act in respect of Children, no. 76/2003 (A man who has agreed that his wife be artificially inseminated according to the Act on is deemed to be the father of a child so conceived. The same applies to a man and a woman who have registered their cohabitation with the National Registry. A man who donates sperm for the purpose of it being used in artificial insemination of a woman other than his wife or cohabiting spouse, cf. paragraph 1, according to the provisions of the Act on Artificial Insemination will not be deemed to be the father of a child conceived with his sperm. -A man who donates sperm for another purpose than stipulated in paragraph 2 is deemed to be the father of a child conceived with his sperm unless the sperm is used without his knowledge or after his decease.)
Luxembourg - Financial aspects
3. Are MAP procedures covered by the social security system? Yes
4. Are there specific criteria for such coverage? Yes. Age limit of woman – 40 years old.
5. Is the financial coverage limited to a number of MAP procedures? Yes. Four attempts.
Luxembourg - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? No
b. possible for women not living in a heterosexual couple? Yes. Selection on the basis of a psychologist’s opinion and following the recommendations formulated by the National Ethics Commission.
Luxembourg - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? Yes. This depends on the legislation of the countries from which the donations originate.
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself; ii. For the parents; iii. For a court NA
a. Identity of the donor(s)
i. For the child him or herself; ii. For the parents; iii. For a court NA
b. Certain health information concerning the donor(s)
i. For the child him or herself; ii. For the parents; iii. For a court NA
c. Other information
i. For the child him or herself; ii. For the parents; iii. For a court
This depends on the legislation of the countries from which the donations originate.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? No. See Art.312 of the Civil Code cited in the section I – relevant instruments or draft instruments.
Malta - Legal regulation or practice and access to MAP
- Title of the law: Embryo Protection Act 2018
- Date of adoption and entry into force: 2018
- Published in: Laws of Malta; Government Gazette
Malta - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? No
b. possible for women not living in a heterosexual couple? Yes
Surrogacy is not allowed but donation of sperm is allowed and therefore homosexual female couples can use sperm donation or adoption of frozen embryos
Norvège - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous?
sperm No / oocytes No / embryos NA. Sperm or oocyte donors cannot be anonymous.
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No. Children born after sperm donation have the right to know the identity of their donor when they (the children) reach the age of 15 (or 18 for those born from sperm donated before 2021).
a. Identity of the donor(s)
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No.
b. Certain health information concerning the donor(s)
i. For the child him or herself No; ii. For the parents No; iii. For a court No. For donors recruited in Norway, the parents will be familiar with the general criteria for selection of a donor (good physical and mental health, no serious inheritable disease; as well as the test regimes) but will not have any other information about the donor. Norway allows import of sperm or oocytes from banks established outside of Norway, but only if they can provide sperm/oocytes from open donors, and in conformity with the relevant EC directives. Oocytes can only be imported from other Nordic countries.
c. Other information
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No. At the age of 15 (or 18, se previous text), the child can obtain information about the identity of the donor (name and address according to the registry and if necessary, date of birth and national identity number). This is the only information that will be provided.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? Yes.
- a child or a parent, as well as a third person who claims paternity of a child with another legal father may contest paternity in front of a court. There is no exception for children or parents of children born after MAP, but a sperm donor cannot contest paternity of a child born after MAP procedures using donated sperm.
- the donor has no legal responsibility for the child, and has no right to any information about children that have been born using his sperm (except for the maximum number).
- according to Norwegian family law provisions, the legal father of a child conceived after MAP is the one the mother is married to at birth (“pater est”). If the woman is not married, the legal father will be the man who acknowledge paternity for the child.
according to family law the woman who gave birth to a child is the child's mother.
Türkiye - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? No
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No
8. Are there specific criteria for donation of sperm/oocytes/embryos? Oocyte and embryo donation are prohibited.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? No
10. Are there special measures for the prevention of consanguinity? Yes. Sperm, oocyte and embryo donation is forbidden.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No
Türkiye - Financial aspects
3. Are MAP procedures covered by the social security system? Yes
4. Are there specific criteria for such coverage? Yes. Married, infertile couples, older than 23, younger than 40 years old can benefit from assisted reproduction (IVF) techniques
5. Is the financial coverage limited to a number of MAP procedures? No
Türkiye - Medical aspects
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? Yes; For women not living in a heterosexual couple? No
b. Risk of transmission of a disease
For a heterosexual couple No?; For women not living in a heterosexual couple? No
c. Other N/A
Hungary - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? Updating of the national regulation is intended in the next future.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. In 2015 a case has been concluded by the Hungarian supreme court (Kúria) where paternity was contested after MAP based on the exception if the husband had not consented to the MAP intervention.
The married couple separated shortly after the birth of the child. The couple had agreed about procreating a child with MAP intervention. The separated husband contested his paternity because a genetic DNA test excluded his biological parentship while supported that of the mother. The court has accepted the action of the ex-husband not to be the father based on the fact that he consented to generate a child with MAP but did not consent to the actual intervention; the document of consent did not contain that the sperm might come from a foreign donor. Not the fact that he could not be the biological father but the lack of a legally valid declaration of consent served as the base of the judgement. (Case EBH2015 P.8.)
Spain - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. Where permitted by law: infertility, therapeutic or preventive purposes.
4. Are there specific criteria for such coverage? Yes.
Medically assisted procreation (MAP) is applied in the National Health System to people who meet the following criteria or situations including:
1. Women will be over 18 and under 40 and men over 18 and under 55 years at the time the infertility was taken into consideration.
2. People without any child, prior and healthy. In case of couples, no common, prior and healthy child.
3. The woman did not present any pathology in which pregnancy may have caused a serious and uncontrollable risk, both for their health and for their potential offspring.
5. Is the financial coverage limited to a number of MAP procedures? Yes.
The financial coverage limited to:
Three IVF procedures only
Artificial insemination with sperm from the couple: maximum number of cycles, four
Artificial insemination with donor gamete: maximum number of cycles, six.
Spain - Medical aspects
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? Yes; For women not living in a heterosexual couple? Yes
b. Risk of transmission of a disease
For a heterosexual couple Yes?; For women not living in a heterosexual couple? Yes
c. Other N/A
Spain - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous?
sperm Yes / oocytes Yes / embryos Yes
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court Yes
a. Identity of the donor(s)
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court Yes
b. Certain health information concerning the donor(s)
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court Yes
c. Other information
i. For the child him or herself No; ii. For the parents No; iii. For a court No
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? No
Spain - Legal aspects
1. Is access to medically assisted procreation (MAP) (artificial insemination, in vitro fertilization procedures (IVF)
- restricted to heterosexual couples? Yes
- possible for women not living in a heterosexual couple? Yes
Every woman over 18 years with full capacity to act may be a recipient or user of the techniques regulated by this Law, provided that he has given his written consent. The woman may be user or recipient of the techniques covered in this law regardless of their marital status and sexual orientation.
Sweden - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? sperm Yes /oocytes Yes /embryos No
Sperm and oocyte donation are allowed. Embryo donation will be allowed from the 1st January 2019, if a couple or a single female consent in writing, they have children of their own, one of them is genetically linked to the embryo, and they are informed of the consequence of the donation; that their children may have genetic siblings in another family and will have the right to know of their origin. Any third party donor must consent specifically to embryo donation only if they donated before the law was amended, i.e. before the 1st January 2019.
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? -
8. Are there specific criteria for donation of sperm/oocytes/embryos? sperm Yes /oocytes Yes /embryos -
The donor is assessed on numerous conditions. The donor has to be in good health, physically and mentally. He/she must understand the consequences; He/she has no authority over the conceived child, he/she should not have regrets and it is preferred that he/she has a social network to cope with any possible thoughts, and the donor has to accept the possibility that children may in the future ask for his identity and make contact, as donation by Swedish law is not anonymous. The donor must be above 18 and his/her maturity is assessed in line with the above conditions. The donor must give written consent and has the option to withdraw the consent before the oocyte is fertilized.
The donor must be alive at the time of fertilization.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes. The responsible physician shall choose a matching appearance.
10. Are there special measures for the prevention of consanguinity? Yes. It is not recommended that a donor conceives more than 12 children (2 children in 6 families). There is no national register.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? Yes. Adoption is possible.
Sweden - Legal aspects
1. Is access to medically assisted procreation (MAP) (artificial insemination, in vitro fertilization procedures (IVF)
- restricted to heterosexual couples? No
- possible for women not living in a heterosexual couple? Yes. As from 1/4/2016 single females gain access.
Sweden - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues?
In the recent publication on the 24th February 2016 “Olika vägar till föräldraskap (SOU 2016:11)” a government inquiry had been issued to consider different ways to increase the possibilities for involuntarily childless people to become parents. One legal change to occur on April 1st is that single women can now receive MAP. The inquiry has proposed that one should no longer demand a genetic link between the child and one of the parents, which might mean that embryo donation will become possible. The inquiry also included considering whether to permit altruistic surrogacy, if any, in Sweden. The inquiry’s conclusion was that commercial surrogacy should not be permitted, nor should altruistic surrogacy, and that society should also counter that type of surrogacy. The final report has been submitted to a large number of stakeholders, organisations and authorities, for comments by the 23rd June 2016.
In a new government inquiry followed by a law proposal by the government on the 15th March 2018 “Modernare regler om assisterad befruktning och föräldraskap (proposition 2017/18:155)” which will entered into force on January 1st, 2019, the legislator has made embryo donation possible. A couple or a single female may donate fertilized eggs if they already have children of their own and if the egg is genetically linked to one of them (or to the single female). The children born from embryo donation shall have a right to enter their personal information into the special registry to be kept about the donation for 70 years, for any possible genetic siblings to be retrieved upon request.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. -
Switzerland - Legal aspects
1. Is access to medically assisted procreation (MAP) (artificial insemination, in vitro fertilization procedures (IVF)
- restricted to heterosexual couples? No
- possible for women not living in a heterosexual couple? Yes
Switzerland - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? sperm Yes /oocytes No /embryos No
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No
8. Are there specific criteria for donation of sperm/oocytes/embryos? sperm Yes /oocytes - /embryos -
Medical criteria (good health).
Oocyte and embryo donation are prohibited.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes. Matching appearance of donor to recipient (including blood type)
10. Are there special measures for the prevention of consanguinity? Yes. 8 children only
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? Yes. This has nothing to do with MAP.
Switzerland - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? Yes. Recently, Parliament has decided that oocyte donation should be permitted. As a result, the Federal Council (government) has to prepare a corresponding draft law.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. -
Switzerland - Financial aspects
3. Are MAP procedures covered by the social security system? IUI (intrauterine insemination) YES, IVF NO.
4. Are there specific criteria for such coverage? Yes. Only married couples have access to IUI.
5. Is the financial coverage limited to a number of MAP procedures? Yes. IUI: a maximum of 3 IUI cycles
Denmark - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes
In general, all men can donate sperm and all women can donate oocytes if this does not involve any known serious genetic or infectious risk. The establishments in charge of testing, processing, preservation, storage or distribution of human tissues and cells have the responsibility to ensure the quality of sperm and oocytes. Donation of embryo is only permitted for research purposes, not for assisted reproduction.
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No. It is not allowed to sell or otherwise assist in the sale of unfertilized or fertilized oocytes. The compensation to the donor for donation of oocytes is, therefore limited to expenses actually incurred and disadvantages that are directly related to the donation.
8. Are there specific criteria for donation of sperm/oocytes/embryos? Yes. In general, all men can donate sperm and all women under the age of 35 years can donate oocytes if this does not involve any known serious genetic or infectious risk. The establishments in charge of testing, processing, preservation, storage or distribution of human tissues and cells have the responsibility to ensure the quality of sperm and oocytes. Donation of embryos is only possible for research purposes, not for assisted reproduction.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes
10. Are there special measures for the prevention of consanguinity? Yes. A sperm donor cannot have more than twelve offsprings.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? Yes.
By December 2013 the Children Act was amended with rules on co-maternity. Co-maternity can be established when the mother has been treated with assisted reproduction and has a female spouse or partner who has agreed to the treatment.
In other cases, homosexual couples have the same rights to adoption as heterosexual couples, which also include the possibility for stepchild adoption.
Belgium - Financial aspects
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
Austria - Sperm/oocyte/embryo donation
6. Are sperm, oocytes or embryos donation permitted in your country?
It is permitted to donate sperme and oocytes, but not embryos.
7. Are there specific compensation arrangements for such donations(s)?
No
8. Are there sepcific criteria for sperm, oocytes and embryos donation?
Yes, for sperm and oocyte donation, No for embryos donation.
Written consent of the donor is required. Donation can only be done to a specifically authorized hospital. Age limit for egg donation: 30 years (donor), 45 years (recipient)
9. Are there specific non-medical criteria for selection of gametes/embryo to be used for MAP?
No
10. Are there special measures for the prevention of consanguinity?
Yes, sperm and eggs of a donor may only be used in favour of three couples. The donation by a certain donor is permitted only to one single hospital.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of his or her legal parent?
Yes, the legal mother's partner is automatically the other parent of the child if that partner has given written consent for the PMA with a sperm donation.
Belgium - Current debate and specific situations
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.
United Kingdom - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? Yes.
The 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)