a) Act on the Protection of Embryos [Embryonenschutzgesetz – ESchG];
b) Section 27a of Book V of the Social Code [Fünftes Buch Sozialgesetzbuch – SGB V];
c) Sections 1591 to 1600d, 1682, 1685, 1741 and 1742 of the Civil Code [Bürgerliches Gesetzbuch – BGB];
d) Section 9 of the Act on Registered Life Partnerships [Lebenspartnerschaftsgesetz – LPartG];
e) Section 8b of the Transplantation Act [Transplantationsgesetz – TPG];
f) Tissues and Cells Regulation of the Transplantation Act [TPG-Gewebeverordnung – TPG-GewV];
g) Sperm Donor Register Act [Samenspenderregistergesetz – SaRegG]
a) 13 December 1990; 1 January 1991
b) 26 June 1990; 1 January 1989 (as amended)
c) Civil Code as amended by the Act to Law on the reform of guardianship and care law [Gesetz zur Reform des Vormundschafts- und Betreuungsrechts]: 4 May 2021; 1 January 2023
d) 16 February 2001; 1 August 2001
e) 20 July 2007; 1 August 2007
f) 26 March 2008; 5 April 2008
g) 17 July 2017; 1 July 2018
a) German: http://www.gesetze-im-internet.de/eschg/
b) German: http://www.gesetze-im-internet.de/sgb_5/
c) German: http://www.gesetze-im-internet.de/bgb/
English: http://www.gesetze-im-internet.de/englisch_bgb/
d) German: http://www.gesetze-im-internet.de/lpartg/
English: http://www.gesetze-im-internet.de/englisch_lpartg/
e) German: http://www.gesetze-im-internet.de/tpg/
f) German: http://www.gesetze-im-internet.de/tpg-gewv/
g) German: https://www.gesetze-im-internet.de/saregg/
Ongoing revision of Sections 1591–1600d of the Civil Code and the Sperm Donor Register Act to implement the requirements of the coalition agreement (parenthood agreements prior to conception, automatic assignment of the mother's wife, gender-independent recognition, determination procedure without status consequences, and opening of the Sperm Donor Register Act to sperm donations made before 2018, home inseminations by known donors and embryo donations).
On the basis of paragraph 16b of the German Transplantation Act the German Medical Association has published Guidelines on the Procurement and Transfer of Human Germ Cells or Germ Cell Tissue in the context of Assisted Reproduction dated 11 March 2022 (Richtlinie zur Entnahme und Übertragung von menschlichen Keimzellen oder Keimzellgewebe im Rahmen der assistierten Reproduktion; https://www.bundesaerztekammer.de/fileadmin/user_upload/BAEK/Themen/Medizin_und_Ethik/RiLi-ass-Reproduktion.pdf).
Bosnia and Herzegovina still have no specific legislation on MAP covering entire country. Currently, MAP is regulated by the Health Insurance legislation bylaws (in both B&H entities: Federation BiH and Respublika Srpska and Brcko District BiH), mainly regulating the rights of the couple to reimbursement of IVF costs for two procedures.
Date of adoption and entry into force:
Federation BIH: Decision on Establishment of Basic Patients Rights http://mz.ks.gov.ba/sites/mz.ks.gov.ba/files/Odluka%20o%20utvrdjivanju%20Osnovnog%20paketa%20slnFBiH21-09.pdf chapter X (11.,12.)
Adopted on 19. March 2009, in force as of 01.04.2009
Published in: Službene novine Federacije BiH”, 21/09 of 01. 04.2009.
In the entity Republika Srpska and Brcko district, Health Insurance Fund endorse the budget for MAP each year, depending on the funds availability
Indicate if process of revision is ongoing and, in your answers, provide information on provision in the draft law
MAP as a medical procedure is well established both in public and private sector in Bosnia and Herzegovina.
A draft Law on Medically Assisted Reproduction in the entity Federation B&H, after two years of preparation by the Federal Ministry of Health, and extensive public debate, has been rejected by the Parliament of Federation B&H in June 2014 https://www.google.ba/#q=+nacrt+zakon+o+biomedicinski+potpomognutoj+oplodnji
In 2016. B&H state level Parliamentary Group on Gender Equality drafted the B&H Framework Law on MAP (Setting standards for the entire country); however, despite support by the Council of Ministers of B&H, it has been rejected by Constitution-legal Commission of the House of Representatives, not for the content, due to for political reasons . http://static.parlament.ba/doc/46496_ZAKON%20O%20LIJE%c4%8cENJU%20NEPLODNOSTI_BIH%20%20nacrt_%20pre%c4%8di%c5%a1%c4%87eni%20(1). (July 2016)
Currently (January 2017) the new draft law on MAP (proposed by the Socialist Democrat Party MS) is in the Parliamentary procedure in B&H Entity Federation BIH, while the Draft of the MAP law prepared by the competent Ministry of Health will be on the Parliament agenda in 2017 as well.
a) The law of Georgia on Health Care (LHC) - Chapter XXIII Family Planning
b) The Draft law on Reproductive Health and Reproductive Rights (DL-RHRR)
a) LHC - Adopted by Parliament of Georgia on 10 December 1997
b) DL-RHRR– Submitted to the Georgian Government in December 2003
Later the document was sent to the various Ministries, Departments and governmental agencies and their comments have been taken into consideration as well.
The next steps should be: (a) discussions within the apparatus of the President and later (b) debates in the Parliament.
Title of the law: No specific law, but different articles in the Code make a reference to it:
Law of population health protection
Date of adoption: 26 June 1997; entry into force: 24 September 1997.
Chapter 5.
Article 29 Artificial insemination and embryo implantation.
Article 40. The usage of semen and human organs for transplantation.
The Criminal Code of Azerbaijan Republic
Date of adoption: 30 December 1999; entry into force: 01 September 2000
Chapter 8.
Article 136. Illegal Artificial insemination.
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
The Law on MAP of the Republic of Lithuania states that MAP can be applied to infertile couples when infertility cannot be treated by any other methods.
b. Risk of transmission of a disease
For a heterosexual couple? Yes; For women not living in a heterosexual couple? No
According to the above-mentioned Law, MAP can also be used if there is a high probability of transmitting a disease, which could cause severe disability to a future child.
c. Other No
3. Are MAP procedures covered by the social security system? Yes. In Lithuania infertility considered as a disease therefore MAP services are paid for in accordance with the Law on Health Insurance of the Republic of Lithuania. 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). Age limit of woman for compensation - 42 years old.
4. Are there specific criteria for such coverage? Yes. Infertility is the condition for the coverage of MAP. Woman age limit for treatment of infertility with MAP is 42 years.
5. Is the financial coverage limited to a number of MAP procedures? Yes. A maximum of 2 treatment cecles per couple is reimbursed.
6. Is donation of sperm/oocytes/embryos permitted in your country? sperm Yes /oocytes Yes /embryos No
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No
8. Are there specific criteria for donation of sperm/oocytes/embryos? sperm Yes /oocytes Yes /embryos Yes. In fact there is neither a collection nor a bank in Luxembourg. The service functions in collaboration with a foreign bank.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes. Five classic characteristics (blood group, complexion, eyes, colour of hair, height).
10. Are there special measures for the prevention of consanguinity? No. The straws of sperm come from abroad.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No. Currently no legislation.
19. Is there an important current debate in your country on these or related issues? Yes.
Yes. The question of surrogacy was delayed due to the controversial nature of abuse of the female body, and legal consequences surrogacy is seen to cause in some cases. However it would seem that the discussion will be raised in the future for both heterosexual and homosexual couples. The Embryo Protection Act as amended does not permit the use of surrogacy and the subject is not even discussed.
Note: Having said that, as article 19, discussed above, indicates, donation of gametes is a private agreement so homosexual couples, for example, may bypass provisions by having sperm donated to them in the case of female homosexual couples, and, male homosexual couples can donated their sperm by a private agreement to a woman, who can be the surrogate (using her own ova by Artificial Insemination by Donor) and then give up the child. Article 19 of the Act seems to prohibit this under my interpretation. In any case, the law does not discuss Surrogacy so at most it can be tolerated but not protected by law when it comes to filiation.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law.
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 No?; For women not living in a heterosexual couple? No
c. Other N/A
In the absence of legal framework, that depends on the moral integrity and the personal values of the practitioners and the researchers.
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 No?; For women not living in a heterosexual couple? NA
c. Other N/A
There is not a law or specific articles in the healthcare law addressing MAP or people who are not living in heterosexual couple.
3. Are MAP procedures covered by the social security system? Yes.
MAP procedures are covered by the National Health care system and by co-payments. The (outpatient) clinic where the MAP procedure is conducted is financed as follows:
4. Are there specific criteria for such coverage? Yes.
All couples that are offered MAP have a right to partial coverage of the medicines and treatment costs for IVF/ICSI treatment, limited to three attempts per child.
As a first step in the process, the woman/couple will consult their family physician. Based on a medical and psychosocial evaluation of the woman/couple the physician will decide whether to recommend the couple to one of the clinics offering MAP. The physician at the clinic decides whether or not the woman/couple will be offered MAP. According to the Biotechnology Act, a clinic offering MAP needs authorisation or approval from the Directorate of Health.
To have access to MAP through the clinics financed by the national health care system, an evaluation of the presumed cost-effectiveness of the treatment for the woman/couple is carried out,
Many clinics have established guidelines for evaluation of couples asking for medically assisted procreation.
Women/couples may also choose to pay for treatment in private clinics, this may provide shorter waiting time, and these clinics are not bound by the same principles of cost-efficiency.
A woman cannot be older than 46 at the time of insemination or implantation of embryo.
5. Is the financial coverage limited to a number of MAP procedures? Yes. Financial coverage is limited to three MAP procedures (three IVF or ICSI procedures - or a combination, where a procedure includes the retrieval of ova). Implantation of stored embryos (FER) is not counted as a “MAP procedure”.
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? Yes; For women not living in a heterosexual couple? No
b. Risk of transmission of a disease
For a heterosexual couple Yes?; For women not living in a heterosexual couple? No
c. Other Yes
Criteria for access to IVF is infertility or that the woman is affected by or carrier of serious hereditary disease.
Lesbian couples and single women have access to MAP by insemination or IVF. Criteria for assisted procreation by insemination to heterosexual couples is infertility or that the man has or is carrier of serious hereditary disease. :
The act does not specify a right to treatment in cases where there is a risk of transmission of diseases such between the woman and her husband/spouse.
Regarding situation where one or both partners have a serious and chronic sexually transmitted infection: Where the woman is infected, an evaluation of the risk of transmitting the virus to the child must be made in each case before it is decided to proceed.
A woman cannot be older than 46 at the time of insemination or implantation of embryo.
The criteria for infertility for access to IVF does not apply in cases where same-sex couple have treatment using partner donation (one of the women donates her egg to the other who carries the child).
Other known genetic disorders
16. Is donation of sperm/oocytes/embryos anonymous? Yes.
Lack of specific legal provisions on the subject.
Anonymity of donations is a matter of medical confidentiality. The Opinion of the Polish Association of Obstetricians recommends double anonymity (of both the donor and the receiver). Clinics’ internal regulations may provide otherwise.
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself No; ii. For the parents No; iii. For a court No.
There are no specific legal provisions on the subject.
Doctors are therefore bound by medical confidentiality in respect of both the donor and the receiver of the gametes. Information concerning the donor may be revealed only on medical grounds, when the life or health of the child is threatened.
a. Identity of the donor(s)
i. For the child him or herself No; ii. For the parents No; iii. For a court No. See above comment
b. Certain health information concerning the donor(s)
i. For the child him or herself No; ii. For the parents No; iii. For a court No. See above comment
c. Other information
i. For the child him or herself No; ii. For the parents No; iii. For a court No. See above comment
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? NA
There is no specific legal provisions on the subject.
Under the general laws governing descent, it is not possible to contest paternity in the event of homologous insemination within a married couple.
In cases of heterologous insemination, however, paternity may be contested, but only if the spouse of the inseminated woman did not consent to insemination with another man’s sperm.
Relevant provisions:
Presumption of paternity:
Art. 62 of the Code of the Family and Guardianship:
“1. A child born in wedlock or within three-hundred days of the dissolution or annulment of the marriage shall be presumed to be the child of the mother’s husband.
2. A child born within three-hundred days of the dissolution or annulment of the marriage, but after the mother has remarried, shall be presumed to be the child of the second husband.
3. These presumptions may be rebutted only through action to disclaim paternity.”
Art. 63 of the Code of the Family and Guardianship:
“The husband of the mother may take action to disclaim paternity within six months of learning of the birth.”
Art. 85 of the Code of the Family and Guardianship:
“1. The man who had intercourse with the mother of the child between three-hundred days and one-hundred-and-eighty-one days before its birth shall be presumed to be its father.
2. The fact that, during that period, the mother also had intercourse with another man shall rebut this presumption only if, under the circumstances, the other man appears more likely to be the father."
Abuse of rights and public policy:
Art. 5 of the Civil Code:
“No person shall use their rights in a manner contrary to the social and economic purpose of those rights or the rules of life in society. Abuse or abusive non-use of a right shall not be considered as exercise of that right, or enjoy the protection of the law.”
Art. 58 para. 2 of the Civil Code:
“Any legal act contrary to the rules of life in society shall be null and void.”
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes.
There are no legal provisions on the subject.
Clinics’ internal regulations define the specific medical criteria applicable to donors. Some questions are covered by the Opinion of the Polish Association of Obstetricians.
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No.
There are no legal provisions on the subject.
The Opinion of the Polish Association of Obstetricians provides for the lump-sum compensation of donors of genetic material for the expenses incurred.
8. Are there specific criteria for donation of sperm/oocytes/embryos? Yes.
Criteria for donation of sperm:
There are no legal provisions on the subject.
Some questions are covered by the Opinion of the Polish Association of Obstetricians. Clinics’ internal regulations define the medical criteria applicable to donors. These include: age: 30 - 45 years (correlation between the risk of a genetic disorder, such as Down’s syndrome, and age), state of health (absence of mental, systemic, tumour or infectious disease), and testing for viruses and sexually transmitted diseases. Where there is a high risk of the mother transmitting a genetic disorder to her offspring, the sperm donor must undergo exclusion tests for the same autosomal recessive gene. The donor’s blood group must also be known, to make sure it is compatible with the parents’ blood groups.
Sperm tests are carried out in conformity with WHO standards. Sperm is only preserved if bacteriological tests yield negative results. Donated sperm must be frozen for 6 months prior to the first insemination.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? No.
There are no legal provisions on the subject.
In practice basic physical and ethnic resemblance (skin colour) is taken into account.
10. Are there special measures for the prevention of consanguinity? No.
There is no legal provisions on the subject.
Clinics’ internal regulations may settle this question. According to the Opinion of the Polish Association of Obstetricians, the number of pregnancies obtained using sperm from the same donor may not exceed five.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No.
There are no legal provisions on the subject.
A legal relationship between a child and the homosexual partner of his or her legal parent would be considered contrary to the spirit of Polish law on families and descent, which defines the family as the union of two individuals of the opposite sex.
3. Are MAP procedures covered by the social security system? Yes. Previously, infertility was considered as a disease, now, since July 2016, according to what the law calls principle of equality, every women, single or married, with or without infertility can ask to be inseminated
4. Are there specific criteria for such coverage? Yes.
There is only a lower age limit 18 years (no2, art 6, law 32/2006 in all the country
40 years in the NHS.
5. Is the financial coverage limited to a number of MAP procedures? Yes.
3 cycles for IVF at the National Health Service
At the moment it is not clear how many artificial inseminations can be done in single or homosexual women in NHS.
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? NA
c. Other N/A
3. Are MAP procedures covered by the social security system? Yes.
Yes, but partly. In case of IVF, there is a maximum of three attempts.
4. Are there specific criteria for such coverage? Yes. Age limit of woman – 42 years old.
5. Is the financial coverage limited to a number of MAP procedures? Yes. See answer to question 3.
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 No?; For women not living in a heterosexual couple? No
c. Other N/A
Risk of transmission is possible if donors have not gone through medical examination.
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
Possible for single women; not for persons living in homosexual couple.
Are there specific criteria for access to MAP?
Yes, Access permitted for heterosexual and homosexual couples, no access for single women. Access in case of high risk of transmission of a serious disease, e.g. HIV.
6. Is donation of sperm/oocytes/embryos permitted in your country? NA
7. Are there specific compensation arrangements for such donation? NA
8. Are there specific criteria for donation of sperm/oocytes/embryos? NA
9. Are there specific non-medical criteria for selection of gametes/embryo to be used for MAP? NA
10. Are there special measures for the prevention of consanguinithy? NA
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal partner? NA
3. Are MAP procedures covered by the social security system? NA
4. Are there specific criteria for such coverage? NA
5. Is the financial coverage limited to a number of MAP procedures? NA
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. Only direct costs are allowed to be reimbursed (such as: traveling costs)
8. Are there specific criteria for donation of sperm/oocytes/embryos? Yes. Donors are assessed according to the requirements of the EU Tissues and Cells Directives and other professional standards comprising at least: assessment of the risk for transmission of blood-borne diseases (history of behaviour and testing), medical history, physical examination, genetic testing.
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? Yes. Official Registry is about to be established. Number of donations is limited up to 3 children born (after 3 births donations from donor that is biological parent shall be discarded).
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? NA. Homosexual couples are not permitted to access MAP
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
16. Is donation of sperm/oocytes/embryos anonymous? Yes. According to the Czech Act on Specific Health Services (Act No. 373/2011 Sb.)
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. Only some very basic health, psychosocial and appearance information.
a. Identity of the donor(s)
i. For the child him or herself No, ii. For the parents No, iii. For a court Yes.
b. Certain health information concerning the donor(s)
i. For the child him or herself Yes, ii. For the parents Yes, iii. For a court Yes.
c. Other information
i. For the child him or herself Yes, ii. For the parents Yes, iii. For a court Yes. No exact legal framework for that.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? No. According to the Civil Code, the mother is the woman who gave birth to the child and the father who agreed with the treatment.
3. Are MAP procedures covered by the social security system? Yes. Estonian Health Insurance Fund covers 6 consecutive attempts for women until age 40. In general MAP is allowed for women until age 50. Reason is not defined by law or other legislative documents.
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. Limits are set by law - 6 consecutive procedures are covered by EHIF
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes. Donation of gametes (sperm and oocytes) and fertilized ova (only supernumerary fertilized ova) is allowed only with consent of the donors.
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? Yes.
According to Law 3305/05, (Art 8, para 1) “Reward or compensation for donation of gametes and fertilized ova are prohibited. However, medical, nursing or laboratory expenses travel and accommodation expenses as well as compensation for absence from work are possible.”
The National Authority for Medically Assisted Reproduction with a subsequent Decision (Decision No 36, State Journal 670 B’ 16.4.2008) provides for compensation of medical, laboratory and nursing expenses occurring before and after donation. It also provides for accommodation and transportation expenses. This amount must not exceed 200E for sperm donation and 600 E for oocyte donation. Compensation is also provided for absence from work.
8. Are there specific criteria for donation of sperm/oocytes/embryos? Yes.
Donors must have reached the age of majority with full judicial capacity. Regarding sperm donors must be under 40 years of age whereas for oocytes donors must be under 35 years of age. These age limits can be extended to 50 and 40 years of age respectively in case of donation of fertilized ova or when there is a serious reason, after authorization by the National Authority on MAR. In these cases, special information to the recipients is required regarding increased risk for genetic diseases as well as the need for prenatal testing.
Donors are submitted to special medical and laboratory tests defined (due to scientific developments) by the National Authority.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes. According to the Law the selection of the donor is the responsibility of the MAR Unit. During this selection other criteria like blood group (Rhesus) as well as phenotypic characteristics are taken into consideration. The same criteria apply to fertilized ova donation.
10. Are there special measures for the prevention of consanguinity? Yes.
The number of children born from gametes by the same donor must not exceed 10, unless it is about the birth of a new child of a couple which has already had a child from the gametes of this particular donor. The National Authority may determine the exact number of children resulting from the use of gametes by the same donor, depending on the population of a certain region and other special conditions.
[Comment: the law refers to the actual number of children born and not to the number of cycles of treatment attempted].
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No. This law does not include any provisions for homosexual couples.