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
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.
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.
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. NA
2. Are there specific criteria for access to MAP? See general comment on relevant legal instrument.
Medical reasons:
a. Infertility:
For a heterosexual couple?; For women not living in a heterosexual couple?
b. Risk of transmission of a disease
For a heterosexual couple?; For women not living in a heterosexual couple?
c. Other
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? No; For women not living in a heterosexual couple? No
b. Risk of transmission of a disease
For a heterosexual couple No?; For women not living in a heterosexual couple? No
c. Other N/A
Provision of treatment on the National Health Service (NHS) varies across the UK with different local clinical commissioning groups (CCGs) or health boards having differing levels of provision and different eligibility criteria. The National Institute of Clinical Health and Excellence (NICE) is the NHS body who developed the overarching guidelines which CCGs then apply locally. Guidelines can be viewed here: https://www.nice.org.uk/guidance/cg156. Private fee-paying (non-National Health Service) patients can have treatment for purely non-medical reasons if they wish.
As the UK’s regulator for assisted reproduction, the HFEA requires licensed fertility clinics to follow screening requirements to avoid the transmission of diseases. Donors have to be screened for infectious diseases such as HIV, Hepatitis B and C and Cytomegalovirus (CMV). Among the criteria to be considered is the patient’s age, health and ability to provide for the needs of a child/children. Further information on screening requirements can be viewed in the HFEA’s code of practice: http://www.hfea.gov.uk/498.html
Clinics ultimately must decide fairly whether to offer or refuse treatment. Further information on guidance to treating people fairly when receiving fertility treatment is included in the HFEA code of practice: https://www.hfea.gov.uk/media/2793/2019-01-03-code-of-practice-9th-edition-v2.pdf
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.
Article 28 (paragraph 1-3) regulates Prohibition of Gain from BMAF Procedures
Prohibitions referred to in paragraph 1 to 3 above shall not be applicable to:
1) living donor compensation for loss of earnings or other income for time spent in a medical institution or during recovery, or during temporary inability to work, or compensation for other eligible expenses that the donor has had due to the procedure of retrieval of reproductive cells (transport, accommodation, food costs etc.);
2) eligible compensation in connection with payment for medical or other services related to retrieval of reproductive cells;
3) compensation in the event of excessive damage arising from the retrieval of reproductive cells.
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? NA
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
3. Are MAP procedures covered by the social security system? Yes
4. Are there specific criteria for such coverage? Yes.
Age limit for treatment of infertility with MAP was 40 years, since 2022 is changed:
The service is intended for insured persons, women up to the age of 45 in accordance with the Rule book on the content and scope of the right to health care from compulsory health insurance and on participation for the year 2022.
5. Is the financial coverage limited to a number of MAP procedures? Yes. Three stimulated procedures of biomedically assisted fertilization with donated spermatozoa, three procedures of biomedically assisted fertilization with donated egg cells, as well as three cryoembryotransfers with donated spermatozoa or egg cells in a woman up to the age of 45, if one of the partners (marital or common-law) does not have a child.
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? No
b. possible for women not living in a heterosexual couple? Yes. The Human Fertilisation & Embryology Act 1990 (HFE Act) does not prohibit treatment for same sex couples or single women
Is donationn of the sperm, oocytes and embryos permitted? Yes
Are there specific compensation arrangements for such donations?
No. The 2007 Act states that only donations of supernumerary embryos and gametes which are made free of charge are lawful.
The Act does allow the King, however, to specify an allowance to cover the travel expenses or loss of earnings of the person from whom the gametes are being obtained. This allowance can also cover the hospital fees arising from the retrieval of oocytes from the donor. So far, however, no decrees have been issued to this effect.
In practice, all costs arising from medical examinations and procedures during treatment are borne by the recipient. Sometimes, too, the fertility centre requires the woman receiving the oocytes to pay the donor an “allowance” while sperm donors receive a small amount of compensation for each usable sample.
Are there specific criteria for donation of the sperm, oocytes and embryos?
The 2007 Act states that gamete retrieval is available to adult women up to the age of 45 years. Retrieval of gametes, supernumerary embryos, gonads or gonad fragments for cryogenic storage may be carried out, on medical advice, on a minor, however.
Donations of supernumerary embryos or gametes for eugenic purposes or for the purposes of sex selection are prohibited.
There must be a written agreement between the donor and the accredited fertility centre. The law does not specify any medical criteria for harvesting.
Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP?
In practice, the centres try to avoid too great a dissimilarity between donors and recipients.
The law of 2007 specifies that pairing between donor and recipient may not be considered as a practice with eugenic character.
Are there special measures for the prevention of consanguinity?
The 2007 Act states that supernumerary embryos from the same donor or couple of donors or gametes from the same donor, must not result in births in more than 6 different women.
In a homosexual couple, is a legal relationship possible between a child and the partner of his or her legal parent?
The Act of 18 May 2006 amended certain provisions of the Civil Code to allow same-sex adoption.
Is donation of the sperm, oocytes or embryos anonymous?
Yes. In the case of gametes, anonymity is the rule. The law does, however, allow non-anonymous donations if they are based on an agreement between the donor and the recipient or recipients.
Is it possible to obtain information about the biological origin of a child born after gametes or embryo donnation?
The law provides that once supernumerary embryos or gametes have been implanted, the parentage rules set out in the Civil Code operate in favour of the author or authors of the parental project. No parentage suit may be filed against the donor by the recipient or by the child born through the use of supernumerary embryos or gametes.
There are no specific legal provisions that would apply to the courts in this area. It cannot be ruled out that a court might obtain information about the biological origin of a child born through gamete or embryo donation if it deemed this necessary.
Is it possible to obtain information about the identity of the donors ?
No for the child and the parents, yes for the court
The fertility centre is legally bound to render inaccessible any data that could be used to identify the embryo or gamete donor. Anyone working for or in a fertility centre who becomes aware of information that could be used to identify the donor is subject to the professional secrecy requirement (Art. 458 of the Criminal Code). Non-anonymous gamete donations are permitted, however, if they are based on an agreement between the donor and the recipient or recipients.
Is it possible to obtain certain health information concerning the donors?
For the child, for the parents, for the court: yes
The Act specifies that the center registers specific data concerning the donor, such as the physical characteristics of the biological parents, in case of an embryo, or of the gamete’s donor but provides for the parents and the child to have access only to the necessary medical data that can be important for the child’s health.
Is it possible to obtain other information?
For the child, for the parents no, for the court yes
The law requires the centre to record certain data relating to the donor, including the physical characteristics of both embryo providers or of the gamete donor. The law only allows the parents and child access to such medical data as are necessary for the child’s health, however.
Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions?
No, the law states that once supernumerary embryos or gametes have been implanted, the parentage rules laid down in the Civil Code operate in favour of the authors of the parental project.
No lawsuit relating to parentage or to its effects on property rights may be brought by donors of supernumerary embryos or gametes.
3. Are MAP procedures covered by the social security system?
Unfulfilled desire to have children is not considered as a disease. A fund is established to cover 70% of costs of IVF – treatments under specific conditions.
4. Are there specific criteria for such coverage?
Yes:
5. Is financial coverage limited to a number of MAP procedures?
Yes, limitation to four IVF procedures; if a pregnancy is achieved further four IVF procedures are possible.
Title of the law: Law on Medical Assisted Reproduction “Fortpflanzungsmedizingesetz”
Date of adoption: 14 May 1992 entry into force 1 July 1992
Published: in Federal Gazette “Bundesgesetzblatt” BGBl. Nr. 275/1992
Amendment: Fortpflanzungsmedizinrechts-Änderungsgesetz 2015
Date of Adoption: 23 February 2015, entry into force: 24 February 2015
Published in: Federal Gazette “Bundesgesetzblatt” BGBl. I Nr. 35/2015
Revision concerning egg donation, sperm donation and PGD
1. Is access to MAP
Access for homosexual and heterosexual couples, no access for single women.
Des critères spécifiques sont-ils retenus pour l’accès à la PMA ?
L'accès à la PMA est ouvert aux couples hétérosexuels et homosexuels, mais pas aux femmes célibataires. Accès en cas de risque élevé de transmission d’une maladie grave, par ex. VIH.
19. Is there an important current debate in your country on these or related issues?
Not at present. However, in 2001, an amended law on medically assisted procreation was passed, making, among other things, the MAP services freely accessible to single women without male partners and without a medical fertility problem, which under the previous law (2000) had not been possible. An opposition group in the Parliament called for a legislative referendum, triggering fervent public debate. The National Medical Ethics Committee (NMEC) and the National Health Council advised against arbitrary use of medicine for interventions with far reaching consequences, when, such as in this case, there is no valid medical indication. The NMEC quoted the Ad Hoc Committee of Experts on Progress in Biomedical Sciences (CAHBI)’s Report on human artificial procreation, 1989, which restricts the use of MAP procedures to heterosexual couples and to the situations with strict medical indications (infertility, failure of other methods of treatment, need to avoid transmission of a grave disease) as in fact contained in the previous law.
In the referendum, the voters rejected the new law with an overwhelming, nearly 3:1, majority. As a result, the law of 2000 described above remained in force.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law.
The matter of the law is published in:
ZUPANCIC, Karel, MEDEN-VRTOVEC, Helena, TOMAZEVIC, Tomaz, ZNIDARSIC, Viktorija. The future law on infertility treatment and on biomedically assisted procreation in Slovenia. J. assist. reprod. genet., Oct. 2000, vol. 17, issue 9, pp. 496-497.
(The paper refers to the draft, but the final version is essentially unchanged).
Information on some other aspects of the legislation and practice of MAP in Slovenia are contained in a IFFS survey (See Addendum).
19. Is there an important current debate in your country on these or related issues? The Spanish Surrogate Association is promoting the legalisation of this method as another Assisted Reproductive Technology.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. -
6. Is donation of sperm/oocytes/embryos permitted in your country? sperm Yes/oocytes Yes/embryos Yes
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? Yes. The National Commission for Assisted Reproduction approved in 1998 the figure of 600 euros as compensation for the expense and inconvenience of the donor. Currently some private clinics are paying 1000 euros.
8. Are there specific criteria for donation of sperm/oocytes/embryos? sperm Yes/oocytes Yes/embryos Yes
Sperm donor: no more than 50 years old. Oocyte donor: no more than 35 years old.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes. Matching appearance and immunological compatibility of donor and future parent(s).
10. Are there special measures for the prevention of consanguinity? Yes. No donor can be parent of more than six children. This is controlled through the National Registry of Donors and the banks of the clinics of assisted reproduction.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? Yes; For women not living in a heterosexual couple? Yes
b. Risk of transmission of a disease
For a heterosexual couple Yes?; For women not living in a heterosexual couple? Yes
c. Other N/A
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? Yes. The couple must have attempted natural conception for a reasonable period of time, unless inapplicable.; 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? Yes
The parents’ state of health may be assessed (including parents’ age, if life expectancy considering illnesses is above 18 yrs, the ability to give the child good living conditions; an assessment in the child’s best interest)
c. Other N/A
16. Is donation of sperm/oocytes/embryos anonymous?
sperm No / oocytes - / embryos -
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.
Sperm donation in accordance with Art. 18 ff. RMA is the only permissible heterologous reproductive method in Switzerland. The child conceived by means of heterologous sperm donation has a right of access to certain relevant data, including the appearance, name, place of residence, date of birth, nationality, education and profession of the donor (Art. 24 para. 2 lit. a and d RMA), without having to claim a legitimate interest. The minor child also has a right to information, provided that there is a legitimate interest, often a medical interest (Art. 27 para. 2 RMA).
ii. For the parents No; iii. For a court Yes, if necessary, in particular in the context of paternity proceedings or proceedings to challenge the presumption of marriageability.
a. Identity of the donor(s)
i. For the child him or herself Yes; ii. For the parents No; iii. For a court Yes, if necessary
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
Yes, in the case of procreation through sperm donation, if certain requirements are met:
If you can claim an interest worthy of protection (for example, for medical reasons), you will receive further information, such as the results transmitted by the doctors for the medical examination (Art. 27 para. 2 RMA).
c. Other information
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No
Yes, in addition to information on origin, the child may also request information on occupation, education and physical appearance (Art. 27 para. 1 RMA). He or she may request information about all the donor's data - including the date of the sperm donation and the results of the medical examination - if he or she has an interest worthy of protection (Art. 27 para. 2 RMA). At the request of the sperm donor, further donor data in addition to the data mentioned in Art. 24 FMedG, namely pictures of the donor, are retained (Art. 17 RMA).
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? No. Art. 256 para. 3 Swiss Civil Code; Art. 23 RMA
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
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.
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
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.
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
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
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
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
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
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
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
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.
5. Is the financial coverage limited to a number of MAP procedures? Yes. Only one IVF 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? 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.
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.
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
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
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
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.
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.
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
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.
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.
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
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
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
16. Is donation of sperm/oocytes/embryos anonymous?
sperm No / oocytes No / embryos No
Due to amendments to the Human Fertilisation and Embryology Act – the law overseeing the use of fertility treatment in the UK – donor conceived people born after 1 April 2005 can request identifying information about their donor from the HFEA once they reach 18 years old. This, however, means that there are different information access rights depending on when the donor conceived person was conceived. These are set out below.
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself Yes; ii. For the parents No; iii. For a court Yes
The HFE Act 1990 (as amended) allows donor conceived people to apply for non- identifying information about the donor, if available, such as family medical history, hair/eye colour and interests, when they reach 16. If they were conceived after 1 April 2005, when the donor conceived person reaches 18 years old, they may apply to the HFEA to receive identifying information about their donor.
Parents of children conceived through donor conception can access non identifying information about the donor from the HFEA.
Section 34 of the HFE Act 1990 permits the Authority to make disclosure where it is necessary for the purposes of instituting proceedings under the Congenital Disabilities Act.
a. Identity of the donor(s)
i. For the child him or herself Yes; ii. For the parents No; iii. For a court Yes
b. Certain health information concerning the donor(s)
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court Yes
c. Other information
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court Yes
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? Yes.
Whether patients’ own gametes are used in assisted fertility treatment or whether donor gametes are used, where the couple is either married or in a civil partnership, both parents will be the legal parents of any child born from the treatment from the date of birth of the child. The law endeavours to put couples who have had assisted fertility treatment in a similar position to couples who conceive naturally as regards legal parenthood and parental responsibility. It is however possible for the father or second parent (in the case of a female same sex couple who are in a civil partnership) to resist legal parenthood but only where the person can demonstrate that he or she did not consent to their partner’s treatment (see section 35(1) and section 42(1) of the HFE Act 2008).
When donor gametes are used in treatment, and where the couple having treatment is neither married nor in a civil partnership, the second parent (i.e. not the birth mother) can acquire legal parentage if the agreed parenthood conditions are met (see section 37 and 44 of the HFE Act 2008). In cases where the agreed parenthood conditions are not met, parenthood will be in question and in order to establish legal parenthood, the couple would need to seek a declaration of parenthood from Court.
Further information on legal parenthood can be found on these pages of the HFEA website:
https://www.hfea.gov.uk/treatments/explore-all-treatments/becoming-the-legal-parents-of-your-child/
Definitions of mother and father in accordance to (HFE) Act 2008 are as follows:
Meaning of "mother"
(1) The woman who is carrying or has carried a child as a result of the placing in her of an embryo or of sperm and eggs, and no other woman, is to be treated as the mother of the child.
(2) Subsection (1) does not apply to any child to the extent that the child is treated by virtue of adoption as not being the woman’s child.
(3) Subsection (1) applies whether the woman was in the United Kingdom or elsewhere at the time of the placing in her of the embryo or the sperm and eggs.
Meaning of "father"
35 Women married at time of treatment
(1) If -
(a) at the time of the placing in her of the embryo or of the sperm and eggs or of her artificial insemination, the woman was a party to a marriage, and
(b) the creation of the embryo carried by her was not brought about with the sperm of the other party to the marriage, then, subject to section 38(2) to (4), the other party to the marriage is to be treated as the father of the child unless it is shown that he did not consent to the placing in her of the embryo or the sperm and eggs or to her artificial insemination (as the case may be).
(2) This section applies whether the woman was in the United Kingdom or elsewhere at the time mentioned in subsection (1)(a)
19. Is there an important current debate in your country on these or related issues? As referred to at 18 above, in cases where the agreed parenthood conditions of the HFE Act 2008 have not been met, legal parenthood does not automatically follow for the second parent. In such cases one of the only remedies for the second parent to seek a declaration of legal parenthood from the Court. See for example the recent case (Neutral Citation Number: [2015] EWHC 2602 (Fam) which can be found here: https://www.judiciary.gov.uk/wp-content/uploads/2015/09/parentage.pdf
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law.
R (TT) v Registrar General for England and Wales & Ors ((2019) EWHC 2384 (Fam))
The case concerns a transgender man (TT) who has a gender recognition certificate (GRC) confirming that he is male for all legal purposes except the limited exceptions set out in the Gender Recognition Act 2004 (GRA). TT had artificial insemination using donor sperm in a licenced fertility clinic, fell pregnant as a result, gave birth to a child, in 2017. He tried to register the birth as the father but was refused by the Registrar General (RG) who was only able to register the birth with TT as the mother. The birth has remained unregistered.
The judgement was handed down on 25 September 2019. The judge supported the Government’s position that a person who gives birth to a child (i.e. including a trans man such as TT) will be the child’s mother. The Government’s view is that the judgment has no effect on the availability of regulated fertility treatment in the UK. The Government considers that regulated fertility treatment is currently, and will remain, equally available to all (trans) women and (trans) men under the Human Fertilisation and Embryology Acts.
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
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.
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.
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
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”
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.
19. Is there an important current debate in your country on these or related issues? No
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
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).
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.
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
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.
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
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.
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
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.
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
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:
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.
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:
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.
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.
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.”
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.