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
Title of the law: There are no general laws or regulations on medically assisted procreation in Poland
If no legal instrument please describe the practice: In view of the lack of specific legal provisions, MAP may be practised under the general rules of medical law and in particular those governing the practice of medicine (duty to inform patients of the medical and legal consequences, confidentiality with regard to the MAP itself and the identity of the donor of the gametes, due care in the choice of the donor and examination of the genetic material to be used, the duty to obtain free and informed consent, etc), the corresponding rights of patients, the general laws on families, descent and registration, and the Medical Code of Ethics (which does not address this issue specifically). Some questions are addressed in the Opinion of the Polish Association of Obstetricians concerning the MAP techniques used in the treatment of infertility, and others by the internal regulations of the clinics practising MAP (practice may therefore vary from one place or establishment to another).
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
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
19. Is there an important current debate in your country on these or related issues? N/A
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. N/A
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? N/A
c. Other N/A
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.
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.
6. Is donation of sperm/oocytes/embryos permitted in your country? sperm Yes/oocytes Yes/embryos No
See http://eng.heilbrigdisraduneyti.is/laws-and-regulations/nr/686
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 *
* See regulation: http://eng.heilbrigdisraduneyti.is/laws-and-regulations/nr/686
(Artificial insemination with donor sperm shall only be carried out if the fertility of the man is impaired, he has a serious hereditary disease or there are other medical reasons to use of donor sperm. (Article 8)
In vitro fertilization shall only be carried out with the gamete of the couple. It is however permitted to use donor gamete if the fertility of the man or the woman is impaired, either of them has a serious hereditary disease or there are other medical reasons to use of donor gamete. It is prohibited to carry out in vitro fertilization unless the gamete of either partner or either cohabitant is used. Donation of embryos and surrogacy is prohibited. (Article 9))
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes. If donated gametes are used, the doctor in charge of the treatment shall select the appropriate donor. A donor of gamete shall be healthy and have no hereditary diseases. Necessary tests shall be carried out to ensure that the donor is healthy and fertile and to prevent the transmission of diseases with the gamete. If imported gametes are used, the fulfilment of the aforementioned demands must be ensured. A doctor shall endeavour to realize the wishes of applicants that the build, height, colour of eyes and hair and the blood type of the gamete donor is as closely resembling the parent's as is possible . (art.17 reg.568/1997)
10. Are there special measures for the prevention of consanguinity? Yes. Indirectly, see art.18 reg.568/1997 (If a donor wishes to remain anonymous, health workers are obliged to ensure that this is respected. In this case, the donor may neither receive information about the couple receiving the donated gamete or the child, nor the couple or the child receive information about the donor. If a donor does not wish to remain anonymous, the institution shall preserve information about him in a special file. If the donation of gamete leads to the birth of a child, information about the child and the couple who received the gamete shall be kept in the same file. A child born on account of a gamete donation where the donor does not wish to remain anonymous can at the age of 18 gain access to a file pursuant to paragraph 2 for the purpose of obtaining information about the identity of the donor. If a child receives information about the gamete donor at the institution, the said institution shall as soon as possible inform the donor that the information has been given.)
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? Yes. Art. 6, Act no. 87/1996 (The provisions of the Adoption Act relating to spouses shall not apply to registered partnership. A person in registered partnership can however adopt a child of the other partner of whom that partner has custody, provided the child has not been adopted from another country. Nor statute provisions on artificial insemination apply to registered partnership. Ni statute provisions involving particular rules depending on the sex of a married spouse shall apply to registered partnership. 1). Provisions of international agreements to which Iceland is a party shall not apply to registered partnership unless approved by the other party.)
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? Yes. Financial rewards are explicitly prohibited. Compensation for travel costs, administrative burdens and loss of earnings are legal under conditions (Act § 170 (3))
8. Are there specific criteria for donation of sperm/oocytes/embryos? Yes.
For a. and b. In a concrete intervention with gamete donation only one and the same person can be the donor.
The donation is prohibited (Act §171 (7))
Sperm: if the donor has a pathology excluding donation (Decree, appendix Nr. 3)
Oocytes: the donor refuses giving his/her personal data required (Act §171 (3))
Embryos: if the donor does not appear in person at the center
Age limit is 35 years (Act §171 (1))
Embryo donation is anonymous
Further conditions for embryo donation are detailed in Act §176
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes.
For gametes, the appearance, as well as eventual illness of the donor are registered data.
For oocyte donation, the level of eventual parent status must be considered (Act § 171 (4)).
For embryo donation, embryos issuing from the same couple may only be implanted in MAP for maximum two different persons. (Act § 175 (4)).
10. Are there special measures for the prevention of consanguinity?
The number of descendants from the same gamete donor with different persons included in MAP intervention cannot exceed 4.
MAP intervention can only be requested by persons who are not in level of parentage that would prevent legal marriage between them (Civil Code § 4:12 (1) a) and b), i.e. between linear relatives and brothers/sisters).
In MAP with persons in other level of consanguinity the physician indicating MAP has to previously consult with the Regional Genetic Center (Decree §1 (3)).
Embryos issuing from the same couple may only be implanted in MAP for two different persons (Act § 175 (4)).
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No. MAP is restricted to heterosexual couples.
16. Is donation of sperm/oocytes/embryos anonymous? sperm Yes and No/oocytes Yes and No/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; iii. For a court
Detailed provisions in Act § 179 (1)
a. Identity of the donor(s)
i. For the child him or herself Yes; ii. For the parents; iii. For a court
Detailed provisions in Act § 179 (1)
b. Certain health information concerning the donor(s)
i. For the child him or herself Yes; ii. For the parents; iii. For a court
Detailed provisions in Act § 179 (1)
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, with exceptions.
The assumption of paternity cannot be contested by the father, with the exception if the husband or common-law companion has not consented to the MAP process (Civil Code § 4:108 a)).
The donor of sperm or embryo is excluded by law from fatherhood (Civil Code § 4: 103 (5)).
The donor of oocyte or embryo is excluded by law from motherhood (Civil Code § 4: 115 (4).
The woman delivering the child is considered the mother.
3. Are MAP procedures covered by the social security system? No. Although in vitro fertilisation (IVF) treatment is not provided by the Irish public health service, there is some support available in that patients who access IVF treatment privately may claim tax relief on the costs involved under the tax relief for medical expenses scheme. In addition, a defined list of fertility medicines needed for fertility treatment is covered under the High Tech Scheme administered by the Health Service Executive (HSE). Medicines covered by the High Tech Scheme must be prescribed by a consultant/specialist and approved by HSE ‘High Tech Liaison Officers’. The cost of the medicines is then covered, as appropriate, under the Medical Card or Drugs Payment Scheme.
4. Are there specific criteria for such coverage? Assisted human reproduction is provided for in the private sector and at present there are no standard limits relating to age or infertility. However, most providers of assisted human reproduction services adhere to the guidelines produced by the Irish Fertility Society.
5. Is the financial coverage limited to a number of MAP procedures? No
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple?; For women not living in a heterosexual couple?
b. Risk of transmission of a disease
For a heterosexual couple?; For women not living in a heterosexual couple?
c. Other
As previously mentioned, it is proposed that legislation will permit assisted human reproduction services to be available to people irrespective of gender, marital status or sexual orientation. However, in the interests of any child to be born as a result of assisted human reproduction (or any existing children in families wishing to avail of assisted human reproduction), the legislation will provide for child welfare assessments which will afford a way of assessing whether intending parents are suitable for assisted human reproduction treatment. The purpose of these assessments will be used to assess intending parents’ age, health and ability to provide a stable and healthy environment for a child/children.
3. Are MAP procedures covered by the social security system? Yes. Partially covered
4. Are there specific criteria for such coverage? Yes. The proportion of the payment covered by the social security system differs according to how many times treatment has been undertaken.
5. Is the financial coverage limited to a number of MAP procedures? Yes.
For couples without a child together coverage for first treatment approx. 50%
For second to fourth treatments approx. 70%. No coverage for further treatments.
For couples with one child. Coverage for first to fourth treatment approx. 20%. No coverage for further treatments. No coverage for couples with more than one child.
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
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.
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.
Title of the legislation: Law 12/2019, of the 15th February, described as techniques of assisted reproduction
Date of adoption and of entry into force: adopted on 15.02.2019 and came into force on 21.03.2019
Published in the Official Bulletin of the Principality of Andorra (B.O.P.A)