Access to medically assisted procreation - Search
Sweden - Legal regulation or practice and access to MAP
- Title of the law: Lagen (2006:351) om genetisk integritet (The Act on Genetic Integrity)
- Date of adoption and entry into force: Adopted 18/5/2006 and entered into force 1/7/2006.
- Published in: Svensk Författningssamling, SFS
Amendments in the law will enter into force on April 1st 2016, allowing single females to be fertilized by assisted reproduction. The egg cell must be the single female’s own gametes.
The questions about the requirement of a) a genetic link between one of the parents and the child, and b) whether altruistic surrogacy, if any, should be allowed, were recently assessed. The government inquiry “Olika vägar till föräldraskap (SOU 2016:11)” has in a publication on the 24th February 2016 proposed to remove the requirement of a genetic link between the child and one of the parents but to not allow surrogacy.
Spain - Legal regulation or practice and access to MAP
- Title of the law: Ley 14/2006, de 26 de mayo, sobre técnicas de reproducción humana asistida (Law 14/2006 on assisted reproductive techniques)
- Date of adoption [and entry into force]: 26 May 2006
- Published (entry into force) in: Boletín Oficial del Estado nº 126, 27 May 2006 (the modification of this law has been published in Boletín Oficial del Estado nº 167, 15 October 2015).
- Title of the law: Real Decreto 1030/2006, de 15 de septiembre, por el que se establece la cartera de servicios comunes del Sistema Nacional de Salud y el procedimiento para su actualización (Royal Decree 1030/2006, of 15 September, establishing the porfolio of common services of the National Health System).
- Date of adoption [and entry into force]: 16 September 2006
- Published (entry into force) in: Boletín Oficial del Estado nº 222, 16 September 2006
Slovenia - Legal regulation or practice and access to MAP
- Title of the law: The Law on treatment of infertility and procedures of fertilization with biomedical assistance (Zakon o zdravljenju neplodnosti in postopkih oploditve z biomedicinsko pomočjo (ZZNPOB))
- Date of adoption and entry into force 28 July 2000 / 8 September 2000
- Published in Uradni list RS 70/2000 z dne 8 August 2000 (Official Gazette of the Republic of Slovenia, 8 August 2000, 3307).
- Indicate if process of revision is ongoing and, in your answers, provide information on provision in the draft law: Not at present
Slovak Republic - Legal regulation or practice and access to MAP
If no legal instrument please describe the practice There is no law regulating in particular assisted reproduction techniques, but these methods are generally permitted. As for the insurance, basic problems of MAP are partially solved by the Sanitary Order Law / the definitions of indications, contra – indications for reimbursement of MAP are: more than 38 years of age, tubal sterility or previous interruption for social or personal reasons. Only for 2 cycles of MAP can be reimbursed.
Türkiye - Legal regulation or practice and access to MAP
- Title of the law: Regulation on Assisted Reproductive Treatment Centres / Regulation on Assisted Reproductive Treatment Practices and Assisted Reproductive Treatment Centres
- Date of adoption and entry into force: 30.09.2014
- Published in Official Gazette
North Macedonia - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? NA
17. Is it possible to obtain information about the biological origin of a child born after gametes 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
North Macedonia - Financial aspects
3. Are MAP procedures covered by the social security system? No. MAP is not incorporated in the social security system. The drugs for infertility may be covered (80 %) only if patient is treated by the hospital facilities.
4. Are there specific criteria for such coverage? No
5. Is the financial coverage limited to a number of MAP procedures? No
Norvège - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? NA
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. NA
Legal regulation or practice and access to MAP
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).
Portugal - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? Yes. There is a waiting list (both in public and private centers) for MPA procedures, that was aggravated during 2020-21 due to the pandemic situation.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. NA
San Marino - Medical aspects
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
United Kingdom - Medical aspects
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? No; For women not living in a heterosexual couple? 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
Serbia - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No.
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
Serbia - Financial aspects
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.
United Kingdom - Medical aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? No
b. possible for women not living in a heterosexual couple? Yes. The Human Fertilisation & Embryology Act 1990 (HFE Act) does not prohibit treatment for same sex couples or single women
Pays-Bas - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No. Compensations are legally limited to only compensation of costs made for the donation.
8. Are there specific criteria for donation of sperm/oocytes/embryos? Yes.
Within the Embryos Act, there are criteria to guarantee the free consent of the donor. In addition to that, the professional Guideline states that oocyte donation is contraindicated for
- women who are older than 40 years,
- women who have a higher risk on complications is case of oocyte-stimulation- or punction;
- women with sexually transmitted diseases who cannot be cured
- women with a genetic disease within their family.
These contraindications are absolute. In addition, some women have a relative contraindication to oocyte donation, for instance women who have no children themselves and are under the age of 30.
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 a professional guideline that limits the number of offspring of one donor to 25 children or 12 families. Because clinics now don’t have a legal basis to check if a donor also donates in other clinics, there is a legal change in preparation which allows national registration of donors, so that the limited number of offspring can be monitored.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? Yes. When two women are married, the second mother can easily become the legal mother. In other cases, an adoption procedure is required.
Pays-Bas - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? No
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. Na
Slovak Republic - Current debate and specific situations
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
Slovak Republic - Medical aspects
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? Yes; For women not living in a heterosexual couple? No
b. Risk of transmission of a disease
For a heterosexual couple Yes?; For women not living in a heterosexual couple? N/A
c. Other N/A
Estonia - Medical aspects
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? Yes; For women not living in a heterosexual couple? Yes
b. Risk of transmission of a disease
For a heterosexual couple Yes?; For women not living in a heterosexual couple? Yes
c. Other N/A
Sweden - Medical aspects
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
Switzerland - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous?
sperm No / oocytes - / 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
Slovenia - Current debate and specific situations
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).
Spain - Sperm/oocyte/embryo donation
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
- Donor: Adult (18 years old or more) and legally capable.
Sperm donor: no more than 50 years old. Oocyte donor: no more than 35 years old.
- No lucrative or commercial purposes.
- Good psychophysical health and they do not suffer from genetic, hereditary or transmissible infectious diseases to offspring.
- Written contract.
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
Spain - Current debate and specific situations
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. -
Croatia - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? No. After reaching the age of 18 a person born from the MAP procedure is allowed to have access to data on identity of biological parent(s).
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself Yes; ii. For the parents No; iii For a court Yes
After reaching the age of 18, every person born from a MAP procedure is allowed to have access to data on identity of biological parent(s).
Parents do have a right to access the donor data in the case of medical indication.
Both, child and parents should require data access from the MAP Registry.
a. Identity of the donor(s)
i. For the child him or herself, ii. For the parents, iii. For a court NA
b. Certain health information concerning the donor(s)
i. For the child him or herself Yes; ii. For the parents Yes; iii For a court Yes
c. Other information
i. For the child him or herself Yes; ii. For the parents No; iii. For a court Yes
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? Yes. Contest is regulated within the Family Law. It is possible to contest maternity or paternity only in the cases when MAP procedure was performed without consent.
Cyprus - Financial aspects
3. Are MAP procedures covered by the social security system? No. The Ministry of Finance covers the cost of MAP procedures.
4. Are there specific criteria for such coverage? Yes. Specific criteria for such coverage are: (1) infertility (2) for women under 40 years old.
5. Is the financial coverage limited to a number of MAP procedures? Yes. The financial coverage is limited to only one (1) MAP procedure
France - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. Medically assisted procreation is considered a health care activity. Law N°2021-1017 of August 2nd 2021 provides for the possibility of reimbursement of MAP by social security under the same conditions for unmarried single women, female couples and heterosexual couples. The MAP procedure is covered by national solidarity. The beneficiaries are exempt from the co-payment.
4. Are there specific criteria for such coverage? Yes. The law of August 2, 2021 removed the criterion of infertility, MPA procedures are covered at 100% by the Assurance Maladie for a maximum of : - 6 inseminations (only one artificial insemination per cycle) to obtain a pregnancy; - 4 in vitro fertilization attempts to achieve a pregnancy. This coverage is the same for everyone (heterosexual couple, couple made up of 2 women, unmarried woman) Knowing that, for the retrieval or the collection in a project of AMP, there are conditions of ages: - oocyte retrieval can be performed in women up to their 43rd birthday; - Sperm collection can be performed in men up to their 60th birthday; And for the performance of MPA: - until her 45th birthday for the woman, unmarried or within the couple, who will carry the child; - until his 60th birthday for the person in the couple who will not carry the child.
5. Is the financial coverage limited to a number of MAP procedures? Yes. The health insurance system will cover six inseminations and four complete cycles, i.e. concluded by embryo transfer. Any IVF cycle broken off before embryo transfer, irrespective of the stage at which it is abandoned, will not be counted by the health insurance system. Reimbursement is subject to a preliminary agreement procedure.
Should pregnancy and delivery occur, the count restarts from zero, and coverage is provided for four new attempts. This does not apply to miscarriages or extrauterine pregnancies.
Georgia - Medical aspects
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? LHC: Yes, DL-RHRR: Yes;
For women not living in a heterosexual couple? LHC: No, DL-RHRR: Yes
2bi
LHC: Yes
“Risk of transmission of a genetic disease”
DL-RHRR: Yes
a) “Proven likelihood of the transmission of a serious genetic disease to a naturally conceived child from a woman or man, that may result in a child’s severe disability and/or premature death.”
b) “Proven likelihood that a child from natural insemination will be born with a non-genetic disease that may result in grave disability and/or premature death.”
b. Risk of transmission of a disease
For a heterosexual couple?; LHC: Yes “Risk of transmission of a genetic disease” DL-RHRR: Yes
a) “Proven likelihood of the transmission of a serious genetic disease to a naturally conceived child from a woman or man, that may result in a child’s severe disability and/or premature death.”
b) “Proven likelihood that a child from natural insemination will be born with a non-genetic disease that may result in grave disability and/or premature death.”
For women not living in a heterosexual couple? LHC: No, DL-RHRR: Yes
a) “Proven likelihood of the transmission of a serious genetic disease to a naturally conceived child from a woman or man, that may result in a child’s severe disability and/or premature death.”
b) “Proven likelihood that a child from natural insemination will be born with a non-genetic disease that may result in grave disability and/or premature death.”
Accordingly, the draft law of Georgia on Reproductive Health and Reproductive Rights permits access to medically assisted reproductive technologies for heterosexual couples or single women only if at least one of the conditions listed below are met:
- A woman and/or man of reproductive age is infertile, other alternatives available in the country for treating infertility have proved ineffective; or such treatment hasn’t yet been carried out, but there is a reason to assume that it will be ineffective, as attested by a duly authorised state medical institution;
- There is a proven likelihood of the transmission of a serious genetic disease to a naturally conceived child from a woman or man, which may result in a child’s severe disability and/or premature death;
- There is a proven likelihood, that a child from natural insemination will be born with a non-genetic disease, that may result in grave disability and/or premature death;
- A woman carries a disease due to which the pregnancy may endanger the woman’s life and/or health.
c. Other There is one more medical criterion, but only for accessing surrogacy: existence of a disease due to which the pregnancy may endanger the woman’s life and/or health.
Georgia - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples?
LHC: Insemination-No; IVF-Yes
a) At present the law gives access to artificial insemination to heterosexual couples as well as to single women.
b) However in vitro fertilization (IVF) is accessible only to couples.
DL-RHRR: No. Draft law gives access to medically assisted procreation (artificial insemination as well as in vitro fertilization procedures) to heterosexual couples as well as to single women.
b. possible for women not living in a heterosexual couple?
LHC: Insemination-Yes; IVF-No
a) Law gives access to artificial insemination to single women. However, the Law does not specify whether women should be living in heterosexual couple or not.
b) IVF is not accessible for single women.
DL-RHRR: Yes. Draft law gives access to medically assisted procreation (artificial insemination as well as in vitro fertilization procedures) to single women.
Italy - Réglementation ou pratique et accès à la PMA
- Titre de la législation : Règles en matière de procréation médicalement assistée.
- Date de l’adoption et de l’entrée en vigueur 19 février 2004 n°40
- Publiée dans : Gazzetta Ufficiale della Repubblica Italiana (publication officielle contenant les éléments des nouvelles lois).
- Indiquer si une révision est en cours et, dans vos réponses, fournir des informations sur les dispositions du projet de loi :
Le 12 juin 2005 a eu lieu un référendum populaire pour modifier plusieurs dispositions de cette loi. L’abrogation de ces dispositions a été rejetée, le taux d’abstention ayant été de 74 % (51 % de votes favorables auraient été nécessaires pour changer la loi).
Résumé
1. Protection des désirs de maternité/paternité et règles d’exercice des droits découlant de la loi n° 40/2004.
L’accès aux techniques de procréation assistée est réservé à des couples hétérosexuels majeurs, mariés ou menant une vie commune, dont les membres sont tous deux vivants et en âge de procréer.
Il est interdit aux personnes célibataires et aux homosexuels.
Le couple qui demande un accès aux techniques de procréation (médicalement) assistée doit produire un certificat médical attestant l’existence d’une stérilité ou d’une infertilité pour lesquelles il n’existe aucune autre solution possible.
Le consentement, écrit et librement révocable jusqu’au moment de la fécondation in vitro de l’ovocyte, est obligatoirement précédé d’une information sur le plan technique, juridique, et éthique ainsi que sur le coût des procédures et sur les conséquences possibles des techniques de procréation assistée pour l’enfant à naître.
Lors de l’entretien avec le responsable du centre médical, les couples sont également informés des possibilités d’adopter un enfant ou de devenir famille d’accueil d’un enfant en vue de son adoption (loi n° 184 du 4 mai 1983).
Un délai de réflexion de sept jours doit être respecté avant le début des procédures de procréation assistée.
Ces techniques sont appliquées de manière progressive en commençant par les moins invasives afin d’éviter de recourir à des interventions dont le caractère invasif, au plan technique et psychologique, les rend plus pénibles pour les personnes concernées.
Le médecin responsable du centre médical est en droit de prendre la décision de ne pas recourir aux techniques de procréation assistée, exclusivement pour des raisons médicales ou de santé.
La cryoconservation des gamètes masculins et féminins est autorisée, à condition que les personnes concernées aient été informées et y aient donné leur consentement écrit.
La loi, dans sa formulation d’origine, interdisait le recours à des techniques de type hétérologue (avec don de gamètes d’un tiers extérieur au couple). L’intervention de la Cour constitutionnelle (arrêt n° 162 de 2014) a supprimé cette interdiction.
2.Protection de l’enfant à naître
Le statut juridique de l’enfant né par techniques de procréation assistée est celui d’un enfant légitime ou reconnu par le couple. Le désaveu de paternité est exclu en cas de fécondation hétérologue. Le donneur de gamètes n’acquiert aucun lien juridique de parenté avec l’enfant né (aucun droit ni devoir).
La mère ne peut plus, au moment de l’accouchement, déclarer sa volonté de ne pas être connue, comme cela est autorisé pour la conception naturelle (Décret du Président de la République n° 396 du 3 novembre 2000).
3.Protection de l’embryon
Il est interdit de procéder à la cryoconservation ou à la suppression d’embryons, sous réserve des dispositions de la loi n° 194 du 22 mai 1978 (loi sur l’interruption volontaire de grossesse).
La loi, dans sa formulation d’origine, disposait que les techniques de production d’embryons, compte tenu de l’évolution technique et scientifique et de ce qui pourra être établi à l’avenir par des orientations juridiques du ministre de la Santé, ne peuvent conduire à la création d’un nombre d’embryons supérieur à celui strictement nécessaire à la réalisation d’un transfert unique et simultané, ce nombre ne pouvant en aucun cas être supérieur à trois.
Lorsque le transfert des embryons dans l’utérus se révèle impossible pour raison majeure grave et prouvée, ayant trait à l’état de santé de la femme et non prévisible au moment de la fécondation, la cryoconservation des embryons est autorisée jusqu’à la date du transfert, qui sera effectué aussitôt que possible. Depuis la décision n° 151/2009 de la Cour constitutionnelle, la détermination du nombre d’embryons à créer et à transférer dans le cadre d’une procédure d’implantation reste à l’appréciation du médecin qui tient compte de l’état de santé de la femme. Il ne doit pas être supérieur au nombre strictement nécessaire à la procréation.
En vertu de la loi sur la procréation médicalement assistée, il est interdit de procéder à la réduction embryonnaire de grossesses multiples, sauf dans les cas prévus par la loi n° 194 du 22 mai 1978 (loi sur l’interruption volontaire de grossesse).
Les sujets visés à l’article 5 sont informés du nombre et, s’ils le demandent, de l’évaluation des embryons produits à transférer dans l’utérus.
À la suite de la décision n° 96 du 5 juin 2015, la Cour constitutionnelle a levé l’interdiction qui était faite aux couples fertiles porteurs connus de maladies génétiques graves de recourir au diagnostic génétique préimplantatoire. Les maladies en question doivent répondre aux critères de gravité énoncés à l’article 6, paragraphe 1, lettre b) de la Loi n° 194 du 22 mai 1978 et être détectées par les prestataires publics de soins de santé compétents. Il appartient au Parlement de définir les critères d’agrément de ces structures.
Toute expérimentation sur l’embryon humain est interdite.
La recherche clinique et expérimentale sur l’embryon humain est autorisée à condition que les buts en soient exclusivement thérapeutiques et diagnostiques, en vue de la protection de la santé et du développement de l’embryon.
Sont interdites :
(a) la production d’embryons humains aux fins de recherche ou d’expérimentation ou à toutes fins autres que celles prévues par la loi. Interdiction des dons d’embryon à des fins de recherche : dans l’arrêt Parrillo c. Italie (requête n°46470/11) du 27 août 2015, la Cour européenne des droits de l’homme a reconnu que l’interdiction faite à une femme de donner à la recherche scientifique des embryons résultants d’une fécondation in vitro n’était pas contraire à son droit au respect de sa vie privée (il n’y avait pas de violation de l’article 8 (droit au respect de la vie privée) de la Convention européenne des droits de l’homme). Elle a également affirmé que les embryons humains ne sauraient être réduits à des « biens ». La Cour a considéré qu’il convenait de reconnaître à l’Italie une large marge d’appréciation dans cette affaire, qui mettait en jeu des questions morales et éthiques sensibles, d’autant plus qu’il n’y avait pas de consensus européen sur la question délicate du don d’embryons non destinés à l’implantation. La Cour constitutionnelle a rejeté un recours récent sur ces questions, affirmant qu’il appartenait au législateur de modifier la loi.
(b) toute forme de sélection dans un but eugénique, des embryons et des gamètes, ou des interventions qui, au moyen de techniques de sélection, de manipulation, ou par des procédés artificiels, visent à altérer le patrimoine génétique de l’embryon ou du gamète, ou à en prédéterminer les caractéristiques génétiques, à l’exception des interventions à des fins diagnostiques et thérapeutiques. Cela dit, l’arrêt n° 229/2015 de la Cour constitutionnelle n’a supprimé l’interdiction de la sélection d’embryons que dans des circonstances particulières, considérant qu’il ne s’agissait pas d’une infraction lorsqu’elle vise à prévenir l’implantation d’embryons nés de couples présentant un risque de transmission de maladies génétiques graves, conformément à l’article 6, 1 B de la loi 194 (relative à l’interruption de grossesse) dans des structures publiques désignées. Une question de constitutionnalité concernant l’article 13 (paragraphes 3, alinéa b) et 4) de la Loi n° 40/2004 a été soulevée. Le jugement rendu est conforme à l’arrêt précité.
Il souligne toutefois la protection nécessaire a conférer à l’embryon humain à la protection nécessaire, rappelant que « l’enjeu est ici la nécessité de protéger la dignité de l’embryon, à laquelle aucune autre réponse que la cryoconservation ne peut actuellement être apportée. Un embryon, quel que soit le statut juridique plus ou moins déterminé associé au début de la vie, ne saurait être réduit à un simple matériau biologique ».
(c) des interventions de clonage par transfert de noyau ou de scission précoce de l’embryon ou d’ectogenèse, à des fins de procréation ou de recherche ;
(d) la fécondation d’un gamète humain par un gamète d’espèce différente et la production d’hybrides ou de chimères.
4. Sanctions
Le texte de la loi 40/2004 prévoit différentes sanctions progressives en cas de violation de la loi, qui s’appliquent aux médecins et aux Centres autorisés mettant en œuvre les techniques de procréation assistée.
L’homme ou la femme auxquels sont appliquées les techniques ne peuvent être sanctionnés que s’ils n’ont pas suivi les procédures prévues. La sanction pour insémination hétérologue a été supprimée. Les sanctions qui restent en vigueur sont définies à l’article 12 de la Loi n° 40/2004.
5. Autorisations
Un système d’autorisation régionale des structures jugées adéquates est prévu, sur la base :
(a) des données techniques, scientifiques et d’organisation de ces structures ;
(b) des qualifications du personnel.
Les conditions requises sont établies par actes des Régions.
Il existe un Registre obligatoire des structures autorisées, établi et tenu par l’Institut supérieur de la santé, qui suit l’application des techniques de procréation médicalement assistée, les embryons formés et les enfants nés à la suite de l’application de ces techniques.
L’Institut supérieur de la santé prépare le rapport annuel à présenter au Parlement.
Après la décision n° 162/2014, le ministère de la Santé a approuvé les Lignes directrices pour l’application des techniques de reproduction hétérologues au couple qui reçoit le gamète. En ce qui concerne le don de gamètes, l’Italie adoptera la Directive UE 2006/17, ALL.III, PAR.3,4 et ses modifications ultérieures. Le texte sera approuvé dans le système normatif (sous la forme d’un décret gouvernemental). L’un des éléments fondamentaux issus du système juridique Italien est le principe selon lequel le don de sperme et d’ovocyte doit être un acte volontaire, altruiste et non rémunéré.
Ireland - Legal regulation or practice and access to MAP
Until recently in Ireland the provision of assisted human reproduction (AHR) services was largely unregulated. However, in April 2015 Parliament passed the Children and Family Relationships Act which deals with the limited topic of parentage in the case of donor assisted human reproduction. Under the Children and Family Relationships Act 2015, gamete and embryo donation are permitted on a non-anonymous basis. In addition, this legislation provides for the establishment of a national register of gamete/embryo donors, recipients and donor-conceived children (the National Donor-Conceived Person Register), which will allow donor-conceived children to access certain information regarding the gamete/embryo donor involved in procedures leading to their conception.
Moreover, although AHR services are not currently regulated by any specific health legislation, in February 2015, the Minister for Health received Government approval to draft a General Scheme of legislative provisions which would deal with a wide range of issues from the beginning to the end of the AHR process. Following the completion of the General Scheme, the Government approved its publication and the drafting of a Bill on assisted human reproduction based on this General Scheme. The drafting of this Bill is currently ongoing.
Under the proposed legislation, a number of practices will be regulated, including gamete and embryo donation, surrogacy and the assignment of parentage in such cases, pre-implantation genetic screening/diagnosis, sex selection for medical purposes, and posthumous assisted reproduction as well as associated research. It is also proposed that the legislation will establish a regulator to promote patient safety and good clinical practice in the area of assisted human reproduction. The regulator will maintain the National Donor-Conceived Person Register, establish the National Surrogacy Register and maintain records of all assisted human reproduction activities and services.
In January 2018 the General Scheme was submitted to the relevant parliamentary committee for review as part of the pre-legislative scrutiny process. This committee published the report of its review in July 2019, making recommendations which include proposals related to both broad policy objectives and more technical amendments. Its recommendations are being considered during the ongoing process of drafting the AHR Bill.
Norvège - Legal regulation or practice and access to MAP
- Title of the law: The act relating to the application of biotechnology in human medicine etc
- Adopted 5 December 2003, partly into force from 1 January 2004, 1 September 2004 and 1 January 2005. Limited use of PGD was allowed (only in cases of X-linked diseases), and research on surplus embryos was banned. An amendment in force from September 2004 allowed PGD also in cases of serious hereditary diseases for which no treatment is available. New regulations regarding PGD and research on surplus embryos entered into force in July 2008; allowing research on surplus embryos under certain conditions, and PGD or PGD/HLA in situations of serious hereditary disease. New regulations regarding access to MAP for lesbian couples entered into force in January 2009. In 2013 the act was amended to allow MAP to otherwise fertile couples, where one person has a serious and chronic sexually transmitted infection. In 2020 single women who live alone were given access to MAP, and from 2021 oocyte donation is allowed. Egg donation is accessible only to couples able to use their own sperm. Same-sex female couples can donate oocytes to each other (partner donation) and use sperm from a donor.
Iceland - Legal regulation or practice and access to MAP
- Title of the law: Artificial Fertilisation Act N° 55/1996
- Date of adoption and entry into force: 1 June 1996
- Published in: http://eng.heilbrigdisraduneyti.is/laws-and -regulations/nr/685
- Indicate if process of revision is ongoing and, in your answers, provide information on provision in the draft law: No process of revision has yet been embarked upon, a parliamentary resolution on the necessity of a revision, specifically with regards to issues pertaining to embryonic stem cell research, is being discussed.
Lithuania - Legal regulation or practice and access to MAP
- Title of the law: The Law on the Assisted Reproduction of the Republic of Lithuania
- Date of adoption: 14th September 2016 (amended 24th May 2022, 30th May 2019 and 17th January 2017)
- Entry into force: 1st January 2017
- Published in: the Lithuanian Register of Legal Acts
In the last revision of the Law entered into force on the 1st of July 2022, the requirement to store embryos for the unlimited period of time was abolished. This requirement was replaced by a requirement to store embryos for 10 years after the assisted reproduction procedure.
Malta - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes.
Regarding ‘embryos’ this is when the couple do not use the remaining frozen embryos; government can then take custody through the Authority set up by the Embryo protection Act and give them up for adoption.
Donation of gametes is only possible by a ‘confidential agreement between the donor and the licensee:’
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No
8. Are there specific criteria for donation of sperm/oocytes/embryos? Yes.
No age limit stated
The Embryo Protection authority ensure high standards. In the case of adoption of embryos a medical practitioner must declare the prospective parent physically fit.
See also 6 above.
Donation of embryos remains confidential and anonymity of the biological parents is entrenched into the law. Besides, all parental and filial rights are relinquished. That is to say, for example, the donated embryo would have no right to inherit the biological parents who gave up the embryo. Conversely the former would have no right on the latter.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? No
10. Are there special measures for the prevention of consanguinity? Yes. There is an official register kept by the Authority. Article 4, Section 3 states that ‘the Authority shall make all reasonable efforts to match prospective adoptive parents with the embryos who require an adoption placement’.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? Yes
North Macedonia - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? No. There is no legal regulation in the country therefore no gamete banks aiming to this are functioning.
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No
8. Are there specific criteria for donation of sperm/oocytes/embryos? NA
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? NA
10. Are there special measures for the prevention of consanguinity? With the exception of the occasional donations for inseminations with fresh sperm which may be done outside of any control, other donor procedures have not been performed in the country.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No. No legal regulations.
North Macedonia - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? Some debates have just started in many professional organisations - obstetricians/gynaecologists.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law.
Current healthcare law predates the era of MAP. No updates concerning MAP have been made.
In family law there are standard articles addressing the contesting of the paternity but not in relation to MAP.
North Macedonia - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? Yes
b. possible for women not living in a heterosexual couple? No
Türkiye - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? No
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No
8. Are there specific criteria for donation of sperm/oocytes/embryos? Oocyte and embryo donation are prohibited.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? No
10. Are there special measures for the prevention of consanguinity? Yes. Sperm, oocyte and embryo donation is forbidden.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No
Türkiye - Financial aspects
3. Are MAP procedures covered by the social security system? Yes
4. Are there specific criteria for such coverage? Yes. Married, infertile couples, older than 23, younger than 40 years old can benefit from assisted reproduction (IVF) techniques
5. Is the financial coverage limited to a number of MAP procedures? No
Türkiye - Medical aspects
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? Yes; For women not living in a heterosexual couple? No
b. Risk of transmission of a disease
For a heterosexual couple No?; For women not living in a heterosexual couple? No
c. Other N/A
Ireland - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? No. As previously indicated, under the Children and Family Relationships Act gamete and embryo donation is permitted on a non-anonymous basis. Gamete and embryo donors will be required to provide name; place and date of birth; nationality, place and date on which s/he provided the donation; and contact details. Once a donor-conceived child has attained the age of 18 years s/he may request the name, date of birth and contacts details of the relevant donor, as recorded in the National Donor-Conceived Person Register.
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court NA
According to the Children and Family Relationships Act 2015, a donor-conceived child who has attained the age of 18 years, or the parent of a donor-conceived child who has not attained the age of 18 years, may request the following information from the Register:
(a) information other than the relevant donor’s name, date of birth and contact details, that is recorded on the Register in respect of the relevant donor;
(b) the number of persons who have been born as a result of the use in a donor-assisted human reproduction procedure of a gamete donated by the relevant donor, and the sex and year of birth of each of them.
In addition, the Act provides that, a donor-conceived child who has attained the age of 18 years may request the name, date of birth and contacts details of a relevant donor, as recorded in the Register. The donor must be issued with a notice informing him or her that a request has been made by the donor-conceived child. The requested information may be released 12 weeks from the date on which on which the notice is sent (with very restrictive exceptions).
a. Identity of the donor(s)
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court NA
See answer to previous question
b. Certain health information concerning the donor(s)
i. For the child him or herself; ii. For the parents; iii. For a court
Under the proposed assisted human reproduction legislation, medical information relating to the donor may be released to a medical practitioner in order to avoid an imminent and serious risk to the health of a person or to enable the medical practitioner to provide medical advice to a person regarding the existence of a genetic or hereditary condition.
c. Other information
i. For the child him or herself; ii. For the parents; iii. For a court NA
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? Yes/No.
According to the Irish Constitution, the woman who has given birth to a child is always regarded as the legal mother. This assertion was challenged in the Irish Courts, but it was upheld in the Supreme Court in 2014 in the MR and Anor – v- An tArd Chlaraitheoir & Ors (Surrogacy) case.
According to the Children and Family Relationships Act 2015, the parents of a donor-conceived child are the mother and her husband, civil partner or cohabitant as the case may be. A donor of a gamete or embryo is not regarded as the parent of a donor-conceived child.
Iceland - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? sperm Yes/oocytes Yes/embryos -
See art.18 reg.568/1997 (If a donor wishes to remain anonymous, health workers are obliged to ensure that this is respected. In this case, the donor may neither receive information about the couple receiving the donated gamete or the child, nor the couple or the child receive information about the donor. If a donor does not wish to remain anonymous, the institution shall preserve information about him in a special file. If the donation of gamete leads to the birth of a child, information about the child and the couple who received the gamete shall be kept in the same file. A child born on account of a gamete donation where the donor does not wish to remain anonymous can at the age of 18 gain access to a file pursuant to paragraph 2 for the purpose of obtaining information about the identity of the donor. If a child receives information about the gamete donor at the institution, the said institution shall as soon as possible inform the donor that the information has been given.)
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No
The child cannot obtain information if the donor has wished to remain anonymous, See art.18 reg.568/1997.
a. Identity of the donor(s)
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No
The child cannot obtain information if the donor has wished to remain anonymous, See art.18 reg.568/1997.
b. Certain health information concerning the donor(s)
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No
The child cannot obtain information if the donor has wished to remain anonymous, See art.18 reg.568/1997.
c. Other information
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No
The child cannot obtain information if the donor has wished to remain anonymous, See art.18 reg.568/1997.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? No. See art.6, Act in respect of Children, no. 76/2003 (A man who has agreed that his wife be artificially inseminated according to the Act on is deemed to be the father of a child so conceived. The same applies to a man and a woman who have registered their cohabitation with the National Registry. A man who donates sperm for the purpose of it being used in artificial insemination of a woman other than his wife or cohabiting spouse, cf. paragraph 1, according to the provisions of the Act on Artificial Insemination will not be deemed to be the father of a child conceived with his sperm. -A man who donates sperm for another purpose than stipulated in paragraph 2 is deemed to be the father of a child conceived with his sperm unless the sperm is used without his knowledge or after his decease.)
Switzerland - Legal regulation or practice and access to MAP
- Title of the law: Federal Act on Medically Assisted Reproduction (Reproductive Medicine Act, RMA), Reproductive Medicine Ordinance (RMO)
- Date of adoption and entry into force RMA: 18.12.1989 / 1.1.2001 and RMO: 4.12.2000 / 1.1.2001
- Published in: https://www.admin.ch/opc/fr/classified-compilation/20001938/index.html , and
- https://www.admin.ch/opc/fr/classified-compilation/20002342/index.html
- Revision: June 5th,2016, popular vote on the revision of the RMA regarding the regulation of Preimplantation Genetic Screening (PGS) and Preimplantation Genetic Diagnosis (PGD) (prohibited until now)
Norvège - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous?
sperm No / oocytes No / embryos NA. Sperm or oocyte donors cannot be anonymous.
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No. Children born after sperm donation have the right to know the identity of their donor when they (the children) reach the age of 15 (or 18 for those born from sperm donated before 2021).
a. Identity of the donor(s)
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No.
b. Certain health information concerning the donor(s)
i. For the child him or herself No; ii. For the parents No; iii. For a court No. For donors recruited in Norway, the parents will be familiar with the general criteria for selection of a donor (good physical and mental health, no serious inheritable disease; as well as the test regimes) but will not have any other information about the donor. Norway allows import of sperm or oocytes from banks established outside of Norway, but only if they can provide sperm/oocytes from open donors, and in conformity with the relevant EC directives. Oocytes can only be imported from other Nordic countries.
c. Other information
i. For the child him or herself Yes; ii. For the parents No; iii. For a court No. At the age of 15 (or 18, se previous text), the child can obtain information about the identity of the donor (name and address according to the registry and if necessary, date of birth and national identity number). This is the only information that will be provided.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? Yes.
- a child or a parent, as well as a third person who claims paternity of a child with another legal father may contest paternity in front of a court. There is no exception for children or parents of children born after MAP, but a sperm donor cannot contest paternity of a child born after MAP procedures using donated sperm.
- the donor has no legal responsibility for the child, and has no right to any information about children that have been born using his sperm (except for the maximum number).
- according to Norwegian family law provisions, the legal father of a child conceived after MAP is the one the mother is married to at birth (“pater est”). If the woman is not married, the legal father will be the man who acknowledge paternity for the child.
according to family law the woman who gave birth to a child is the child's mother.
Ukraine - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? It is necessary to renew Decree of the Ministry of Health.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. NA
Ukraine - Financial aspects
3. Are MAP procedures covered by the social security system? No. First step is made to cover one cycle in case of bilateral tubectomy.
4. Are there specific criteria for such coverage? Yes.
- Only tubal factor of infertility.
- Age up 35 years.
5. Is the financial coverage limited to a number of MAP procedures? Yes. Only one IVF procedure.
Pays-Bas - Medical aspects
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? Yes; For women not living in a heterosexual couple? Yes
b. Risk of transmission of a disease
For a heterosexual couple Yes?; For women not living in a heterosexual couple? Yes
c. Other Yes
There is a screening on sexually transmitted diseases.
Bosnia and Herzegovina - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous?
NA
17. Is it possible to obtain information about the biological origin of a child born after gametes or embryo donation?
i. For the child him or herself NA
ii. For the parents NA
iii. For a court NA
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions?
NA
Azerbaijan - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? NA
20. Particular cases encountered in your country, and especially your case-law, in relation to the questions appearing in Sections I and II above
The law on reproductive health is being elaborated. Many aspects of MAP were included during discussions on the draft law.
Cyprus - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? There is no indication for the practice followed by several clinical centers, due to the non-existence of relevant legislation
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation? There are no legal provisions. There is no indication for the practices followed by the IVF centers, due to the non-existence of relevant legislation.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? NA
Cyprus - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? The drafting of a law regulating MAP and IVF is currently under consideration. For this purpose a Steering Committee has been established by the Ministry of Health. The Committee is composed of representatives from Services and interested groups on MAP issues.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. There is no case-law up-to-date.
Denmark - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. The Region must provide cost-free treatment for MAP to single women who do not have children, and couples who do not have children together.
4. Are there specific criteria for such coverage? Yes. Women over 45 year of age cannot receive treatment.
5. Is the financial coverage limited to a number of MAP procedures? Yes. Practice: 3 procedures with IVF and more if there are one or more spare, frozen embryos from the woman.
Denmark - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? No
b. possible for women not living in a heterosexual couple? Yes
There are no restrictions in the access to medically assisted procreation neither to hetero couples nor single women.
Lithuania - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. The compensation is available to people who have entered into a marriage or registered partnership agreement in accordance with the law and have been diagnosed with infertility (female, male or both). The woman must be at least 42 years old.The compensation is available to people who have entered into a marriage or registered partnership agreement in accordance with the law and have been diagnosed with infertility (female, male or both). The woman must be at least 42 years old.
4. Are there specific criteria for such coverage? Yes. When the woman is 42 yearl old and the partners are infertile
5. Is the financial coverage limited to a number of MAP procedures? Yes. A maximum of 2 treatment cycles per couple is reimbursed
Lithuania - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? Yes
b. possible for women not living in a heterosexual couple? No
Poland - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? NA
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law.
Homologous insemination in a married couple has no legal incidence: the mother’s spouse becomes the child’s biological father; the means of conception (natural or artificial) has no legal incidence, nor does consent or the lack of it.
Heterologous insemination, on the other hand, raises legal questions concerning filiation. The donor of the sperm is certainly the child’s biological father, but it is impossible to prove legal paternity as the identity of the donor is in principle unknown to the mother and the doctor is sworn to secrecy. Furthermore, no action to prove paternity may be opened in this case as Article 85 para. 1 of the Code of the Family and Guardianship makes sexual intercourse a prerequisite of such action.
The question of the legal paternity of the child thus remains open. In the case of an unmarried woman, action to prove paternity should be excluded, as the donor has the right to remain anonymous. However, if the child is born in wedlock or within 300 days of the marriage being dissolved or annulled, the mother’s husband is presumed to be the legal father. He may take action to contest his paternity within six months of finding out about the birth (art. 63). This is a peremptory time limit, after which only the public prosecutor may institute such proceedings.
The situation is more complex in the event of heterologous insemination carried out with the husband’s consent. As there are no specific legal provisions in the matter, the husband has the right to contest his paternity even though he did give his consent. Theoretically he only needs to prove that the birth was the result of MAP. However, according to a decision of the Court of Cassation on 27 October 1983: “Action by the spouse of the mother contesting paternity of a child born following MAP performed, with said spouse’s consent, with the sperm of another man may be considered contrary to public policy.” In stating its reasons, the Court stressed the importance of the child’s welfare, arguing that if it were to accept an action contesting the father’s paternity of a child born following MAP carried out with his consent using another man’s sperm, the child would, to all intents and purposes, be fatherless; it would be virtually impossible to prove the paternity of the donor because of the rules protecting his anonymity. And the donor has no interest in proving his paternity. This interpretation also takes into account the interests of the family formed subsequent to the couple’s decision to have recourse to MAP.
San Marino - Financial aspects
3. Are MAP procedures covered by the social security system? Infertility is followed free of charge, the healthcare system covering 2 pharmacological treatment cycles and the pre and post implantation. The gametes extraction techniques, fertilisation, implantation and embryo storage at Italian specialised structures are the responsibility of the couple as well as any subsequent treatment cycles to the two provided free of charge.
4. Are there specific criteria for such coverage? No. See comments on relative legal instruments.
5. Is the financial coverage limited to a number of MAP procedures? Yes. See comment to question 3.
Portugal - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? No
b. possible for women not living in a heterosexual couple? Yes
Any women – even being single and without any sexual relationship, and without infertility can go to a specific ART centre and ask for artificial insemination
Poland - Financial aspects
3. Are MAP procedures covered by the social security system? No
4. Are there specific criteria for such coverage? NA
5. Is the financial coverage limited to a number of MAP procedures? Na
Slovenia - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. Indeed, infertility is considered a medical condition of the couple.
4. Are there specific criteria for such coverage? Yes. The criteria are the same as those entitling the couple to MAP. These include infertility not treatable in other ways, age appropriate for pregnancy (the upper age limit for the woman is 43 years) and parenthood, the need to avoid transmission of a serious genetic disorder.
5. Is the financial coverage limited to a number of MAP procedures? Yes. Up to four IVF procedures are covered. The rate of pregnancies achieved is among the highest in Europe, in spite of the fact that since 1999, a maximum of two embryos is transferred in a single MAP procedure.
Slovenia - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? Yes. Art. 5: MAP is available to heterosexual couples living in marriage or in extra-marital relationship, which must exist at the time the procedure is performed.
b. possible for women not living in a heterosexual couple? No
Slovenia - Medical aspects
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? Yes; For women not living in a heterosexual couple? N/A
b. Risk of transmission of a disease
For a heterosexual couple Yes?; For women not living in a heterosexual couple? N/A
Risk of transmission of serious genetically determined disease (Art. 5).
c. Other N/A
Germany - Sperm/oocyte/embryo donation
6. Is donation of sperm Yes/oocytes No/embryos* permitted in your country? Yes.
*Embryo donation per se is not regulated by law. However, the Embryo Protection Act provides that an oocyte may only be artificially fertilised for the purpose of bringing about a pregnancy in the same woman from whom the oocyte has been obtained (Section 1(1) number 2 of the Embryo Protection Act) and that it is prohibited to remove an embryo from a woman before its nidation is completed, in order to transfer it to another woman (Section 1(1) number 6 Embryo Protection Act). In addition, the Embryo Protection Act incorporates provisions aimed to prevent the creation of supernumerary embryos in the course of artificial fertilisation (especially the ban on the artificial fertilisation of more oocytes than can be inserted into a woman within one cycle – Section 1(1) number 5 Embryo Protection Act). Consequently, permissible embryo donation is only conceivable in exceptional instances where an artificially created embryo can unexpectedly no longer be transferred to the woman from whom the oocyte originated.
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No
8. Are there specific criteria for donation of sperm Yes/oocytes/embryos?
Gametes may be used for medically assisted procreation only after full medical assessment and if their use is medically indicated and the protection of the recipient’s and the child’s health is guaranteed (Section 6(1) of the Tissues and Cells Regulation of the Transplantation Act). The use of sperm cells for heterologous fertilisation as a medically assisted procreation technique furthermore requires that the sperm donor is medically assessed as suitable for sperm donation with regard to his age, state of health and medical history and that the use of the donated sperm will not pose any health risks to others. The necessary donor information must be collected by questionnaire and by means of a subsequent personal interview with the donor by the physician.
An age limit exists for eligibility to cost coverage by the health insurance funds (see response to question 4).
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? No
10. Are there special measures for the prevention of consanguinity? No. As part of a voluntary commitment physicians, sperm banks and laboratories have limited the number of offspring from a sperm donation to 15 (Richtlinien des Arbeitskreises für Donogene Insemination zur Qualitätssicherung der Behandlung mit Spendersamen in Deutschland).
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? Yes.
German law includes the following provisions governing the legal relationship between the child and the spouse of the legal parent:
- Authority of the spouse/registered partner of a parent who has the sole parental care (decision-making authority) about the child to have a say in matters of daily life (so-called “small care” – Section 1687b(1) of the Civil Code, Section 9(1)of the Act on Registered Life Partnership). In case of imminent danger, the spouse/registered partner is also entitled to perform all acts necessary for the child's welfare (Section 1687b(2) of the Civil Code, Section 9(2) of the Act on Registered Life Partnership).
- Right of contact with the child, if a “family-like social relationship” has evolved between the parent’s spouse and the child (Section 1685(2) of the Civil Code),
- In case the child has been living in one household with one parent who dies or is no longer able to exercise parental care or whose parental care has been suspended, the court may deny the other parent’s request to give the child to him or her and order that the child should stay with the spouse/registered partner of the first parent (ex officio or by request of that spouse), provided the child has been living in that household for a longer time (Section 1682 sentence 2 of the Civil Code). Similar rules apply for staying with the partner of a deceased parent or a parent who cannot exercise his or her parental care.
Pursuant to Section 1741(2) sentence 4 of the Civil Code/Section 9(7) sentence 1 of the Act on Registered Life Partnership, a spouse/registered partner is entitled to adopt his or her spouse’s/registered partner’s biological child. According to Section 1742 of the Civil Code/Section 9(7) sentence 2 of the Act on Registered Life Partnership, a spouse/registered partner may also adopt the child adopted by his or her spouse/registered partner. There is no longer a distinction between heterosexual and homosexual married couples, registered partners or between married and unmarried stable couples in case they want to adopt the child of their partner (Section 1766a of the Civil Code). In addition, married couples regardless of the sex of the spouses may adopt any other child as common parents, whereas unmarried couples and registered partners do not have this option to become common parents of the child simultaneously. They have to adopt the child successively.
Germany - Financial aspects
3. Are MAP procedures covered by the social security system? Yes
MAP is a medical therapy under Section 27a of Book V of the Social Code.
The medical services covered by the statutory health insurance also include medical interventions aimed to induce a pregnancy. MAP measures must be medically diagnosed as necessary and have reasonable chances of success.
The Statutory Health Insurance Modernisation Act [GKV-Modernisierungsgesetz] reasonably restricted the entitlement to MAP measures from 1 January 2004 onwards. Since then Section 27a of Book V of the Social Code specifies that 50% of the costs are covered by the health insurance fund, so that the insured equally share in the costs of MAP interventions with a co-payment of 50%.
To reduce the financial burden caused by the 2004 cutback in costs covered by the statutory health insurance fund, in 2012 the Federal Ministry for Family Affairs launched the federal initiative “Hilfe und Unterstützung bei ungewollter Kinderlosigkeit” (assistance and support for involuntary childlessness). The funds are paid from both the federal budget and the budget of the Länder in which the couples concerned have their principal residence. Currently, twelve of the sixteen Länder participate in the initiative. Federal funding is generally provided for the first four treatment cycles of in-vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI). Couples can be reimbursed up to 25 per cent of the share they have to pay in addition to the costs covered by the health insurance fund.
Until 2015, only married couples were entitled to additional federal financial assistance. Today, also unmarried couples living in a non-marital long-term relationship can receive federal financial assistance under the amended federal guidelines on financial assistance for assisted reproduction procedures (Richtlinie über die Gewährung von Zuwendungen zur Förderung von Maßnahmen der assistierten Reproduktion), which took effect on 7 January 2016. However, pursuant to Section 27a of Book V of the Social Code, entitlement to benefits from the statutory health insurance fund is still restricted to married couples only.
4. Are there specific criteria for such coverage? Yes.
The criteria included in Section 27a of Book V of the Social Code:
Coverage of part of the costs by the statutory health insurance funds is subject to the following requirements:
- the measures must be medically diagnosed as necessary
- according to medical diagnosis, the intervention must be reasonably likely to induce a pregnancy
- the procedure may be performed up to three times
- only married couples are eligible (non-married couples are not)
- only the spouses’ egg and sperm cells may be used (homologous system)
- prior to treatment, the spouses must have themselves thoroughly informed about the medical and psychosocial aspects involved by a physician other than the one who will perform the treatment
- MAP may only be performed by physicians or facilities that are suitably qualified and have obtained an appropriate licence from the authority responsible under the law of the federal Land
Any method other than homologous fertilisation is excluded from the mandatory package of benefits and services of the statutory health insurance system.
The restriction of eligibility to married couples is in accordance with the German Constitution (cf. Judgment of 28 February 2007 – 1 BvL 5/03, BVerfGE 117, 316).
Eligibility is subject to age limits of between 25 and 40 years for women and between 25 and 50 years for men.
Although unmarried heterosexual couples are not entitled to benefits from the statutory health insurance fund pursuant to Section 27a of Book V of the Social Code, they can receive the voluntary financial assistance offered through the federal initiative “Hilfe und Unterstützung bei ungewollter Kinderlosigkeit”.
5. Is the financial coverage limited to a number of MAP procedures? Yes. Pursuant to Section 27a of Book V of the Social Code three attempts to induce a pregnancy are partially covered by the health insurance funds. The payment of expenses by the health insurance funds has been limited to 50% of the costs approved along with the treatment schedule.
Georgia - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous?
LHC: no specific provisions are included in the LHC on this issue.
*DL-RHRR:
Donation of gametes and embryo is not anonymous; however information on the identity of a gamete donor is confidential. Also, any personal data collected about a couple or single women applying for MAP is confidential.
United Register of Gamete Donors will include data about the identity of gamete donors as well as of couple.
These data are confidential. However, the law may make exceptions for specific cases; e.g. “when the disclosure of information on the donor’s genetic characteristics is necessary for the health purposes of the child, born as a result of medically assisted reproductive technologies”.
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself; ii. For the parents; iii. For a court Yes. LHC: no specific provisions are included in the LHC on this issue. The answers given to question 17 are based on DL-RHRR.
a. Identity of the donor(s)
i. For the child him or herself; ii. For the parents; iii. For a court No
b. Certain health information concerning the donor(s)
i. For the child him or herself; ii. For the parents; iii. For a court Yes. Health data of the gamete donor, particularly information about the donor’s genetic characteristics, could be disclosed from the register of gamete donors if this is necessary for the health purposes of the child, born as a result of MAP.
c. Other information
i. For the child him or herself NA; ii. For the parents; Yes. A couple or a single woman has the right to request and receive information on the donor’s age, appearance, ethnic background, and health condition.
- Obligation of gamete donor to provide information about his/her health:
According to the DL-RHRR gamete donors are obligated “to give the medical personnel complete and comprehensive information on his/her health condition prior to gamete donation.”
- Right of the gamete donor to receive information about his/her health:
According to the DL-RHRR gamete donors are entitled to receive “information concerning his/her own health, which may be discovered as a result of monitoring the child born after utilizing assisted reproductive technologies.”
iii. For a court NA
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? There are no specific provisions on this subject in family law at present.
Georgia - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues?
Debates took place about the draft Law on Reproductive Health and Reproductive Rights among the representatives of various professionals, especially medical professionals, representatives of church and religious groups, representatives of Ministry of Health and Social Affairs, etc.
As the above draft Law is more specific than the Law on Health Care it will change existing legal situation (details are already specified throughout the questionnaire).
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law.
English versions of the following legislation related to MAP are presented in the Addendum:
- Law on Health Care (Relevant articles from Chapter XXIII Family Planning) [see Addendum];
- Draft Law on Reproductive Health and Reproductive Rights [see Addendum].
Germany - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? No
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. See section I above for links to the updated versions of German laws
Andorra - Financial aspects
3. Are MAP procedures covered by teh social secutiy system? NA
4. Are there specific criteria for such coverage? NA
5. Is the financial coverage limited to a number of MAP procedures? NA
Italy - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? sperm Yes/oocytes Yes/embryos No
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself NA; ii. For the parents NA; iii. For a court NA
a. Identity of the donor(s)
i. For the child him or herself NA; ii. For the parents NA; iii. For a court NA
b. Certain health information concerning the donor(s)
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court NA
c. Other information
i. For the child him or herself NA; ii. For the parents NA; iii. For a court NA
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? No. In the case of reproduction using a heterologous donor - even if prevented by law - the donor cannot disown the child (Art 9). The mother of the child after MAP cannot declare her wish not to be entered in the birth registers as provided for by dpr no 396 (2000).
Belgium - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? No
b. possible for women not living in a heterosexual couple? No
The 2007 Act makes no mention of such a restriction. Each centre is free to accept or refuse requests from homosexual couples.
Latvia - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? No
b. possible for women not living in a heterosexual couple? Yes
Latvia - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No
8. Are there specific criteria for donation of sperm/oocytes/embryos? Yes.
For sperm age limit 18-45.
For oocytes 18-35.
If checking on sexually transmitted disease STD, Hepatitis B, C are positive.
If General health are not in good condition.
If in anamnesis have genetic diseases.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes
10. Are there special measures for the prevention of consanguinity? Yes. No more than three children can be born from one donor, furthermore, special means are taken if the children born from donor have genetically hereditary disease.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No
Latvia - Legal regulation or practice and access to MAP
Title of the law “Law on reproductive and sexual Health”
Date of adoption 31 January 2002 and entry into force 01 July 2002
Published in 19 February 2002