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
16. Is donation of sperm/oocytes/embryos anonymous? 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 No; iii. For a court No
The law provides for access to the donor's non-identifying medical information for the treating physician and in the event of a therapeutic necessity concerning a child conceived from donated gametes. Since the law n°2021-1017 of 2 August 2021 on bioethics, the child born from a MAP can, at their majority, if they so wish, access the non-identifying data (age, general state, physical characteristics, family and professional situation, country of birth, motivation for the donation) and the identity of the donor. As of 1 September 2022, the donor's consent to this communication becomes a sine qua non condition of the donation and the persons born of these donations are therefore guaranteed to be able to access this data when they reach the age of majority if they so wish. As regards donations made before 1 September 2022, the legislator allows the donor to consent to this disclosure after the fact, either by a simple spontaneous expression of interest or by means of a procedure for contacting the donor. These donors retain the possibility of refusing the communication of their data. The anonymity of the donation between donors and recipients is not called into question.
a. Identity of the donor(s)
i. For the child him or herself Yes; ii. For the parents NA; iii. For a court NA. See answer to the previous question
b. Certain health information concerning the donor(s) See answer to 1st question of table 17
i. For the child him or herself; ii. For the parents; iii. For a court
c. Other information See answer to 1st question of table 17
i. For the child him or herself; ii. For the parents; iii. For a court
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? Yes. It is not possible to establish a parent-child relationship between the child resulting from MAP and the donor, or to bring an action for liability against the donor. No action may be brought to establish or contest parentage on behalf of the child unless it is argued that the child is not the product of medically assisted procreation or that consent has been rendered ineffective.
a) The law of Georgia on Health Care (LHC) - Chapter XXIII Family Planning
b) The Draft law on Reproductive Health and Reproductive Rights (DL-RHRR)
a) LHC - Adopted by Parliament of Georgia on 10 December 1997
b) DL-RHRR– Submitted to the Georgian Government in December 2003
Later the document was sent to the various Ministries, Departments and governmental agencies and their comments have been taken into consideration as well.
The next steps should be: (a) discussions within the apparatus of the President and later (b) debates in the Parliament.
a) Act on the Protection of Embryos [Embryonenschutzgesetz – ESchG];
b) Section 27a of Book V of the Social Code [Fünftes Buch Sozialgesetzbuch – SGB V];
c) Sections 1591 to 1600d, 1682, 1685, 1741 and 1742 of the Civil Code [Bürgerliches Gesetzbuch – BGB];
d) Section 9 of the Act on Registered Life Partnerships [Lebenspartnerschaftsgesetz – LPartG];
e) Section 8b of the Transplantation Act [Transplantationsgesetz – TPG];
f) Tissues and Cells Regulation of the Transplantation Act [TPG-Gewebeverordnung – TPG-GewV];
g) Sperm Donor Register Act [Samenspenderregistergesetz – SaRegG]
a) 13 December 1990; 1 January 1991
b) 26 June 1990; 1 January 1989 (as amended)
c) Civil Code as amended by the Act to Law on the reform of guardianship and care law [Gesetz zur Reform des Vormundschafts- und Betreuungsrechts]: 4 May 2021; 1 January 2023
d) 16 February 2001; 1 August 2001
e) 20 July 2007; 1 August 2007
f) 26 March 2008; 5 April 2008
g) 17 July 2017; 1 July 2018
a) German: http://www.gesetze-im-internet.de/eschg/
b) German: http://www.gesetze-im-internet.de/sgb_5/
c) German: http://www.gesetze-im-internet.de/bgb/
English: http://www.gesetze-im-internet.de/englisch_bgb/
d) German: http://www.gesetze-im-internet.de/lpartg/
English: http://www.gesetze-im-internet.de/englisch_lpartg/
e) German: http://www.gesetze-im-internet.de/tpg/
f) German: http://www.gesetze-im-internet.de/tpg-gewv/
g) German: https://www.gesetze-im-internet.de/saregg/
Ongoing revision of Sections 1591–1600d of the Civil Code and the Sperm Donor Register Act to implement the requirements of the coalition agreement (parenthood agreements prior to conception, automatic assignment of the mother's wife, gender-independent recognition, determination procedure without status consequences, and opening of the Sperm Donor Register Act to sperm donations made before 2018, home inseminations by known donors and embryo donations).
On the basis of paragraph 16b of the German Transplantation Act the German Medical Association has published Guidelines on the Procurement and Transfer of Human Germ Cells or Germ Cell Tissue in the context of Assisted Reproduction dated 11 March 2022 (Richtlinie zur Entnahme und Übertragung von menschlichen Keimzellen oder Keimzellgewebe im Rahmen der assistierten Reproduktion; https://www.bundesaerztekammer.de/fileadmin/user_upload/BAEK/Themen/Medizin_und_Ethik/RiLi-ass-Reproduktion.pdf).
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? Yes
b. possible for women not living in a heterosexual couple? Yes
Restricted to health condition (infertility) or age consideration connected with health
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? Yes
b. possible for women not living in a heterosexual couple? Yes
The law stipulates that all adult persons have the right of access to methods pf MAP and for women the age limit is 50 years of age. Persons under 18 years of age have exceptionally the right of access only in case of a very serious disease. The law only refers specifically to married heterosexual couples who wish to have a child and to unmarried women either single or living as part of a heterosexual couple. It does not refer to homosexual couples, but it does indirectly forbid their access to fertility services.
According to the 2002 Law [3089/02]:
A. the written consent of the married couple is required before the MAP procedure
3. Are MAP procedures covered by the social security system? Yes.
Hungarian legal regulation considers infertility a pathological condition attaining families or even single women desiring to be mothers. The legal model of the treatment of MAP is the same as that of any other disease. (Act and Decree 49/1997 of the Minister of Welfare on Medical interventions against infertility to be financed by the social security system).
4. Are there specific criteria for such coverage? Yes.
Infertility is the condition for the coverage of MAP. Age can only be considered in respect of the health condition preventing fertility.
Decree 49/1997 specifies more closely the conditions to be applied.
5. Is the financial coverage limited to a number of MAP procedures? Yes. Interventions ending with embryo implantation can be covered five times maximum for the same patient.
3. Are MAP procedures covered by the social security system? Yes. Article 28, para 1 of Law 3305/05 refers to the reimbursement of MAP procedures by Social Security, the presuppositions of which will be defined by a presidential decree to be published. The same presidential decree will assess the conditions under which reimbursement by the Social Welfare is given to people who wish to participate in MAP procedures and who are not insured. Therefore, as far as security coverage is concerned, the situation in Greece remains variable, depending on different social security funds. The Opinion proposed for full coverage of all necessary medication.
4. Are there specific criteria for such coverage? Yes. The presidential decree which will be published according to the provisions of Law 3305 will cover terms, conditions and procedures for financial coverage by social security organisations.
5. Is the financial coverage limited to a number of MAP procedures? Yes. In the Opinion submitted by the National Authority it was proposed to cover 4 IVF/GIFT/ZIFT attempts. The Opinion also included a variety of medical criteria and age limits. As far as sperm injection is concerned the Opinion proposed for financial coverage of 6 attempts.
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? No
c. Other NA
Art 4, para 1 of the 3305/05 Law refers to:
The law does not provide anything for women not living in a heterosexual couple.
Art 4, para 2 refers to an obligatory examination for HIV-1&2, hepatitis B & C and syphilis before submission to MAP procedures. People with an HIV infection who wish to undergo MAP, need special permission from the National Authority of MAP.
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
Regulated in paragraphs 167, (3) and (4) of the Act, paragraphs 1 (2), (3), 1/A, 1/B, 1/C of the Decree.
b. Risk of transmission of a disease
For a heterosexual couple? Yes; For women not living in a heterosexual couple? Yes
Prohibited in risk of transmission of a disease endangering the viability or health of the child, and in risk of transmission of an infection
c. Other NA
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? 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.
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes. Donation of gametes (sperm and oocytes) and fertilized ova (only supernumerary fertilized ova) is allowed only with consent of the donors.
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? Yes.
According to Law 3305/05, (Art 8, para 1) “Reward or compensation for donation of gametes and fertilized ova are prohibited. However, medical, nursing or laboratory expenses travel and accommodation expenses as well as compensation for absence from work are possible.”
The National Authority for Medically Assisted Reproduction with a subsequent Decision (Decision No 36, State Journal 670 B’ 16.4.2008) provides for compensation of medical, laboratory and nursing expenses occurring before and after donation. It also provides for accommodation and transportation expenses. This amount must not exceed 200E for sperm donation and 600 E for oocyte donation. Compensation is also provided for absence from work.
8. Are there specific criteria for donation of sperm/oocytes/embryos? Yes.
Donors must have reached the age of majority with full judicial capacity. Regarding sperm donors must be under 40 years of age whereas for oocytes donors must be under 35 years of age. These age limits can be extended to 50 and 40 years of age respectively in case of donation of fertilized ova or when there is a serious reason, after authorization by the National Authority on MAR. In these cases, special information to the recipients is required regarding increased risk for genetic diseases as well as the need for prenatal testing.
Donors are submitted to special medical and laboratory tests defined (due to scientific developments) by the National Authority.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes. According to the Law the selection of the donor is the responsibility of the MAR Unit. During this selection other criteria like blood group (Rhesus) as well as phenotypic characteristics are taken into consideration. The same criteria apply to fertilized ova donation.
10. Are there special measures for the prevention of consanguinity? Yes.
The number of children born from gametes by the same donor must not exceed 10, unless it is about the birth of a new child of a couple which has already had a child from the gametes of this particular donor. The National Authority may determine the exact number of children resulting from the use of gametes by the same donor, depending on the population of a certain region and other special conditions.
[Comment: the law refers to the actual number of children born and not to the number of cycles of treatment attempted].
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No. This law does not include any provisions for homosexual couples.
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.
This may differ between counties but normally MAP is covered up to a limited number of attempts, presently most state owned/contracted clinics offer three attempts by national recommendation (by the Swedish Association of Local Authorities and Regions, SKL).
MAP is considered part of health care.
4. Are there specific criteria for such coverage? By national recommendations: If the couple/female is approved by above mentioned criteria she will receive up to three attempts. Females above 40 will however normally not be approved for treatment, unless embryos were frozen before she turned 40, in which case the embryos may be used before she turns 45. This applies regardless of financial coverage. The other parent must not be above 56 years old.
5. Is the financial coverage limited to a number of MAP procedures? Yes. Up to three attempts are normally covered.
16. Is donation of sperm/oocytes/embryos anonymous?
sperm No / oocytes No / embryos N/A
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. Yes, by request to the clinic which has a special registry about the donors (to be saved for 70 years). For embryo donor children it will be possible to find genetic siblings who have requested to be entered into the register.;
ii. For the parents No;
iii. For a court No. Unlikely, but potentially if court rules it necessary.
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 Yes, if relevant and noted in the donor registry; ii. For the parents No; iii. For a court No
c. Other information
i. For the child him or herself Yes,
Contact info and any other info provided in the medical file
A donor child has the right to, at a “mature age” (interpreted as appx 18) and upon request, find out the identity and contact information of their donor. This information is to be kept for 70 years in a special donor registry. The parents are encouraged to inform their child about the donation;
ii. For the parents No; iii. For a court No
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? No.
Paternity is regulated in the Parental Code.
Paternity can be contested if, having regard to all the circumstances, it is not probable that the child was conceived by insemination or IVF.
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.
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
Female married couples have access to sperm donation even if there is no infertility in the medical sense.
b. Risk of transmission of a disease
For a heterosexual couple Yes?; For women not living in a heterosexual couple? Yes
Female married couples have access to sperm donation and pre-implantation genetic diagnosis if there is a risk of transmitting a predisposition to a serious disease.
c. Other N/A
19. Is there an important current debate in your country on these or related issues? Yes.
Yes. The question of surrogacy was delayed due to the controversial nature of abuse of the female body, and legal consequences surrogacy is seen to cause in some cases. However it would seem that the discussion will be raised in the future for both heterosexual and homosexual couples. The Embryo Protection Act as amended does not permit the use of surrogacy and the subject is not even discussed.
Note: Having said that, as article 19, discussed above, indicates, donation of gametes is a private agreement so homosexual couples, for example, may bypass provisions by having sperm donated to them in the case of female homosexual couples, and, male homosexual couples can donated their sperm by a private agreement to a woman, who can be the surrogate (using her own ova by Artificial Insemination by Donor) and then give up the child. Article 19 of the Act seems to prohibit this under my interpretation. In any case, the law does not discuss Surrogacy so at most it can be tolerated but not protected by law when it comes to filiation.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law.