Access to medically assisted procreation - Search
Slovenia - 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 -
Art. 18 specifies the rules of confidentiality regarding both the couples receiving MAP and the gamete donors.
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself No; ii. For the parents No; iii. For a court Yes
Art. 18: The child may request medically important information about the donor after reaching 15 years of age, provided that he/she is mentally competent. The child’s legal representative may be given such information only with a permission issued by court, in cases of exceptionally important medical reasons.
The child’s physician has the right to access information in the donors’ registry for health reasons.
The court and administrative body have a right to access information in the registry if that is absolutely necessary for carrying out their official duties under this law.
a. Identity of the donor(s)
i. For the child him or herself No; ii. For the parents No; iii. For a court Yes. See comment to first table answer 17.
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. See comment to first table answer 17.
c. Other information
i. For the child him or herself No; ii. For the parents No; iii. For a court Yes. See comment to first table answer 17.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions?
In principle, no.
- Art. 41: Maternity cannot be contested if the mother had consented to the MAP procedure. When a donated egg is used, the donor cannot claim maternity for the child, nor can biological maternity be determined in the interest of other parties.
- Art. 42: Paternity may not be contested, unless it is claimed that the child had in fact not been conceived with a MAP procedure. In that case articles 96-99 of the Marriage and family relations Act apply.
When donated sperm is used, the donor cannot claim paternity for the child, nor can biological paternity be determined in the interest of other parties.
Sweden - 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 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.
Sweden - Financial aspects
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.
Switzerland - 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
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
Türkiye - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? These issues are currently being discussed in medical faculties, medical doctors' councils and among lawyers.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. -
Belgium - Right to know about his or her biological origin for children born after MAP
Is donation of the sperm, oocytes or embryos anonymous?
Yes. In the case of gametes, anonymity is the rule. The law does, however, allow non-anonymous donations if they are based on an agreement between the donor and the recipient or recipients.
Is it possible to obtain information about the biological origin of a child born after gametes or embryo donnation?
The law provides that once supernumerary embryos or gametes have been implanted, the parentage rules set out in the Civil Code operate in favour of the author or authors of the parental project. No parentage suit may be filed against the donor by the recipient or by the child born through the use of supernumerary embryos or gametes.
There are no specific legal provisions that would apply to the courts in this area. It cannot be ruled out that a court might obtain information about the biological origin of a child born through gamete or embryo donation if it deemed this necessary.
Is it possible to obtain information about the identity of the donors ?
No for the child and the parents, yes for the court
The fertility centre is legally bound to render inaccessible any data that could be used to identify the embryo or gamete donor. Anyone working for or in a fertility centre who becomes aware of information that could be used to identify the donor is subject to the professional secrecy requirement (Art. 458 of the Criminal Code). Non-anonymous gamete donations are permitted, however, if they are based on an agreement between the donor and the recipient or recipients.
Is it possible to obtain certain health information concerning the donors?
For the child, for the parents, for the court: yes
The Act specifies that the center registers specific data concerning the donor, such as the physical characteristics of the biological parents, in case of an embryo, or of the gamete’s donor but provides for the parents and the child to have access only to the necessary medical data that can be important for the child’s health.
Is it possible to obtain other information?
For the child, for the parents no, for the court yes
The law requires the centre to record certain data relating to the donor, including the physical characteristics of both embryo providers or of the gamete donor. The law only allows the parents and child access to such medical data as are necessary for the child’s health, however.
Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions?
No, the law states that once supernumerary embryos or gametes have been implanted, the parentage rules laid down in the Civil Code operate in favour of the authors of the parental project.
No lawsuit relating to parentage or to its effects on property rights may be brought by donors of supernumerary embryos or gametes.
Belgium - Sperm, oocytes and embryos donation
Is donationn of the sperm, oocytes and embryos permitted? Yes
Are there specific compensation arrangements for such donations?
No. The 2007 Act states that only donations of supernumerary embryos and gametes which are made free of charge are lawful.
The Act does allow the King, however, to specify an allowance to cover the travel expenses or loss of earnings of the person from whom the gametes are being obtained. This allowance can also cover the hospital fees arising from the retrieval of oocytes from the donor. So far, however, no decrees have been issued to this effect.
In practice, all costs arising from medical examinations and procedures during treatment are borne by the recipient. Sometimes, too, the fertility centre requires the woman receiving the oocytes to pay the donor an “allowance” while sperm donors receive a small amount of compensation for each usable sample.
Are there specific criteria for donation of the sperm, oocytes and embryos?
The 2007 Act states that gamete retrieval is available to adult women up to the age of 45 years. Retrieval of gametes, supernumerary embryos, gonads or gonad fragments for cryogenic storage may be carried out, on medical advice, on a minor, however.
Donations of supernumerary embryos or gametes for eugenic purposes or for the purposes of sex selection are prohibited.
There must be a written agreement between the donor and the accredited fertility centre. The law does not specify any medical criteria for harvesting.
Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP?
In practice, the centres try to avoid too great a dissimilarity between donors and recipients.
The law of 2007 specifies that pairing between donor and recipient may not be considered as a practice with eugenic character.
Are there special measures for the prevention of consanguinity?
The 2007 Act states that supernumerary embryos from the same donor or couple of donors or gametes from the same donor, must not result in births in more than 6 different women.
In a homosexual couple, is a legal relationship possible between a child and the partner of his or her legal parent?
The Act of 18 May 2006 amended certain provisions of the Civil Code to allow same-sex adoption.
Austria - Legal regulation or practice and access to MAP
Title of the law: Law on Medical Assisted Reproduction “Fortpflanzungsmedizingesetz”
Date of adoption: 14 May 1992 entry into force 1 July 1992
Published: in Federal Gazette “Bundesgesetzblatt” BGBl. Nr. 275/1992
Amendment: Fortpflanzungsmedizinrechts-Änderungsgesetz 2015
Date of Adoption: 23 February 2015, entry into force: 24 February 2015
Published in: Federal Gazette “Bundesgesetzblatt” BGBl. I Nr. 35/2015
Revision concerning egg donation, sperm donation and PGD
Austria - Financial aspects
3. Are MAP procedures covered by the social security system?
Unfulfilled desire to have children is not considered as a disease. A fund is established to cover 70% of costs of IVF – treatments under specific conditions.
4. Are there specific criteria for such coverage?
Yes:
- male sterility and/or female sterility (occluded fallopian tubes, endometriosis, polycystic ovary syndrome (PCO);
- age of intended mother up to 40 years, age of the partner up to 50 years.
5. Is financial coverage limited to a number of MAP procedures?
Yes, limitation to four IVF procedures; if a pregnancy is achieved further four IVF procedures are possible.
Austria - Legal aspects
1. Is access to MAP
- restricted to heterosexual couples? No
- possible for women not living in a heterosexual couple? Yes
Access for homosexual and heterosexual couples, no access for single women.
Des critères spécifiques sont-ils retenus pour l’accès à la PMA ?
L'accès à la PMA est ouvert aux couples hétérosexuels et homosexuels, mais pas aux femmes célibataires. Accès en cas de risque élevé de transmission d’une maladie grave, par ex. VIH.
Andorra - Medical aspects
2. Are there specific criteria for access to MAP?
Adults between 18 years and – 50 years subject to exceptions. For example, if necessary, minors could cryopreserve gametes for their own use at a later stage, in order to preserve fertility in situations of pathological procedures. Always under medical guidance.
Azerbaijan - Financial aspects
3. Are MAP procedures covered by the social security system?
No
4. Are there specific criteria for such coverage?
No
5. Is the financial coverage limited to a number of MAP procedures?
Yes
Andorra - 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
Bosnia and Herzegovina - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocyte/embryos permitted in your country?
No
7. Are there specific compensation arrangements for such donations?
NA
8. Are there specific criteria for donation of sperm/oocytes/embryos?
NA
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP?
NA
10. Are there special measures for teh prevention of consanguinity?
NA
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? MAP legal only for heterosexual couples
Bosnia and Herzegovina - Medical aspects
2. Are these specific criteria for access to MAP?
Medical reasons:
a. Infertility
i. for a heterosexual couple? Yes
ii. for women not living in a heterosexual couple? Currently no, but envisaged for single woman in the new draft legislation.
b. Risk of transmission of a disease (please specify the risk and/or disease)
i. for a heterosexual couple? No
ii. for women not living in a heterosexual couple? No
Bosnia and Herzegovina - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restrictd to heterosexual couples? Yes
b. possible for women not living in a heterosexal coupe? Currently No, but envisaged in the new draft legislation.
Bulgaria - Medical aspects
2. Are there specific criteria for access to MAP? NA
Cyprus - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes. Sperm donation is being done in practice but not under the provisions of any law. For oocytes and embryos the situation is unknown as there are no cases referred to.
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? It is not possible to say whether there are specific compensation arrangements for such donations as it is not a legally regulated issue.
8. Are there specific criteria for donation of sperm/oocytes/embryos? No for sperm. It is not possible to say whether there are specific criteria for oocytes and embryos donations, as they are not legally regulated issues.
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? It is unknown whether there are special measures for the prevention of consanguinity.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? It is not possible to say whether in a homosexual couple, a legal relationship is possible between a child and the partner of his or her legal parent. There are no referred cases of homosexuals having a child.
Czech Republic - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? Yes. In April 2021, negotiations on an amendment to the Civil Code allowing "marriage for all" progressed to the next round in Parliament. Adopting the change would be a step towards homosexual couples' access to assisted reproduction, surrogacy and changing the birth certificates of the child.
b. possible for women not living in a heterosexual couple? No.
Czech Republic - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. Infertility is defined as a disease.
4. Are there specific criteria for such coverage? Yes. 4 IVF cycles up to the age of 40 of the woman are covered.
5. Is the financial coverage limited to a number of MAP procedures? Yes. 6IUI cycles/year, IVF cycles/life
France - Right to know about his or her biological origin for children born after MAP
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.
France - 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
Since the law n°2021-1017 of 2 August 2021 on bioethics, access is reserved for couples composed of a man and a woman or two women or any unmarried woman, alive, who has already consented to embryo transfer or insemination.
Recourse to MPA is now conditional on the existence of a parental project. The medical criteria relating to medically established pathological infertility or the transmission of a particularly serious disease, which previously conditioned access to MAP have been removed. Obstacles to insemination or embryo transfer include the death of one of the members of the couple, the filing of an application for divorce or legal separation, the signing of a divorce or legal separation agreement by mutual consent, or the cessation of cohabitation, as well as the written revocation of consent to the doctor in charge of implementing medically assisted procreation or to the notary who received the consent.
Germany - 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
Iceland - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? sperm Yes/oocytes Yes/embryos No
See http://eng.heilbrigdisraduneyti.is/laws-and-regulations/nr/686
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No
8. Are there specific criteria for donation of sperm/oocytes/embryos? sperm Yes/oocytes Yes/embryos *
* See regulation: http://eng.heilbrigdisraduneyti.is/laws-and-regulations/nr/686
(Artificial insemination with donor sperm shall only be carried out if the fertility of the man is impaired, he has a serious hereditary disease or there are other medical reasons to use of donor sperm. (Article 8)
In vitro fertilization shall only be carried out with the gamete of the couple. It is however permitted to use donor gamete if the fertility of the man or the woman is impaired, either of them has a serious hereditary disease or there are other medical reasons to use of donor gamete. It is prohibited to carry out in vitro fertilization unless the gamete of either partner or either cohabitant is used. Donation of embryos and surrogacy is prohibited. (Article 9))
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes. If donated gametes are used, the doctor in charge of the treatment shall select the appropriate donor. A donor of gamete shall be healthy and have no hereditary diseases. Necessary tests shall be carried out to ensure that the donor is healthy and fertile and to prevent the transmission of diseases with the gamete. If imported gametes are used, the fulfilment of the aforementioned demands must be ensured. A doctor shall endeavour to realize the wishes of applicants that the build, height, colour of eyes and hair and the blood type of the gamete donor is as closely resembling the parent's as is possible . (art.17 reg.568/1997)
10. Are there special measures for the prevention of consanguinity? Yes. Indirectly, see art.18 reg.568/1997 (If a donor wishes to remain anonymous, health workers are obliged to ensure that this is respected. In this case, the donor may neither receive information about the couple receiving the donated gamete or the child, nor the couple or the child receive information about the donor. If a donor does not wish to remain anonymous, the institution shall preserve information about him in a special file. If the donation of gamete leads to the birth of a child, information about the child and the couple who received the gamete shall be kept in the same file. A child born on account of a gamete donation where the donor does not wish to remain anonymous can at the age of 18 gain access to a file pursuant to paragraph 2 for the purpose of obtaining information about the identity of the donor. If a child receives information about the gamete donor at the institution, the said institution shall as soon as possible inform the donor that the information has been given.)
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? Yes. Art. 6, Act no. 87/1996 (The provisions of the Adoption Act relating to spouses shall not apply to registered partnership. A person in registered partnership can however adopt a child of the other partner of whom that partner has custody, provided the child has not been adopted from another country. Nor statute provisions on artificial insemination apply to registered partnership. Ni statute provisions involving particular rules depending on the sex of a married spouse shall apply to registered partnership. 1). Provisions of international agreements to which Iceland is a party shall not apply to registered partnership unless approved by the other party.)
Hungary - 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? 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.
Hungary - Right to know about his or her biological origin for children born after MAP
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.
Hungary - Financial aspects
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.
Ireland - Medical aspects
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.
Iceland - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. Partially covered
4. Are there specific criteria for such coverage? Yes. The proportion of the payment covered by the social security system differs according to how many times treatment has been undertaken.
5. Is the financial coverage limited to a number of MAP procedures? Yes.
For couples without a child together coverage for first treatment approx. 50%
For second to fourth treatments approx. 70%. No coverage for further treatments.
For couples with one child. Coverage for first to fourth treatment approx. 20%. No coverage for further treatments. No coverage for couples with more than one child.
Iceland - 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
Germany - Legal regulation or practice and access to MAP
- Title of the law:
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]
- Date of adoption and entry into force:
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
- Published in:
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/
- Indicate if process of revision is ongoing and, in your answers, provide information on provision in the draft law:
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).
- If no legal instrument please describe the practice:
On the basis of paragraph 16b of the German Transplantation Act the German Medical Association has published Guidelines on the Procurement and Transfer of Human Germ Cells or Germ Cell Tissue in the context of Assisted Reproduction dated 11 March 2022 (Richtlinie zur Entnahme und Übertragung von menschlichen Keimzellen oder Keimzellgewebe im Rahmen der assistierten Reproduktion; https://www.bundesaerztekammer.de/fileadmin/user_upload/BAEK/Themen/Medizin_und_Ethik/RiLi-ass-Reproduktion.pdf).
Bosnia and Herzegovina - Legal regulation or practice and access to MAP
Bosnia and Herzegovina still have no specific legislation on MAP covering entire country. Currently, MAP is regulated by the Health Insurance legislation bylaws (in both B&H entities: Federation BiH and Respublika Srpska and Brcko District BiH), mainly regulating the rights of the couple to reimbursement of IVF costs for two procedures.
Date of adoption and entry into force:
Federation BIH: Decision on Establishment of Basic Patients Rights http://mz.ks.gov.ba/sites/mz.ks.gov.ba/files/Odluka%20o%20utvrdjivanju%20Osnovnog%20paketa%20slnFBiH21-09.pdf chapter X (11.,12.)
Adopted on 19. March 2009, in force as of 01.04.2009
Published in: Službene novine Federacije BiH”, 21/09 of 01. 04.2009.
In the entity Republika Srpska and Brcko district, Health Insurance Fund endorse the budget for MAP each year, depending on the funds availability
Indicate if process of revision is ongoing and, in your answers, provide information on provision in the draft law
MAP as a medical procedure is well established both in public and private sector in Bosnia and Herzegovina.
A draft Law on Medically Assisted Reproduction in the entity Federation B&H, after two years of preparation by the Federal Ministry of Health, and extensive public debate, has been rejected by the Parliament of Federation B&H in June 2014 https://www.google.ba/#q=+nacrt+zakon+o+biomedicinski+potpomognutoj+oplodnji
In 2016. B&H state level Parliamentary Group on Gender Equality drafted the B&H Framework Law on MAP (Setting standards for the entire country); however, despite support by the Council of Ministers of B&H, it has been rejected by Constitution-legal Commission of the House of Representatives, not for the content, due to for political reasons . http://static.parlament.ba/doc/46496_ZAKON%20O%20LIJE%c4%8cENJU%20NEPLODNOSTI_BIH%20%20nacrt_%20pre%c4%8di%c5%a1%c4%87eni%20(1). (July 2016)
Currently (January 2017) the new draft law on MAP (proposed by the Socialist Democrat Party MS) is in the Parliamentary procedure in B&H Entity Federation BIH, while the Draft of the MAP law prepared by the competent Ministry of Health will be on the Parliament agenda in 2017 as well.
Georgia - Legal regulation or practice and access to MAP
- Title of the law:
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)
- Date of adoption and entry into force:
a) LHC - Adopted by Parliament of Georgia on 10 December 1997
b) DL-RHRR– Submitted to the Georgian Government in December 2003
- Published in: LHC - News of the Parliament, 1997, Dec.
- Indicate if process of revision is ongoing and, in your answers, provide information on provision in the draft law: DL-RHRR– Before submitting the draft law to the Government, it was discussed among main stakeholders within the healthcare system and relevant non-governmental organizations. Professor of Toronto University Bernard Dickens (expert in the field of health law) was involved in the drafting process.
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.
Azerbaijan - Legal regulation or practice and access to MAP
Title of the law: No specific law, but different articles in the Code make a reference to it:
Law of population health protection
Date of adoption: 26 June 1997; entry into force: 24 September 1997.
Chapter 5.
Article 29 Artificial insemination and embryo implantation.
Article 40. The usage of semen and human organs for transplantation.
The Criminal Code of Azerbaijan Republic
Date of adoption: 30 December 1999; entry into force: 01 September 2000
Chapter 8.
Article 136. Illegal Artificial insemination.
Finland - Legal regulation or practice and access to MAP
- Title of the law: Act on Assisted Fertility Treatments (laki hedelmöityshoidoista; 1237/2006)
- Date of adoption and entry into force: 22/12/2006; 1 September 2007
- Title: Decree of the Ministry of Social Affairs and Health on Assisted Fertility Treatments (Sosiaali- ja terveysministeriön asetus hedelmöityshoidoista; 825/2007)
- Date of adoption and entry into force: 29/8/2007; 1 September 2007
- Published in: Statute Book of Finland (Suomen säädöskokoelma)
Czech Republic - Legal regulation or practice and access to MAP
- Title of the law: Czech Act on Specific Health Services (Act No. 373/2011 Sb.) and related laws
- Date of adoption and entry into force: Adoption 8.12.2011, force 1.4.2012
- Published in Collection of Laws
- Indicate if process of revision is ongoing and, in your answers, provide information on provision in the draft law: Revisions are discussed continuously
Ukraine - Legal regulation or practice and access to MAP
- Title of the law:
- Decree of the Ministry of Health dtd 4 February 1997
- Family Code of Ukraine dtd 1 January 2004
- Decree N52/5 of the Ministry of Justice dtd 18 October 2000
- Date of adoption and entry into force: 1 january 2004
- Published in: Vydavnychiy dim ‘Kuïb’ 2004
Lithuania - 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
The Law on MAP of the Republic of Lithuania states that MAP can be applied to infertile couples when infertility cannot be treated by any other methods.
b. Risk of transmission of a disease
For a heterosexual couple? Yes; For women not living in a heterosexual couple? No
According to the above-mentioned Law, MAP can also be used if there is a high probability of transmitting a disease, which could cause severe disability to a future child.
c. Other No
Financial aspects
3. Are MAP procedures covered by the social security system? Yes. In Lithuania infertility considered as a disease therefore MAP services are paid for in accordance with the Law on Health Insurance of the Republic of Lithuania. The compensation is available to people who have entered into a marriage or registered partnership agreement in accordance with the law and have been diagnosed with infertility (female, male or both). Age limit of woman for compensation - 42 years old.
4. Are there specific criteria for such coverage? Yes. Infertility is the condition for the coverage of MAP. Woman age limit for treatment of infertility with MAP is 42 years.
5. Is the financial coverage limited to a number of MAP procedures? Yes. A maximum of 2 treatment cecles per couple is reimbursed.
Luxembourg - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? sperm Yes /oocytes Yes /embryos No
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No
8. Are there specific criteria for donation of sperm/oocytes/embryos? sperm Yes /oocytes Yes /embryos Yes. In fact there is neither a collection nor a bank in Luxembourg. The service functions in collaboration with a foreign bank.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes. Five classic characteristics (blood group, complexion, eyes, colour of hair, height).
10. Are there special measures for the prevention of consanguinity? No. The straws of sperm come from abroad.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No. Currently no legislation.
Malta - Current debate and specific situations
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.
- There are doubts as to whether all medically assisted procreation in Malta use husband's sperm;
- There are concerns that men are being offered sums of money to donate sperm; that is a source of concern ;
- There is evidence that the number of ova being taken from a woman's ovary was higher than the amount which both scientifically and ethically makes sense. This can endanger the health of women (hyper stimulation syndrome).
- There is concern that more than two or three embryos are being transferred into a woman’s uterus.
- There are concerns about the current services being provided to infertile couples. These include: the need for infertile couples to be managed with more sensitivity; and the need for the couple to be given information and counselling about treatment options and associated risks, about possible solutions and their likelihood of success and failure.
Malta - 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 No?; For women not living in a heterosexual couple? No
c. Other N/A
In the absence of legal framework, that depends on the moral integrity and the personal values of the practitioners and the researchers.
North Macedonia - 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? NA
b. Risk of transmission of a disease
For a heterosexual couple No?; For women not living in a heterosexual couple? NA
c. Other N/A
There is not a law or specific articles in the healthcare law addressing MAP or people who are not living in heterosexual couple.
Norvège - Financial aspects
3. Are MAP procedures covered by the social security system? Yes.
MAP procedures are covered by the National Health care system and by co-payments. The (outpatient) clinic where the MAP procedure is conducted is financed as follows:
- Fee-for-service reimbursement from the National Insurance Scheme based on the treatments of IVF and intracytoplasmic sperm injection (ICSI) procedures
- en bloc subsidies from the state
- Co-payments from the patients, the woman/couple pays maximum NOK 18800 to cover some medicines and treatment costs for IVF/ICSI. The couples are usually offered three treatment cycles (three IVF or ICSI procedures, or a combination) per child.
4. Are there specific criteria for such coverage? Yes.
All couples that are offered MAP have a right to partial coverage of the medicines and treatment costs for IVF/ICSI treatment, limited to three attempts per child.
As a first step in the process, the woman/couple will consult their family physician. Based on a medical and psychosocial evaluation of the woman/couple the physician will decide whether to recommend the couple to one of the clinics offering MAP. The physician at the clinic decides whether or not the woman/couple will be offered MAP. According to the Biotechnology Act, a clinic offering MAP needs authorisation or approval from the Directorate of Health.
To have access to MAP through the clinics financed by the national health care system, an evaluation of the presumed cost-effectiveness of the treatment for the woman/couple is carried out,
Many clinics have established guidelines for evaluation of couples asking for medically assisted procreation.
Women/couples may also choose to pay for treatment in private clinics, this may provide shorter waiting time, and these clinics are not bound by the same principles of cost-efficiency.
A woman cannot be older than 46 at the time of insemination or implantation of embryo.
5. Is the financial coverage limited to a number of MAP procedures? Yes. Financial coverage is limited to three MAP procedures (three IVF or ICSI procedures - or a combination, where a procedure includes the retrieval of ova). Implantation of stored embryos (FER) is not counted as a “MAP procedure”.
Norvège - 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? No
c. Other Yes
Criteria for access to IVF is infertility or that the woman is affected by or carrier of serious hereditary disease.
Lesbian couples and single women have access to MAP by insemination or IVF. Criteria for assisted procreation by insemination to heterosexual couples is infertility or that the man has or is carrier of serious hereditary disease. :
- the woman is a carrier of serious X-linked diseases. In such cases, the act allows that procedures for selection of sperm can be used to ensure a female offspring. Such procedures can only be accepted after thorough scientific evaluation, and must be approved by the Directorate for Health and Social affairs.
- the husband/spouse is affected by or carrier of a serious inheritable disorder
- if there is a risk of transmission of a serious and chronic sexually transmissible disease.
The act does not specify a right to treatment in cases where there is a risk of transmission of diseases such between the woman and her husband/spouse.
Regarding situation where one or both partners have a serious and chronic sexually transmitted infection: Where the woman is infected, an evaluation of the risk of transmitting the virus to the child must be made in each case before it is decided to proceed.
A woman cannot be older than 46 at the time of insemination or implantation of embryo.
The criteria for infertility for access to IVF does not apply in cases where same-sex couple have treatment using partner donation (one of the women donates her egg to the other who carries the child).
Other known genetic disorders
Poland - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? Yes.
Lack of specific legal provisions on the subject.
Anonymity of donations is a matter of medical confidentiality. The Opinion of the Polish Association of Obstetricians recommends double anonymity (of both the donor and the receiver). Clinics’ internal regulations may provide otherwise.
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation?
i. For the child him or herself No; ii. For the parents No; iii. For a court No.
There are no specific legal provisions on the subject.
Doctors are therefore bound by medical confidentiality in respect of both the donor and the receiver of the gametes. Information concerning the donor may be revealed only on medical grounds, when the life or health of the child is threatened.
a. Identity of the donor(s)
i. For the child him or herself No; ii. For the parents No; iii. For a court No. See above comment
b. Certain health information concerning the donor(s)
i. For the child him or herself No; ii. For the parents No; iii. For a court No. See above comment
c. Other information
i. For the child him or herself No; ii. For the parents No; iii. For a court No. See above comment
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? NA
There is no specific legal provisions on the subject.
Under the general laws governing descent, it is not possible to contest paternity in the event of homologous insemination within a married couple.
In cases of heterologous insemination, however, paternity may be contested, but only if the spouse of the inseminated woman did not consent to insemination with another man’s sperm.
Relevant provisions:
Presumption of paternity:
Art. 62 of the Code of the Family and Guardianship:
“1. A child born in wedlock or within three-hundred days of the dissolution or annulment of the marriage shall be presumed to be the child of the mother’s husband.
2. A child born within three-hundred days of the dissolution or annulment of the marriage, but after the mother has remarried, shall be presumed to be the child of the second husband.
3. These presumptions may be rebutted only through action to disclaim paternity.”
Art. 63 of the Code of the Family and Guardianship:
“The husband of the mother may take action to disclaim paternity within six months of learning of the birth.”
Art. 85 of the Code of the Family and Guardianship:
“1. The man who had intercourse with the mother of the child between three-hundred days and one-hundred-and-eighty-one days before its birth shall be presumed to be its father.
2. The fact that, during that period, the mother also had intercourse with another man shall rebut this presumption only if, under the circumstances, the other man appears more likely to be the father."
Abuse of rights and public policy:
Art. 5 of the Civil Code:
“No person shall use their rights in a manner contrary to the social and economic purpose of those rights or the rules of life in society. Abuse or abusive non-use of a right shall not be considered as exercise of that right, or enjoy the protection of the law.”
Art. 58 para. 2 of the Civil Code:
“Any legal act contrary to the rules of life in society shall be null and void.”
Poland - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? Yes.
There are no legal provisions on the subject.
Clinics’ internal regulations define the specific medical criteria applicable to donors. Some questions are covered by the Opinion of the Polish Association of Obstetricians.
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No.
There are no legal provisions on the subject.
The Opinion of the Polish Association of Obstetricians provides for the lump-sum compensation of donors of genetic material for the expenses incurred.
8. Are there specific criteria for donation of sperm/oocytes/embryos? Yes.
Criteria for donation of sperm:
There are no legal provisions on the subject.
Some questions are covered by the Opinion of the Polish Association of Obstetricians. Clinics’ internal regulations define the medical criteria applicable to donors. These include: age: 30 - 45 years (correlation between the risk of a genetic disorder, such as Down’s syndrome, and age), state of health (absence of mental, systemic, tumour or infectious disease), and testing for viruses and sexually transmitted diseases. Where there is a high risk of the mother transmitting a genetic disorder to her offspring, the sperm donor must undergo exclusion tests for the same autosomal recessive gene. The donor’s blood group must also be known, to make sure it is compatible with the parents’ blood groups.
Sperm tests are carried out in conformity with WHO standards. Sperm is only preserved if bacteriological tests yield negative results. Donated sperm must be frozen for 6 months prior to the first insemination.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? No.
There are no legal provisions on the subject.
In practice basic physical and ethnic resemblance (skin colour) is taken into account.
10. Are there special measures for the prevention of consanguinity? No.
There is no legal provisions on the subject.
Clinics’ internal regulations may settle this question. According to the Opinion of the Polish Association of Obstetricians, the number of pregnancies obtained using sperm from the same donor may not exceed five.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No.
There are no legal provisions on the subject.
A legal relationship between a child and the homosexual partner of his or her legal parent would be considered contrary to the spirit of Polish law on families and descent, which defines the family as the union of two individuals of the opposite sex.
Portugal - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. Previously, infertility was considered as a disease, now, since July 2016, according to what the law calls principle of equality, every women, single or married, with or without infertility can ask to be inseminated
4. Are there specific criteria for such coverage? Yes.
There is only a lower age limit 18 years (no2, art 6, law 32/2006 in all the country
40 years in the NHS.
5. Is the financial coverage limited to a number of MAP procedures? Yes.
3 cycles for IVF at the National Health Service
At the moment it is not clear how many artificial inseminations can be done in single or homosexual women in NHS.
Portugal - 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? NA
c. Other N/A
Pays-Bas - Financial aspects
3. Are MAP procedures covered by the social security system? Yes.
Yes, but partly. In case of IVF, there is a maximum of three attempts.
4. Are there specific criteria for such coverage? Yes. Age limit of woman – 42 years old.
5. Is the financial coverage limited to a number of MAP procedures? Yes. See answer to question 3.