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.

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.

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

• Title of the law: Embryo Protection Act 2018
• Date of adoption and entry into force:  2018
• Published in: Laws of Malta; Government Gazette

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

Surrogacy is not allowed but donation of sperm is allowed and therefore homosexual female couples can use sperm donation or adoption of frozen embryos

16. Is donation of sperm/oocytes/embryos anonymous? sperm No / oocytes No / embryos Yes. Articles 6 though to 9 of the Act

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

a. Identity of the donor(s)

i. For the child him or herself No; 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

c. Other information

i. For the child him or herself No; ii. For the parents No; iii. For a court No

Article 19 has two provisions:

19(1): That any child born of any medically assisted procreation, including cases where the child was born from donated germ line cells or a donated embryo, shall be considered as the child of the prospective parent(s) who has/have expressed their consent to the procedure. It also states that for all intents and purposes of the law, the child will be considered to have been ‘naturally born of the same prospective parent or prospective parents’. The child will be registered in any act of civil status as the direct descendant of such prospective parent(s), who then have the rights and duties under the law in respect of the child.

19(2) states explicitly that there shall be no link of filiation between the child born from donated germ line cells or adopted embryos and the persons from whom donated germ line cells or adopted embryos originated.

Note : (Interestingly, in a scientific sense, this also acknowledges that the Gestational mother is more important that the Genetic mother under these circumstances)

The law does not explicitly mention the cases ticked ‘NO’ above, but Article 22 of the Act does oblige the licensee who performs MAP to ‘keep a confidential register with full details of every medically assisted procreation procedure, germ line donation, cryo-preservation of germ line cells and cryo-preservation of embryos in terms of this Act and to pass on this information to the Authority without delay’

Note: Presumably therefore, the Authority may in certain circumstances, e.g. for health reasons, give permission to reveal identities. This is not however explicitly stated, but keeping the register mean implicitly having a safety net.

18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? See comments in point 19 

3. Are MAP procedures covered by the social security system? Yes. Infertility treatment is of course a disease when biological; however social infertility presumably allowed by law due to equal rights for married couples.

4. Are there specific criteria for such coverage? Yes. Depends on the Authority for MAP

5. Is the financial coverage limited to a number of MAP procedures? Yes