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.

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

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.

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. -

• 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).

• 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.

• 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)

• 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

• 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 1^st 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 24^th February 2016 proposed to remove the requirement of a genetic link between the child and one of the parents but to not allow surrogacy.

• 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

• Title of the law:

1. Decree of the Ministry of Health dtd 4 February 1997
2. Family Code of Ukraine dtd 1 January 2004
3. 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

• 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

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

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”.

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).

2.b.X linked diseases

                        Other known genetic disorders

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

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.”

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.

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