13.         Who is recognised as the legal parent(s) of a child born following surrogacy?     

a. surrogate mother  Yes. Czech law: the woman who gives birth is the legal parent

b. oocyte donor  No            

c. sperm donor No

d. intended mother  No, she has to go through the adoption procedures

e. intended father  Yes, if the surrogate is not married and if she determines the intended father as the child's father         

14.         Do mechanisms exist to transfer parentage from the surrogate mother to the intended parent(s) (e.g. adoption procedures)? Yes, adoption   

15.         Is the existence of a genetic link required for establishing paternity/maternity? No, in cases of MAP.

16.         Are the other parties involved mentioned in the birth certificate or other official document connected to the birth?   

a. surrogate mother  Yes, before the adoption

b. oocyte donor  No            

c. sperm donor No

d. intended mother  No at first, after adoption yes

e. intended father  Yes, if the surrogate is not married 

17.         Are foreign birth certificates in surrogacy cases registered in your country. Yes. Very recently (mid May 2018). The reason is the best interest of the child.

8.            Can the surrogate also be the oocyte donor? Theoretically, because there is no law. The Czech MAP Society has issued recommendation not to use her eggs.

6.            Is access to surrogacy subject to specific criteria?             

a. medical criteria (e.g. infertility of the intended parent(s))  No     

b. other criteria (please specify)  No. Surrogacy is not regulated by law. The Czech MAR Society has issued recommendations (exclusively medical indications, weighting with the applicants' own gametes, transfer of a single embryo, age of the surrogate mother under 49, surrogate mothers’ permanent residence in the Czech Republic, etc.), but the compliance is not enforceable.           

11.         If surrogacy is forbidden, is the conduct of the following persons criminalised by the law?

a. surrogate mother    No   

b. intended parent(s)    No 

c. gamete donor    No            

d. facilitator    Yes                   

12.         Subject to the applicable law, are you aware of the following unlawful practices in your country?   The Federal Government is not aware of any of the unlawful practices referred to in a. to e. in Germany. However, since oocyte transfer is prohibited too, German artificial reproduction clinics cannot engage in any form of surrogacy.          

a.            remuneration of the surrogate  No

b.            remuneration of the gamete donor    No      

c.            advertising for surrogacy services    No          

d.            remuneration of facilitators    No      

e.            any other unlawful practices (please specify)   No  

5.            Is surrogacy prohibited in your country?              

a. any form of surrogacy    Yes          

b. only specific forms of surrogacy (e.g. commercial) (please specify)    NA  

1.           Is surrogacy regulated by a specific law in your country?    No specific law, but specific provisions in more general laws         

2.           Is surrogacy regulated in another way? (please specify)  Yes. 

Surrogacy is not allowed in Spain, although it is recognized as an assisted reproductive technology in the Law 14/2006 on Assisted Human Reproduction Technologies (LTRHA) approved in 2006.

This Law declares null and void any contract agreement of surrogate motherhood conducted by a woman who refuses the filiation in favour of the contracting part or of a third party beneficiary, no matter it is with or without remuneration. It also lays down that filiation of children born by surrogate motherhood is determined by birth and that the fatherhood claim of the biological father remains possible.

Although the law in general seems to be very innovative and according to the critics, it is one of the most permissive regulations in the world, in relation to surrogate motherhood it takes a conservative character.

3.           Has surrogacy been the subject of jurisprudence/court cases in your country?    Yes

4.           Is there a legal definition of the term “surrogacy”? (please specify)    Yes. It is defined in the LTRHA as surrogate gestation: gestation, with or without price, in charge of a woman who refuses motherhood filiation in favour of the contracting part or of a third party beneficiary. 

9.           Is it lawful to advertise surrogacy services?    No     

10.         Is it lawful to remunerate a facilitator/surrogacy agency   NA

13.         Who is recognised as the legal parent(s) of a child born following surrogacy?      

a. surrogate mother   Yes    

b. oocyte donor    No          

c. sperm donor  No 

d. intended mother   Yes/No 

The intended mother is recognised as the legal mother of the child born through surrogate motherhood if she is an egg donor and if there is a foreign surrogacy judgment, recognisable in Switzerland, which establishes the legal parent-child relationship between the genetic intended mother and the child born through surrogate motherhood.

e. intended father    Yes/No   

The intended father is recognised as the legal father of the child born as a result of surrogate motherhood if he is a sperm donor and if there is a foreign surrogacy judgment, recognisable in Switzerland, establishing the legal parent-child relationship between the genetic father of intent and the child born as a result of surrogate motherhood. 

Note: if this condition is not met, the parent-child relationship between the intended parents and the child born as a result of surrogate motherhood can only be established through adoption.

14.         Do mechanisms exist to transfer parentage from the surrogate mother to the intended parent(s) (e.g. adoption procedures)?  Yes, in most cases the parent-child relationship between the intended parents and the child born as a result of surrogate motherhood can be established through adoption.

15.         Is the existence of a genetic link required for establishing paternity/maternity?  Yes. 

No genetic relationship between the intended parents and the child born of surrogate motherhood is required for adoption. However, the parent-child relationship between the intended parents and the child can only be directly recognised on the basis of a foreign surrogacy judgment (e.g. in the United States) if the intended parents are also the genetic parents of the child.

See also the answer to question 13 above.

16.         Are the other parties involved mentioned in the birth certificate or other official document connected to the birth?         

a. surrogate mother  No       

b. oocyte donor   No             

c. sperm donor   No 

a, b, c - The details of the surrogate mother, egg donor and sperm donor are recorded in the civil register, in the event that the child born after surrogacy wishes to know about them at a later date. However, they do not appear on any official document (birth certificate, etc.). This also applies after the child has been adopted by the intended parents.

d. intended mother   Yes     

e. intended father     Yes       

d, e - Yes, if the parent-child relationship between the intended parents and the child born through surrogate motherhood can be recognised in Switzerland (see also question 13), the intended parents will be entered in the civil status register as the child's legal parents and will appear on civil status documents (birth certificate, etc.). This also applies if the child is adopted by the intended parents.

17.         Are foreign birth certificates in surrogacy cases registered in your country  No, foreign birth certificates are never recognised directly in surrogacy cases. It is only when there is a foreign judgment that can be recognised in Switzerland (art. 70 LDIP), which establishes the parent-child relationship with the intended (genetic) parents, that the foreign birth certificate drawn up on the basis of the judgment can also be recognised (case law of the Federal Court).

6.           Is access to surrogacy subject to specific criteria?            

a. medical criteria (e.g. infertility of the intended parent(s))    N/A    

b. other criteria (please specify)   N/A      

1.           Is surrogacy regulated by a specific law in your country? No             

2.           Is surrogacy regulated in another way? (please specify) No

3.           Has surrogacy been the subject of jurisprudence/court cases in your country? Not for the moment

4.           Is there a legal definition of the term “surrogacy”? (please specify) No      

8.            Can the surrogate also be the oocyte donor? N/A

5.           Is surrogacy prohibited in your country?  It is not subject of any law or reglementation. It is not regulated.             

13.         Who is recognised as the legal parent(s) of a child born following surrogacy? The Law of Civil Registry of July 11, 1996, Article 62 provides for the need to prove maternity and so this would be the surrogate mother.     

a. surrogate mother       

b. oocyte donor               

c. sperm donor 

d. intended mother        

e. intended father          

14.         Do mechanisms exist to transfer parentage from the surrogate mother to the intended parent(s) (e.g. adoption procedures)? Adoption could be possible.

15.         Is the existence of a genetic link required for establishing paternity/maternity?  N/A

16.         Are the other parties involved mentioned in the birth certificate or other official document connected to the birth?  N/A         

a. surrogate mother       

b. oocyte donor               

c. sperm donor 

d. intended mother        

e. intended father          

17.         Are foreign birth certificates in surrogacy cases registered in your country   N/A

7.            If surrogacy is allowed, is it lawful for the surrogate mother to receive:  

a. refund of medical expenses N/A

b. refund of other expenses N/A

c. compensation for loss of income N/A        

d. other compensation including non-pecuniary N/A              

e. remuneration or comparable advantage N/A        

• refund of medical expenses       
• refund of other expenses            
• compensation for loss of income             
• other compensation including non-pecuniary   
• remuneration or comparable advantage

9. Is it lawful to advertise surrogacy services? No

10. Is it lawful to remunerate a facilitator/surrogacy agency  No

1.           Is surrogacy regulated by a specific law in your country?    No. 

There is no specific law in Republic of San Marino.

In case of infertile heterosexual couples are guaranteed links with the Italian reference centers to proceed with the medical procedure in order to proceed with the medically assisted fertilization. Therefore, the laws that underlie these subjects are Italian.

In San Marino as in many Italian hospitals, obstetrics deals with physiological pregnancies, while for those at risk is used to have the Rimini (Italy) hospital consulting for the guarantee offered by the neonatology service. However, it is easy to say that our hospital, like many in Italy, do not have a structure that deals with fertility treatment that would require a contribution offered by a molecular biology and cellular service, and cryopreservation. We have only a gynecology and obstetrics service that deals with the health of women and pregnancy, childbirth and the postnatal period but not of assisted reproductive technology.

Those who want to make this kind of surgery have to go to an Italian structure and pay all procedures of their own pockets. San Marino covers only the pharmaceutical expenses for two cycles of therapy linked to the induction of ovulation in the woman to perform the oocytes explantation. At the failure of the second attempt, if there are no frozen embryos to replant and the couple wanted to undergo another treatment, the couple pays also drug costs.

If pregnancy occurs, after a few attempts (it makes no difference whether the first or second) through assisted reproduction techniques it will be followed as a normal pregnancy and all health coverage that are entitled to residents or citizens of the state.

The health care system provides drug treatment for two cycles of ovarian stimulation and all medical examinations pre and post implant.

To sum up:

None of the questions about surrogacy is affirmative for Republic of San Marino.

All questions related to medically assisted fertilization with the possible donation of gametes are the same answers from Italy, although the Italian Republic has bound to specific laws.

Infertility is followed free of charge by the health care system in respect of two pharmacological cycles and the pre and post implantation. The gamete extraction techniques, fertilization, implantation and embryo storage at Italian specialized structures are the responsibility of the couple as well as any subsequent pharmacological cycles to the two provided free and the possible pregnancy of control remains in the responsibility of the health care system.       

2.           Is surrogacy regulated in another way? (please specify)   No. In case of infertile heterosexual couples are guaranteed links with the Italian reference centers to proceed with the medical procedure in order to proceed with the medical assisted fertilization. Therefore the laws that underlie these subjects are Italian.

3.           Has surrogacy been the subject of jurisprudence/court cases in your country?    No

4.           Is there a legal definition of the term “surrogacy”? (please specify)     No    

18.         Is there:              

a. any public discussion about the topic   NA

b. planning of new regulation at national level   NA

19.         Please specify any additional relevant aspects which were not mentioned.  NA

6.            Is access to surrogacy subject to specific criteria?             

a. medical criteria (e.g. infertility of the intended parent(s))     Yes.

b. other criteria (please specify)     Not commercial  

18.         Is there:              

a. any public discussion about the topic  Yes

b. planning of new regulation at national level   Yes

19.         Please specify any additional relevant aspects which were not mentioned.     

Draft law no 6568 proposes to prohibit surrogacy (“any agreement for surrogacy is void”).

See the recent opinion of the NEC: MAP, Surrogacy anonymously: so many ethical challenges to society (pages 24-26)

http://www.cne.public.lu/publications/avis/Avis_26.pdf

8.            Can the surrogate also be the oocyte donor?   Yes. Oocyte donation is regulated by the same law as surrogacy (Law on Infertility Treatment with Assisted Reproductive Technologies). Instead of surrogacy which is prohibited, oocyte donation is allowed, and the criteria are specified.