Access to medically assisted procreation - Search
North Macedonia - Right to know about his or her biological origin for children born after MAP
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
Poland - Legal regulation or practice and access to MAP
- Title of the law: There are no general laws or regulations on medically assisted procreation in Poland
- If no legal instrument please describe the practice: In view of the lack of specific legal provisions, MAP may be practised under the general rules of medical law and in particular those governing the practice of medicine (duty to inform patients of the medical and legal consequences, confidentiality with regard to the MAP itself and the identity of the donor of the gametes, due care in the choice of the donor and examination of the genetic material to be used, the duty to obtain free and informed consent, etc), the corresponding rights of patients, the general laws on families, descent and registration, and the Medical Code of Ethics (which does not address this issue specifically). Some questions are addressed in the Opinion of the Polish Association of Obstetricians concerning the MAP techniques used in the treatment of infertility, and others by the internal regulations of the clinics practising MAP (practice may therefore vary from one place or establishment to another).
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.”
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.
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 - 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
Portugal - Legal regulation or practice and access to MAP
- Title of the law Law: 17/2016 Enlarges those who can benefit from ART (June 20, 2016). Creation of human embryos for for research purposes remains prohibited under the provisions of Law 32/2006, which regulates the use of Medically Assisted Reproduction (MAR) techniques.
- Date of adoption and entry into force: August 1, 2017
- Published in: Diário da República, Iª série – Nº 116 , pp 1903-1904, June 20, 2016
Portugal - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? Yes. There is a waiting list (both in public and private centers) for MPA procedures, that was aggravated during 2020-21 due to the pandemic situation.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. NA
San Marino - Medical aspects
2. Are there specific criteria for access to MAP? See general comment on relevant legal instrument.
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
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 - 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.
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 - Legal regulation or practice and access to MAP
- 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 1st 2016, allowing single females to be fertilized by assisted reproduction. The egg cell must be the single female’s own gametes.
The questions about the requirement of a) a genetic link between one of the parents and the child, and b) whether altruistic surrogacy, if any, should be allowed, were recently assessed. The government inquiry “Olika vägar till föräldraskap (SOU 2016:11)” has in a publication on the 24th February 2016 proposed to remove the requirement of a genetic link between the child and one of the parents but to not allow surrogacy.
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
Spain - Legal regulation or practice and access to MAP
- 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
Serbia - Financial aspects
3. Are MAP procedures covered by the social security system? Yes
4. Are there specific criteria for such coverage? Yes.
Age limit for treatment of infertility with MAP was 40 years, since 2022 is changed:
The service is intended for insured persons, women up to the age of 45 in accordance with the Rule book on the content and scope of the right to health care from compulsory health insurance and on participation for the year 2022.
5. Is the financial coverage limited to a number of MAP procedures? Yes. Three stimulated procedures of biomedically assisted fertilization with donated spermatozoa, three procedures of biomedically assisted fertilization with donated egg cells, as well as three cryoembryotransfers with donated spermatozoa or egg cells in a woman up to the age of 45, if one of the partners (marital or common-law) does not have a child.
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. -
Türkiye - Legal regulation or practice and access to MAP
- 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
Serbia - Legal regulation or practice and access to MAP
- Title of the law: Law on biomedically assisted procreation
- Date of adoption and entry into force: adoption 25 April 2017; entry into force 5 May 2017,
- Published in: "Official Gazette of the Republic of Serbia ", No. 40/2017 and 113/2017
- Indicate if process of revision is ongoing and, in your answers, provide information on provision in the draft law: At the moment, new law is in the process of adoption by the Serbian Parliament. Public debate is finished, and the new law is correlated with EU Directives
San Marino - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? See comment on relevant legal instruments
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? 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 the prevention of consanguinity? NA
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? NA
Andorra - Right to know about his or her biological origin for children born after MAP
16. Are donation of the sperm/oocytes/embryos anonymous?
Yes, specify the legal provisions. Law 12/2019, of the 15th February, described as techniques of assisted reproduction
17. Is it possible to obtain information about the biological origin of a child bornn after gametes or embryo donation for the child/for the parents/for the court?
Yes for the child
No for the parents
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions?
No
Andorra - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? If so, what might the implications be?
NA
20. Particular cases encountered in your country, and expecially, their case-law
NA
Andorra - Financial aspects
3. Are MAP procedures covered by teh social secutiy system? NA
4. Are there specific criteria for such coverage? NA
5. Is the financial coverage limited to a number of MAP procedures? NA
Austria - Right to know about their origin for children born after MAP
16. Is donation of sperm, oocytes and embryos anonymous?
No
17. Is it possible to obtain information about the biological origin of a child born after gametes or embryo donation? For the child? For the parents? For a court?
Yes
In particular: identity of the donors for the child, for the parents, for a court?
Yes
Certain health information concerning the donor(s), for the child, for the parents, for a court?
Yes, details in § 20 Law on Medical Assisted Procreation “Fortpflanzungsmedizingesetz”.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions (family law provisions)?
Yes, under Austrian law, the mother is the woman who gave birth to the child. The father is the husband of the mother, or the man who recognized paternity or whose fatherhood was imposed by the court. The donor of sperm/eggs is excluded by law from fatherhood/motherhood.
Regulations see § 144 and §145 Austrian Civil Code “Allgemeines Bürgerliches Gesetzbuch”
Azerbaijan - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples? Yes
b. possible for women nnot living in a heterosexual couple? Yes
Azerbaijan - Medical aspects
2. Are there 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? Yes
b. Risk of transmission of a disease (please specify the risk and/or disease)
i. for a heterosexual couple? Yes
ii. for women not living in a heterosexual couple? Yes
Azerbaijan - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? NA
20. Particular cases encountered in your country, and especially your case-law, in relation to the questions appearing in Sections I and II above
The law on reproductive health is being elaborated. Many aspects of MAP were included during discussions on the draft law.
Belgium - 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? No
The 2007 Act makes no mention of such a restriction. Each centre is free to accept or refuse requests from homosexual couples.
Belgium - Legal regulation or practice and access to MAP
Title of the law: Medically Assisted Procreation and Destination of Supernumerary Embryos and Gametes Act of 6 July 2007
Entry into force 27 July 2007
Published in: the Moniteur belge [Official Gazette] on 17 July 2007, p.38575
Articles 26 and 55, paragraph 2, of the Act, inserted by a law of 10 April 2014 and entered into force on 10 May 2014 provides that if the two authors of the parental project are two women, they are considered as a single woman, when counting the maximum of six women who can give birth to children from gametes or surplus embryos from one donor or donor couple.
Bosnia and Herzegovina - Right to know about his or her biological origin for children born after MAP
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 or embryo donation?
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?
NA
Latvia - 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? No
8. Are there specific criteria for donation of sperm/oocytes/embryos? Yes.
For sperm age limit 18-45.
For oocytes 18-35.
If checking on sexually transmitted disease STD, Hepatitis B, C are positive.
If General health are not in good condition.
If in anamnesis have genetic diseases.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes
10. Are there special measures for the prevention of consanguinity? Yes. No more than three children can be born from one donor, furthermore, special means are taken if the children born from donor have genetically hereditary disease.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No
Italy - 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 No
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 NA; ii. For the parents NA; iii. For a court NA
a. Identity of the donor(s)
i. For the child him or herself NA; ii. For the parents NA; iii. For a court NA
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 NA
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. In the case of reproduction using a heterologous donor - even if prevented by law - the donor cannot disown the child (Art 9). The mother of the child after MAP cannot declare her wish not to be entered in the birth registers as provided for by dpr no 396 (2000).
Italy - Réglementation ou pratique et accès à la PMA
- Titre de la législation : Règles en matière de procréation médicalement assistée.
- Date de l’adoption et de l’entrée en vigueur 19 février 2004 n°40
- Publiée dans : Gazzetta Ufficiale della Repubblica Italiana (publication officielle contenant les éléments des nouvelles lois).
- Indiquer si une révision est en cours et, dans vos réponses, fournir des informations sur les dispositions du projet de loi :
Le 12 juin 2005 a eu lieu un référendum populaire pour modifier plusieurs dispositions de cette loi. L’abrogation de ces dispositions a été rejetée, le taux d’abstention ayant été de 74 % (51 % de votes favorables auraient été nécessaires pour changer la loi).
Résumé
1. Protection des désirs de maternité/paternité et règles d’exercice des droits découlant de la loi n° 40/2004.
L’accès aux techniques de procréation assistée est réservé à des couples hétérosexuels majeurs, mariés ou menant une vie commune, dont les membres sont tous deux vivants et en âge de procréer.
Il est interdit aux personnes célibataires et aux homosexuels.
Le couple qui demande un accès aux techniques de procréation (médicalement) assistée doit produire un certificat médical attestant l’existence d’une stérilité ou d’une infertilité pour lesquelles il n’existe aucune autre solution possible.
Le consentement, écrit et librement révocable jusqu’au moment de la fécondation in vitro de l’ovocyte, est obligatoirement précédé d’une information sur le plan technique, juridique, et éthique ainsi que sur le coût des procédures et sur les conséquences possibles des techniques de procréation assistée pour l’enfant à naître.
Lors de l’entretien avec le responsable du centre médical, les couples sont également informés des possibilités d’adopter un enfant ou de devenir famille d’accueil d’un enfant en vue de son adoption (loi n° 184 du 4 mai 1983).
Un délai de réflexion de sept jours doit être respecté avant le début des procédures de procréation assistée.
Ces techniques sont appliquées de manière progressive en commençant par les moins invasives afin d’éviter de recourir à des interventions dont le caractère invasif, au plan technique et psychologique, les rend plus pénibles pour les personnes concernées.
Le médecin responsable du centre médical est en droit de prendre la décision de ne pas recourir aux techniques de procréation assistée, exclusivement pour des raisons médicales ou de santé.
La cryoconservation des gamètes masculins et féminins est autorisée, à condition que les personnes concernées aient été informées et y aient donné leur consentement écrit.
La loi, dans sa formulation d’origine, interdisait le recours à des techniques de type hétérologue (avec don de gamètes d’un tiers extérieur au couple). L’intervention de la Cour constitutionnelle (arrêt n° 162 de 2014) a supprimé cette interdiction.
2.Protection de l’enfant à naître
Le statut juridique de l’enfant né par techniques de procréation assistée est celui d’un enfant légitime ou reconnu par le couple. Le désaveu de paternité est exclu en cas de fécondation hétérologue. Le donneur de gamètes n’acquiert aucun lien juridique de parenté avec l’enfant né (aucun droit ni devoir).
La mère ne peut plus, au moment de l’accouchement, déclarer sa volonté de ne pas être connue, comme cela est autorisé pour la conception naturelle (Décret du Président de la République n° 396 du 3 novembre 2000).
3.Protection de l’embryon
Il est interdit de procéder à la cryoconservation ou à la suppression d’embryons, sous réserve des dispositions de la loi n° 194 du 22 mai 1978 (loi sur l’interruption volontaire de grossesse).
La loi, dans sa formulation d’origine, disposait que les techniques de production d’embryons, compte tenu de l’évolution technique et scientifique et de ce qui pourra être établi à l’avenir par des orientations juridiques du ministre de la Santé, ne peuvent conduire à la création d’un nombre d’embryons supérieur à celui strictement nécessaire à la réalisation d’un transfert unique et simultané, ce nombre ne pouvant en aucun cas être supérieur à trois.
Lorsque le transfert des embryons dans l’utérus se révèle impossible pour raison majeure grave et prouvée, ayant trait à l’état de santé de la femme et non prévisible au moment de la fécondation, la cryoconservation des embryons est autorisée jusqu’à la date du transfert, qui sera effectué aussitôt que possible. Depuis la décision n° 151/2009 de la Cour constitutionnelle, la détermination du nombre d’embryons à créer et à transférer dans le cadre d’une procédure d’implantation reste à l’appréciation du médecin qui tient compte de l’état de santé de la femme. Il ne doit pas être supérieur au nombre strictement nécessaire à la procréation.
En vertu de la loi sur la procréation médicalement assistée, il est interdit de procéder à la réduction embryonnaire de grossesses multiples, sauf dans les cas prévus par la loi n° 194 du 22 mai 1978 (loi sur l’interruption volontaire de grossesse).
Les sujets visés à l’article 5 sont informés du nombre et, s’ils le demandent, de l’évaluation des embryons produits à transférer dans l’utérus.
À la suite de la décision n° 96 du 5 juin 2015, la Cour constitutionnelle a levé l’interdiction qui était faite aux couples fertiles porteurs connus de maladies génétiques graves de recourir au diagnostic génétique préimplantatoire. Les maladies en question doivent répondre aux critères de gravité énoncés à l’article 6, paragraphe 1, lettre b) de la Loi n° 194 du 22 mai 1978 et être détectées par les prestataires publics de soins de santé compétents. Il appartient au Parlement de définir les critères d’agrément de ces structures.
Toute expérimentation sur l’embryon humain est interdite.
La recherche clinique et expérimentale sur l’embryon humain est autorisée à condition que les buts en soient exclusivement thérapeutiques et diagnostiques, en vue de la protection de la santé et du développement de l’embryon.
Sont interdites :
(a) la production d’embryons humains aux fins de recherche ou d’expérimentation ou à toutes fins autres que celles prévues par la loi. Interdiction des dons d’embryon à des fins de recherche : dans l’arrêt Parrillo c. Italie (requête n°46470/11) du 27 août 2015, la Cour européenne des droits de l’homme a reconnu que l’interdiction faite à une femme de donner à la recherche scientifique des embryons résultants d’une fécondation in vitro n’était pas contraire à son droit au respect de sa vie privée (il n’y avait pas de violation de l’article 8 (droit au respect de la vie privée) de la Convention européenne des droits de l’homme). Elle a également affirmé que les embryons humains ne sauraient être réduits à des « biens ». La Cour a considéré qu’il convenait de reconnaître à l’Italie une large marge d’appréciation dans cette affaire, qui mettait en jeu des questions morales et éthiques sensibles, d’autant plus qu’il n’y avait pas de consensus européen sur la question délicate du don d’embryons non destinés à l’implantation. La Cour constitutionnelle a rejeté un recours récent sur ces questions, affirmant qu’il appartenait au législateur de modifier la loi.
(b) toute forme de sélection dans un but eugénique, des embryons et des gamètes, ou des interventions qui, au moyen de techniques de sélection, de manipulation, ou par des procédés artificiels, visent à altérer le patrimoine génétique de l’embryon ou du gamète, ou à en prédéterminer les caractéristiques génétiques, à l’exception des interventions à des fins diagnostiques et thérapeutiques. Cela dit, l’arrêt n° 229/2015 de la Cour constitutionnelle n’a supprimé l’interdiction de la sélection d’embryons que dans des circonstances particulières, considérant qu’il ne s’agissait pas d’une infraction lorsqu’elle vise à prévenir l’implantation d’embryons nés de couples présentant un risque de transmission de maladies génétiques graves, conformément à l’article 6, 1 B de la loi 194 (relative à l’interruption de grossesse) dans des structures publiques désignées. Une question de constitutionnalité concernant l’article 13 (paragraphes 3, alinéa b) et 4) de la Loi n° 40/2004 a été soulevée. Le jugement rendu est conforme à l’arrêt précité.
Il souligne toutefois la protection nécessaire a conférer à l’embryon humain à la protection nécessaire, rappelant que « l’enjeu est ici la nécessité de protéger la dignité de l’embryon, à laquelle aucune autre réponse que la cryoconservation ne peut actuellement être apportée. Un embryon, quel que soit le statut juridique plus ou moins déterminé associé au début de la vie, ne saurait être réduit à un simple matériau biologique ».
(c) des interventions de clonage par transfert de noyau ou de scission précoce de l’embryon ou d’ectogenèse, à des fins de procréation ou de recherche ;
(d) la fécondation d’un gamète humain par un gamète d’espèce différente et la production d’hybrides ou de chimères.
4. Sanctions
Le texte de la loi 40/2004 prévoit différentes sanctions progressives en cas de violation de la loi, qui s’appliquent aux médecins et aux Centres autorisés mettant en œuvre les techniques de procréation assistée.
L’homme ou la femme auxquels sont appliquées les techniques ne peuvent être sanctionnés que s’ils n’ont pas suivi les procédures prévues. La sanction pour insémination hétérologue a été supprimée. Les sanctions qui restent en vigueur sont définies à l’article 12 de la Loi n° 40/2004.
5. Autorisations
Un système d’autorisation régionale des structures jugées adéquates est prévu, sur la base :
(a) des données techniques, scientifiques et d’organisation de ces structures ;
(b) des qualifications du personnel.
Les conditions requises sont établies par actes des Régions.
Il existe un Registre obligatoire des structures autorisées, établi et tenu par l’Institut supérieur de la santé, qui suit l’application des techniques de procréation médicalement assistée, les embryons formés et les enfants nés à la suite de l’application de ces techniques.
L’Institut supérieur de la santé prépare le rapport annuel à présenter au Parlement.
Après la décision n° 162/2014, le ministère de la Santé a approuvé les Lignes directrices pour l’application des techniques de reproduction hétérologues au couple qui reçoit le gamète. En ce qui concerne le don de gamètes, l’Italie adoptera la Directive UE 2006/17, ALL.III, PAR.3,4 et ses modifications ultérieures. Le texte sera approuvé dans le système normatif (sous la forme d’un décret gouvernemental). L’un des éléments fondamentaux issus du système juridique Italien est le principe selon lequel le don de sperme et d’ovocyte doit être un acte volontaire, altruiste et non rémunéré.
Ireland - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? No. As previously indicated, under the Children and Family Relationships Act gamete and embryo donation is permitted on a non-anonymous basis. Gamete and embryo donors will be required to provide name; place and date of birth; nationality, place and date on which s/he provided the donation; and contact details. Once a donor-conceived child has attained the age of 18 years s/he may request the name, date of birth and contacts details of the relevant donor, as recorded in the National Donor-Conceived Person Register.
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 Yes; iii. For a court NA
According to the Children and Family Relationships Act 2015, a donor-conceived child who has attained the age of 18 years, or the parent of a donor-conceived child who has not attained the age of 18 years, may request the following information from the Register:
(a) information other than the relevant donor’s name, date of birth and contact details, that is recorded on the Register in respect of the relevant donor;
(b) the number of persons who have been born as a result of the use in a donor-assisted human reproduction procedure of a gamete donated by the relevant donor, and the sex and year of birth of each of them.
In addition, the Act provides that, a donor-conceived child who has attained the age of 18 years may request the name, date of birth and contacts details of a relevant donor, as recorded in the Register. The donor must be issued with a notice informing him or her that a request has been made by the donor-conceived child. The requested information may be released 12 weeks from the date on which on which the notice is sent (with very restrictive exceptions).
a. Identity of the donor(s)
i. For the child him or herself Yes; ii. For the parents Yes; iii. For a court NA
See answer to previous question
b. Certain health information concerning the donor(s)
i. For the child him or herself; ii. For the parents; iii. For a court
Under the proposed assisted human reproduction legislation, medical information relating to the donor may be released to a medical practitioner in order to avoid an imminent and serious risk to the health of a person or to enable the medical practitioner to provide medical advice to a person regarding the existence of a genetic or hereditary condition.
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? Yes/No.
According to the Irish Constitution, the woman who has given birth to a child is always regarded as the legal mother. This assertion was challenged in the Irish Courts, but it was upheld in the Supreme Court in 2014 in the MR and Anor – v- An tArd Chlaraitheoir & Ors (Surrogacy) case.
According to the Children and Family Relationships Act 2015, the parents of a donor-conceived child are the mother and her husband, civil partner or cohabitant as the case may be. A donor of a gamete or embryo is not regarded as the parent of a donor-conceived child.
Latvia - Legal regulation or practice and access to MAP
Title of the law “Law on reproductive and sexual Health”
Date of adoption 31 January 2002 and entry into force 01 July 2002
Published in 19 February 2002
Latvia - 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
Lithuania - 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
Lithuania - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. 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). The woman must be at least 42 years old.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). The woman must be at least 42 years old.
4. Are there specific criteria for such coverage? Yes. When the woman is 42 yearl old and the partners are infertile
5. Is the financial coverage limited to a number of MAP procedures? Yes. A maximum of 2 treatment cycles per couple is reimbursed
Lithuania - 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? No
8. Are there specific criteria for donation of sperm/oocytes/embryos? Yes
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
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No
Lithuania - Legal regulation or practice and access to MAP
- Title of the law: The Law on the Assisted Reproduction of the Republic of Lithuania
- Date of adoption: 14th September 2016 (amended 24th May 2022, 30th May 2019 and 17th January 2017)
- Entry into force: 1st January 2017
- Published in: the Lithuanian Register of Legal Acts
In the last revision of the Law entered into force on the 1st of July 2022, the requirement to store embryos for the unlimited period of time was abolished. This requirement was replaced by a requirement to store embryos for 10 years after the assisted reproduction procedure.
Luxembourg - Financial aspects
3. Are MAP procedures covered by the social security system? Yes
4. Are there specific criteria for such coverage? Yes. Age limit of woman – 40 years old.
5. Is the financial coverage limited to a number of MAP procedures? Yes. Four attempts.
Luxembourg - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? Yes. This depends on the legislation of the countries from which the donations originate.
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
This depends on the legislation of the countries from which the donations originate.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? No. See Art.312 of the Civil Code cited in the section I – relevant instruments or draft instruments.
Lithuania - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? Yes. Surrogacy is widely discussed in Lithuania
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. NA
Luxembourg - 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. Selection on the basis of a psychologist’s opinion and following the recommendations formulated by the National Ethics Commission.
Malta - Legal regulation or practice and access to MAP
- Title of the law: Embryo Protection Act 2018
- Date of adoption and entry into force: 2018
- Published in: Laws of Malta; Government Gazette
Malta - 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
Surrogacy is not allowed but donation of sperm is allowed and therefore homosexual female couples can use sperm donation or adoption of frozen embryos
Malta - Sperm/oocyte/embryo donation
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
North Macedonia - 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
North Macedonia - Sperm/oocyte/embryo donation
6. Is donation of sperm/oocytes/embryos permitted in your country? No. There is no legal regulation in the country therefore no gamete banks aiming to this are functioning.
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No
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 the prevention of consanguinity? With the exception of the occasional donations for inseminations with fresh sperm which may be done outside of any control, other donor procedures have not been performed in the country.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? No. No legal regulations.
North Macedonia - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? Some debates have just started in many professional organisations - obstetricians/gynaecologists.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law.
Current healthcare law predates the era of MAP. No updates concerning MAP have been made.
In family law there are standard articles addressing the contesting of the paternity but not in relation to MAP.
United Kingdom - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. Infertility is classified as a medical condition.
4. Are there specific criteria for such coverage? Yes. As public funding for medical services has to cover priorities within a set budget, there are conditions for access to National Health Service (NHS) funded treatment. The UK’s National Institute for Clinical Excellence (NICE) has provided guidance on access to NHS funded treatment which can be found on this page: https://www.nice.org.uk/guidance/cg156
5. Is the financial coverage limited to a number of MAP procedures? No. Although guidelines exist on access to NHS funded treatment for IVF and IUI, it is for local clinical commissioning groups (CCGs) or health boards to decide the appropriate health care services to fund for their communities. Patients who pay for their own treatment are not limited in the number of procedures they can have.
France - Legal regulation or practice and access to MAP
- Laws and regulations
Law n°2021-1017 of 2 August 2021 on bioethics
Order n°2008-480 of 22 May 2008 transposing Directive 2004/23/EC of the European Parliament and of the Council of 31 March 2004 on gamete donation and medically assisted procreation
Decree n° 2021-1243 of 28 September 2021 setting the conditions for the organisation and management of medically assisted procreation procedures
Decree n° 2021-1933 of 30 December 2021 setting the conditions for authorising gamete self-preservation activities for non-medical reasons in application of article L. 2141-12 of the public health code and carrying various adaptations to the regulatory part of the same code with regard to the provisions of law n° 2021-1017 of 2 August 2021 relating to bioethics
Date of adoption and entry into force
First bioethics laws adopted in 1994, last revision: Law No. 2011-814 of 7 July 2011, which entered into force on 9 July 2011
Ordinance No. 2008-480 of 22 May 2008, which entered into force on 24 May 2008.
French Bioethics Law n°2021-1017 of 2 August 2021 on bioethics, entered into force on 4 August 2021.
Adoption on 29 June by the National Assembly and promulgation on 2 August 2021
Staggered entry into force according to the implementing texts.
- Published in: Official Journal of the French Republic (Journal officiel de la République française https://www.legifrance.gouv.fr/jorf/id/JORFTEXT000043884384)
- Next revision: 2028 maximum, (review within a maximum of 7 years from the promulgation of the law of 2 August 2021)
France - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. Medically assisted procreation is considered a health care activity. Law N°2021-1017 of August 2nd 2021 provides for the possibility of reimbursement of MAP by social security under the same conditions for unmarried single women, female couples and heterosexual couples. The MAP procedure is covered by national solidarity. The beneficiaries are exempt from the co-payment.
4. Are there specific criteria for such coverage? Yes. The law of August 2, 2021 removed the criterion of infertility, MPA procedures are covered at 100% by the Assurance Maladie for a maximum of : - 6 inseminations (only one artificial insemination per cycle) to obtain a pregnancy; - 4 in vitro fertilization attempts to achieve a pregnancy. This coverage is the same for everyone (heterosexual couple, couple made up of 2 women, unmarried woman) Knowing that, for the retrieval or the collection in a project of AMP, there are conditions of ages: - oocyte retrieval can be performed in women up to their 43rd birthday; - Sperm collection can be performed in men up to their 60th birthday; And for the performance of MPA: - until her 45th birthday for the woman, unmarried or within the couple, who will carry the child; - until his 60th birthday for the person in the couple who will not carry the child.
5. Is the financial coverage limited to a number of MAP procedures? Yes. The health insurance system will cover six inseminations and four complete cycles, i.e. concluded by embryo transfer. Any IVF cycle broken off before embryo transfer, irrespective of the stage at which it is abandoned, will not be counted by the health insurance system. Reimbursement is subject to a preliminary agreement procedure.
Should pregnancy and delivery occur, the count restarts from zero, and coverage is provided for four new attempts. This does not apply to miscarriages or extrauterine pregnancies.
Georgia - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous?
LHC: no specific provisions are included in the LHC on this issue.
*DL-RHRR:
Donation of gametes and embryo is not anonymous; however information on the identity of a gamete donor is confidential. Also, any personal data collected about a couple or single women applying for MAP is confidential.
United Register of Gamete Donors will include data about the identity of gamete donors as well as of couple.
These data are confidential. However, the law may make exceptions for specific cases; e.g. “when the disclosure of information on the donor’s genetic characteristics is necessary for the health purposes of the child, born as a result of medically assisted reproductive technologies”.
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 Yes. LHC: no specific provisions are included in the LHC on this issue. The answers given to question 17 are based on DL-RHRR.
a. Identity of the donor(s)
i. For the child him or herself; ii. For the parents; iii. For a court No
b. Certain health information concerning the donor(s)
i. For the child him or herself; ii. For the parents; iii. For a court Yes. Health data of the gamete donor, particularly information about the donor’s genetic characteristics, could be disclosed from the register of gamete donors if this is necessary for the health purposes of the child, born as a result of MAP.
c. Other information
i. For the child him or herself NA; ii. For the parents; Yes. A couple or a single woman has the right to request and receive information on the donor’s age, appearance, ethnic background, and health condition.
- Obligation of gamete donor to provide information about his/her health:
According to the DL-RHRR gamete donors are obligated “to give the medical personnel complete and comprehensive information on his/her health condition prior to gamete donation.”
- Right of the gamete donor to receive information about his/her health:
According to the DL-RHRR gamete donors are entitled to receive “information concerning his/her own health, which may be discovered as a result of monitoring the child born after utilizing assisted reproductive technologies.”
iii. For a court NA
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? There are no specific provisions on this subject in family law at present.
Georgia - Legal aspects
1. Is access to medically assisted procreation (MAP)
a. restricted to heterosexual couples?
LHC: Insemination-No; IVF-Yes
a) At present the law gives access to artificial insemination to heterosexual couples as well as to single women.
b) However in vitro fertilization (IVF) is accessible only to couples.
DL-RHRR: No. Draft law gives access to medically assisted procreation (artificial insemination as well as in vitro fertilization procedures) to heterosexual couples as well as to single women.
b. possible for women not living in a heterosexual couple?
LHC: Insemination-Yes; IVF-No
a) Law gives access to artificial insemination to single women. However, the Law does not specify whether women should be living in heterosexual couple or not.
b) IVF is not accessible for single women.
DL-RHRR: Yes. Draft law gives access to medically assisted procreation (artificial insemination as well as in vitro fertilization procedures) to single women.
Georgia - Medical aspects
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? LHC: Yes, DL-RHRR: Yes;
For women not living in a heterosexual couple? LHC: No, DL-RHRR: Yes
2bi
LHC: Yes
“Risk of transmission of a genetic disease”
DL-RHRR: Yes
a) “Proven likelihood of the transmission of a serious genetic disease to a naturally conceived child from a woman or man, that may result in a child’s severe disability and/or premature death.”
b) “Proven likelihood that a child from natural insemination will be born with a non-genetic disease that may result in grave disability and/or premature death.”
b. Risk of transmission of a disease
For a heterosexual couple?; LHC: Yes “Risk of transmission of a genetic disease” DL-RHRR: Yes
a) “Proven likelihood of the transmission of a serious genetic disease to a naturally conceived child from a woman or man, that may result in a child’s severe disability and/or premature death.”
b) “Proven likelihood that a child from natural insemination will be born with a non-genetic disease that may result in grave disability and/or premature death.”
For women not living in a heterosexual couple? LHC: No, DL-RHRR: Yes
a) “Proven likelihood of the transmission of a serious genetic disease to a naturally conceived child from a woman or man, that may result in a child’s severe disability and/or premature death.”
b) “Proven likelihood that a child from natural insemination will be born with a non-genetic disease that may result in grave disability and/or premature death.”
Accordingly, the draft law of Georgia on Reproductive Health and Reproductive Rights permits access to medically assisted reproductive technologies for heterosexual couples or single women only if at least one of the conditions listed below are met:
- A woman and/or man of reproductive age is infertile, other alternatives available in the country for treating infertility have proved ineffective; or such treatment hasn’t yet been carried out, but there is a reason to assume that it will be ineffective, as attested by a duly authorised state medical institution;
- There is a proven likelihood of the transmission of a serious genetic disease to a naturally conceived child from a woman or man, which may result in a child’s severe disability and/or premature death;
- There is a proven likelihood, that a child from natural insemination will be born with a non-genetic disease, that may result in grave disability and/or premature death;
- A woman carries a disease due to which the pregnancy may endanger the woman’s life and/or health.
c. Other There is one more medical criterion, but only for accessing surrogacy: existence of a disease due to which the pregnancy may endanger the woman’s life and/or health.
Georgia - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues?
Debates took place about the draft Law on Reproductive Health and Reproductive Rights among the representatives of various professionals, especially medical professionals, representatives of church and religious groups, representatives of Ministry of Health and Social Affairs, etc.
As the above draft Law is more specific than the Law on Health Care it will change existing legal situation (details are already specified throughout the questionnaire).
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law.
English versions of the following legislation related to MAP are presented in the Addendum:
- Law on Health Care (Relevant articles from Chapter XXIII Family Planning) [see Addendum];
- Draft Law on Reproductive Health and Reproductive Rights [see Addendum].
Croatia - Legal regulation or practice and access to MAP
- Title of the law: Act on Medically Assisted Fertilisation
- Date of adoption and entry into force: Adopted on 18th July 2012.
- Entered into force: 4th August 2012.
- Published in: Official Gazette No 86 from 27th July 2012
- Indicate if process of revision is ongoing and, in your answers, provide information on provision in the draft law: Revision of the Act is planned for the last quarter of the 2016. Revision will be primarily focused on the technical aspects, i.e. harmonisation with acquis communautaire in this field (EU tissues and cells directives).
Croatia - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? No. After reaching the age of 18 a person born from the MAP procedure is allowed to have access to data on identity of biological parent(s).
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 Yes
After reaching the age of 18, every person born from a MAP procedure is allowed to have access to data on identity of biological parent(s).
Parents do have a right to access the donor data in the case of medical indication.
Both, child and parents should require data access from the MAP Registry.
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 Yes; ii. For the parents Yes; iii For a court Yes
c. Other information
i. For the child him or herself Yes; ii. For the parents No; iii. For a court Yes
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? Yes. Contest is regulated within the Family Law. It is possible to contest maternity or paternity only in the cases when MAP procedure was performed without consent.
Cyprus - Legal regulation or practice and access to MAP
- Title of the law: Not Applicable
Cyprus - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? There is no indication for the practice followed by several clinical centers, due to the non-existence of relevant legislation
17. Is it possible to obtain information about the biological origin of a child born after gametes of embryo donation? There are no legal provisions. There is no indication for the practices followed by the IVF centers, due to the non-existence of relevant legislation.
18. Is it possible to contest maternity and paternity of children born utilising MAP and under which conditions? NA
Cyprus - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? The drafting of a law regulating MAP and IVF is currently under consideration. For this purpose a Steering Committee has been established by the Ministry of Health. The Committee is composed of representatives from Services and interested groups on MAP issues.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. There is no case-law up-to-date.
Cyprus - Financial aspects
3. Are MAP procedures covered by the social security system? No. The Ministry of Finance covers the cost of MAP procedures.
4. Are there specific criteria for such coverage? Yes. Specific criteria for such coverage are: (1) infertility (2) for women under 40 years old.
5. Is the financial coverage limited to a number of MAP procedures? Yes. The financial coverage is limited to only one (1) MAP procedure
Denmark - 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
There are no restrictions in the access to medically assisted procreation neither to hetero couples nor single women.
Denmark - Financial aspects
3. Are MAP procedures covered by the social security system? Yes. The Region must provide cost-free treatment for MAP to single women who do not have children, and couples who do not have children together.
4. Are there specific criteria for such coverage? Yes. Women over 45 year of age cannot receive treatment.
5. Is the financial coverage limited to a number of MAP procedures? Yes. Practice: 3 procedures with IVF and more if there are one or more spare, frozen embryos from the woman.
Denmark - Legal regulation or practice and access to MAP
- Title of the law: Act on medically assisted procreation in connection with medical treatment, diagnosis and research etc. (Loi no. 460/1997)
- Date of adoption and entry into force: 1 October 1997
- Published in Danish Law Journal
- Indicate if process of revision is ongoing and, in your answers, provide information on provision in the draft law: The law was last recently amended in January 2021.
Denmark - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? No
Finland - 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
The national legislation is based on the concepts of a “couple” (that is, a woman and a man living together in marriage or in a relationship comparable to marriage or two women living together in marriage, registered partnership or in a relationship comparable to marriage) and a “person receiving treatment” (a couple or a woman not living in a marriage, registered partnership or a relationship comparable to marriage). The provisions in certain sections of the Act vary depending on whether the treatment is provided to a couple or to a single woman.
Clinics in the public sector have declined to provide MAP to female couples and single women, on the grounds that these services are provided only on the basis of medical indications. Female couples and single women have for this reason sought services from the private sector.
Estonia - 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? Yes
c. Other N/A
Estonia - 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? Yes
Greece - Right to know about his or her biological origin for children born after MAP
16. Is donation of sperm/oocytes/embryos anonymous? Yes.
The law adopts the principle of anonymity regarding any donation, therefore, the identity of the donor cannot be revealed under any circumstances.
According to Art 8, para 6 of the new law, medical information that concerns the donor are kept in an anonymous codified form in the Cryopreservation Bank and in the National Registry of Donors and Receivers.
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 Yes; iii. For a court Yes
The child and his legal representative may have access only to medical data which are kept in secrecy and in a codified form in Cryopreservation Banks.
Law 2472/1997 on the “Protection of individuals with regard to the processing of personal data” qualifies health data as “sensitive” kind of information and stipulates special permission of the Data Protection Authority (Article 7).
According to Art 20, para 3 of Law 3305, access to the National Registry of Donors and Receivers is permitted only to the child and for reasons related to his health, with the permission of the Data Protection Authority and as long as the conditions of Law 2472/1997 regarding protection of personal data are fulfilled. The parents may have access to information only when they act as representatives of the child. The Court may order access.
a. Identity of the donor(s)
i. For the child him or herself No; ii. For the parents No; iii. For a court No
The law adopts the principle of anonymity regarding any donation, therefore, the identity of the donor cannot be revealed under any circumstances. The child and his legal representative may have access only to medical data which are kept in secrecy and in a codified form in Cryopreservation Banks.
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
The child or the parents (acting as representatives of the child) can have access to health information which are kept in secrecy and in a codified form in Cryopreservation Banks but not to the identity of the donor. The Court also may authorize access to health information.
c. Other information
i. For the child him or herself No; 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? Yes.
Contestation of maternity and paternity: contestation of paternity is not allowed when the father has provided consent at the beginning of the treatment.
Also, according to Law 3089/02, consent before a notary public of a man and a woman living in a free union takes place in order to guarantee their affiliation with the child to be born. As a result of that, contestation of the voluntary affiliation is forbidden.
In the case of surrogate motherhood, according to the law, the woman to whom the Court’s approval has been given is considered to be the legal mother of the child. Exceptionally, either the commissioning, or the surrogate mother, may contest this in Court, under conditions provided for by the law.
Germany - Financial aspects
3. Are MAP procedures covered by the social security system? Yes
MAP is a medical therapy under Section 27a of Book V of the Social Code.
The medical services covered by the statutory health insurance also include medical interventions aimed to induce a pregnancy. MAP measures must be medically diagnosed as necessary and have reasonable chances of success.
The Statutory Health Insurance Modernisation Act [GKV-Modernisierungsgesetz] reasonably restricted the entitlement to MAP measures from 1 January 2004 onwards. Since then Section 27a of Book V of the Social Code specifies that 50% of the costs are covered by the health insurance fund, so that the insured equally share in the costs of MAP interventions with a co-payment of 50%.
To reduce the financial burden caused by the 2004 cutback in costs covered by the statutory health insurance fund, in 2012 the Federal Ministry for Family Affairs launched the federal initiative “Hilfe und Unterstützung bei ungewollter Kinderlosigkeit” (assistance and support for involuntary childlessness). The funds are paid from both the federal budget and the budget of the Länder in which the couples concerned have their principal residence. Currently, twelve of the sixteen Länder participate in the initiative. Federal funding is generally provided for the first four treatment cycles of in-vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI). Couples can be reimbursed up to 25 per cent of the share they have to pay in addition to the costs covered by the health insurance fund.
Until 2015, only married couples were entitled to additional federal financial assistance. Today, also unmarried couples living in a non-marital long-term relationship can receive federal financial assistance under the amended federal guidelines on financial assistance for assisted reproduction procedures (Richtlinie über die Gewährung von Zuwendungen zur Förderung von Maßnahmen der assistierten Reproduktion), which took effect on 7 January 2016. However, pursuant to Section 27a of Book V of the Social Code, entitlement to benefits from the statutory health insurance fund is still restricted to married couples only.
4. Are there specific criteria for such coverage? Yes.
The criteria included in Section 27a of Book V of the Social Code:
Coverage of part of the costs by the statutory health insurance funds is subject to the following requirements:
- the measures must be medically diagnosed as necessary
- according to medical diagnosis, the intervention must be reasonably likely to induce a pregnancy
- the procedure may be performed up to three times
- only married couples are eligible (non-married couples are not)
- only the spouses’ egg and sperm cells may be used (homologous system)
- prior to treatment, the spouses must have themselves thoroughly informed about the medical and psychosocial aspects involved by a physician other than the one who will perform the treatment
- MAP may only be performed by physicians or facilities that are suitably qualified and have obtained an appropriate licence from the authority responsible under the law of the federal Land
Any method other than homologous fertilisation is excluded from the mandatory package of benefits and services of the statutory health insurance system.
The restriction of eligibility to married couples is in accordance with the German Constitution (cf. Judgment of 28 February 2007 – 1 BvL 5/03, BVerfGE 117, 316).
Eligibility is subject to age limits of between 25 and 40 years for women and between 25 and 50 years for men.
Although unmarried heterosexual couples are not entitled to benefits from the statutory health insurance fund pursuant to Section 27a of Book V of the Social Code, they can receive the voluntary financial assistance offered through the federal initiative “Hilfe und Unterstützung bei ungewollter Kinderlosigkeit”.
5. Is the financial coverage limited to a number of MAP procedures? Yes. Pursuant to Section 27a of Book V of the Social Code three attempts to induce a pregnancy are partially covered by the health insurance funds. The payment of expenses by the health insurance funds has been limited to 50% of the costs approved along with the treatment schedule.
Germany - Sperm/oocyte/embryo donation
6. Is donation of sperm Yes/oocytes No/embryos* permitted in your country? Yes.
*Embryo donation per se is not regulated by law. However, the Embryo Protection Act provides that an oocyte may only be artificially fertilised for the purpose of bringing about a pregnancy in the same woman from whom the oocyte has been obtained (Section 1(1) number 2 of the Embryo Protection Act) and that it is prohibited to remove an embryo from a woman before its nidation is completed, in order to transfer it to another woman (Section 1(1) number 6 Embryo Protection Act). In addition, the Embryo Protection Act incorporates provisions aimed to prevent the creation of supernumerary embryos in the course of artificial fertilisation (especially the ban on the artificial fertilisation of more oocytes than can be inserted into a woman within one cycle – Section 1(1) number 5 Embryo Protection Act). Consequently, permissible embryo donation is only conceivable in exceptional instances where an artificially created embryo can unexpectedly no longer be transferred to the woman from whom the oocyte originated.
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No
8. Are there specific criteria for donation of sperm Yes/oocytes/embryos?
Gametes may be used for medically assisted procreation only after full medical assessment and if their use is medically indicated and the protection of the recipient’s and the child’s health is guaranteed (Section 6(1) of the Tissues and Cells Regulation of the Transplantation Act). The use of sperm cells for heterologous fertilisation as a medically assisted procreation technique furthermore requires that the sperm donor is medically assessed as suitable for sperm donation with regard to his age, state of health and medical history and that the use of the donated sperm will not pose any health risks to others. The necessary donor information must be collected by questionnaire and by means of a subsequent personal interview with the donor by the physician.
An age limit exists for eligibility to cost coverage by the health insurance funds (see response to question 4).
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? No. As part of a voluntary commitment physicians, sperm banks and laboratories have limited the number of offspring from a sperm donation to 15 (Richtlinien des Arbeitskreises für Donogene Insemination zur Qualitätssicherung der Behandlung mit Spendersamen in Deutschland).
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? Yes.
German law includes the following provisions governing the legal relationship between the child and the spouse of the legal parent:
- Authority of the spouse/registered partner of a parent who has the sole parental care (decision-making authority) about the child to have a say in matters of daily life (so-called “small care” – Section 1687b(1) of the Civil Code, Section 9(1)of the Act on Registered Life Partnership). In case of imminent danger, the spouse/registered partner is also entitled to perform all acts necessary for the child's welfare (Section 1687b(2) of the Civil Code, Section 9(2) of the Act on Registered Life Partnership).
- Right of contact with the child, if a “family-like social relationship” has evolved between the parent’s spouse and the child (Section 1685(2) of the Civil Code),
- In case the child has been living in one household with one parent who dies or is no longer able to exercise parental care or whose parental care has been suspended, the court may deny the other parent’s request to give the child to him or her and order that the child should stay with the spouse/registered partner of the first parent (ex officio or by request of that spouse), provided the child has been living in that household for a longer time (Section 1682 sentence 2 of the Civil Code). Similar rules apply for staying with the partner of a deceased parent or a parent who cannot exercise his or her parental care.
Pursuant to Section 1741(2) sentence 4 of the Civil Code/Section 9(7) sentence 1 of the Act on Registered Life Partnership, a spouse/registered partner is entitled to adopt his or her spouse’s/registered partner’s biological child. According to Section 1742 of the Civil Code/Section 9(7) sentence 2 of the Act on Registered Life Partnership, a spouse/registered partner may also adopt the child adopted by his or her spouse/registered partner. There is no longer a distinction between heterosexual and homosexual married couples, registered partners or between married and unmarried stable couples in case they want to adopt the child of their partner (Section 1766a of the Civil Code). In addition, married couples regardless of the sex of the spouses may adopt any other child as common parents, whereas unmarried couples and registered partners do not have this option to become common parents of the child simultaneously. They have to adopt the child successively.
Germany - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? No
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. See section I above for links to the updated versions of German laws
Greece - Current debate and specific situations
19. Is there an important current debate in your country on these or related issues? No process of revision is currently foreseen for this Law.
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. NA