Access to medically assisted procreation - Search
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Italy
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
Judgment No. 69/2025 confirms the prohibition preventing single women from accessing MAP techniques.
2. Are there specific criteria for access to MAP?
Medical reasons:
a. Infertility:
For a heterosexual couple? Yes; For women not living in a heterosexual couple No?
b. Risk of transmission of a disease
For a heterosexual couple? Yes; For women not living in a heterosexual couple? No
c. Other NA
Access to MAP in Italy is allowed for fertile couples who are carriers of genetic diseases. In this case, MAP is preceded by pre-implantation genetic diagnosis (in line with Constitutional Court Judgment No. 96/2015 – see above).
3. Are MAP procedures covered by the social security system? Yes, partly. MAP procedures are not entirely covered by the national social security system. Indeed, patients in Italy need to pay the so-called “ticket”. The "ticket" refers to a co-payment or a fee that patients are required to pay for certain healthcare services, including MAP procedures, under the National Health Service. The amount of the ticket can vary depending on the Region.
4. Are there specific criteria for such coverage? Yes. The criteria are established by each Italian Region autonomously.
5. Is the financial coverage limited to a number of MAP procedures? Yes. The criteria are established by each Italian Region autonomously.
Over the years, the abovementioned Law has been amended several times by the following Italian Constitutional Court judgements:
Judgment No. 151/2009 – In this case the Court considered a challenge to Law No. 40/2004, which imposed numerous restrictions on fertility treatment including, inter alia, a maximum limit of three oocytes, the requirement that they be implanted at the same time, the prohibition on cryopreservation other than in exceptional circumstances, and the inability to withdraw consent to the treatment after the egg has been fertilised. The Court noted that the legislative discretion of Parliament was not absolute, and had to take into account the scientific state of the art.
It finally declared that Article 14(2) of Law No. 40/2004 is unconstitutional, limited to the words “for one single and simultaneous implantation, and in any case not more than three”; it also declared that Article 14(3) of the Law is unconstitutional insofar as it does not provide that the transfer of embryos, which according to that provision must be carried out as soon as possible, is to be carried out without jeopardising the health of the woman.
The questions concerning the constitutionality of the other challenged aspects of the law (mentioned above) were declared as manifestly inadmissible.
https://www.cortecostituzionale.it/documenti/download/doc/recent_judgments/CC_SS_151_2009_EN.pdf
Judgment No. 162/2014 - In this case the Court heard a referral challenging legislation which prevented couples suffering from absolute and irreversible infertility or sterility from engaging in heterologous medically assisted reproduction. The Court drew on the constitutional right to health of the parents, which it took to include their mental well-being, and held that this right had been infringed in that well-being may be jeopardised by the failure to have children. Since the absolute prohibition imposed by Law No. 40/2004 was not the only way of guaranteeing protection to the other constitutional values affected, it thus ruled unconstitutional the bar on heterologous medically assisted reproduction for couples affected by irreversible sterility or infertility.
More specifically, the Court declared, inter alia, that Article 4(3) of Law No. 40/2004 is unconstitutional insofar as it imposes a prohibition on the recourse to heterologous medically assisted reproduction techniques where an illness has been diagnosed that is the cause of absolute and irreversible sterility or infertility for couples falling under Article 5(1) of the Law.
https://www.cortecostituzionale.it/documenti/download/doc/recent_judgments/162-2014_en.pdf
Judgment No. 96/2015 - In this case the Court heard two referrals questioning Article 1 (1) and (2), and Article 4 (1) of Law No. 40/2004, which permitted access to medically assisted procreation (MAP) only in cases of certified and incurable sterility or infertility of a couple. The referrals dealt with two, nearly identical claims brought by fertile couples who were carriers of serious genetic diseases, and who had, in the past, ended natural pregnancies by means of abortion upon discovering that they had conceived offspring affected by the respective diseases. Both couples wanted recourse to MAP methods with preimplantation diagnosis to select embryos unaffected by their respective diseases. The referrals alleged contradiction with Articles 2, 3, 32, and 117 (with reference to ECHR Articles 8 and 14) of the Constitution. The Court declared the questioned provisions to be unconstitutional, finding that there was an unavoidable element of unreasonableness in prohibiting fertile couples who were carriers of genetic diseases from having access to MAP methods in light of their Constitutional right to a healthy child, also reflected in Article 6 (1) letter b) of Law No. 194 of 22 May 1978 (Rules on the social protection of motherhood and the voluntary termination of pregnancy), which allows couples to pursue their goal of having a healthy child by means of therapeutic abortion to eliminate natural pregnancies affected by anomalies and malformations meeting a normative threshold for seriousness. The Court declared that the provisions, therefore, amounted to an unreasonable balancing of the interests involved, since any offspring affected by the relevant genetic diseases would be, in any case, legally exposed to abortion. The Court also found a violation of a woman’s right to health enshrined in Article 32 of the Constitution, in that the provisions deprived certain women of the means to avoid resorting to the traumatic method of voluntary abortion in order to obtain the objective of a healthy child, by preventing her from having access to anterior means that the Court considered less dangerous to her mental and physical health.
More specifically, the Court declared Article 1 (1) and (2), and Article 4 (1) of Law No. 40/2004 to be unconstitutional, to the extent to which they do not allow fertile couples who are carriers of genetic diseases that meet the criteria for seriousness under Article 6 (1), letter b) of Law No. 194 of 22 May 1978 (Rules on the social protection of motherhood and the voluntary termination of pregnancy), diagnosed by the appropriate public institutions, to have access to methods of medically assisted procreation.
(https://www.cortecostituzionale.it/documenti/download/doc/recent_judgments/S96_2015_en.pdf)
Judgment No. 229/2015 - In this case the Court considered a referral order from the Tribunale Ordinario of Naples questioning the constitutionality of Articles 13 and 14 of Law No. 40/2004 to the extent that they forbid and attach criminal sanctions to any form of embryonic selection for eugenic purposes, without providing an exception in the definition of the offense for situations in which medical providers’ actions are intended to avoid implanting embryos affected by genetic diseases in the woman’s uterus. The Court noted that its prior Judgement No. 96 of 2015 had declared unconstitutional certain provisions of the same Law, thereby already rendering legal the form of embryo selection in question. Therefore, the Court held that the provisions which, in contradiction with that Judgement, purported to criminalize said selection were unconstitutional. The Court also held that the question concerning the Law’s criminalization of extermination of those embryos not selected for implantation due to genetic disease to be unfounded, as there were no prevailing, conflicting, constitutionally protected rights at stake that would carry the provisions outside the bounds of legislative discretion.
More specifically, the Court declared Article 13 (3), letter b), and (4) of Law No. 40/2004 to be unconstitutional, to the extent to which they characterize as a criminal offense the act of selecting embryos even in cases in which this selection is solely intended to avoid implantation in the woman’s uterus of embryos affected by hereditary genetic diseases that meet the criteria for seriousness under Article 6, (1), letter b) of Law No. 194 of 22 May 1978 (Rules on the social protection of motherhood and the voluntary termination of pregnancy), diagnosed by the appropriate public institutions. The Court also declared the question of the constitutionality of Article 14 (1) and (6) of Law No. 40/2004, with reference to Articles 2 and 3 of the Constitution and Article 117, first paragraph, of the Constitution as it relates to Article 8 of the ECHR, signed in Rome on 4 November 1950, and ratified and executed with Law no. 848 of 4 August 1955, to be unfounded.
https://www.cortecostituzionale.it/documenti/download/doc/recent_judgments/S229_2015_en.pdf
16. Is donation of sperm/oocytes/embryos anonymous? sperm Yes/oocytes Yes/embryos No
The anonymity is guaranteed only between donor and recipient, but not for the child born after MAP, in compliance with Directive 2004/23/EC of the European Parliament and of the Council of 31 March 2004 on setting standards of quality and safety for the donation, procurement, testing, processing, preservation, storage and distribution of human tissues and cells and Regulation (EU) 2024/1938 of the European Parliament and of the Council of 13 June 2024 on standards of quality and safety for substances of human origin intended for human application and repealing Directives 2002/98/EC and 2004/23/EC.
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
a. Identity of the donor(s)
i. For the child him or herself No; ii. For the parents No; iii. For a court Yes
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 Yes
c. Other information
i. For the child him or herself No; 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. The conditions are complex and regulated by the Italian Civil Code and case law.
19. Is there an important current debate in your country on these or related issues? NA
20. Delegations are invited to provide information, in this section, on particular cases encountered in their country, and especially their case-law. NA
6. Is donation of sperm/oocytes/embryos permitted in your country? sperm Yes/oocytes Yes/embryos No
7. Are there specific compensation arrangements for donations of sperm/oocytes/embryos? No
8. Are there specific criteria for donation of sperm/oocytes/embryos? sperm Yes/oocytes Yes/embryos No
The criteria for donation of sperm and oocytes include age limits and an evaluation of the clinical condition of the donor.
9. Are there specific non-medical criteria for selection of gametes/embryos to be used for MAP? Yes.
The non-medical criteria for selection of gametes/embryo to be used for MAP are identified by the Decree of the President of the Republic No. 131 of 23 August 2019 on “Regulation implementing Commission Directive 2012/39/EU of November 26, 2012, which amends Directive 2006/17/EC regarding certain technical requirements related to tests carried out on human tissues and cells. (19G00114) (Official Journal No. 267 of 14 November 2019). (https://www.normattiva.it/esporta/attoCompleto?atto.dataPubblicazioneGazzetta=2019-11-14&atto.codiceRedazionale=19G00114)
The non-medical criteria for selection of gametes/embryo to be used for MAP are also specified by each Region through specific guidelines (https://www.iss.it/normativa-regionale). Non-medical criteria can include, inter alia, anonymity and the ban for the practitioner performing MAP to act as a donor. The same ban can apply to the owners, operators, directors, and employees of the MAP lab or centre.
10. Are there special measures for the prevention of consanguinity? Yes. Decree of the President of the Republic No. 131 also provides for criteria for the selection of donors, including limited numbers of donations and genetic screening.
11. In a homosexual couple, is a legal relationship possible between a child and the partner of the legal parent? Yes. In a homosexual couple, the only legal relationship possible between a child and the partner of his or her legal parent in Italy is adoption (stepchild adoption). However, the possibility of stepchild adoption is established by the Juvenile Court on a case-by-case basis.
Judgment No. 68/2025 recognised, from birth, the legal status of a child born in Italy to a lesbian couple who resorted to MAP techniques abroad.