LONDON
(AP) -- More than three decades after
Britain produced the world's first test-tube baby, Europe is a patchwork of
restrictions for people who need help having a child.
Many
countries have strict rules on who is allowed to get fertility treatments. And
recent court rulings suggest nothing's likely to change anytime soon.
France
and Italy forbid single women and lesbian couples from using artificial
insemination and in vitro fertilization, or IVF, to conceive. Austria and Italy
are among those banning all egg and sperm donations for IVF. Germany and Norway
ban donating eggs, but not sperm.
Countries
including Sweden require couples to have a stable relationship for at least a
year to qualify for fertility treatment. Switzerland, among others, requires
couples to be married.
And
nearly everywhere in Europe except Ukraine, couples are banned from hiring a
woman to carry a pregnancy for them.
"These
laws are completely out of date," said Dr. Francoise Shenfield, a
fertility expert at University College London.
"It's
a medical treatment and the decision to treat should be up to doctors,"
not judges, said Shenfield, an ethics expert for the European Society for Human
Reproduction and Embryology.
Placing
bans on egg and sperm donation is "discriminating against infertile
couples," she added, although she acknowledged there were valid medical
reasons for not treating some patients, like women over 50.
The
European laws stand in contrast to comparatively few restrictions elsewhere,
including in the U.S., Australia, Brazil and Canada.
Experts
estimate thousands of Europeans travel to another country each year for help
having a baby, though exact figures aren't recorded. Many are single women who
go abroad to get artificial insemination, which is banned for single women in
countries including Sweden, Germany and Italy.
Marie
Eriksson, a 36-year-old single mother in Sweden, described the restrictions as
prejudice. "Having a child is not a right, but the possibility should not
be forbidden because you don't have a partner," she said.
Eriksson,
a librarian, traveled to a fertility clinic in Denmark after deciding she
wanted to have a child on her own. "The alternative was to go out and meet
a stranger at a pub," she said.
She
gave birth to her daughter, Sonja, in 2008. "It was totally worth
it," she said of the seven treatments she paid for.
Reasons
for the restrictions vary from country to country. Many cite concerns about
creating "unnatural" relationships between donors, parents and
children. Others are driven by religious or cultural objections.
Recent
attempts to change the laws have so far failed. Last November, the European
Court of Human Rights upheld an Austrian regulation that forbids using sperm
and egg donors for IVF.
In that
case, two married couples sued the Austrian government, arguing the ban
violated their right to a "private and family life" under the
European Convention on Human Rights. The court ultimately ruled the restriction
was justified and cited problems like "splitting motherhood" between
a biological mother and the woman carrying the fetus.
"I'm
often dumbfounded by the position some European countries take on IVF,"
said Dr. Norbert Gleicher, medical director of the Center for Human
Reproduction, a private clinic in New York City.
The
restrictions in many European countries would be unthinkable in the U.S.,
Gleicher said, adding about 40 percent of his patients travel from abroad, many
from Europe.
In
Sweden, lawmakers are considering whether to change the law so that all single
women have access to fertility treatment.
Eriksson
said the restrictions no longer match reality. "There are so many
different kinds of families today that it is not sustainable to maintain laws
and regulations based on traditional family ideals," she said.
For
IVF, women must undergo hormone stimulation to produce eggs and a procedure to
extract them from the ovaries. Embryos are created by mixing sperm and eggs
together in a lab, then transferred into a woman's womb.
Fertility
treatment remains a taboo subject in many countries.
Germany's
history of eugenics - where Nazi doctors forcibly sterilized or euthanized
people in an attempt to eliminate hereditary illnesses and handicapped people -
makes officials nervous about any procedures that handle embryos. It was only
last year that Germany approved an embryo test commonly used elsewhere to spot
genetic problems. The test, generally used only in IVF pregnancies, is still
banned in Austria and Italy.
In
other countries, religion carries more weight. France and Italy both have
strong historic ties to the Roman Catholic Church, which forbids IVF, primarily
because the procedure may involve the destruction of embryos. The church is
also against artificial insemination because it believes procreation should
only be by a husband and wife through the natural act of sex.
Until
2004, Italy's fertility laws were fairly lax, leading to pregnancies in women
as old as 60, and a proliferation of woman "renting" their wombs. A
law supported by leading Catholic groups that year clamped down on egg and
sperm donation, limited the number of embryos transferred, and outlawed the
practice of freezing embryos. The law restricts IVF to "stable,
heterosexual couples who live together and are of childbearing age."
Italy
says allowing donated eggs could exploit women and that the practice
"would lead to a weakening of the entire structure of society."
Most
couples seeking fertility treatments don't need donated eggs and sperm. And
many government health systems will pay for fertility treatments for those who
have been trying at least three years to conceive.
People
in Western Europe who seek medical treatment elsewhere cannot be prosecuted at
home even if the treatment is illegal in their own country. But there can be
other complications. For example, in France, children born through surrogacy
are not entitled to a French passport.
Still,
authorities are struggling with how to deal with the complexity of IVF
families. Last month, France's Court of Appeal upheld a decision to grant civil
status - similar to nationality - to twins carried by a surrogate mother in
India for a French couple. But in 2011, the French Supreme Court denied civil
status to twins born to a surrogate mother in the U.S.
For gay
and lesbian couples in France, Italy, Switzerland and elsewhere, only one
partner can be the child's legal father or mother.
"These
restrictions imply that gays and lesbians are second-class citizens and that a
child has to be raised in a conventional family," said Angelo Berbotto, a
lawyer and acting secretary of NELFA, Europe's largest organization for gay and
lesbian families.
Opponents
say national health systems are not obligated to allow artificial reproduction
techniques for same-sex couples.
"The
desire to be a parent does not create the right to have children," said
Gregor Puppinck, director general of the European Center for Law and Justice, a
Christian group that lobbies European lawmaking bodies.
"What's
lost is the best interests of the child," Puppinck said. "The child
has a right not to have two fathers or two mothers."
Dr.
Heinz Strohmer, a fertility doctor at a Vienna clinic, said most of his clients
needing egg or sperm donations were more concerned about the logistics of
getting treatment abroad than challenging Austria's law banning them.
"The
only question they have is if we can organize everything for them," he
said. Strohmer often works with clinics in the Czech and Slovak republics and
Spain to get around the Austrian rules on IVF.
When
Italian residents Giuseppina La Delfa and Raphaelle Hoedts decided to have a
baby, they knew that would mean crossing borders. Needing a sperm donation for
IVF that they couldn't get in Italy, the lesbian couple went to Belgium for
more than a dozen cycles of fertility treatment. La Delfa gave birth to
daughter Lisa-Marie in 2003.
"It
was very difficult and it cost a lot of money, but it was the only way,"
said La Delfa, a 49-year-old French teacher. "Nothing was more important
to us than her."
La
Delfa considers the restrictions imposed on IVF for lesbian and gay couples not
only archaic, but ineffective.
"They
think there's only one way to be a parent," she said, of governments that
ban fertility treatments. "They don't realize people will do whatever it
takes to have a family."
For the
two women, that meant another IVF trip last year, this time to Spain. Hoedts is
currently pregnant with the couple's second child.
La
Delfa said Lisa-Marie, now 8, is proud of her unusual origins.
"I
joke with her that her big ears come from her donor," La Delfa said.
MARIA
CHENG
AP
Medical Writer
Fertility
group: http://www.fertilityeurope.eu/
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