National Academy Leopoldina and Academy Union Recommend a Contemporary Law on Reproductive Medicine

The Embryo Protection Act of 1990 still governs the treatment of reproductive medicine. This legal situation often requires the attending physician to undergo treatment that is no longer appropriate for the international medical profession of today and entails unnecessary risks for the mother and the child. In addition, the Embryo Protection Act no longer meets the challenges of social change and the diversity of current family forms. An interdisciplinary working group of the Leopoldina and Academy unions dealt with the medical, legal and ethical issues of reproductive medicine. Particular attention is given to the authors of information and advice, including the psychosocial counseling of affected couples, as well as the organization and funding of reproductive medicine. The resulting opinion includes the following points to regulate:

Elective transfer of a single embryo: in this case, on a larger number of embryos, only the one with the highest viability should be selected, and only this one to the woman. This method, used in many countries, avoids multiple pregnancies at risk and endangering health, without significantly reducing the chances of getting pregnant. However, this procedure is prohibited in Germany under pain of punishment.

Oocyte donation: sperm donation is allowed in Germany, oocyte donation is prohibited. Although infertile men can start a family with the help of a germ cell donation, women who are no longer able to produce their own eggs due to cancer are prohibited. This difference in treatment is difficult to justify. Due to the legal situation, many couples are forced to donate an egg abroad. Anonymous donation is often practiced, thus depriving the constitutionally recognized right of the child to know his or her origin. In this regard, the prohibition of egg donation in Germany indirectly affects the well-being of the child.

Embryo donation: The applicable law authorizes the donation of embryo in exceptional cases. However, there is no clear legal regulation for donating and receiving donated embryos. In particular, the implications for family law require clear regulation.

Substitution Maternity: Particularly difficult ethical and legal issues raise the issue of surrogacy in Germany. In any case, it is necessary to regulate children born abroad to a surrogate mother but who grew up in Germany.

Oocyte Cryopreservation: Egg cells are cryopreserved in many reproductive health centers. This happens, for example, for medical reasons, such as before chemotherapy. In the interest of the woman, the couple and the future child, the conditions of storage, fertilization and transmission should be regulated.

Reimbursement of costs related to reproductive medicine: a restriction of funding couples legally insured couples and strict age limits are medically and socially unjustifiable. Partial reimbursement of the substantial costs of treatment also creates social injustices.

The opinion presented by Leopoldina and Akademienunion offers a comprehensive review of reproductive health practices and their medical, ethical and legal problems. On this basis, the basic ideas and the central aspects of a future legal settlement are set out. Specific regulatory proposals will be developed for common reproductive medical procedures, including egg donation, sperm donation, embryo donation and preimplantation genetic diagnosis. For surrogacy, acute need for regulation and long-term action options are indicated.

"Reproductive Medicine in Germany – For Modern Legislation" – Joint Statement by the National Academy of Sciences Leopoldina and the Union of German Academies of Science, 2019, 124 p., ISBN: 978-3 -8047-3423-4

idw 2019/06