In Austria reproductive medicine is strictly regulated by law and additionally all IVF institutes are amenable to the Federal Hospitals Act. Two laws that especially deal with reproductive medicine and the cost coverage for such treatment are the Austrian Reproductive Medicine Act and the IVF fund law.
The Austrian Reproductive Medicine Act
The federal law which regulates the medically assisted reproduction became effective on the 1st of July 1992 and was amended in 2004 and 2015.
IVF fund law
The IVF fund law became effective on the 1st of January 2000. This law regulates the constitution of the IVF fund, as well as which couples under which conditions can make use of which treatments. An amendment of the law was conducted as part of the amendment of the Austrian Reproductive Medicine Act in 2004, 2010 and 2015.
Which developments resulted from the amendment of 2015?
As a consequence of the settled decision of the Constitutional Court in January 2015, the treatment of lesbian couples with insemination or IVF was established.
Insemination & IVF for lesbian couples
Analogous to heterosexual couples lesbian couples need a notary deed for treatments with donor sperm in which they consent to the treatment. Thereby, after the birth of the child both female partners count as parents. For a treatment plan we solely need the medical findings of the recipient.
Until 2015 the in-vitro fertilization was only possible using the partners sperm, from now on the law allows the use of donor sperm as well. In a few rare cases men suffer from complete infertility as there are no sperm cells produced in the testicles. Consequently, a pregnancy can only be achieved with the help of a sperm donor. A treatment using donor sperm is sometimes used in cases of an increased risk for a genetic disease or a testicular biopsy (TESE) is refused or not possible.
Indications for an IVF using donor sperm are:
- poor semen quality or no semen production at all
- previous attempts using the ICSI fertilization resulted in fertilization failure
- additionally to the above mentioned indications: if an additional female factor exists such as obstruction of the fallopian tubes, PCO syndrome or endometriosis
The egg donation is a suitable treatment choice for women suffering from post ovarian failure or those who have an insufficient ovarian reserve left. For a treatment in Austria the donor cannot be older than 30 years, the recipient cannot be older than 45 years. The egg cells of the donor will be fertilized with the sperm of the partner and afterwards the embryos will be returned to the recipient during the embryo transfer. The future child has the right to request information on the identity of the donor from the age of 14 years onwards. Still she is never required to pay alimony or attend her duties as the genetic parent. Additionally, the probition of commercialisation states that a donor cannot claim any reimbursements.
The most controversial topic within the amendment was the PID which is now allowed under certain restrictions. The procedure is indicated after 3 failed IVF attempts or 3 miscarriages. in order to evaluate the viability of the embryo. Moreover the preimplantation diagnostics are permitted if there is an increased risk for a severe genetic disease caused by genetic disposition of one parent.
What is preimplantation diagnostics?
Preimplantation diagnostics (PID) is an early form of prenatal screening and offers couples the possibility to prevent genetic diseases or congenital defects of the child as well as the risk of subsequent abortions. The Austrian legal framework only allows limited use of PID. Embryonic tests are prohibited in Austria. A special form of PID which we use at the Kinderwunschzentrum Goldenes Kreuz is the so-called Polar Body Diagnostics. This is not an examination of the embryo but of the polar bodies. In the framework of an IVF treatment this allows indirect conclusions regarding the genetic health of the oocyte however not on sperm cells.