Four neighbouring countries — four fundamentally different approaches. For anyone planning treatment or co-parenting involving citizens of these states, understanding the legal landscape is not a formality but a necessity.
The European Union has no unified legislation on assisted reproductive technologies. Each member state establishes its own rules — and the variation is enormous. What is permitted in Spain may be a criminal offence in France. What is routine in Denmark remains the subject of fierce debate in Poland. Four countries — Italy, Austria, Switzerland and Poland — represent a particularly contrasting cross-section of European approaches to reproductive law.
Knowing them matters for several reasons. Citizens of these countries actively participate in reproductive tourism and need to understand the legal status of their actions. International co-parenting couples where one partner holds citizenship of one of these countries face specific legal consequences at home. And medical tourism from these countries has its own characteristics precisely because domestic legislation is restrictive.
Italian Law 40/2004 on assisted reproduction is one of the most restrictive in Europe. It was passed amid fierce political conflict and represented a compromise between the medical community, the Catholic Church and various political forces. The compromise was, to put it gently, peculiar. The law prohibited third-party egg and sperm donation entirely at the time of enactment, banned surrogacy as a criminal offence, restricted preimplantation genetic testing, and closed access to single women and same-sex couples.
In 2014, Italy's Constitutional Court struck down the ban on heterologous donation (from third parties) as unconstitutional. This opened the path to egg and sperm donation for couples in marriage or stable heterosexual unions. However, single women, same-sex couples and surrogacy remain outside the law. Italy leads Europe in citizens travelling abroad for treatment — several thousand Italian couples annually undergo donor egg IVF in Spain, Greece, the Czech Republic and elsewhere. In 2023, Italian authorities issued a circular effectively prohibiting the registration of children born through foreign surrogacy to two fathers, generating intense legal controversy that continues to evolve.
The Austrian Reproductive Medicine Act (FMedG) was adopted in 1992 and has been revised several times — each time in a more liberal direction, however slowly. A 2015 ruling by Austria's Constitutional Court struck down bans on egg donation and on IVF access for same-sex female couples as unconstitutional. Since 2015, access to ART extends to heterosexual couples (married or not), same-sex female couples, and single women with certain restrictions. Surrogacy remains fully prohibited. Donor anonymity was abolished in 2005: children born using donated material have the right to know the donor's identity from age fourteen. Austria has also moved to permit both same-sex parents to be listed on birth certificates for registered couples.
Switzerland — not an EU member — has full autonomy over ART regulation and uses it in its own distinctive way. The Federal Act on Medically Assisted Reproduction (FMedG) of 1998 is supplemented by a constitutional provision. The Swiss Constitution directly prohibits surrogacy — not merely by statute but as a constitutional norm, changeable only by referendum. Egg donation was prohibited until 2017; a 2016 referendum changed this. Current picture:
Poland is perhaps the most dynamic example of how a change of political regime can radically alter reproductive legislation in a short time. The Infertility Treatment Act passed in 2015 under the Tusk government was relatively liberal by Polish standards:
The key rule: the law of the country of permanent residence determines the legal status of the child and parents — not the law of the country where treatment was performed. An Italian woman who undergoes donor egg IVF in Spain returns home with a child whose origins are not fully recognised by Italian law. A Swiss couple who used surrogacy abroad will face serious difficulties registering the child at home. This does not mean reproductive tourism is impossible or illegal — it is possible and it is widespread. But it requires legal preparation in advance: a family lawyer consultation in the country of residence before treatment begins, not after the child is born.
Italy, Austria, Switzerland and Poland represent four fundamentally different approaches. Austria has liberalised and continues on that path. Switzerland moves slowly, constrained by constitutional limits, but makes progress. Italy has liberal constitutional precedents but remains politically conservative. Poland is the most unpredictable context, where law changes with governments. For anyone connected to these countries through citizenship, residence or partnership, understanding the legal landscape matters at least as much as choosing a clinic.