Key Findings

• The Europe Atlas of Fertility Treatment Policies maps disparities in fertility treatment laws, funding, and patient involvement across 49 European countries.
• IVF and ICSI with own gametes are universally accessible to heterosexual couples, but access for single women and female same-sex couples remains limited and inconsistent.
• Recent reforms in countries like Bulgaria, Greece, France, Germany, and Denmark show progress yet highlight ongoing uneven access and support.
• The Atlas calls for universal recognition of fertility treatment as a right, expanded public funding, patient engagement, and public education to reduce stigma and inequality.

The newly published  EU Atlas of Fertility Treatment Policies offers a comprehensive map of fertility treatment regulations, funding, and patient experiences across 49 European countries and territories. This initiative, led by Fertility Europe (FE) and the European Parliamentary Forum for Sexual and Reproductive Rights (EPF), aims to shed light on disparities and encourage policy harmonization for equal, safe, and efficient access to assisted reproductive technologies (ART).​

What the Atlas Reveals

The  EU Atlas of Fertility Treatment Policies analyzes each country based on three main criteria: legal regulations on ART access, public funding and reimbursement, and the integration of patient perspectives in policymaking. According to the Atlas’ findings, 42 countries now have dedicated ART legislation, while 36 operate national registers of fertility treatment activities. However, only 19 countries include patient associations in developing public policies for ART, and just 10 provide funded psychological support for those undergoing treatment.​

Disparities and Policy Changes

While all 49 nations provide IVF and ICSI using a couple’s own gametes for heterosexual couples, access expands much less consistently to single women and same-sex couples. Only 21 countries support IVF/ICSI with sperm donation for female couples and 37 for single women. Egg donation options are also limite, just 16 countries offer these treatments to female couples and 28 to single women.​

Recent policy shifts have occurred in several nations:

• Bulgaria enacted a new ART law in 2023.​
• Greece now allows non-anonymous gamete donation using a mixed system.​
• France expanded fertility education and added public funding for non-medical egg freezing in 2023.​
• Germany initiated a review of MAR legislation, and Denmark increased funding for second-child treatments.

Who can access treatment?

The Atlas confirms that all 49 countries provide IVF and ICSI using a couple’s own gametes for heterosexual couples, making this the most universally accessible form of ART in the region. Access for single women and female same-sex couples is far more restricted and inconsistent, highlighting ongoing discrimination against diverse family forms.​

Only 21 countries offer IVF/ICSI with sperm donation to female couples, and 37 extend this option to single women, while egg donation is available to female couples in just 16 countries and to single women in 28. Age limits and medical criteria also vary widely, leading to situations where some patients cross borders to seek treatment that is either unavailable or heavily restricted in their home state.

Recent Legal and Policy Developments

The 2024 edition documents several notable policy shifts since the previous Atlas. Bulgaria adopted a new ART law in 2023, providing a clearer regulatory framework and signaling stronger institutional engagement with fertility care. Greece introduced a mixed system allowing both anonymous and non-anonymous gamete donation, aligning its legislation more closely with evolving ethical and patient rights debates.​

France expanded fertility education and incorporated public funding for non-medical egg freezing in 2023, broadening reproductive options and acknowledging changing reproductive life courses. Germany launched a review of its medically assisted reproduction legislation, and Denmark increased public funding for second-child treatments, reflecting an incremental move towards more comprehensive support in some higher-scoring countries.​

Scale of the Challenge

The Atlas situates these policy debates within the wider public health context, noting that infertility affects an estimated 25 million individuals in the European Union and roughly one in six couples worldwide. The World Health Organization has identified infertility as a major but often neglected health issue, with profound medical, psychological and social consequences when left unaddressed.​

Despite this burden, infertility services are still frequently treated as optional or “luxury” care and are underfunded or excluded from standard health coverage. The Atlas warns that such neglect exacerbates demographic concerns, entrenches inequality between and within countries, and fuels unregulated or unsafe treatment pathways, including cross-border care.​

Recommendations and Call to Action

In its concluding sections, the EU Atlas of Fertility Treatment Policies sets out a series of recommendations aimed at European and national policymakers. It calls on governments to recognize the right to have a child as a universal right, ensure equal access to fertility care regardless of marital status or sexual orientation, and provide public funding for the full range of medically indicated treatment lines.​

The Atlas urges authorities to strengthen data collection through national registers, systematically involve patient associations in law and policy development, and invest in comprehensive fertility education and destigmatizing public communication. It also stresses the need for routine, funded psychological support as an integral part of fertility care rather than an optional add-on.​

Towards a More Equal Fertility Landscape

Fertility Europe and EPF present the Atlas as both a benchmarking instrument and an advocacy tool for civil society, clinicians, and decision-makers seeking to close the gaps in fertility treatment access across the continent. By documenting where progress has been made and where barriers persist, the report aims to support evidence-based reforms and greater alignment with human rights standards in reproductive health.​

The authors call for sustained political commitment at EU and national levels to turn the report’s findings into practical changes in law, funding, and service delivery. As infertility rates remain high and demand for ART continues to grow, the Atlas positions equal, safe, and affordable access to fertility treatment as a test of Europe’s commitment to reproductive rights and social justice.