On 30 January 2025, the Swiss Federal Council announced plans for a comprehensive reform of the Reproductive Medicine Act (RMA) to align it with advances in reproductive medicine and contemporary social realities, while maintaining ethical safeguards.
The RMA, in place since 2001, currently prohibits egg donation, embryo donation and surrogacy, while restricting access to sperm donation to married couples (RMA Art. 3(3); Art. 4). Beyond the gap with current realities, the need for reform arises from the fact that many Swiss residents seek fertility treatment, most commonly egg donation, abroad – a trend the Federal Council views with concern.
Following its thorough evaluation of the RMA, the Federal Council reported mostly positive findings. The assessment confirmed that the act has effectively fulfilled its purpose, is properly implemented in practice, and provides adequate protection for embryos and children while preventing abuse. However, certain aspects require updates and improvements.
As to the plans already confirmed, the most significant change will be in allowing egg donation. In 2022, the Swiss Parliament mandated the removal of the current ban to address discrimination against couples in which the woman is infertile and must go abroad to fulfil their desire to have biological children – unlike couples where the man is infertile and can access sperm donation in Switzerland.
However, the Parliament had only asked to make egg donation available to married couples, in line with the current eligibility rules for sperm donation (see BioNews 1245).
The Federal Council announced a plan to extend both egg and sperm donation to unmarried couples – as previously recommended by the National Advisory Commission on Biomedical Ethics. According to the Federal Council, limiting access to married couples no longer reflects social reality. When the law was drafted nearly 30 years ago, marriage was viewed as a guarantee of stability. Today, however, many unmarried couples raise children in stable, supportive environments. Moreover, in most European countries, both married and unmarried couples have access to gamete donation.
Despite going beyond the mandate set by Parliament, important restrictions will remain in place. Single individuals will still be denied access to assisted reproductive technologies (ART), and gamete donation will remain limited to cases of medically certified infertility or hereditary disease risk (RMA Art. 5).
The only exception is for married lesbian couples who have access to sperm donation since the legalisation of same-sex marriage in 2022. However, this raises a new question: whether gay couples, could be considered to face sex/gender discrimination compared to lesbian couples, given the Federal Council's confirmed plan to uphold the ban on surrogacy and embryo donation (Swiss Federal Constitution Art. 119(d)).
Moreover, the Federal Council clarified that the term 'couple' will be clearly defined, in terms of criteria such as the stability and duration of the relationship, excluding, for instance, two people who randomly meet on the street. This raises the question of why two adults who choose to have a child together without being in a romantic relationship should be excluded – especially considering that a romantic relationship is no guarantee for a stable environment.
The reform is presented as being guided by two fundamental principles: the wellbeing of the child and the wellbeing of the egg donor. Regarding the former, important emphasis is placed on ensuring the protection of the fundamental right to know one's origins (Swiss Federal Constitution Art. 119(g)). To this end, the Federal Council announced plans to create a donor registry, similar to the one currently in place for sperm donation. The overall aim of the reform is to discourage people from seeking gamete donation abroad, where legal frameworks may fail to protect the right to know one's origins for donor-conceived individuals, or where egg donors may face financial pressure or be treated unethically.
This is precisely what the Swiss reform aims to prevent in the future. Another point on which there is already considerable clarity is the absence of remuneration for egg donors, which is not uncommon in Europe. While compensation for expenses may be introduced, the goal is to ensure that donors are well-informed about the risks involved and donate out of altruism and empathy towards couples suffering from infertility, rather than financial need.
Considering the clear intention to avoid any pressure, we might expect that incentives – like free or discounted IVF treatment, or free storage to patients who agree to share their eggs with another patient or couple having treatment – will also not be seen as viable or desirable options. One could question whether approaches of this kind, which are largely built around narratives of altruism and solidarity, ultimately neglect or fail to sufficiently acknowledge the material, corporeal, and affective dimensions of egg donation – essentially, the fact that what egg donors do is 'bodily, reproductive labour' (Perler and Sanchez Pérez, 2024).
Beyond the confirmed changes, the reform will also address several issues on which the Federal Council has yet to take a position.
One point of discussion is the possible revision of the so-called '12-rule', which currently limits the number of fertilised eggs that can develop into embryos per treatment cycle to a maximum of 12. There is an ongoing debate over whether this rule should be abolished or relaxed to improve pregnancy chances and reduce the need for additional treatment cycles.
Another sensitive issue under consideration is the introduction of fixed age limits for intended parents using sperm or egg donation. Given that egg donation allows women to conceive even after menopause, the question arises whether age restrictions should be implemented to ensure the child's best interests or if the current limitation of being able to raise the child until it reaches the age of maturity is sufficient (RMA Art. 3(2)(b)). Similarly, the maximum storage duration of ten years for sperm and embryos, which could also be extended to eggs, is up for discussion in light of the fact that couples may need more time before they are able to realise their parental plans.
Finally, the reform will also examine restrictions on the number of children that can be conceived per egg donor. Currently, sperm donors are limited to producing a maximum of eight children.
To conclude, this reform goes beyond initial expectations – namely, the opening of egg donation to married couples. The Federal Council's announcement reflects a willingness to take responsibility for, rather than outsource, the moral dilemmas raised by ART and evolving societies – a welcome development, especially considering Switzerland's historically restrictive stance on ART.
There is an explicit recognition that protecting both children and egg donors, among others, means reducing the need for people to seek treatment abroad, where egg donation may be poorly regulated or ethical safeguards might be lacking. That being said, as the Federal Council itself acknowledges, this plan is far from reckless progressivism ('progressisme téméraire').
One crucial factor in fertility treatment decisions is cost. The effectiveness of the Swiss reform will largely depend on who will bear the financial burden – whether health insurance will cover (part of) these expenses, and more broadly, how much public responsibility will be taken for what is still largely considered a private matter.
There is still a long way to go, and it remains to be seen which of these changes will eventually be implemented in the RMA. The Federal Council's proposal is expected by the end of 2026, after which consultations with key stakeholders will begin.
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