Greece social briefing: Greece’s new law for Medical Assisted Reproduction

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Weekly Briefing, Vol. 53. No. 3 (GR) July 2022

 

Greece’s new law for Medical Assisted Reproduction

 

 

Summary

The briefing presents the current demographic trends of Greece. The demographic indicators of the country reveal a continues decrease of the population. The population of Greece is not only decreasing but simultaneously is aging. This is a major risk factor for the economic development of the country. The new law on medically assisted reproduction introduces reforms intended to facilitate couples during this process and potential increase births. Further measures need to be taken in order to reverse the phenomenon.

 

Introduction

The negative demographic developments in Greece, with the reduction of births compared to deaths, is expected to continue over the next decades, resulting in the progressive reduction and aging of the country’s population. This phenomenon has serious implications to the economy and society of the country. The parameters that lead to the reduction of the population are numerous and mostly related to socioeconomic factors. The decrease of income of households, as well as the work-related insecurity, due to the high unemployment, creates a vicious circle of fewer births and decrease of the working force of the country. Better employment and increase of the household income can have a positive impact in the demographic indicators.

The new law for the “Reforms for medically assisted reproduction” extends the age limit from 50 years to 54 years and introduces other innovative measures in order to assist couples in the process of having children with assisted reproduction techniques. The law offers the framework for applying the most recent scientific techniques and in parallel protecting human rights. These are the necessary actions which are expected to increase the rate of births of children conceived with assisted reproduction techniques. However, it should be mentioned that this is a small step, which cannot lead by itself to a drastic increase of the population of the country. Thus, in order to tackle the demographic problem, the government needs to create a multidimensional plan, combining numerous economic and social measures.

 

Current statistics

According to the Hellenic Statistical Authority (ELSTAT) Greece’s population in 2020 decreased by 39,933 people in comparison to 2019, since the number of births was lower than the number of deaths. Specifically, the population of the country on 1st January 2021 was 10,678,632 in comparison to 10,718,565 people estimated on 1st January 2020. In addition, the net migration was estimated in the same period at 6,384 people in comparison with the 34,439 people estimated in 2019. Furthermore, people with the age of 0-14 years cover the 14.1% of the total populations of Greece, while people aged 15-64 amounted to 63.3%. It should be mentioned that 13,451 people are over 100 years old (1).

Statistics reveal that Greece’s population is not only shrinking but also ageing. According to a study held by Dianeosis, it is forecasted that by 2050 the population of the country will be 10 million people, as per the optimistic scenario, and 8,3 million people, according to the pessimistic scenario. The working force of the country from 4,7 million people in 2015 it is predicted that by 2050 will be shrank to 3-3,7 million. In parallel, the median age in 1951 was 26 years and in 2016 was 44 years. It is predicted that in 2050 the median age will be increased by 5 to 8 years. This phenomenon of the aging and shrinking of the population has serious implications to the society and the economy of the country. The state needs to address the issue and curve policies that will reverse the phenomenon and its negative effects (2).

The fertility indicators in Greece are not optimistic as well. According to EUROSTAT, in 1970 2.40 live births per woman were registered in Greece and only 1.39 in 2020. In addition, according to the same data, the average age that Greek women give birth to their first child is 31.7 years (3). It should be mentioned that concerning the statistics on assisted reproduction, in 2019, 29,000 in vitro fertilization (IVF) cycles were registered in Greece and 5,521 IVF conceived children were born in the same year, corresponding to 6.4% of total births in the country. It should be mentioned that this percentage would be higher, as several couples visit Greece to undergo assisted reproduction, but the children are born in other countries (4).

 

Provisions of the law

On the 19th of July the discussion on the new bill of the Ministry of Health for “Reforms for medically assisted reproduction” took place in the parliament. PM Kyriakos Mitsotakis during his speech stated that “Assisted Reproduction is worth holding an open discussion on, with all the society. Even more so given that this challenge is linked to other important national goals, such as protecting individual rights, modernizing daily life and of course the tackling of the demographic issue” (5). The bill was passed from the parliament by majority. Specifically, New Democracy (ND) and PASOK-KINAL voted in favor. SYRIZA voted “present”, KKE voted against, Greek Solution voted “present” and Mera25 voted against (6). The resulting law was numbered 4958/2022.

Among key points introduced by the new law are the increase of the age limit of women who want to use assisted reproduction methods from 50 years to 54 years, the option of cryopreservation of ova for social reasons and not only medical, as well as the abolition of the 20-year ceiling of the duration of the cryopreservation. In addition, the right of the individual to deposit non-fertilized genital material for cryopreservation without the consent of the spouse and the free use in the event of divorce is included. Furthermore, the new law provides the right of gamete donor to anonymity by given the option to full anonymity or the option of either declare its name, or alternative give a relative name so that the child when reached adulthood will be able to know the personal details of the donor. It should be mentioned that the donor is protected from any paternity claim. Another provision of the law is the establishment of a Cryopreservation Bank exclusively for the service of HIV-positive persons. Moreover, it includes provisions for the respect of the personality of intersex persons and the right to physical self-determination, as well as regulations on the conditions under which intervention in the sex characteristics of minor intersex persons will exceptionally be allowed.

 

The debate

The new law introduces innovative provisions in the field of medical assisted reproduction. As the president of the National Authority of Assisted Reproduction Nikolaos Vrachnis stated, “The new law is about facilitating people to regain rights won by science”. He noted that the previous institutional framework was innovative for its time, however under today’s developments in reproductive science and embryology, it was considered obsolete and therefore reforms were mandatory. Concerning the provision of extending the age limit from 50 years to 54 years old for women who have decided to use assisted reproduction Vrachnis mentioned that it is a fact that in Greece women over 50 have given birth. These women had to visit third countries in order to undergo assisted reproduction techniques. Specifically, 135 children were born from women over 50 in Greece. Thus, the extension of the age limit was necessary (4).

However, many members of the parliament criticized the provision. George Lamproulis, deputy speaker and member of the communist party KKE stated that this bill tries unsuccessfully to hide the anti-popular policies of the government that undermine the lives and dreams of the young couples. Consequently, due to the poor working and living conditions women, who want to have children, postpone this decision.  Maria Athanasiou, member of the party Greek Solution also criticized the provision. She noted that the claims of the ruling New Democracy party that the age limit had to be increased since life expectancy is also increased, but despite this there is no scientific data available to prove such increase in the age of the natural reproductive capacity for women. Furthermore, Maria Apatzidi, stated that the government’s criterion for introducing such provisions was the profitability of centers of medically assisted reproduction. She also added that the offer of gametes by relatives can potentially burden the family relationships on multiple levels. In addition, she indicated that the major issue is what will be done with the unused fertilized ova and argued that keeping the fertilized eggs indefinitely through cryopreservation raises bioethical issues, which are overlooked in the name of profit (7).

 

Conclusion

The new law introducing reforms on medically assisted reproduction and offers an updated framework for the application of recent scientific techniques. The extension of age limit of women that want to use such procedures from 50 years to 54 years will facilitate many couples that due to the age restriction had to travel to third countries in order to undertake assisted reproduction techniques. Furthermore, it is expected that the new measures introduced will result in the increase of births. Since Greece’s demographic indicators are not optimistic, even these small changes in the law framework can positively contribute to the target of increasing the country’s population. Of course, in order to tackle the demographic problem, the government needs a comprehensive plan that will introduce innovative and multidimensional measures contributing to the increase of the country’s population.

 

 

References