It is almost never the medical practice that differs from one country to another. It is the law. Here is the table I ask every patient to read before she chooses a destination.
A 46-year-old patient, a female couple, a couple requiring a double donation: in each of these cases, the answer depends less on the doctor than on the parliament of the country in question. Understanding these four legal frameworks saves months of research and unnecessary appointments.
| Criterion | France | Greece | Spain | Belgium |
|---|---|---|---|---|
| Age limit (IVF) | 45 years old, reimbursed up to 43 | 54 years old (special authorisation from 50 to 54) | 50 years old in practice | 47 years old for embryo transfer |
| Single women | Yes, since 2021 | Yes | Yes | Yes |
| Female couples | Yes, since 2021 | Not recognised as a couple | Yes | Yes |
| ROPA method | No | No | Yes | Yes |
| Egg donation | Yes, voluntary, waiting time ~22 months | Yes, compensated, no waiting period | Yes, compensated, no waiting period | Yes, compensated |
| Double donation | No | Yes | Yes | Yes |
| Anonymity of the donation | Lifted: access to origins since 2022 | Strict | Strict | Anonymous or directed, depending on the clinic |
| PGT-A (aneuploidy screening) | No | Yes | Yes | Yes |
| Reimbursement | 4 IVF and 6 IUI treatments up to the age of 43 | None for non-residents | None for non-residents | Partial for residents |
The 2021 Bioethics Act opened up assisted reproductive technology (ART) to single women and female couples, and introduced access to information about their origins for children born through donation from 2022 onwards. These two advances have come at a cost: demand has skyrocketed without a corresponding increase in the pool of donors, and the lifting of anonymity has caused the number of donors to plummet during the transition period. As a result, the average waiting time for an egg donation is around twenty-two months. Financially speaking, the system remains the most generous in Europe for those who meet its criteria.
The 2022 reform raised the age limit to 54, the highest in Europe, with authorisation from the National Assisted Reproduction Authority required for women aged between 50 and 54. Donation is anonymous and compensated, with no waiting list, and pre-implantation genetic testing for aneuploidy (PGT-A) is available. The limitation of the Greek framework concerns female couples, whom the law does not recognise: one partner accesses treatment as a single woman, and the issue of the second mother’s parentage is then settled under French law, which means it is advisable to consult a solicitor before travelling.
The 2006 law permits all of the above, including the ROPA method, whereby a woman carries the embryo derived from her partner’s egg. It is one of the most popular destinations in Europe, with well-organised French-speaking teams and a national register that publishes the results. Prices there are higher than in Greece, and the age limit is, in practice, around 50.
A liberal, French-speaking environment, just two hours from Paris. Donation can be anonymous or directed, depending on the clinic, which appeals to couples who wish to have a known donor. The age limit is 45 to start treatment and 47 for embryo transfer, placing it between France and Greece.
My rule is simple. Start with the criterion that’s holding you back, not the country. If it’s age beyond 50, Greece is the only option. If it’s ROPA, it’ll be Spain or Belgium. If it’s the waiting time for a donation and budget is a factor, Greece. If it’s the independent publication of results, Spain. If it’s the distance, Belgium. The rest — the quality of the laboratories, the professionalism of the teams — can be found in all four countries, and should be assessed clinic by clinic, not country by country. The detailed comparison between Spain and Greece is here.
One final point I often reiterate: the law of the country where you receive treatment does not determine your child’s parentage in France. It is French law that applies to civil status. For a married heterosexual couple or a single woman, there are no difficulties. For a female couple, joint recognition of paternity must be arranged, and this must be done before departure, not after the birth.
Greece, up to the age of 54, with special authorisation from the National Authority for women aged between 50 and 54. In practice, the age limit in Spain is 50, in Belgium 47 for embryo transfer, and in France 45.
No. It is authorised in Spain and Belgium, but neither Greek nor French law provides for it.
No. It is strictly anonymous in Greece and Spain, and may be anonymous or directed depending on the clinic in Belgium. In France, anonymity has been lifted: children born through donation since 2022 can access the donor’s identity upon reaching the age of majority.
No. It is French law that applies to the child’s civil status. For a female couple, joint recognition of paternity must be arranged before departure.
Source: https://fertilitegrece.com/en/blog/fertility-law-france-greece-spain-belgium/ — Triada Baloukoudis, IVF patient coordination in Greece. General information, not medical or legal advice. Printed on
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