Table 1.

Surrogacy legislative frameworks in major European countries.

Countries	Legal Status	Legislation
France	Banned	Art. 16-7 of the Civil Code created by law No. 94-653 of 29 July 1994—Art. 3 JORF, 30 July 1994; brokering agreements on procreation or gestation on behalf of third parties is a criminal offence (under Art. 227-12) [20,21].
Germany	Banned	Embryonenschutzgesetz (“Law for the protection of the embryo”), enacted on 13 December 1990, according to which genetic, biological and social motherhood are inextricably bound [22].
Italy	Banned	Surrogacy, often termed by its Italian detractors “uterus for rental”, is subject to law No. 40. The law allows the use of MAP in order to favor the solution of reproductive problems deriving from documented sterility or infertility, provided that it is not possible to remove otherwise the impeding causes of procreation and in the manner prescribed by law, which protects the rights of all those involved, including the child. The law bans heterologous MAP techniques (i.e., those using gametes from third-party donors) and states that, in the event of violation of this prohibition, the gamete donor does not acquire any legal parental relationship with the child and cannot claim any rights or be the holder of obligations against him [23,24].
Spain	Banned	Art. 10 within law 14/2006, passed on 26 May (“Sobre técnicas de reproducción humana asistida”), according to which all surrogacy agreements are null and void [25,26].
Greece	Legal for intended parents in a heterosexual partnership or single females. The latter are required to medically prove their inability to have a pregnancy and be no older than 50 at the time of the contract. Surrogates must be tested for medical and mental fitness.	Law 3305/2005 (“Enforcement of Medically Assisted Reproduction”). Law 4272/2014 has repealed the requirement of permanent residence in Greece [27].
Netherlands	Altruistic surrogacy is legal in the Netherlands, whereas commercial surrogacy is banned. However, few hospitals provide related services in the country, with strict rules to get access, which has resulted in many Dutch couples traveling abroad to seek it.	No targeted legislation. Articles 151b and 151c of the Criminal Code make promoting commercial surrogacy illegal [28,29,30].
Belgium	No official law explicitly forbids altruistic surrogacy, although access is hard to gain. Commercial surrogacy is illegal.	No targeted legislation currently in place [31].
Denmark	Legal, as long as it is done in its altruistic variant and no assisted reproduction techniques are used: the surrogate mother must use her own eggs (traditional surrogacy).	The surrogacy process is not regulated by targeted legislation [32,33].
Czech Republic	There is currently no legislation governing surrogacy, which is considered legal in its altruistic form.	No targeted legislation currently in place, but commercial surrogacy is deemed a criminal offense. The practice is reported to be on the rise, though legal experts warn that any contract or agreements in that respect is unenforceable [34,35,36].
Portugal	Illegal due to Constitutional Court decision, which declared law 25/2016 unconstitutional.	The legislature passed law 25/2016 on 20 July 2016, legalizing surrogacy. On 24 April 2018, and, on September 2019, the Constitutional Court of Portugal overrode several provisions of the law enacted by Parliament, suspected to violate constitutional principles and rights [37,38].
United Kingdom	Altruistic surrogacy is legal. Commercial surrogacy is banned.	Surrogacy is recognized under section 30 of the Human Fertilisation and Embryology Act 2008; In May 2016, a ruling by the Family Division of the High Court of Justice for England and Wales determined that single people can apply to be recognized as the legal parents of a child following a surrogacy arrangement. The law was subsequently changed in December 2018 to allow applications from individual, subject to conditions, including genetic relation to the child. Singles as well as homosexuals seeking parenthood may use it as well, provided that they are UK residents. Surrogacy-related commercial arrangements are prohibited by the 1985 Surrogacy Arrangements Act [39,40].
Russia	Full or gestational surrogacy is legal, i.e., the surrogate mother cannot have a genetic tie with the child. Commercial surrogacy is legal as well.	Gestational surrogacy, even commercial, is legal and available to practically all adults seeking parenthood. A set of medical requirements must be met: Müllerian agenesis, uterine cavity synechia, deformity of the uterine cavity or cervix, somatic diseases contraindicating pregnancy or repeated IVF failure despite use of high-quality embryos [41,42,43].
Ukraine	Surrogacy is legal in all its forms.	Surrogacy is officially regulated by Clause 123 of the Family Code of Ukraine and the order of the Ministry of health of Ukraine “On approval of the application of assisted reproductive technologies in Ukraine” from 9 September 2013 No. 787 [44,45,46,47].
Lithuania	Surrogacy is illegal in Lithuania, and any agreement would be unenforceable.	Article 11 of the Law on Medically Assisted Procreation of the Republic of Lithuania (14 September 2016 No. XII-2608) declares all surrogacy agreements null and void. Moreover, the Lithuanian parliament (Seimas) has recently issued a resolution decrying surrogacy and urging the President and the Ministry of Foreign Affairs to propose amendments to international treaties meant to facilitate a surrogacy ban at the national level. It also calls on the Council of Europe to launch an inquiry into whether existing international laws have been fully complied with by EU member states [48].