Reproductive medicine laws in Germany 'shockingly unjust'

Published 18 July 2026 · health

Infertility affects one in six women in Germany. However, access to reproductive medicine is not available to all. Surrogacy as well as egg donation are

Infertility affects one in six women in Germany. However, access to reproductive medicine is not available to all. Surrogacy as well as egg donation are banned. "It was one of the most harrowing moments of my life," said Marriette, who didn't want her last name used to protect her privacy, about the moment she was told that conceiving without medical intervention likely would not happen for her. "I sat on the floor and cried for six hours in my best friends' apartment with them and their baby." When she was in her early 30s, Marriette had an operation to remove cysts on both her ovaries. Unbeknown to her at the time, this resulted in a depleted egg reserve. Newly single after a breakup, at the age of 36 Marriette started having hot flashes and was diagnosed with premature ovarian insufficiency and already in perimenopause. What began next has been what she calls a "shockingly unjust" fight to conceive as a single woman in Germany, where the cost of infertility treatment is only covered for married couples, who get 50% of the costs for a maximum of three rounds of treatment paid for by health insurers. "My first fertility doctor told me to just go out and sleep with lots of people," explained Marriette. "It just feels very unjust. I can't believe that after paying health insurance and taxes here for 18 years, for my health care problem, the solution depends on whether I'm married or not." Marriette said the regulations governing access to fertility treatment in Germany are 'shockingly unjust' Image: Tessa Walther/DW Since beginning fertility treatment two years ago, Marriette has had to pay for everything herself: for every injection and drug, every ultrasound and blood test, even for the cost of a postage stamp for a letter she received from a fertility clinic. She remembered one incident in particular when she was in a surgical gown waiting for surgery and the anesthesiologist approached her with a syringe full of anesthetic and a credit card machine.

"He told me he would also accept cash," Marriette recalled. "I just can't believe that's the reality." The experience has been grueling. Suffering from burnout after working three jobs and repeated failed attempts to conceive, Marriette was eventually forced to take time off work and reevaluate her options. "Those last six months basically broke me," she said. "I had nothing to show for all this pain, anguish and hard work. Not only have I got nothing to show for it, I'm in €13,000 ($14,000) of debt and now on antidepressants." 'Outdated and discriminatory' legal situation in Germany Germany has one of the oldest and most outdated laws on fertility in Europe, according to Fertility Europe, a pan-European NGO representing patients' associations dedicated to infertility. Under the healthcare system, some states do offer subsidies for same-sex and unmarried couples, but that is the exception rather than the rule. Egg donation and surrogacy are both forbidden in Germany. "In Germany, less than 3% of babies are born through [assisted fertility treatments]. In Croatia, that number is 5% and 10% in Denmark," Klaudija Kordic, the chair of Fertility Europe, told DW. "What you are doing here is stopping potential parents from having children because they can't afford it, or they feel embarrassed because it's not paid for them, there must be something wrong." Germany scores a "medium" 69%, on par with Austria, Bulgaria, Italy, Latvia and North Macedonia, on Fertility Europe's atlas 2021 ranking of fertility treatment policies on a scale from excellent to exceptionally poor. Only Belgium, France, Israel and the Netherlands rank as excellent. Fertility treatments hotly debated in Polish elections To view this video please enable JavaScript, and consider upgrading to a web browser that supports HTML5 video "Many countries in Europe complain about the low birth rates, but there isn't enough long-term planning to support the people who want to have children," said Anita Fincham, head of advocacy at Fertility Europe. She said the regulations in Germany are discriminatory, and that those who can afford it go abroad.