Couples will have to see a psychologist before assisted reproduction: New guidelines coming

Croatia has introduced new guidelines requiring couples and individuals undergoing medically assisted heterologous conception, using donated gametes or embryos, to undergo mandatory psychological counseling before proceeding with treatment. The Croatian Psychological Chamber has issued these directives, which specifically target procedures involving donor sperm, eggs, or embryos, marking a shift from previous general guidelines applicable to all forms of medically assisted reproduction. Under the new rules, couples and single women must have at least two sessions with a psychologist, one joint session and one individual session with the woman. An additional individual session with the man is recommended if there are emotional difficulties or conflicts within the relationship. The guidelines outline the content of the counseling, including how to cope with infertility, the relationship with the donor, expectations from the treatment, preparation for parenthood, and discussions about how the child will learn about their origins. The chamber also states that a certificate confirming the counseling will not be issued if partners disagree on the procedure or if they indicate they do not intend to inform the child about the method of conception. Dinka Pavičić Baldani, president of the Croatian Society of Gynecological Endocrinology and Human Reproduction under the Croatian Medical Association, emphasized that the biggest challenge for many couples is accepting the reality that parenthood will not occur through their own gametes. She noted that the goal of the psychological counseling is to help individuals and couples make informed decisions and prepare for the long-term consequences of such treatment. The process of heterologous medically assisted reproduction has lasting effects on the entire family. Croatia has struggled to establish a sustainable national program for donating gametes over the past 14 years since the Law on Medically Assisted Reproduction was enacted. As a result, individuals requiring donated eggs, sperm, or embryos for treating infertility often seek treatment abroad, either with approval from the Croatian Health Insurance Fund or at their own expense. Although some people occasionally express interest in donating, the number is insufficient to maintain a viable program. One reason for low interest is the legal framework surrounding donations. According to the law, individuals conceived using donated gametes or embryos have the right to know their biological origins, including the identity of the donor, once they reach the age of 18. At the same time, Croatian law prohibits financial compensation or any other form of benefit for donating gametes or embryos. Potential donors must undergo extensive medical, psychological, and genetic screening to eliminate the risk of transmitting infectious or hereditary diseases. The introduction of the new guidelines comes amid ongoing debates about reproductive rights, ethical considerations, and the role of psychological support in fertility treatments. While the focus on psychological readiness reflects growing awareness of the emotional complexities involved in assisted reproduction, critics argue that the legal restrictions on donation may further limit access to treatment for those who need it most. Some experts suggest that revising the legal framework could encourage more people to participate in donation programs while ensuring transparency and protection for both donors and recipients. The requirement for psychological counseling is part of a broader effort to ensure that individuals undergoing medically assisted reproduction are fully prepared for the emotional and social implications of the process. This includes addressing potential issues related to identity, family dynamics, and the child’s future understanding of their origins. The guidelines also emphasize the importance of mutual agreement among partners and the necessity of informing the child about the circumstances of their conception. In practice, the implementation of these new rules will depend on the availability of trained psychologists specializing in reproductive health and the willingness of healthcare providers to comply with the requirements. The Croatian Psychological Chamber has outlined specific educational programs for psychologists to ensure they are equipped to provide the necessary guidance. Additionally, a registry of authorized psychologists will be maintained to track compliance and ensure consistency in the quality of counseling provided. The new regulations reflect Croatia's evolving approach to reproductive medicine, balancing the need for ethical oversight with the practical challenges of maintaining a functional donation system. As the country continues to navigate these complex issues, the impact of the guidelines on access to treatment and patient well-being will likely become clearer in the coming months.