ART and Assisted Reproduction Act in Taiwan

In 1985, Taiwan witnessed the birth of its first test-tube baby conceived through Assisted Reproductive Technology (ART). In 2007, following numerous negotiations between the governing and opposition parties, the Legislative Yuan passed the “Assisted Reproduction Act.” Since its enactment, minor modifications were made in 2017, primarily involving the name change of the supervisory authority and adjustments to criminal provisions. According to the “Assisted Reproduction Act,” the use of overseas donations of eggs and sperms is prohibited, and individuals must meet the following four conditions to undergo ART:

1. The individuals must be legally married.

2. One spouse must be infertile or have a significant hereditary disease listed by the authority.

3. At least one spouse must possess healthy reproductive cells and not require donated sperm or eggs from others.

4. ****The individual must pass examinations and assessments of their mental and physical health, as well as personal and family medical history, to determine the suitability for undergoing ART.

The law requires marriage as a prerequisite for ART and restricts the use of this technology to infertile couples. However, over the last decade and as Taiwan legalized same-sex marriage, calls for legislative amendments have gradually increased. Recently, surrogate motherhood and artificial reproduction for single individuals have emerged as key areas for legislative reforms. In 2024, the Ministry of Health and Welfare prioritized amendment of the “Assisted Reproduction Act” for the current session of the Legislative Yuan.

The section is contributed by Charlotte Chiu.

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As a woman growing up in Taiwan, marriage and childbearing seemed to be societal norms, taken for granted, and unquestionable. However, in recent years, three significant events have challenged my perspective: witnessing my younger brother and his same-sex partner struggling to conceive despite their marriage, my own journey of freezing eggs and embryos, and marriage. These experiences have sparked profound shifts in my understanding of women’s roles and attitudes towards reproduction. I now believe there is room for refining Taiwan’s “Assisted Reproduction Act” as well as the need to foster more societal dialogue to ensure ongoing progress.

My younger brother bravely disclosed his sexual orientation and his desire to marry his partner to our family in 2019, when Taiwan legalized same-sex marriage. While surprised, older members of our family ******quickly embraced it with love, and accepted my brother’s partner. However, despite the legal milestone of same-sex marriage, it closed the door on their dreams of parenthood.

At that time, same-sex couples were unable to adopt children together, and Taiwan’s assisted reproductive technology was limited to married heterosexual couples. Seeking surrogacy abroad became the only recourse, but the financial burden was immense, with surrogacy in the US costing millions of Taiwanese dollars.

Amidst the challenges of navigating information and language barriers, tales of being misled or returning empty-handed were common. These hurdles postponed my brother and his partner’s journey to parenthood until 2023, when the Legislative Yuan passed legislation allowing same-sex couples to adopt children jointly, finally giving hope on their path to becoming parents.

My story

In 2018, I pursued graduate studies in the United States and started working there after graduation. Despite having a long-term partner, neither of us felt pressured to rush into marriage or parenthood. However, despite the best technological advancements, female fertility still faces biological constraints. Since the quality of eggs plunges after the age of 35, my partner and I decided to freeze our embryos so we will have healthy ones available when we are ready. We opted to freeze embryos instead of eggs because, from a medical standpoint, the success rate of implanting frozen embryos is significantly higher than that of frozen eggs.

Unmarried individuals are permitted to freeze embryos under the laws in the US. However, I learned from my female friends who were also considering to freeze their eggs that currently, only married heterosexuality couples can freeze embryos in Taiwan. Even if a woman freezes healthy eggs, she cannot even combine her eggs with sperm to create embryos for in vitro fertilization unless she is married to a man. Therefore, in Taiwan, if a woman wants to fulfill her dream of having a baby, she has to either marry a man, or travel to a country where single women can access sperm donors and undergo IVF procedures.

Afterwards, I did get married, and “family planning” became a significant topic for my partner and me. Yet, it was not until the moment where I faced the reality of “giving birth to a baby” that I realized how unfair the entire process of childbirth is for women. Those who encourage women to have children often emphasize how much joy it brings, but few mention all the sacrifices women have to make – including financial resources, time, mobility, energy, physical and mental well-being – and particularly the profound impact on women’s careers.

The Economist featured an article titled “How motherhood hurts careers,” which highlights research indicating that women’s careers suffer due to pregnancy and childbirth regardless of the country. Scholars refer to this phenomenon as the “motherhood penalty.” In poorer countries, women frequently leave the workforce upon marriage. Even in wealthier countries, almost all gender disparities in labor participation occur post-childbirth. Additionally, even in more progressive Western countries, many women must leave their jobs within the first year following childbirth due to exorbitant childcare costs.

The Economist illustrates this phenomenon through charts: across countries like Africa, Asia, and South America, women’s careers are adversely affected for a minimum of ten years post-childbirth, whereas men’s careers are hardly affected. In contrast to the “motherhood penalty,” there’s a term called “fatherhood premium,” which describes how men experience career bonuses and advancements following marriage and parenthood. The ten-year setback in women’s careers means that women with children have to exert significantly more effort to bridge the gap with men. It’s not simply just about working harder; it also requires significant financial resources and support systems.

Motherhood and careers

Taking myself as an example: my profession demands extensive mobility and frequent international travel. If I become pregnant, it would undoubtedly impair my work performance due to potential sleep deprivation or unexpected circumstances with the child. Moreover, I would not be able to undertake tasks involving travel or simply being away from home. The ramifications of having a child extend far beyond a mere one or two years.

I love Taiwan dearly, yet women in Taiwan who choose not to marry or have children often encounter excessive concerns or even ridicule. Our president, Tsai Ing-wen, and other outstanding female politicians have frequently been publicly criticized or discriminated against because of their choice to remain unmarried and not have children. It is crucial to contemplate whether our society provides women with sufficient resources and support so that they can feel empowered in their choices regarding childbirth, and alternatives should be offered so that marriage is not the only option.

The notion of having children was once considered the default in my life. Growing up, there were few discussions about the impacts childbirth may have on women mentally and physically. Women seem to have limited choices and are simply expected to follow social norms. Under the Taiwan‘s current “Assisted Reproduction Act,” even though women can freeze the eggs, they lack the freedom to determine how to use their own eggs. Furthermore, those who suffer from infertility or cannot physically bear pregnancy have no option for surrogacy. These restrictions deprive women, as well as LGBTQ+ individuals and those struggling with infertility, of the freedom to pursue their reproductive rights.

The issues associated with the “Assisted Reproduction Act” and “Surrogacy” are extremely complex and require extensive deliberation and discussion, alongside the need for relevant legal readiness. Taiwan’s progression toward embracing progressive values involves resolving diverse perspectives throughout the process.

Engaging in rational discussions allows us to explore various viewpoints and such dialogue requires neutral and truthful information. We hope to foster more discussions to facilitate Taiwan’s ongoing advancement while empowering women to recognize that life should never be confined to a singular choice.

(Feature photo by THIS IS ZUN on Pexel)

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