Taiwan’s Assisted Reproduction: An Embryo Crosses Borders, But a Family Cannot Automatically Cross the Law

30-Second Overview: In 2020, female partners Mota and City traveled to Cambodia for IVF, spending approximately NT$2 million over four years. Taiwan’s medical technology is already mature, but the law has long only allowed heterosexual married couples to use it. From the 2007 Assisted Reproduction Act to the 2025 legislative draft, this article looks not at “whether one can give birth,” but at who is allowed into the clinic, who is recognized as a parent after the child’s birth, and the dilemmas left by surrogacy. ¹

In 2020, female partners Mota and City underwent assisted reproduction in Cambodia. During Mota’s pregnancy, she experienced hypertension, gestational diabetes, and ascites; their daughter, Doby, was ultimately born safely. Two years later, City underwent IVF again, but encountered fetal cardiac arrest at 37 weeks of pregnancy. Within four years, this family spent approximately NT$2 million on cross-border treatment. ¹

They were not lacking medical technology. What they lacked was the ability to be legally recognized as eligible recipients of that technology in their own country. An embryo can cross borders, but a family cannot automatically cross the law.

Image source: Wikimedia Commons: File:Embryo, 8 cells.jpg. Author ekem, work released into the public domain.

📝 Curator’s Note: Assisted reproduction is not a simple story of “technology fulfilling dreams.” It is simultaneously a list of qualifications, determining who can enter the clinic, who can keep an embryo, and whose parent-child relationship will be recognized by law.

A Medical Technology That Matured Before the Law

Taiwan’s first test-tube baby was born in 1985. At that time, embryos could already be fertilized in vitro, but the law had not yet established a complete system to handle the donation of reproductive cells, embryo preservation, patient consent, and the child’s identity issues. ²

On March 21, 2007, the Assisted Reproduction Act was promulgated and implemented. The law placed assisted reproduction within a framework of medical institution licensing, recipient eligibility, donation management, and data reporting. Assisted reproduction institutions must report the number of patients treated, success rates, causes of infertility, and the types of assisted reproduction techniques used, enabling the competent authority to establish a database. ³

This law originally addressed how “infertile couples” could use assisted reproduction. Scholars analyzing data from 1998 to 2017 pointed out that the basic unit at the time was married couples, and at least one party had to possess healthy reproductive cells. Donors and recipients could not mutually designate each other, and the donation of reproductive cells from abroad was also restricted. ²

Thus, the Assisted Reproduction Act is not merely a hospital’s operating manual. It also draws lines around “family.” Physicians handle eggs, sperm, embryos, and implantation. The law handles who is qualified to request this service and who is the legal parent after the child is born.

📝 Curator’s Note: Technology is born first; the law later names it. Later still, the law recognizes that those who use the technology are not of only one kind.

A Growing Medical Network

The system did not stop in 2007. The National Health Administration’s 2022 National Report on Assisted Reproduction indicates that Taiwan had 48 assisted reproduction institutions in early 1998. By July 2024, the number of licensed medical institutions had increased to 101. The 2022 statistics analyzed treatment cases from 99 institutions. ³

Assisted reproduction is therefore no longer a marginal technology explored by a few doctors on their own. It has a licensing system, treatment records, regulations for the acceptance, preservation, and provision of donated reproductive cells, and regular quality management reviews of assisted reproduction institutions by the competent authority.

The expansion of this medical network is also reflected in birth statistics. Calculating data from 1998 to 2016, the proportion of births resulting from assisted reproduction out of total births rose from 0.86% in 1998 to 1.44% in 2007, and then to 4.33% in 2016. Research estimates that five years after the implementation of the Assisted Reproduction Act, the number of births via assisted reproduction increased relatively by 78.51%. ⁴

An increase in numbers does not mean the threshold has disappeared. The medical system can expand, but it must still serve recipients according to the legal definition. The state can encourage childbirth, yet simultaneously leave certain people who wish to reproduce outside the legal treatment process.

📝 Curator’s Note: The most counter-intuitive aspect of assisted reproduction is not that it can keep embryos in vitro, but that the more complete the medical network, the clearer it becomes who is excluded.

Subsidies Make Infertility a Public Policy Issue

In July 2021, the government launched an expanded IVF subsidy program, allowing eligible infertile couples to access public resources. This policy changed not only household expenditures, but also how society discusses assisted reproduction. It is no longer just a medical choice that individuals must bear, but is placed within discussions of low birth rates, population aging, and public finance. ⁵

A study published in 2024 built a fiscal model using Taiwan’s subsidy policies and assisted reproduction birth data. The study estimates that for every NT$1 invested, the government may receive approximately NT$5.6 in fiscal returns over the life cycle of IVF-born individuals. The study simultaneously cautions that this result is based on long-term assumptions regarding wages, working years, tax revenue, benefits, and discount rates, and cannot be treated as a fixed return for every household. ⁵

This model presents an important contrast. When the state calculates the value of subsidies based on future labor and tax revenue, assisted reproduction is no longer just about helping individual families; it is also treated as a tool of population policy.

But subsidies are not synonymous with “universal availability.” Subsidies can lower costs for eligible couples, but they cannot alone change who is qualified to enter the door of the Assisted Reproduction Act’s system. For unmarried women and female same-sex couples, the problem is often not whether they can afford a single treatment cycle, but whether Taiwan’s medical institutions can legally begin treatment for them.

📝 Curator’s Note: If the state hopes assisted reproduction will increase birth numbers, it cannot only ask whether a household can afford it; it must also ask whether that household is seen by the law.

The Law Lags Behind Families Already in Existence

After the legalization of same-sex marriage in 2019, legal recognition of family forms moved forward by one step. However, the Assisted Reproduction Act still primarily targets heterosexual married couples as its subjects of application. The establishment of marriage does not mean that every type of family within that marriage can use the same reproductive medical technologies.

The amendment draft passed by the Executive Yuan in 2025 proposes including unmarried women and registered female same-sex couples as subjects of application for assisted reproduction. The Executive Yuan explicitly stated that current regulations can no longer equally protect the basic rights of unmarried, divorced, widowed, and same-sex married women to manage family life. ⁶

The National Health Administration stated that the legislative revision convened experts in children’s rights, gender equality, law, and medicine starting in 2020, holding more than 30 meetings and two public hearings. The draft not only expands the subjects of application but also incorporates informed consent, management of reproductive cell donation, the best interests of the child, and the right to know one’s genetic origins. ⁷

The Public Television Service (PTS) compiled the Executive Yuan’s draft, noting that children born via assisted reproduction will be able to query non-identifying information about donors, such as height, blood type, skin color, and nationality. In cases of major genetic diseases or organ transplant medical needs, the donor’s identity can be queried further. The draft also plans to extend the embryo preservation period to 15 years, subject to the recipient’s consent. ⁸

These articles push the issue from “whether the hospital can do it” to “how to understand one’s origins after the child is born.” When an embryo is frozen, it resembles a medical material awaiting disposal. When the child grows up, it may become the starting point for questioning lineage, blood ties, and health risks.

📝 Curator’s Note: Preserving an embryo is a medical issue. Allowing a child the opportunity to understand their birth origins is a responsibility left by both family and law.

One Embryo Touches Three Rights

The first is the reproductive autonomy of the recipients. Unmarried women and female same-sex couples are fighting for not just “wanting a child,” but for the qualification to use medical technology without first fitting the heterosexual marriage family template.

The second is the child’s legal status. The Executive Yuan’s draft proposes that children born via assisted reproduction to female same-sex couples and unmarried women should have a clear legal status. Even if the female same-sex couple’s marital relationship is later revoked or declared invalid, the child should not thereby fall into the disadvantage of being considered a non-marital child. ⁶

The third is the right to information between the donor and the child. The past system emphasized donor anonymity and medical management. The legislative revision begins to face another question: whether an adult has the right to know how they were born.

This does not mean all family relationships can be reduced to genes. It means that genetic data may have significance in genetic diseases, organ transplants, and self-identity. A child’s rights are not just a field of data on a birth certificate; they are information the child may still need to use as they grow up.

📝 Curator’s Note: What assisted reproduction truly preserves is not just an embryo, but a family’s undecided future and the questions the child may later ask.

Why Surrogacy Is the Most Difficult to Handle

The 2024 legislative version once included single women, female same-sex couples, and surrogacy reproduction in the same discussion, proposing designs such as opening only altruistic surrogacy, limiting surrogate mothers’ compensation, allowing each surrogate mother to carry a pregnancy only once, and conducting economic, psychological, and family status assessments. The Judicial Reform Foundation, which organized related controversies, pointed out that the controversy surrounding single women and female same-sex couples using assisted reproduction is relatively small; what truly deepens social division is whether to open surrogacy. ⁹

The 2025 version submitted by the Executive Yuan chose to first include same-sex spouses and unmarried women, while decoupling issues such as surrogacy and male same-sex spouses. This does not mean the surrogacy controversy has disappeared, but rather that different issues are being separated.

The former primarily involves who can use their own reproductive cells and uterus. The latter involves the surrogate mother’s body, the commissioning party’s parental rights, commercialization risks, and the legal relationships after the child is born.

Surrogacy is difficult not because it is technically impossible, but because reproductive responsibility is dispersed among more people. The egg provider, sperm provider, pregnant carrier, and legal parents may not be the same group of people. Any individual’s autonomy, health, and right to withdraw cannot be brushed aside with a single consent form.

Therefore, the issues the Assisted Reproduction Act must next address are not just whether to open it. It must also answer who bears medical risks, who can withdraw consent, when parental rights are determined, how cross-border births are registered, and who protects the surrogate mother when contracts and the body conflict.

📝 Curator’s Note: Assisted reproduction can split fertilization into several steps. The law, however, cannot split each person’s risks and then pretend they are unrelated.

What Taiwan Is Truly Deciding Now

Taiwan’s history of assisted reproduction looks like a straight line of medical progress. Looking back, one finds it is actually a line of qualifications being continuously redrawn.

In 1985, the question was whether embryos could be fertilized in vitro. In 2007, the question was how to bring assisted reproduction into the law. In 2021, the question was whether public resources should share the costs. In 2025, the question becomes which families should no longer be excluded.

A study points out that assisted reproduction has indeed increased Taiwan’s ART birth numbers. But the study also places assisted reproduction within the context of low birth rates, late marriage, and social pressure. ⁴ If one only treats this technology as a tool to increase birth rates, one will not see the people behind every treatment cycle.

Those people include couples waiting for embryo results in the clinic, women freezing their eggs, same-sex families who must go abroad for treatment, and children who grow up wanting to know where they came from.

This is why the 2025 legislative draft is important, yet cannot be written as “Taiwan has fully opened assisted reproduction.” The draft still requires deliberation by the Legislative Yuan. Issues such as surrogacy and male same-sex spouses have not been automatically resolved by being decoupled.

The law has moved forward one step; the details of medical care, parental rights, and children’s rights must still catch up. Taiwan does not lack reproductive technology; it has simply taken a long time to begin recognizing that those who wish to use the technology are not of only one family type.

📝 Curator’s Note: An embryo can be seen under a microscope. For a family to be seen, however, medical care, law, and society must move forward simultaneously.

Further Reading

National Health Administration: Report on the Implementation Results of the Assisted Reproduction Act

Executive Yuan: Respecting Women’s Reproductive Autonomy, Executive Yuan Passes Amendment Draft of the "Assisted Reproduction Act"

Taipei Times: The quest to amend the Assisted Reproduction Act

References