The trend

Egg freezing, Italy (and the South) pioneer in Europe. How other countries behave

As the birth rate falls and the average age at first maternity rises, interest in social freezing, the freezing of egg cells for non-medical reasons, is growing in Europe

18 July 2025

5' min read

As the birth rate in Europe continues to fall, some countries are beginning to look with interest at social freezing, i.e. the possibility for women to freeze their oocytes at a young age to postpone motherhood. In this context, Italy - and Apulia in particular - offers a rare example of public intervention in a still predominantly private sector. But what happens in other European countries?

In Italy, social freezing remains private

In Italy, the freezing of oocytes for non-medical reasons remains a predominantly private practice, with the exception of a pioneering public trial launched in 2024 by the Apulia Region. In the face of a steadily declining birth rate - with only 379,000 births in 2023, the lowest on record - and an average age at first maternity of over 32, the issue of deferred fertility is becoming increasingly important. However, access to oocyte cryopreservation remains, in most cases, an opportunity reserved for the few.

In our country, the law allows gamete preservation both for medical reasons - as in the case of cancer treatment or gynaecological pathologies - and for non-medical reasons, defined as 'social', i.e. the desire to postpone motherhood. However, the National Health Service only covers medical cases, while social freezing is left to market dynamics, with a total cost that, between hormonal stimulation, examinations, collection and storage for a few years, can exceed 4 thousand euros.

Puglia experiments with reimbursement for young women

In this framework, Puglia has distinguished itself as the first Italian region to introduce a reimbursement programme for social freezing. The project, approved in March 2024, envisages an initial allocation of EUR 900,000, aimed at women aged between 27 and 37 with an ISEE of less than EUR 35,000. Each beneficiary can obtain a public contribution of up to 3 thousand euro to cover the costs of the egg retrieval and freezing procedure, carried out in authorised, public or private affiliated centres.

A measure aimed at giving women the freedom to choose if and when to become mothers, without the economic factor or the biological clock being an obstacle. The Apulian programme represents an absolute novelty in Italy and has already attracted the interest of other regions, but for now it remains an isolated case.

No national monitoring, few official data

There are no official statistics at national level on the number of women who choose to freeze their eggs for social reasons. However, the main private Medically Assisted Procreation (PMA) centres, especially in Northern Italy, are recording a significant increase in demand, particularly from women between 30 and 35 years old, often driven by professional reasons, lack of a stable partner or a simple desire to postpone motherhood.

The Ministry of Health publishes annual data on PMA cycles, but does not distinguish between medical and social reasons for egg freezing. Moreover, there is no national register of frozen oocytes, making any monitoring of the long-term effectiveness of the technique difficult.

Uneven access and lack of a national strategy

The Italian healthcare system only guarantees PMA treatments paid for by the public to heterosexual couples with certified fertility problems, thus excluding singles and homosexual couples, who must turn to the private sector or abroad. Egg freezing is also part of this selective logic.

In the European context, Italy ranks among the countries with the most restricted access to public assisted reproduction, and no national measures are currently planned for social freezing.

France: bioethics law yes, but few resources

In 2021, France introduced a historic reform with its bioethics law allowing the freezing of oocytes without medical justification, for all women between the ages of 29 and 37. A breakthrough, considering that before 2021, only women with medical conditions (such as cancer) could access this technique.

However, the initiative has been called a 'promise without a means'. Egg freezing costs up to EUR 3,000, plus the cost of hormonal stimulation and preliminary analyses. According to Service-Public.fr, the Securité Sociale reimburses the collection phase but does not cover the storage costs, making the process economically burdensome.

By the end of 2023, more than 20,000 women had already requested to freeze their oocytes. However, the public debate remains heated: Emmanuel Macron has spoken of a necessary 'réarmement démographique', but the measure has been criticised by the left and feminist associations for the lack of real structural policies to support parenthood.

Spain: strong increase in demand, but private treatment remains

In Spain, social freezing is booming. According to Elisa Gil, secretary of the Spanish Fertility Society and gynaecologist at the IVI clinic in Zaragoza, there has been a 'real turning point' in recent years.

"Until five years ago, women were coming in late, often around the age of 39. Now the profile has changed: 20-30% of our consultations concern women between 30 and 34 who want to preserve their fertility,' Gil explains.

Egg freezing in Spain has an average cost of 2,000 euros, plus 500-1,000 euros for medication. Again, this is an exclusively private treatment, except for medical cases (such as endometriosis or cancer treatments), which can be covered in some public facilities.

During the regional elections in Galicia, the Partido Popular proposed the inclusion of the technique in the regional health service, but according to Gil, 'the measure has not yet been implemented due to logistical problems'.

Czech Republic: boom in demand, but only for those who can afford it

The situation in the Czech Republic is even more pronounced. According to official data, 3,000 children were born from frozen egg cells in 2020, compared to 894 in 2010. Private clinics, such as Unica Praha and Prague Fertility Centre, record a 300% and 100% increase in requests for egg freezing, respectively.

But the treatment is entirely private, with costs ranging between EUR 2,000 and 2,500, except for oncological cases, which will be covered by the state from 2022.

Politically, only the leader of TOP 09, Markéta Pekarová Adamová, proposed to partially include social cryopreservation among the reimbursable benefits. However, the measure has never been discussed in parliament, and political interest in the topic remains marginal.

Meanwhile, the country faces a deep demographic crisis: 84,311 children were born in 2024, the lowest number since the end of World War II. The fertility rate has fallen to 1.37 children per woman.

A Europe at different speeds

The picture that emerges is clear: cryopreservation of oocytes for social reasons is growing everywhere, but access to treatment is highly dependent on individual economic conditions and national or regional political choices.

Puglia, with its pilot project, represents a unique case in Europe of public intervention aimed at social fertility. A small fund, certainly, but one that opens the way to a possible new season of more inclusive reproductive policies.

"We are not forcing any woman to become a mother," says Dr Gil, "but we want to help those who wish to do so, when the time is right for them.

A message that echoes beyond national borders, in a Europe seeking new strategies to address the great demographic issue of the future.

*This article is part of the European collaborative journalism project "Pulse"with contributions from Petra Dvořáková (Deník Referendum, Czech Republic), Laura López Camacho (El Confidencial, Spain) and Francesca Barca (Voxeurope, France).

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