Rwanda’s Parliament has passed landmark amendments in its new Health Service Bill—expanding access to both gamete preservation and surrogacy for a wider pool of individuals, including single people with medically confirmed infertility.
A neonatal health professional attends to a newborn baby at Kirehe District Hospital. In a bid to give more people the opportunity to have children, Rwanda has expanded access to reproductive technologies.
Expanded Gamete and Embryo Storage
The bill’s Article 74 enshrines the right to store sperm, eggs, or embryos for up to ten years under strict medical oversight. After five years, if there’s no compelling reason to continue storage and agreed fees remain unpaid, the medical facility may responsibly dispose of the material.
Individuals or couples—married or single—must obtain a doctor’s recommendation before storing their reproductive cells. The procedure demands legal, ethical, and technical clearances, ensuring that samples are preserved under optimal conditions until they are needed.
Dr. Yvan Butera, Minister of State for Health, explained that these provisions primarily serve those facing a high risk of future infertility. “Patients undergoing chemotherapy or radiotherapy for cancers affecting reproductive organs can safeguard their fertility by banking sperm or eggs,” he said, noting that congenital risks—like early-onset breast cancer—also qualify one for storage.
Who Can Bank Their Cells?
- Men aged 21 to 45, and women aged 21 to 40, are eligible to deposit gametes.
- Applicants must demonstrate a medically validated risk to their fertility, such as cancer treatment or genetic predisposition to reproductive disorders.
- Health facilities offering assisted reproduction must maintain comprehensive, confidential records and provide counseling services as per Article 81.
Surrogacy: Single or Married, If Medically Necessary
Originally, the bill’s language around assisted reproductive technologies (ART) seemed to restrict services to married couples. A review by the Committee on Social Affairs, chaired by MP Veneranda Uwamariya, clarified that ART—including surrogacy—should apply to any individual who cannot conceive or carry a pregnancy due to biological reasons【Article 69】.
Under Article 77, a woman may act as a surrogate if a qualified medical professional certifies that the intended parent:
- Cannot conceive, or
- Faces medical risks—either to themselves or a potential child—if they attempt pregnancy.
MP Gloriose Mukamwiza championed the explicit inclusion of unmarried people. “Some choose to remain single or simply lack a partner,” she noted. “They deserve the same reproductive options as couples.”
Dr. Butera reaffirmed this inclusive approach: “Assisted reproductive technologies are open to anyone whose biology prevents natural conception. We never intended to exclude single individuals.”
Oversight, Ethics, and Posthumous Use
A forthcoming Ministerial Order will establish a national committee tasked with monitoring ART practices, ensuring adherence to ethical standards and technical guidelines.
Key facility responsibilities include:
- Counseling prospective parents and surrogates.
- Implanting embryos in approved surrogates.
- Safeguarding patient confidentiality and data integrity.
- Reporting annually on service outcomes and compliance.
Article 84 addresses posthumous reproduction. It prohibits the use of stored gametes after a donor’s death unless they explicitly consented in writing to posthumous use.
What’s Next?
With these legislative changes, Rwanda positions itself as a regional leader in reproductive healthcare. Implementation now hinges on developing clear guidelines, training medical personnel, and launching public information campaigns to ensure that eligible Rwandans understand and access these new services.
For further context, forthcoming regulations will detail:
- Fee structures and payment terms for long-term storage.
- Criteria for selecting and approving surrogate mothers.
- Reporting mechanisms on ART outcomes and ethical compliance.
As these services roll out, stakeholders—from medical practitioners to civil society—will watch closely to ensure that Rwanda’s promise of inclusive, safe, and ethical reproductive care becomes a reality.
