One in eight to one in ten couples today encounter difficulties in having a child. Faced with the continued decline in births (the latest figures indicate that the number of births has fallen further in France by 2.3% this year), the government is preparing to launch a national plan against infertility. Among the key measures: an information message on reproductive health sent to all French people at the age of 29, in order to better anticipate risks and avoid too late diagnoses.
A highly anticipated announcement
The much-discussed “demographic rearmament” is finally taking shape. This Monday, December 15, the Minister of Health and Families, Stéphanie Rist, announced to a fact-finding mission from the National Assembly the launch, in the coming weeks, of a national plan to combat infertility. A project announced by Emmanuel Macron at the start of 2024, but which remained unrealized for a long time, causing concern among reproductive specialists and patient associations.
The stakes are high: today, infertility directly affects around 3.3 million French men and women.
If medically assisted procreation (PMA) is often seen as a solution, experts point out that an attempt only results in a birth in around 20% of cases, and that only four attempts are covered by Social Security.
Better inform women aged 29, to better prevent
Among the most significant measures of the plan is the sending, from 2026, of a personalized message from Health Insurance to all people aged 29. A key age, since it corresponds to the moment when gamete conservation becomes possible.
For the minister, the objective is clear: to inform without constraining. It’s about avoiding the feeling of “if I had known”, by giving everyone the means to understand how fertility evolves over time and what levers exist to preserve it.
The message will also include information on contraceptive methods, in order to respect the choices of those who do not wish to have children or prefer to postpone their parental plans.
Multiple causes, often unknown
Infertility does not have a single origin. Specialists today identify three main categories of factors.
THE environmental factorsfirst of all, play an increasing role. Exposure to endocrine disruptors, air pollution or pesticides has a direct impact on fertility, both in women and men.
THE medical causes are also well identified: polycystic ovary syndrome, endometriosis, obstruction of the tubes, premature ovarian failure, etc. All pathologies which increase the risk of infertility and sometimes remain diagnosed late.
Finally, the societal factors weigh heavily. In France, the age of parenthood continues to rise. According to INED projections, the average age at motherhood could soon reach, or even exceed, 32 years. However, female fertility begins to decline from the age of 30 due to the decline in the number and quality of oocytes. Thus, the risk of never becoming a mother increases sharply with age:
- 4% at 20 years old;
- 14% at age 35;
- 35% at age 40;
- Up to 80% after 45 years.
Figures still largely unknown to the general public, which the future plan intends to highlight.
Added to this are the cases ofunexplained infertilitywhich represent between 20% and 30% of situations and whose frequency increases with age.
Strengthened prevention, research and care
Beyond information, the national plan should be structured around several axes: prevention, awareness, support for research and improvement of medical care. A steering committee must meet in January in order to accelerate the deployment of the system, in particular via an information site accessible to all and the development of solutions such as self-preservation of oocytes.
Why this plan is crucial
In a context of historic decline in births, this plan marks political recognition of infertility as a major public health issue, and no longer as a strictly intimate problem.
By focusing on anticipation rather than late repair, the government hopes to give French people the means to make informed choices regarding their reproductive lives.
It now remains to be seen whether this ambition will be accompanied by sufficient resources to meet the expectations of patients and professionals, while time continues to weigh on fertility.