In - vitro fertilization in France : 200 , 000 “ test - tube ” babies in the last 30 years

After one year of unprotected intercourse, 15 to 20% of couples wishing to conceive have still not achieved a successful pregnancy. Medical tests can be performed at this stage to determine the origin of the problem. For 38% of couples, combined infertility due to a problem affecting both partners is diagnosed [2]. In 34% of cases, the problems concerns the woman alone, in 20% the man alone, and in 8% the cause is unexplained. A range of medical treatments and procedures can be used to remedy medically diagnosed infertility, depending on the cause. Treatment often begins with ovarian stimulation alone, before moving on, if necessary, to artificial insemination and in-vitro fertilization. Ovarian stimulation is a procedure whereby the woman receives hormone injections for 8-10 days to stimulate the release of a mature egg. The child is then conceived naturally through normal sexual relations. There is no manipulation of sperm, egg or embryo, so this procedure is outside the scope of assisted reproductive technology (ART). An estimated 2.4% of women who gave birth in metropolitan France in 2003 became pregnant after ovarian stimulation [1]. This represents half of all medically assisted births in the country. Artificial insemination (AI) involves placing sperm in the uterus during the ovulation period with the aim of achieving natural fertilization of the egg. With this procedure, only the sperm is manipulated, but not the egg or the embryo. The term AIH is used when the sperm is that of the husband or partner, and AID when the sperm comes from a donor. As artificial insemination requires only limited equipment and few technical skills, it may well have been practiced secretly since the 18th century. Thanks to the contraceptive revolution, fewer and fewer unwanted babies are born. Today, couples want to choose the number of children they have, and the timing of their births. Expectations among potential parents are very high. Yet as age at childbearing increases, a growing number of couples now have problems conceiving, and are increasingly reliant on medical assistance to achieve a successful pregnancy outcome. At a time of renewed public debate on bioethics, Elise de la Rochebrochard explains how many children are born after in-vitro fertilization in France, how the country compares with its European neighbours, and how the situation is liable to evolve. In-vitro fertilization in France: 200,000 “test-tube” babies in the last 30 years