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Fertility assessment in your twenties: what we know about this measure announced by Emmanuel Macron

  • May 14, 2024
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The outlines of the plan against infertility announced last January par Emmanuel Macron are taking shape little by little. In an interview given to the magazine Elle and published in theediting of May 8, 2024, the President of the Republic confirmed his desire to revive the birth rate.

This measure comes when, according to the figures from INSEE published last January, we note a drop in births in France of nearly 6.6% between 2022 and 2023. However, the French desire to have children amounts to an average of 2.3 per person questioned compared to a birth rate of 1.8. “So there are many couples who want to become parents and do not realize this wish”has reported Emmanuel Macron in the columns of Elle.

Fertility assessment in your twenties: what to do?

Among the avenues studied by the Élysée, the establishment of a birth leave to replace the parental leavebut also that of a “fertility check-up”. More precisely, the big plan against infertility “will be available in triptych”explains the president to Elle. Prevention, pathway and research.

Also, the fertility assessment falls into the prevention aspect. Near ElleEmmanuel Macron details: a health check-up reimbursed by Health Insuranceduring the prevention meeting from 18-25 year olds which will be offered this year to all”and add “for example, around the age of twenty a ‘fertility check-up’ will allow a complete assessment to be carried out, spermogram, ovarian reserve,…”.

This examination would not be compulsory and would be entirely covered by Social Security. Additionally, other consultations may be available for men and women at different ages. According to announcements from the Élysée press point last January, examinations would be available for men and women aged 45 and 65.

Spermogram, ovarian reserve: what are these tests found in the fertility assessment?

As a reminder, a spermogram is a laboratory test that “consists of collecting sperm by masturbation, after three to five days without sexual intercourse, in order to obtain sperm rich in spermatozoa”, as Health Insurance explains. Afterwards, “the sperm is then examined under a microscope in order to carry out a sperm count and observe their morphology”.

The ovarian reserve makes it possible to determine the number of oocytes (ovules) present in the two ovaries. As the Poitiers University Hospital explains, this examination takes place in two stages. A hormonal assessment is carried out using a blood test. This makes it possible in particular to measure the level of different hormones such as anti-Müllerian (AMH) “follicular growth marker, independent of the menstrual cycle and decreasing over time”. A pelvic ultrasound is also performed in order to”estimate the ovarian stock at a time T”.

Fertility assessment during your twenties: a project that is not unanimous among health professionals

However, this proposal is not unanimous. With of FigaroAgnès Buzin, former Minister of Health and Solidarity (between 2017 and 2020) says “surprised”. Indeed, the latter affirms to the national daily that“we do not decide on public health measures without them being scientifically validated, according to precise internationally recognized criteria”. The former president of the High Authority for Health (HAS) notes that it “It is appropriate to tackle above all risk factors, and their prevention, rather than wanting to medicalize the question of demography” before adding that he “There is not an epidemic of infertility but exogenous causes”.

Near theAFPDr Joëlle Belaisch-Allart, president of the National College of French Gynecologists and Obstetricians (CNGOF) believes that a “Ovarian reserve assessment in the general population who have not yet had children has no prognostic value. And I don’t know any professional who will do a spermogram on a 20-year-old young man (who has no plans to have children, editor’s note)… There is surely a misunderstanding in this proposal.” The latter, however, is said “delighted to be talking about infertility”. According to her, information on the causes of infertility, such as smoking or certain environmental factors, must be addressed at different times of life.

Sources :

  • Exclusive – #MeToo, Depardieu, single parenthood, birth leave: Macron answers us – Elle 05/08/2024
  • Agnès Buzyn in Le Figaro: “We cannot respond to the demographic decline with excessive medicalization” – Le Figaro – 05/12/2024
  • AFP
  • Diagnosis of infertility – Poitiers University Hospital
  • The medical assessment of infertility – Health Insurance
  • Élysée press briefing (01/22/2024)
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Louis Tardy