Infertility, a “major public health issue” neglected by public authorities

Infertility is a “major public health issue” which does not have “never been treated as such by the public authorities”. The report on the causes of infertility, commissioned within the framework of the bioethics laws of 2021 and submitted to the Ministry of Health at the end of February, opens with a severe observation, commensurate with the scale of the problem.

In France, write Samir Hamamah, head of the reproductive biology department at Montpellier University Hospital, and Salomé Berlioux, founder of the association Chemins d’avenirs, the two rapporteurs, nearly 3.5 million people are affected by infertility – that’s one in four couples of childbearing age who fail to achieve pregnancy after a year of unprotected intercourse. At the end of the 2010s, about 3.4% of French children were born thanks to a technique of medically assisted procreation, ie one in thirty children.

In the inventory of causes of infertility, the rapporteurs first mention socio-economic causes, in particular changes in the age of first pregnancy. “The average age of women at first birth is gradually increasingthey write. In 2019, it was 28.8 years in France, almost five years older than in 1975, when women gave birth to their first child at 24. However, female fertility declines from the age of 30, and this fall accelerates significantly from the age of 35. »

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The infertility figures by age group quoted by the report – which however date back to 2004 – indicate that when their parental project begins at age 30, 91% of women have a child without resorting to medically assisted procreation. Five years later (35 years), this figure drops to 82%, then to 57% when they are 40 years old.

Lack of knowledge of the general public and professionals

Environmental causes, and in particular exposure to atmospheric pollution, heavy metals and endocrine disruptors – these chemical substances capable of interfering with the hormonal system – are not left out. This theme is “major”write the rapporteurs, although “little known to the general public and health professionals”. “Many studies describe a link between exposure to certain families of chemical substances and disorders of fertility and human reproduction.they point out. Decreased sperm quality, increased frequency of abnormalities in genital development or reproductive function, lowered age of puberty, hormone-dependent cancers such as breast cancer or prostate cancer. »

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