If more than a year without contraception passes without a pregnancy occurring, fertility specialists should be consulted quickly. Too late management of the problem often leads to treatment failure.
- The use of infertility treatment is increasingly late in France.
- This increase in infertility treatments after age 34 raises important questions, because their effectiveness decreases sharply with age.
Over the past decade, the use of infertility treatment has become increasingly delayed, according to a new French study published by INED. More concretely, this rate increased by 24% among women aged 34 or over.
In France, one in four couples fails to achieve pregnancy after 12 months of trying. Using data from French health insurance which are now accessible to research, Khaoula Ben Messaoud, who has just defended her thesis, Elise de La Rochebrochard, researcher at INED, and Jean Bouyer, epidemiologist at Inserm, were able to measure the annual use of infertility treatments. This is the first estimate in the world carried out on a large population and taking into account all infertility treatments. Between 2008 and 2017, 1.25% of women aged 20-49 were treated for infertility each year (more than 150,000 women).
More than one in a hundred women treated for infertility every year
Several medical treatments exist to help women conceive: ovulation induction, medically assisted procreation (MAP) including artificial insemination, and in vitro fertilization with or without Intracytoplasmic Sperm Injection (ICSI). “This unique study was possible because all infertility treatments are covered in France by health insurance and are therefore registered in its management databases which are now open to research”, comment the authors.
The evolution of the rate of recourse to infertility treatments according to age during the last decade in France makes it possible to observe two tendencies going a priori in opposite directions. Among young women, the use is fairly stable, although a slight drop is observed, while among women aged 34 or over, on the contrary, there is a jump of 24%. These two trends are, however, entirely consistent and both reflect the phenomenon of later and later parenthood in developed countries, a movement that began in the early 1970s.
Thus, young women less often try to have children, but the effect on the use of infertility treatments is weak because at these ages, infertility is less frequent. On the contrary, women over the age of 34 more often try to have children, and infertility increases sharply at these ages, which leads to the sharp increase (24%) in the use of infertility treatments. “Even in the case of infertility of male origin, it is the women who undergo treatment”, further specify the authors of the study.
An important public health issue
This increase in infertility treatments after age 34 raises important questions, because the effectiveness of treatments decreases sharply with age. “The medical profession and the public authorities should take this societal trend into account over the long term, in order to best support these couples”, say the researchers.
“By developing a system for monitoring the use of infertility treatments, public health policies could better guide national strategies to prevent and manage infertility, which is increasingly emerging as a major health problem in adulthood”, they conclude.
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