9 months later, the wait for women continues

Single women and female couples can now benefit from assisted reproduction in the same way as women in a heterosexual couple. In fact, nine months after the law was passed, things are not that simple.

“I was offered an appointment on November 27, 2023.” Adeline is 35 and has wanted to have a child for several years. It was also a project she shared with her former partner. But after the failure of her couple, the 30-year-old decides to devote herself to an PMA solo: officially open to single women and female couples by the bioethics law of August 2, 2021.

“I have had delusions in love with the male sex and today I tell myself that I have all my life to meet a man, but not to have a child,” he explains to BFMTV.com. “As soon as the law passed I wanted to make an appointment. But when I called no one knew, the protocols weren’t open, they didn’t know how to proceed”.

“I called back in December, they offered me a first date in two years.”

Which would have meant, at best, a first insemination around the spring of 2024. Delays that she considers “too long”. “I will then be 37 years old. If it is, I will have to undergo in vitro fertilization (IVF) because of my age”, worries the young woman who lives in Isère.

Adeline then goes to another MAP center (for “medically assisted procreation”, a term that falls under the bioethical law, although MAP is more common). She was offered a first date in late August. If your dossier is validated, insemination can be done within six months, you are insured.

“Years go by and I can’t imagine my life without children,” says Adeline. “It would be a life failure for me not to be a mother.”

One or two years of waiting

Officially all women, regardless of their marital status, can now benefit from assisted reproduction up to the age of 45. Different techniques are proposed depending on the situation: artificial insemination or in vitro fertilization, with or without egg donation. It is the Cecos – Center for the Study and Conservation of Oocytes and Human Sperm – which manages egg and sperm donations. France has 31 located in university hospitals.

In principle, the process begins with a request evaluated by the medical team of an ART center. Several interviews are then organized, in particular on the “motivation of the two components of the couple or of the unmarried woman”. After the final interview, applicants are given a reflection period of one month and additional time may be deemed necessary “in the interest of the unborn child”.

A member of the Cecos team at Tenon hospital in Paris performs a medically assisted procreation (MAP) process on September 24, 2019. © Philippe LOPEZ / AFP

The government announced its intention to reduce waiting times from one year to six months thanks to a new investment of 8 million euros. But in fact, as Adeline’s example shows, it is often necessary to wait several months before arriving on the first date, then several more months for the following ones. And from the decree of 28 September 2021, which actually opens the PMA to all women, these deadlines have been further extended.

If the first IVFs for female couples were carried out at the end of last year, for example in Nancy, Sandrine Trichard, co-founder of Matrikas – an association that has campaigned for MAP for all – believes that these few announcements do not reflect reality.

“It depends on the centers but in some, especially those that receive a lot of requests, between the moment you pick up the phone to make the first appointment and the moment you finally benefit from insemination or in vitro fertilization, more than a year, even two, ”he points out to BFMTV.com, sometimes more depending on the center.

“The right to be listed”

Sandrine Trichard therefore believes that with the opening of PMA to all women, especially the latter, “they have earned the right to be registered on the waiting list”. This is all the more difficult to live with since “every month counts”, continues the co-founder of the Matrikas. “A year, a year and a half before hoping to get pregnant, she spends a lot of time, not to mention her fertility decreases over the years (decreases from age 35, ed).”

And not to mention the fact that “when you enter an PMA course, you know the chances of success are low”.

In fact, according to data from the Biomedicine Agency, the success rate – that is, the percentage resulting from the birth of a child – for intrauterine insemination with sperm donation is 19.6%. For IVF, it is 19.8% – 21.3% with egg donation.

Melodie and his partner, who live in the North, therefore decided to look abroad to reduce delays. “In February, we wanted to make an appointment but they couldn’t give us a date, they only processed requests made until December,” she told BFMTV.com.

Concerned, the 34-year-old woman then contacted a clinic in Belgium on the advice of her gynecologist. A month later she is given an appointment with the list of exams to be taken, for a total of 2200 euros. “We took out a loan,” says Melodie. But the approach promises to be effective: her first insemination took place in mid-April. It’s been less than two months since her first phone call.

“When I told my sister, she was hallucinating,” says Melodie. “She herself benefited from an MAP in France to conceive a child with her spouse, but she had to wait two years.”

“Some women can’t wait”

For Catherine Clavin, co-chair of the Association of Gay and Lesbian Parents and Future Parents (APGL), France is still far from the level of its European neighbors. “In Belgium, Spain or the Netherlands, everything is clearer, simpler,” she says. “There are no deadlines and on the first date everything falls into place within three months. Some women can’t wait.”

This is demonstrated by Jade Lorenzo, creator of the Facebook group “PMA speaks to me about love”, mother of a first child born ten years ago by PMA and again about to conceive a second child.

“PMA, in France, is the obstacle course, it takes a mind of steel,” he regrets to BFMTV.com.

Hands of a pregnant woman on the belly (photo illustration)
The hands of a pregnant woman on the belly (photo illustration) © Anthony WALLACE © 2019 AFP

This young woman of 35, who lives in Montpellier, suffers from diseases that affect her fertility. If she still has the chance to benefit from one last IVF in France, she and her husband have decided to try their luck abroad. Jade Lorenzo then notes that doctors in Spain immediately prescribed some tests that their French colleagues had only performed after four miscarriages and eight implant failures.

“In total, I have accumulated thirteen years of experience. And in thirteen years I have seen the conditions worsen. All excuses are good for disappointing women, it becomes a massacre. France is ten years behind the foreigner.”

Gynecologist and reproductive doctor at the La Sagesse mutual clinic in Rennes, Anne Guivarc’h-Lévêque has already accompanied couples of women and single women in their procedures abroad. She now she is overflowing with dating. “We are three doctors in my office,” she explains to BFMTV.com. “From the new law, we receive on average about forty requests per month”.

“We had to limit ourselves to one new patient per week and per doctor in order not to embolize the system.”

For Anne Guivarc’h-Lévêque, the demands relating to the opening of MAP to all women have been largely underestimated by the authorities. “We expected 1,000 more requests in 2021, we are already about 3,500”, admitted the entourage of the Minister of Health in September. Last year, between 1 August and 15 October, 2,753 requests for initial consultation were received from 25 French Cecos, four times more than in the first half of the year as a whole.

Among these new requests, about 1,071 concerned female couples and 1,316 unmarried women, testify BFMTV.com Claire de Vienne, referring physician in medically assisted procreation at the Biomedicine Agency. This means that nearly 90% of the inquiries concerned new profiles of women authorized by law.

“There is a huge increase in activity, unheard of in ART. Centers have to adapt and adapt to this demand knowing that these are time-consuming activities.”

Claire de Vienne wants to be reassuring, it is “a transition period”. And according to this representative of the Biomedicine Agency, the problem does not arise from the reserves of gametes. “The shares are there,” she argues. “As of August 1, 2021, we had 87,926 straws (of sperm, ed).” This is less true for oocytes: around 4,000 applicants are currently on the waiting list.

Member of the Cecos team, the medically assisted procreation (PMA) unit of the Tenon hospital in Paris operates a refrigerated storage facility on 24 September 2019.
A member of the Cecos team, the medically assisted procreation (PMA) unit of Tenon hospital in Paris, operates a refrigerated storage facility, 24 September 2019. © Philippe LOPEZ / AFP

The question of the revocation of anonymity

But from 1 September, the end of donor anonymity will come into effect. In fact, the law of bioethics allows children born to PMA, in their majority, to have access to their origins, and therefore to the identity of their donor, which may discourage some people. Not to mention that the gametes of people who have already donated but who refuse to remove anonymity should be destroyed, causing fear of a shortage.

Which alarms Manon, a professional caregiver. This 26-year-old young woman from Albi took action at the beginning of the year to benefit from an MAP. Alone. Manon defines herself as aromantic – a term for people who don’t fall in love – and asexual – she feels no physical attraction to anyone, male or female, and has never had a sexual relationship.

“They told me that to qualify for a gamete donation you have to wait an average of three to six months after the file is validated,” he tells BFMTV.com. “But with the revocation of anonymity, they told me that the deadlines were in danger of being extended, without being able to tell me exactly how long”. It is unthinkable for her to lose her life plan.

“I’ve never felt anyone’s desire, I realized it pretty soon,” recalls Manon. “But having a child, that, I’ve dreamed of all my life. I’ve been waiting for it for a long time, in fact.”

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