Infertility and Assisted Reproductive Technology: The respective situations of men and women in France

Male and female respondents for the ERFI 2 survey (Study of family and intergenerational relations: France’s contribution to the international longitudinal Generations and Gender Survey or GGS) were asked about whether they had ever in their lives tried in vain to achieve a pregnancy with a partner during a minimum period of 12 months.

Infertility across the lifespan

12% of respondents aged 18-79 reported having experienced infertility, 5% refused to answer, and 1% did not know how to answer. Women’s rate of reported infertility was 15%, men’s 9%—a gap likely to reflect in part the fact that a lower proportion of men had already tried to have a child (Belgherbi and LaRochebrochard 2018). 

An individual’s infertility level as reported over the lifespan logically varies with their age at the time of survey. It rises between the ages of 18 and 40-49, during which time it concerns as many as 24%-26% of women and 14%-16% of men, while at 50 individual reported infertility levels are observed to decrease, possibly reflecting at least in part an effect of “forgetting” among people who no longer feel concerned by reproduction.

Assisted Reproductive Technology (ART; in French Procréation Médicalement Assistée or PMA)

People aged 18-49 were questioned on whether they had ever turned to Assisted Reproductive Technology in their lives (known as Medically Assisted Procreation or PMA in France and, to physicians, as AMP for Medical Assistance for Procreation) (Figure).  
ART includes in-vitro fertilization or IVF techniques (the result used to be termed “test-tube babies”) and artificial sperm insemination (from a life partner or donor). In France, 8% of women and 5% of men have used ART.

If we consider all types of reproductive assistance (ART, drugs, surgery, other treatments, medical consultations, methods to determine time of ovulation), then 27% of women and 19% of men aged 35-49 have used some type of it in their lifetimes. 

Has infertility been underestimated in France?

Several types of information work to reduce the infertility level found by the ERFI 2 survey. To begin with, the survey estimates infertility for the population at large, including people who are not concerned by infertility because they have never tried to have a child. In general, infertility is measured among people seeking to get pregnant, and the aim is to calculate infertility “risk.”

That information is not available in ERFI 2. That means that infertility as observed in the survey varies both by infertility risk and the proportion of people who have already tried to conceive—a fact that in turn means researchers much be cautions in comparing groups, by age, sex, educational attainment, or other criteria. Moreover, the survey evaluated infertility by way of a single question, meaning that contextual and time-related matters such as age at which infertility was discovered were not taken into account and therefore remain unknown. This in turn may have led to underreporting of infertility. Last, the definition of infertility used in the survey corresponds to a previous medical definition, whereas according to the current definition, infertility exists after a wait of 6 (rather than 12) months for women aged 35 or over (ASRM 2023). Lastly, the same definition enlarges the survey frame to encompass single persons, same-sex couples, and trans persons wishing to have a child.