In an interview published this Wednesday, May 8, Emmanuel Macron returned, among other things, to certain measures concerning women’s health. Egg freezing, menopause, GPA… Gynecologist, obstetrician and fertility specialist Meryl Toledano looks back on her answers.
Find our exclusive interview:
SHE. We asked Emmanuel Macron about the waiting times for PMA. He says he wants to open the self-preservation of oocytes to private centers, what will this change in concrete terms?
Meryl Toledano. Today, egg preservation is only authorized in public centers. Excess fees are prohibited. Patients are therefore taken care of in full. But given the delays, a large number of them cannot be supported and turn abroad. These patients go for fertility preservation in private clinics, particularly in Spain. The system is set up in such a way that they can make a request to social security for coverage of their attempt. They are therefore partially reimbursed for a price twice as high as what would be done in France in a private establishment: because the law prohibits treatment there. The situation is quite grotesque.
Currently female fertility preservation (FFP) is authorized in private non-profit centers and not in private centers in general. Waiting times can sometimes go up to a year and most centers no longer accept registrations from patients over 36, on the pretext that they will be over the legal age when their turn comes. Authorizing the self-preservation of oocytes to all private centers that request it would indeed be the solution.
SHE. What do you think of Emmanuel Macron’s announcements concerning a “big plan” on infertility?
I always find it very good to launch measures on fertility. This allows patients to ask questions and not come to consult too late. As fertility doctors, we are confronted with this topic every day.
SHE. Do men and women realize their infertility too late?
MT If we did a fertility assessment around the age of 20, we would be able to detect patients who have low ovarian reserves, and they could thus direct their lives differently, preserve their fertility, but also try to have their children sooner. You should know that fertility preservation is more likely to be effective when it is started early. Statistically speaking, at age 25, 80% of the oocytes collected are chromosomally viable. At age 40 this figure increases to 20%. This is why the age limit of 37 years was set, because it would take too many frozen oocytes and therefore too many treatments and/or punctures to achieve a pregnancy.
SHE. What do you think of the “fertility check-up” that Emmanuel Macron wants to make accessible to young people?
MT Again, I think it’s a good idea. As explained above, a patient who becomes aware of their low ovarian reserve at the age of 20 organizes their life differently. However, low ovarian reserve is not synonymous with infertility. A woman can very well become pregnant with low ovarian reserve, but over a shorter period of time.
SHE. Do you think this check-up will put additional pressure on women?
MT Obviously this will put some pressure on those whose results are not completely normal, but it also allows the prevention of infertility.
SHE. Emmanuel Macron does not wish to legalize surrogacy in France, does this go against his “demographic rearmament”?
MT The question of GPA is very complex And the number of couples concerned is relatively low, so I do not think that this comes into play in its demographic rearmament plan.
There are so many other techniques banned in France, such as preimplantation diagnosis. It is an aberration to perform in vitro fertilization on a 42-year-old woman, without being able to select the embryos, we expose her to a risk of failure, miscarriage, health expenses, etc.
SHE. Emmanuel Macron wants to set up a free consultation on menopause for women over 45, we know in particular that less than 10% of postmenopausal women resort to hormonal treatment for menopause…
MT Here too, it’s a good idea, the problem is that you have to find the doctors to do this consultation.
Hormonal treatment of menopause is an excellent means of preventing cardiovascular disease and osteoporosis. Long criticized, it has now become the standard treatment for osteoporosis in the United States and France. We have always defended this treatment; it would indeed be interesting if women were better informed on the subject through a consultation.
