Infertility, when medicine is invited very early in the child plan

In her pretty office full of light, Doctor Maud Pasquier, specialist in reproductive medicine, receives her patients for a “Fertility check-up”. For three years, the Intercommunal Hospital Center of Créteil (Val-de-Marne) has offered this consultation, which allows anyone who wishes to obtain, in 30 minutes, an update on their fertility.

Organized in three stages – “A questionnaire on the medical history to be completed on a tablet, an ultrasound and an individualized interview”, details Maud Pasquier -, the consultation was born from an observation: many patients come to consult late, either because of their age, or because they had not been concerned, until then, of possible difficulties to have a child. However, the chances of getting pregnant drop significantly after 35 years.

An answer to concerns

And it is precisely women around 34-35 years old, who constitute the bulk of the patients of this specialized and expensive consultation (350 €, not reimbursed). They see it as an opportunity to take stock of their plan to become a mother and the obstacles they have already encountered: romantic break-ups, the inability to conceive… They all push the door in the hope that medicine will help them manage their fertility.

That day, Kim, 34, and her companion, Theo, took their places on the gray sofa in the office. All smiles, they announce that they want to have three children and wonder if they can wait a little longer: “Ideally, we would like to wait a year, but given that we are approaching 35, we do not really know if it is advisable”, explains the young woman. Maud Pasquier gently dissuades her and announces to Kim that her oocyte reserveis below the average for women her age. “Which means you may be postmenopausal early”, she warns.

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The young couple hold hands, look at the charts presented by the doctor. “Basically, the longer we wait, the less it will work, right?” “, summarizes Theo. ” Yes “, opines the doctor, before continuing, bluntly: “The first one should be fine, but you run the risk of not being able to have three children.” “ The couple leaves the meeting with a prescription for an additional radio and advice, but above all determined to become parents as soon as possible.

“It happens that women defy the prognosis”

Whatever the results, the doctor recognizes that receiving people at this pivotal age must be accompanied by caution: “We don’t read in a crystal ball. Sometimes women defy the prognosis and get pregnant when their chances were quite low. We specify that these are only indications. “ Likewise, there is no question of weakening couples, by putting them point blank in the face of a difficulty for which they are not prepared.

But in the office, the requests follow one another and are not alike. “I’m 35 in a month and a half. My companion had promised me that we would have a child. However, he left me as soon as I stopped the pill ”, Sarah begins. Maud Pasquier reassures her that her “fertility check-up” is positive: she still has a little time ahead of her.

But the young woman has another idea: “I heard that now you can freeze your eggs …” The doctor nods. Since the law of bioethics, such a possibility is open without medical reason, “But we still have to wait for the implementing decrees”, she warns. Sarah still takes the name of a hospital that is starting to put patients on the waiting list. “We expect our role to change in the coming months, anticipates Maud Pasquier. We will now respond to requests no longer medical, but social. “


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