PMA for all: an explosion of requests and an extension of deadlines



How does the extension of medically assisted procreation (MAP) take place in the field? What are the dysfunctions or, on the contrary, the successes? To report on this is the mission entrusted to the national reform monitoring committee, whose first meeting took place on Monday, November 15, by videoconference.

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Set up by the Ministry of Health and overseen by the Biomedicine Agency, the committee brings together reproductive medicine professionals, institutions (such as Health Insurance) as well as associations, such as the Inter movement. -LGBT, the association of single mothers Mam’en solo or the Bamp collective, committed against infertility.

An explosion of demands

“Professionals have all made the same observation: the explosion of requests”, says Laurène Chesnel, head of the family division at Inter-LGBT, and present during the meeting. In centers for medically assisted procreation (AMP), between August and mid-October, the activity was multiplied by three on average, by ten in some centers.

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“But some patients make an appointment in several places, to ensure their back, which can distort the figures, shade Laurène Chesnel. In any case, this increase, which is in the upper range of all estimates made, was clearly not anticipated enough.. It is not for lack of warning. ” On the ground, the associations had noticed that women in couple or not had been waiting for years for this new legislation, refusing to go abroad.

Consequence: extended delays. “This is THE big problem. The delays were significant, even before the reform ”, pointe Virginie Rio, from the Bamp collective. In September, Olivier Véran pledged to reduce them to less than six months. “We are not there at all”, notes Mikaël Agopiantz, head of the reproductive medicine service,at Nancy.In his hospital, “The times are certainly lower than the national average.But elsewhere, they can run from 6 to 24 months ”.

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Some patients, especially those over 35, whose fertility is declining, have been advised to go abroad.During the meeting, associations also reported a few cases of discrimination. “If a couple of women called, the dates were far away. If a member of the same couple called back, saying they belonged to a heterosexual couple, a niche would become available ”, says Laurène Chastel.Scenarios “Illegal”, recalls Mikaël Agopiantz.

A lack of personnel

“If the delays are long, it is not necessarily because of a lack of sperm straws”, includes Virginie Rio. According to the Biomedicine Agency, stocks are sufficient to meet demand. As for the campaign to recruit new donors, it ” bearing fruit “. No, “What was mentioned overwhelmingly during the meeting is the lack of human resources”.

In a context of systemic shortage of hospital staff, the recruitment of biologists, gynecologists, psychologists is difficult. Some departments even lack a medical secretary or receptionist. An envelope of 8 million euros has been released by the Ministry of Health. But the administration does not follow. “The validation of hires by the school directors is … complicated”, squeaks a head of reproductive medicine.

“Other questions also remain unanswered and will have to be resolved empirically”, complete Mikaël Agopiantz. Like age limits, in particular. They are set, by decree, at 45 for the woman carrying the child and 60 for the other member of the couple. In a heterosexual couple, what about a husband who would be 59 and a half at the time of the first consultation? Do we tell him to pass his turn? ” The next meeting of the monitoring committee is scheduled for February. Six will be organized, in total, until the end of 2022.

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