Infertility in the public eye

Practitioners (doctors, gynecologists, urologists, andrologists, geneticists, psychotherapists, etc.) have occupied, for 30 years, a central place in the treatment and dissemination of information relating to infertility. Medically assisted procreation (AMP) has become commonplace and children resulting from medically assisted procreation (ranging from ovarian stimulation to heavier techniques) are more and more numerous: one to two children per class in elementary schools (de La Rochebrochard, 2008). It is, moreover, scientifically established that men, as well as women, are responsible for fertility problems in the couple (de La Rochebrochard, 2001). 

Gradually, the notion of "infertile women" is losing ground and, in AMP protocols, medical records are beginning to incorporate the names of men. However, messages on fertility, conveyed by the medical world and picked up by the media, still mainly target women. Most often, these are age-related alerts, such as: "Baby craving, don't wait! », Psychologizing messages, but also hygienic. They aim to remind women to optimize their "performance" as parents and gestators: they are advised "Zen attitude", relaxation, sport, sobriety or alternative medicine. 

The processing of information relating to male fertility is less visible, less systematic, and often refers to the notion of "quality" through current debates around the decline in sperm quality. While the notion of "infertile men" has received much less ink than that of "infertile women," debates about sperm quality are widely publicized today. The "hard" sciences are strongly mobilized with the dissemination of research results documenting this drop in sperm quality due to many endocrine disruptors present in the environment and in food, which would participate in the decline in human studied fertility at present. 

The media treatment of infertility very often goes in the direction of psychologization and empowerment for women, while it puts forward environmental causes, external, for men. While the discovery of the existence of male infertility has established the sharing of responsibilities within the couple (Thonneau et al., 1991), the development of medical treatments for male infertility by in vitro fertilization with Intracytoplasmic sperm injection (IVF ICSI) has two major consequences on couples' infertility pathways. First of all, this technique maintains the manipulations of the body of women since it is an IVF for which the medical protocols are particularly heavy. 

It is, however, the maintechnique implemented and represents more than half of births who received medical assistance in 2009: 38% for IVF with micro-injection and 20% for conventional IVF (Biomedicine Agency, 2011). Then, it maintains the priority given to the "biological" filiation of the two parents since it is much more used than artificial insemination with a donor sperm (much less burdensome medical intervention for women since it does not require a puncture. oocyte and therefore no surgery).

In France, children born following PMA are the result of the gametes of both parents: 94% of the 22,000 children born after PAD in 2009 were “conceived” in marriage (Agence de la Biomédecine, 2011); only 6% of children come from a technique involving donation, almost exclusively of sperm, and recourse to donation is only considered after failure of intramarital techniques (Jouannet 2009) and in the event of irreversible infertility. the “defaulting” spouse; the use of double donation (sperm and oocytes) for the same couple is, for its part, prohibited.

Cassien Tribunal Aungane, Editor