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Background Recent cost studies related to infertility treatment have focused on assisted reproductive technologies. None has examined lower-intensity infertility treatments or analyzed the distribution of infertility treatment expenditures over time. The Purpose of the study was to analyse the size and distribution of infertility treatment expenditures over time, and estimate the economic burden of infertility treatment per 10,000 women aged 18 − 50 in France from a societal perspective. Methods We used French National individual medico-administrative database to conduct a self-controlled before-after analytic cohort analysis with 556 incidental women treated for infertility in 2014 matched with 9,903 controls using the exact matching method. Infertility-associated expenditures per woman and per 10,000 women over the 3.5-year follow-up period derived as a difference-in-differences. Results The average infertility related expenditure per woman is estimated at 6,996 (95% CI: 5,755–8,237) euros, the economic burden for 10,000 women at 70.0 million (IC95%: 57.6–82.4) euros. The infertility related expenditures increased from 235 (IC95%: 98–373) euros in semester 0, i.e. before treatment, to 1,509 (IC95%: 1,277–1,741) euros in semester 1, mainly due to ovulation stimulation treatment (47% of expenditure), to reach a plateau in semesters 2 (1,416 (IC95%: 1,161–1,670)) and 3 (1,319 (IC95%: 943–1,694)), where the share of expenses is mainly related to hospitalizations for assisted reproductive technologies (44% of expenditure), and then decrease until semester 6 (577 (IC95%: 316–839) euros). Conclusion This study informs public policy about the economic burden of infertility estimated at 70.0 million (IC95%: 57.6–82.4) euros for 10,000 women aged between 18 and 50. It also highlights the importance of the share of drugs in infertility treatment expenditures. If nothing is done, the increasing use of infertility treatment will lead to increased expenditure. Prevention campaigns against the preventable causes of infertility should be promoted to limit the use of infertility treatments and related costs.

BACKGROUND: Infertility is defined by WHO as ‘‘a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse’’. The first and second line treatments for infertility are simple hormonal stimulation and assisted reproductive technologies, respectively. The use of these treatments could concern a large proportion of couples but, in France as elsewhere, lack of data on simple hormonal stimulation is a major barrier to exploring this issue. Our objective was to explore use of infertility treatments in the French population.METHODS: Using data from the French national health insurance system, a cohort (the EGB) was implemented in 2005. It includes 500,000 randomly selected participants and constitutes a representative sample of the French population. All health care consumption of these participants is prospectively recorded. For the present study, women participants aged 20-49 years between 2007 and 2017 were extracted (n = 190,312) and explored for use of infertility treatments.RESULTS: In our representative sample of women aged 20-49 years, 4.21% [4.12-4.30] were treated for infertility between 2007 and 2017. Use of infertility treatments varied according to the womens’ age: 0.88% [0.81-0.95] at age 20-24; 3.34% [3.20- 3.47] at 25-29; 4.35% [4.20-4.50] at 30-34; 3.30% [3.17-3.43] at 35-39; 1.84% [1.74-1.94] at 40-44; 0.34% [0.30-0.38] at 45-49. Further analysis will describe care pathways and explore the different treatments for infertility followed by each woman. The association between age and care pathways will be tested.CONCLUSIONS: Taking advantage of data from the French national health insurance system, our work explores for the first time use of infertility treatment in a large representative sample. It shows that infertility treatment has an important public health impact with more than 4% of women aged 20-49 years treated for infertility.KEY MESSAGES:(*) Our work explores for the first time the use of all treatments for infertility by including not only assisted reproductive treatments but also simple hormonal stimulation.(*) Data from the French health insurance system are currently opening to research and are a promising source to address topics previously unexplored because of a lack of reliable medical care data.

The relation between levels of contraceptive use and the incidence of induced abortion remains a topic of heated debate. Many of the contradictions are likely due to the fact that abortion is the end point of a process that starts with sexual activity, contraceptive use (or non-use), followed by unwanted pregnancy, a decision to terminate, and access to abortion. Trends in abortion rates reflect changes in each step of this process, and opposing trends may cancel each other out. This paper aims to investigate the roles played by the dissemination of contraception and the evolving norms of motherhood on changes in abortion rates. Drawing data from six national probability surveys that explored contraception and pregnancy wantedness in France from 1978 through 2010, we used multivariate linear regression to explore the associations between trends in contraceptive rates and trends in (i) abortion rates, (ii) unwanted pregnancy rates, (iii) and unwanted birth rates, and to determine which of these 3 associations was strongest. The association between contraceptive rates and abortion rates over time was weaker than that between contraception rates and unwanted pregnancy rates (p = 0.003). Similarly, the association between contraceptive rates and unwanted birth rates over time was weaker than that between contraceptive rates and unwanted pregnancy rates (p = 0.000).

IntroductionSpontaneous live births (SLB) after in vitro fertilisation (IVF) treatment are not unusual, but reported SLB rates vary widely and little is known of their associated factors. Our objective was to examine the frequency of SLB and their associated factors among couples who had had IVF, successfully or unsuccessfully.MethodsA retrospective cohort of couples was recruited in eight French IVF centers. The couples had begun IVF treatment in the participating centers between 2000 and 2002, and were followed-up by postal questionnaire between 2008 and 2010. Analysis was carried out on 2134 couples who were still together at the time of the postal survey. Separate analyses were conducted according to the outcome of medical treatment: live birth (n=1320) or no (n=814). Multivariate analysis that included socio-demographic and medical characteristics was conducted using logistic regression.ResultsThe SLB rate was 17% among couples who had had a first live birth through medical treatment and 24% among couples who had unsuccessful treatment. In both groups, SLB was associated with younger age of the women, fewer IVF attempts and the origin of infertility. In couples who had not been successful with IVF, SLB was also associated with a shorter duration of infertility.ConclusionEven in a population which had had IVF because of a very low monthly probability of conception, SLB is still possible, especially among couples who did not succeed in having a child through fertility treatment. Occurrence of SLB was mainly related to a better initial fertility prognosis.

Menstrual health is increasingly framed as a multidimensional public issue intersecting with health, education, and gender equality. Yet, national research landscapes remain uneven, shaped by structural neglect, epistemic silences, and sociocultural stigma. France offers a compelling case of such disparities, where academic engagement with menstrual health has only recently gained visibility. This scoping review critically maps the landscape of menstrual health research in France and identifies knowledge gaps. Following PRISMA-ScR guidelines, we analyzed twenty-eight studies retrieved from Medline and Scopus (up to November 2024), covering themes such as menstrual poverty, environmental concerns, cultural representations of menstrual blood, and menopause experiences, involving diverse populations across the life course. While the thematic diversification signals a shifting research agenda, the literature remains fragmented, with limited longitudinal and intervention studies and underrepresentation of marginalized populations. These findings underscore the need for participatory, community-driven approaches and contribute to broader debates on how menstrual health is conceptualized, studied, and translated into policy.

In 2003, one French birth in twenty (5%) was achieved after a medical treatment or procedure. In half of these cases (2.4%) conception was obtained through ovarian stimulation, and the other half by either artificial insemination (0.8%) or in-vitro fertilization (IVF) (1.7%). The proportion of births obtained after IVF alone has increased steadily over the last twenty years, rising from 0.52% of births in 1988 to 1.74% in 2006. This steady rise reflects both more frequent recourse to IVF and a better success rate (currently, 20-25% of attempts lead to the birth of at least one live child). In France, for 97% of children conceived by IVF, the social parents are also the genetic parents, i.e. no sperm or egg donations are involved. In 2006, only 304 children were born as a result of IVF with donor sperm, 106 with donor egg, and 10 with donor embryo. [PUBLICATION ABSTRACT]

In France, it is quite rare to be childless and to report not wanting any children. Who are the people concerned? What are the reasons for their choice? Does living with a partner make any difference? Charlotte Debest and Magali Mazuy have analysed this life choice using data from several surveys, notably 2010 the Fécond survey, and present their findings here.

Des tables de puberté féminine et masculine ont été construites à partir de l'enquête française sur l'Analyse du comportement sexuel des jeunes (ACSJ), menée en 1994 auprès des générations 1975-1978, alors âgées de 15 à 18 ans. Chez les jeunes filles, la puberté est identifiée par la survenue des premières règles dont l'âge médian est de 13,1 ans. À partir de cet indicateur, un déclin séculaire de l'âge à la puberté a été mis en évidence dans l'ensemble des pays développés. Cette évolution historique semble se poursuivre en France alors qu'elle s'est stabilisée dans plusieurs pays. Chez les jeunes hommes, la puberté est plus difficilement repérable et la discussion quant au choix d'un indicateur pour l'identifier reste ouverte. À partir de l'enquête ACSJ, trois indicateurs peuvent être envisagés: la mue de la voix (dont l'âge médian est de 14,8 ans), le pic de croissance (âge médian de 16,0 ans) et la première masturbation (âge médian de 14,2 ans). Parmi ces trois indicateurs, la mue de la voix apparaît comme le plus pertinent pour mesurer la puberté chez le garçon. /// Life tables of male and female puberty were constructed using the Analysis of Sexual Behaviour of Young People (ACSJ) survey conducted in France in 1994 on the 1975-1978 generations, at that time aged between 15 and 18. Puberty in girls is identified by the onset of menstruation, at a median age of 13.1. Using this indicator, a long-term decline in age at puberty has been established for the developed countries as a whole. This historical change seems to be continuing in France though it has stabilized in several countries. Puberty in boys is harder to identify and there is continuing debate over the choice of a suitable indicator. Using the ACSJ survey, three possible indicators can be suggested: the breaking of the voice (median age 14.8), the maximum growth rate (median age 16) and the first masturbation (median age 14.2). Of these three indicators, the breaking of the voice appears to be the most satisfactory for identifying male puberty. /// A partir de la encuesta francesa Análisis del Comportamiento Sexual de los Jóvenes (ACSJ), llevada a cabo en 1994 entre las generaciones de 1975-1978, que entonces tenían entre 15 y 18 años, se construyeron tablas de pubertad femenina y masculina. La primera regla define el inicio de la pubertad de las jóvenes. La edad mediana a la primera regla es de 13,1 años. En base a este indicador, se observa una disminución secular de la edad de inicio de la pubertad en el conjunto de países desarrollados. Esta tendencia se ha estabilizado en varios países pero continua progresando en Francia. El inicio de la pubertad de los adolescentes es más difícil de determinar. La discusión relativa a qué indicador utilizar permanece abierta. Sobre la base de la encuesta ACSJ se pueden considerar tres indicadores: el cambio de la voz (que se produce a una edad mediana de 14,8 años), el punto álgido del crecimiento (edad mediana 16,0 años) y la primera masturbación (edad mediana 14,2 años). De los tres indicadores, el cambio de la voz parece el más pertinente para medir el inicio de la pubertad masculina.