First, avoid panic. We consider that there is an infertility problem after… two years of unsuccessful attempts, not after a month without the pill. For Dr. Sylvie Epelboin, "we must give time to time, especially after a long period of taking contraception" . Beyond that, it is necessary to establish a balance sheet for both partners – hormonal assays such as explorations of the genital tract are necessary, and the spermogram makes it possible to check the quantity and quality of sperm production. A moment that is not necessarily easy to live with, where it is better to avoid relying on erroneous information (the good friend, the Internet, etc.).
Depending on the problem, medically assisted procreation (PMA) may be considered. Several methods exist, whether or not there is recourse to the anonymous donation of sperm or oocytes from a third party.
• Artificial insemination, the oldest. The sperm are deposited inside the uterus and fertilization takes place according to the natural process.
• In vitro fertilization (IVF), which is broken down into five stages, from ovarian stimulation to the transfer of the embryo into the uterus.
• Icsi (intra-cytoplasmic sperm injection) is more precise. While in classic IVF sperm and oocytes are simply brought into contact, here a single sperm is injected into each fertilizable oocyte.
• The Bioethics Law of July 7, 2011 authorizes a new oocyte freezing technique called “vitrification”. Widely used abroad for ten years, it allows women to preserve their fertility as has been the case for men since 1973 with sperm banks. This new method – which raises many ethical and economic questions – cancels the constraints of “synchronization” between donors and recipients in the context of donation, and in particular allows women who are at risk of premature menopause, or who must undergo sterilizing medical treatment, to save their oocytes.
