A child if I want, when I want! This feminist postulate of the 1970s is today being undermined for multiple reasons. More and more young couples wishing to have a child are indeed confronted with the phenomenon of infertility. The figures are impressive:one in six couples consults for help (i.e. 15.6% of couples of childbearing age), and one in ten uses in vitro fertilization (IVF). Today, we all know someone around us, friends, parents or work relationship, in this situation. If the reasons for infertility are diverse, there is still a large part of the unknown in the vagaries of nature. However, a few facts are worth recalling. A healthy lifestyle and a healthy diet are the ABCs of those who have no particular physiological problems. It also happens that the body needs some time to recover from a long period of contraception. Finally, it should be remembered that the more you have a love life (and therefore more relationships), the more chances you have of giving birth to a child! "A baby is made for two" , recalls Dr. Sylvie Epelboin (1). “When a couple has difficulty conceiving, we must take an interest in each other’s fertility. » For one as for the other, there may be genetic or infectious anomalies, which most examinations and treatments today make it possible to resolve or circumvent. Other factors, more related to our time and our lifestyles, come into play.
“Age is the major cause of fertility problems” , emphasizes Professor Jean-Philippe Wolf (2). “In twenty years, the age of first pregnancy has gone from 21 to 30. The period during which a woman wishes to become pregnant is therefore much more restricted, because the age of menopause is always the same. From the age of 37, women's fertility declines cataclysmically. » Few gynecologists dare to raise the question of the biological clock, notes Dr. Sylvie Epelboin. "There is of course no question of an injunction to have children, but we can inform about the different reasons for infertility, without panicking and recalling some obvious facts:the beautiful 50-year-old women who pose on glossy paper with their baby in their arms had to resort to eggs other than their own! A colleague of mine always says "young in life, old in reproduction", it's true! We meet young women aged 35 who will soon no longer be able to produce oocytes and will have to resort to egg donation. The duration of studies, the difficulties in taking one's place in professional life or the weak efforts of society to promote maternity are all elements that delay the decision to conceive a baby. Not to mention that 30% of women have not met the partner with whom they will have a child before the age of 30. »
We know that extreme thinness can trigger amenorrhea (absence of menstruation) and that, conversely, significant overweight will cause serious disturbances in the female cycle. Obesity, considerably on the rise, has become a major factor. “Visceral fat (accumulated in the stomach) is particularly toxic , notes Professor Jean-Philippe Wolf. Women have ovulation disorders, or insulin resistance, which poses a real problem when performing in vitro fertilization. Being overweight is also problematic in men because it affects sperm production and mobility. But you should know that the situation is completely reversible when patients are put on a diet! »
1. Obstetrician gynecologist and reproductive physician at the Bichat-Claude Bernard Hospital Group in Paris.
2. Head of the histology-embryology-reproductive biology department at Cochin Hospital in Paris.
