Lesbian couples and single women in France hailed victory this summer when, after two years of ferocious parliamentary debate, a law was finally passed allowing them access to assisted reproduction (MAP). But the health system is unable to cope with the surge in demand and long delays mean many women continue to seek treatment abroad.
Since 29 September, 2021, all women aged 43 and under can access fertility treatments such as IVF and artificial insemination – treatment previously reserved for heterosexual couples.
The legalisation of MAP for all women was one of Emmanuel Macron’s campaign promises and since becoming president it remains his only major social reform.
But it’s got off to a disappointing start as the country’s fertility clinics struggle to cope with demand.
By end of November last year, 2,750 MAP requests had been made by single women or lesbian couples, triple the usual number.
“It’s far more than we imagined,” said health minister Olivier Véran at the time.
The waiting game
“In two months we had two or three times more requests from women couples and single women than we got from infertile couples over a whole year,” professor Catherine Guillemain from Marseille’s Hôpital de la Conception told RFI.
Guillemain heads up the hospital’s egg and sperm donation centre (Cecos) and says they are “overwhelmed with calls”, and that it's a similar story in the other 28 centres across France.
As a result waiting lists are long, assuming anyone picks up the phone.
“For the moment some centres can’t even fix an appointment, in others we’re talking about a six to 12 month delay,” says Eloïne Fouilloux, vice-president of Enfants d’arc en ciel – a support group for lesbian couples and single women seeking MAP.
“It’s frustrating and many women are continuing to go to Spain or Belgium... it’s quicker and going more smoothly there.”
It's a costly process though, unlike in France where treatment is free for women up to the age of 43.
“Faced with the log-jam, the only thing we can do is get organised little by little, but that only works when staff are ready and have time to process the requests,” said Guillemain.
This subject first featured in the Spotlight on France podcast. Listen to the interview with Eloïne Fouilloux.
LGBT groups argue the government should have anticipated the surge in demand and prepared for it.
In an attempt to speed up waiting times, health minister Véran announced in early October an additional 8 million euros for extra staff and equipment for fertility clinics.
But the impact won’t be immediate. France’s hospitals are understaffed and health professionals say it’s especially hard to recruit biologists, gynaecologists and psychologists.
“Hiring staff takes time,” says Fouilloux, who also fears that in cash-strapped hospitals the funding might not end up where it was intended.
“If the hospital is short of money, hiring a medical secretary is obviously not going to be a priority,” she sighs.
“It’s a transition period, and an uncomfortable one,” recognises Dr Claire de Vienne from France’s state-funded Agency of Biomedecine.
De Vienne told RFI the problem was not lack of sperm.
“We have the stocks of sperm straws, we have the donors,” she said, “but we have to be able to give these women appointments. We need to recruit trained staff and that takes time.”
Sperm and egg shortages?
There may be enough sperm for the moment, but it's far from sure that donations will keep up with the increasing demand.
France forbids the importation of foreign sperm and the Biomedecine Agency’s most recent figures show donations are on the decline – just 317 were made in France in 2019, 18 percent less than previous year.
Women were more generous, despite a much more invasive medical procedure. 836 women gave eggs in 2019, 7.5 percent more than in 2018.
From September 2022, sperm and egg donation will no longer be anonymous, allowing children born from a donation, once adults, to find out their donor’s identity.
Some fear this could deter potential donors, especially men.
Fouilloux, mother of two children born through IVF in Belgium, is full of praise for donors who “gave us the most beautiful gift" but insists they are "donors, not parents”.
Unfortunately, she says, many people in France see things differently.
“Even people who are not opponents of MAP still say that a sperm donor is ‘a father that the children don’t know’, and that’s a very problematic way to think. It makes it difficult to talk about sperm donation and difficult to find donors.”
In a bid to get more donors, France launched an information campaign last autumn, with ads online, in the media and in cinemas encouraging people to donate sperm and eggs.
Fouilloux says this should have been done years ago and the taboo around donation has led to being seen as "something rude, even dirty”.
More open discussion should also help to shift the way French society sees filiation.
“There is this feeling in France that biological procreation is more valuable than parenting, but I don’t think that’s true,” Fouilloux says.
“I have no biological link to my son and he’s my son. He knows how he was created and he knows that none of my genes are in his body. But who cares!”