Do you dream of becoming a parent, but the path to getting there is proving more complicated than expected? Then, assisted reproduction could be an excellent solution for you! This scientific solution to infertility gives thousands of people hope each year of conceiving their baby. Yet, it often remains misunderstood and raises a lot of concerns for many of us. What steps do you have to go through? What are the birth rates? In this article, we demystify the assisted reproduction process and guide you through each step to best prepare you. Ready to become an expert on the subject? Read on!
What is medically assisted procreation?
PMA stands for "Medically Assisted Procreation." Also called "Assisted Medical Procreation" (AMP), it refers to the set of medical techniques that help infertile couples conceive a child. Sometimes, obstacles related to infertility or pathologies can prevent a natural pregnancy. PMA allows some of these to be circumvented.
Its entire principle is based on a medical intervention which allows:
- facilitate the meeting of male and female gametes (spermatozoa and oocytes);
- or to create an environment conducive to the conception of a baby.
Among the most common techniques, we find:
- Artificial insemination: sperm are introduced directly into the uterus at the time of ovulation.
- In vitro fertilization (IVF): gametes are “brought together” in the laboratory before embryo transfer into the uterus.
What you need to know before embarking on a PMA process
The ART process is aptly named because... Yes, it's quite a journey. Are you about to embark on the journey? We'll explain everything you need to know to prepare.
Who can benefit from medically assisted procreation?
In France, the bioethics law defines eligibility criteria. However, since 2021, this law has changed... Fortunately, for the better! Because in addition to allowing access to medically assisted procreation (MAP) for heterosexual couples, it is now also open to single women and lesbian couples.
However, regardless of the marital status of the applicant couple, the age limit remains the same for female beneficiaries, namely 43 years.
For men, there is no strict age limit. However, they will also undergo certain medical evaluations to maintain the framework surrounding these practices.
How much does a PMA course cost?
Once again, we're lucky! Because, in our country, medically assisted procreation (MAP) is partially covered by health insurance. This means that everything is reimbursed:
- consultations;
- ovarian stimulation treatment;
- blood tests;
- egg retrieval;
- embryo transfer.
Everything… Or almost! Because you will still have to plan for some additional expenses. Such as:
- the excess fees charged by certain doctors;
- specific treatments;
- an excess of the number of IVF or inseminations normally reimbursed;
- the preservation of your frozen embryos in an analysis laboratory.
Also, for those who do not meet the reimbursement conditions of Health Insurance (foreign residents or those above the age limit), the cost of medically assisted procreation can quickly climb to several thousand euros.
Pssst, we wrote an article that explains the cause-and-effect link between pollution and fertility . You might find it interesting!
What is the success rate in an assisted reproduction process?
Your chances of success vary depending on the techniques used. However, according to INSERM, they are:
- around 20 to 30% per cycle for IVF;
- between 10 and 15% for artificial insemination.
Of course, these results also depend on other factors, such as:
- the quality of gametes;
- the cause of infertility;
- the woman's age.
Because yes, the chances of success decrease after age 35. But, despite everything, Assisted Reproductive Technology (ART) techniques continue to improve! Year after year, they allow many couples to further boost their chances of pregnancy.
How does a PMA process work?
Assisted reproduction is a medical and emotional journey. We'll detail the various stages of such a journey, from the first stimulation treatment to the (much-anticipated) confirmation of pregnancy.
1. Ovarian stimulation
Step one: the ovarian stimulation phase! To overcome ovarian insufficiency problems, stimulation involves "boosting" your ovaries so they produce multiple mature eggs. This gives you a better chance of pregnancy.
The goal here is to control and synchronize your ovarian cycle while avoiding some not-so-fun complications, such as hyperstimulation. To achieve this, you'll need to have regular ultrasounds and blood tests to monitor your ovaries' response to treatment.
The stimulation cycle generally lasts between 10 and 14 days.
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2. Triggering ovulation
The second stage begins when your eggs become mature enough to trigger ovulation. You are then given a medication that, through injection, will synchronize the timing of your ovulation with the next stages of the process.
Next, we schedule the egg retrieval or artificial insemination within 36 hours of the injection. Yes, that's precise! Because it's this timing that will allow you to fully optimize your chances of fertilization. And it will affect the success of the procedure.
3. The sample
Once the hormone treatment phase is complete, the egg retrieval procedure begins. Rest assured, this procedure is performed under local or general anesthesia. The medical team collects your eggs using a fine needle, guided by ultrasound. This procedure is very quick, lasting approximately 15 to 20 minutes.
At the same time, your partner must have their sperm collected (or the PMA center collects donor sperm for single women or female couples). Then your two gametes go to the analysis laboratory: they will be prepared for fertilization. This is a very important step in the conception phase!
4. Fertilization
In IVF, the gametes of the future parents are brought into contact. To achieve this, the ART center uses the ICSI (Intracytoplasmic Sperm Injection) technique to directly inject a sperm into the egg. If the embryos prove viable, they are then cultured for a few days before transfer.
5. Embryo transfer
The penultimate step: embryo transfer! Or THE moment we've been waiting for impatiently.
After spending a few days in culture, the "solid" embryos are transferred into the uterus. It's a super-fast, 100% painless procedure performed using a thin catheter.
Doctors generally limit the number of embryos transferred to avoid the risk of multiple pregnancies. Therefore, if you have a few good-quality embryos left, you can choose to freeze them for a future parenting project.
6. Pregnancy
The moment of truth has arrived! To confirm or deny your pregnancy, you will need to have hormone tests performed approximately 10 days after the embryo transfer.
If it's a success (we sincerely hope so!), it doesn't end there: you'll receive careful medical monitoring from the very first weeks. This includes, in particular, ultrasounds to verify proper embryo implantation and the development of the pregnancy.
If your attempts are unsuccessful, the midwife or doctor will suggest a medical assessment before starting another attempt. And, likely, a rest cycle to regain your strength.
How to enter into an assisted reproduction process?
Of course, embarking on an assisted reproduction process doesn't happen overnight, and it remains fairly formal. First, start by talking to a gynecologist or fertility specialist. They will be able to assess your medical situation and refer you to a qualified assisted reproduction center. There, the requesting couple must undergo a complete assessment, including:
- hormonal analyses;
- ultrasounds for the recipient woman;
- a spermogram for men;
- sometimes, additional examinations.
At the end of all these steps, the medical team will be able to establish a diagnosis and suggest the ART technique that will best suit your situation.
To create your administrative file, you will need to provide fairly standard documents, such as your identity cards, your health insurance cards, or your family record book. Finally, you will be asked to provide written consent. This document, signed by both partners (or the patient alone), formalizes the final agreement for treatment.
Finally, know that you are entitled to psychological support throughout the entire process—right from the beginning! They can help you manage the roller coaster of ovarian stimulation and hormone treatment. Then, of course, all the emotional challenges of this journey, which can be both demanding and hopeful.
In short, the assisted reproduction process can be a real ordeal, both medically and emotionally. But, often, it's also THE chance some future parents are waiting for to make their parenthood a reality. Heterosexual couples, lesbian couples, single women... Whatever your life situation, all these assisted reproduction techniques and scientific advances bring you a little closer to your dream: that of finally welcoming that long-awaited child.
