International Women's Rights Day: Agence de la biomédecine presents the latest developments in the implementation of the law opening access to MAP for all

To measure the impact of the new bioethics law on activity, the Agence de la biomédecine has conducted surveys of centers authorized to carry out gamete donation (sperm and oocytes) and gamete self-preservation outside a medical indication. The results, observed between July 1 and December 31, 2022, complement the studies presented at previous meetings of the Monitoring Committee, and show a downward trend in requests for PGM with sperm donation. They also show a clear increase in first attempts at MPA (inseminations and IVF), in the number of donors and a stabilization in requests for medical oocyte self-preservation.

With regard to the extension of MPA to female couples and unmarried women, the survey of the 30 centers authorized to carry out sperm donation activities revealed that :

• 764 candidates for sperm donation were identified in 2022; there were almost 600 in 2021 and 317 in 2019. There has therefore been no negative impact on gamete donation as a result of the new provision for access to origins for people born from a donation.
• The available stock of "old regime" sperm straws stood at almost 110,000 (for 29 out of 30 centers) on December 31, 2022. Overall, this stock was sufficient to meet pending requests. 17,000 "new regime" straws have been stored since the implementation of access to origins on September 1, 2022, thanks to 356 donors.
• Approximately 5,800 requests for first consultations have been registered for MPA with sperm donation for female couples or unmarried women for the second half of 2022, representing a downward trend of 38% compared with the first half of 2022 (almost 9,300 requests). In total, therefore, there will be almost 15,100 requests for first consultations for the benefit of female couples or unmarried women in 2022.
• Around 4,200 first consultations were carried out for female couples or unmarried women in the second half of 2022, representing a downward trend of 22% compared with the first half of 2022 (almost 5,400 first consultations carried out). In total, between August 2, 2021 and December 31, 2022, almost 11,800 first consultations were carried out.
• 1,545 attempts at MPA with sperm donation were made in the second half of 2022 for the benefit of these new groups, a significant increase (x3.5) on the first half. In total, since the law came into force, almost 2,000 first attempts at MAP have been carried out for female couples (47%) or unmarried women (53%).
• As of December 31, 2022, nearly 5,600 people were waiting for an MPA with sperm donation, including 36% female couples and 38% unmarried women (i.e. 74% of people on the waiting list, corresponding to the new target groups).
• The waiting time for MPA with sperm donation (from appointment to 1st attempt) varies greatly from one center to another, but the average waiting time as of December 31, 2022 has stabilized and is estimated at 14.4 months nationally.
• As of December 31, 2022, there were 444 progressive pregnancies (i.e. more than 12 weeks of amenorrhea) and 21 deliveries for female couples and unmarried women, resulting from MPA attempts with sperm donation carried out since August 2021.
• 3 new donation centers have been authorized to collect and prepare sperm for donation: Limoges, Orléans and Poitiers.

With regard to oocyte donation and requests for MPA with oocyte donation, a survey of the 35 centers authorized to carry out oocyte donation activities revealed that :

• 990 candidates for oocyte donation were registered in 2022, including 38 with a "rare" phenotype (the definition of a rare phenotype depends on the local situation of each center, but these are often donors from diverse backgrounds). A rising trend, whereas 900 women had donated their oocytes in 2021 and 835 in 2019.
• Nearly 2,000 women were waiting for an oocyte donation on December 31, 2022 (for 31 out of 34 centers). 97% are heterosexual couples, 3% are single women and less than 0.4% are female couples. After the law came into force, the majority of oocyte donation MPA cases continue to involve heterosexual couples.
• The average waiting time for oocyte donation MPA, from the time an appointment is made to the first oocyte allocation, is 23 months nationwide, as of December 31, 2022.
• 2 new donation centers have been authorized to collect and prepare oocytes for donation: Limoges and Orléans.

With regard to the possibility of gamete self-conservation for non-medical reasons, a survey of the 40 authorized centers revealed that: Since the law came into force, almost 11,500 women have requested an initial consultation for oocyte self-conservation, and almost 4,800 initial consultations have been carried out. By the end of 2022, the number of requests and consultations had stabilized, and 1,778 of the women involved had undergone at least one conservation procedure in 2022 (including 1,239 in the second half of the year). By December 31, 2022, the average waiting time for oocyte self-preservation was 7 months nationwide, and 24 months for the Île-de-France region, which accounted for 25% of requests.

*Stakeholders present at the March 6, 2023 follow-up committee meeting:

• Ministry of Health and Prevention - Health Department
• Ministère de la Santé et de la Prévention - Direction Générale de l'Offre de Soins
• Agence technique de l'information sur l'hospitalisation (Technical agency for hospital information)
• Conférence des présidents des commissions médicales d'établissement des CHU (Conference of presidents of university hospital medical boards)
• Conférence des directeurs généraux de CHRU de France
• National Health Insurance Fund
• National Center for Care Abroad
• Association COLLECTIF BAMP!
• Association Mam'ensolo
• Les Enfants d'Arc en Ciel - l'asso !
• Association don d'ovocytes, spermatozoïdes un espoir
• Association of gay and lesbian parents and future parents (APGL)
• Association Afrique Avenir
• Association Dons de gamètes solidaires
• Association PMAnonyme
• Ovocyte Donation Study Group (GEDO)
• Groupe de Recherche et d'Etude de la Conservation de l'Ovaire et du Testicule (GRECOT) (Research and Study Group on Ovarian and Testis Conservation)
• Study Group on In Vitro Fertilization in France (GEFF)
• National College of Gynecologists and Obstetricians of France (CNGOF)
• National Federation of Medical Gynecology Colleges (FNCGM)
• Fédération nationale des biologistes des laboratoires d'étude de la fécondation et de la conservation de l'œuf (BLEFCO - national federation of fertilization and egg preservation laboratory biologists)
• Collective of French private AMP centers (CCP)
• Society for Reproductive Medicine (SMR)
• National Federation of Human Egg and Sperm Study and Conservation Centers (CECOS)
• Gamete donation centers