France's new IVF law aims to extend assisted reproduction technology (ART) coverage to same-sex couples and single women, making treatment free under the country's national healthcare system. Until now, a national ban limited the use of medically assisted reproduction methods to infertile heterosexual couples.
The IVF law would guarantee French women four rounds of assisted reproduction services per pregnancy. The national healthcare system would cover the cost of IVF for all women under age 43. The legislation also changes France's donor anonymity provisions to allow children conceived with donated sperm or eggs to find out the donor's identity once they turn 18.
If approved, the law would bring France in line with other European nations such as Spain, Portugal and the Czech Republic that extend IVF coverage to all women. The French health minister forecasts that an additional 2,000 French women will register for assisted reproduction services each year under the proposed IVF law. Currently, the wait for treatment runs about a year and is expected to increase if the restriction is lifted. In the coming years, clinicians anticipate potential shortages of donated sperm with this increasing demand.
Crossing Borders for IVF
Historically, many French women who were denied access to ART in their home country traveled to fertility clinics abroad to obtain IVF and other reproductive treatment. The phenomenon of cross-border reproductive care is growing internationally, though little is known about its scope or magnitude.
According to findings from the European Society of Human Reproduction and Embryology (ESHRE) reported by the American Society for Reproductive Medicine (ASRM), roughly 5 percent of European fertility care involves patients traveling outside their home countries. When asked to name the chief reasons for traveling abroad for fertility assistance, many patients cited legal restrictions, underscoring how governmental forces shape access to treatment.
Historically, laws haven't stood as the sole restriction. The fertility options of LGBTQIA+ couples also have been limited by prevailing cultural norms, and by systemic pressures such as higher rates of poverty and healthcare discrimination.
Shifting Attitudes Regarding Fertility Treatment
The history of France's IVF restriction dates back to 2013, when the country legalized gay marriage but passed legislation banning same-sex parents from accessing treatments such as IVF, artificial insemination and sperm donation. Now, just six years later, the new IVF law represents a huge governmental and social shift as the country adapts to changing attitudes about the rights of all individuals to build their families.
As dozens of countries worldwide have begun to expand the legal rights of the LGBTQIA+ community, clinical guidance is evolving to reflect the tenor of the times. In a 2013 opinion, the ASRM Ethics Committee urged clinicians to treat all requests for assisted reproduction equally, without regard to marital status or sexual orientation. Fertility coverage for transgender patients is still severely lacking in both the U.S. and the U.K., where the National Health Service has come under fire for failing to provide adequate fertility counseling and care to trans patients. Since roughly half of the United States prohibit discrimination on the basis of sexual orientation and gender identity, the ASRM opinion reminds practitioners that local laws may already mandate equal care for every patient who enters their doors.
Changing fertility laws and expanding access to care means that fertility clinicians are in a prime position to help more people than ever before. And no matter what country they practice in, the mission of the field remains the same: to help individuals and couples overcome obstacles and expand their families.