Infertility Treatment in France, 2008-2017: A Challenge of Growing Treatment Needs at Older Ages

Abstract

Objectives. To measure trends in infertility treatment use between 2008 and 2017 in France using data from the national health insurance system.Methods. Between 2008 and 2017, we observed a representative national sample of nearly 1% of all women aged 20 to 49 years who were affiliated with the main health insurance scheme in France (more than 100 000 women observed each year). We exhaustively recorded all health care reimbursed to these women.Results. Among women aged 20 to 49 years, 1.25% were treated for infertility each year. Logistic regression analysis showed a significant interaction between age and year of treatment use (P < .001). Over the decade, infertility treatment use increased by 23.9% among women aged 34 years or older, whereas among women younger than 34 years there was a nonsignificant variation.Conclusions. Women aged 34 years or older were increasingly treated for infertility between 2008 and 2017.Public Health Implications. Treatment efficiency decreases strongly with a woman's age, presenting a challenge for medical infertility care.

FIGURE 1—

Infertility Treatment Use According to Women’s Age: France, 2008–2017 Note. All infertility treatments are included (i.e., treatments with assisted reproductive technology [ART] and simple hormonal stimulation without ART). The figure shows women included in the one ninety-seventh sample of the French health insurance and affiliated with the main scheme. We used SAS INTERPOL = SM (for spline method) in PROC GPLOT (smoothing curve).