PMA: everything for the love of a child

PMA: from warrior women to courageous mothers, lives turned upside down for the love of a child - Élhée

ARTICLE SUMMARY :

PMA in France
Pamper your body for resilience

In France, according to the latest figures published in 2018, 758,590 babies were born, including 25,120 (3.3%) thanks to MAP. A steadily rising figure since the first birth by in vitro fertilization in 1982. Despite this, the "test-tube babies" born that year required nearly 150,000 insemination attempts from their parents. It's a staggering figure, and one that gives an idea of the strength needed by all couples embarking on the path to medically-assisted procreation. This conviction is all the stronger given that the average success rate of IVF and artificial insemination remains relatively low, between 10 and 25%.

PMA in France

The term procréation médicalement assistée (PMA) or assistance médicale à la procréation (AMP) refers to enabling or facilitating the meeting of an oocyte and spermatozoa, with a view to achieving pregnancy. Like adoption, PMA is one of the solutions available in France to remedy infertility.

Who can benefit?

France's first law on "the donation and use of elements and products of the human body, medically assisted procreation and prenatal diagnosis" dates back to 1994. At the time, it only concerned heterosexual couples experiencing difficulties conceiving a child.

Since then, the bioethics law promulgated in August 2021 has dusted off the codes. PMA is now open not only to heterosexual couples, but also to lesbian couples and single women, whether or not they have fertility problems. This is the advent of "PMA for all".

How do I start an assisted reproduction procedure?

On the whole, the pre-PMA process is the same for everyone. A fertility assessment is carried out for lesbian couples or single women who, on the face of it, have no problems conceiving a child.

For their part, after 12 to 24 months of unsuccessful baby trials, heterosexual couples undergo a infertility work-up to determine, where possible, the medical, genetic, andrological, gynecological... cause of the disorder.

For everyone, it's the start of a long journey, often tiring and emotionally taxing, full of medical appointments, dates, schedules, constraints, examinations, tests, questions, doubts and second-guessing.

Different PMA techniques for different profiles

Depending on the causes of infertility and the profile of the couple or the mother-to-be, three medically assisted reproduction techniques can be proposed.

Artificial insemination
IVF
Embryo reception

Artificial insemination is the oldest and least invasive of the three methods. It is also often the starting point for MAP procedures. It requires, on the one hand, that the mother-to-be's uterine tubes are healthy and, on the other, the collection of sperm from her partner or a donor. The male gametes are then introduced directly into the female uterus to promote natural fertilization.

In vitro fertilization takes place outside the female body. The oocyte and sperm meet in the laboratory, before being implanted in the uterus to develop.

IVF can also be in vitro fertilizationwith ICSI (Intracytoplasmic Sperm Injection). In this case, instead of letting the sperm implant spontaneously into the oocyte, a microinjection is used to directly introduce the best sperm at the best time. The resulting embryo or embryos can then be deposited in the uterus to develop.

Note that IVF can be performed using donor sperm, donor egg or, in some cases, double gamete donation.

In France, embryo reception is the least-used medical procreation technique. It is mainly used when other methods have failed, when there is a risk of transmitting a genetic disease, or to support single, infertile women in their desire to become pregnant.

Here, the embryo implanted in the recipient's uterus comes from anonymous donors who no longer have any parental plans, or who have chosen to donate.

These various procedures are generally preceded byone or more cycles of ovarian stimulation, first orally and then by injections. These moments are often difficult and painful, making the daily lives of future parents and mothers difficult and sometimes psychologically violent. For the love of their child to be conceived, these women draw on and mobilize all the courage they have within them.

PMA and filiation: mothers, fathers and children

As is the case for babies conceived naturally, filiation is automatic for married heterosexual couples using donor-free MAP.Concubine and pacsé couples are required to acknowledge paternity.

For couples, a visit to the notary is required to establish joint recognition of the unborn child. Since filiation between the woman giving birth and her child is established by the birth certificate, both women are full mothers of their child.

Lesbian couples who underwent MAP abroad before August 3, 2021 can also go before a notary for joint recognition of their child until August 3, 2024.

Pamper your body for resilience

Ovarian stimulation, hormone injections, medical monitoring, follicular punctures, general anaesthesia, embryo transfers, blood tests... PMA puts women's bodies to the ultimate test. Their bodies and hearts too.

In 2017, INSERM published the following figures: depending on the technique used, the chances of getting pregnant vary from 10% to around 22% per trial. We also know that age is a key factor in the success of an artificial insemination or in vitro fertilization process. Before the age of 30, the probability is much higher than after the age of 40. In France, the average age of a mother at the birth of her first baby is almost 29. That's why, if you're having trouble conceiving, you should seek medical advice as soon as possible.

Because the MAP process is long, tiring and trying, with hopes and disappointments that are always hard to take, it's essential to take care of your body and mind even before the first insemination. And because, barring a few exceptions, the medical profession will be overwhelmed and unable to listen, it's up to each woman to surround herselfwith the right people and a cocoon of kindness, as soon as possible.

Practicing naturopathy to mitigate the effects of treatment

naturopathy aims to balance the organism through a variety of natural methods, such as a change in diet, fasting and the use of phytotherapy. As a healthcare professional, the naturopath accompanies his or her patients towards autonomous health and the restoration of their self-healing capacities.

Also, to prepare the female body for the battlefield that is MAP, optimizing diet and lifestyle is a plus.

For example, proteins and omega-3s support hormone production, while wholefoods and seasonal fruit and vegetables enrich an anti-inflammatory diet that helps the body function properly.

Meet the French Federation of Naturopaths.

Enjoy the benefits of acupuncture to prepare your body for a new baby

Chinese medicine is concerned with the balance of the body as a whole. Among its various specialties is acupuncture and its many benefits, particularly in terms of fertility and maternity.

In the run-up to and during pregnancy, there are a number of interesting points to work on. Acupuncture can regulate disorders of the female cycle such as menstrual pain or spotting. It also promotes follicle growth, oocyte production, quality of cervical mucus and vascularization of the endometrium, for better implantation.

Two points are among the most widely used in Chinese obstetric medicine: one prepares the body to receive and welcome life, while the other promotes the birth of a calm baby.

Discover the French Federation of acupuncturist midwives.

Get in touch with a doula to discuss your career together

In Socrates' time, the doula, from the ancient Greek for "female slave", was one of the household servants. Dedicated to the care of her mistress, she accompanied her during pregnancy and childbirth.

Today, the doula is more of a spiritual coach or guide for expectant and new mothers, but also for their immediate families, spouses and children. Outside the medical circle and alongside the midwife, she guides, reassures, supports, informs, shares and transmits, remaining 100% available and attentive to needs and emotions.

Within the framework of a MAP program, or outside it, the doula, and more specifically the "fertility doula", can be of precious help. With her, you cantalk about the difficulties of a strict protocol, the physical pain, the desire for a child, the envy of other pregnant women, the incomprehension and perhaps even the guilt of infertility...

Consult thedirectory of doulas in France.