title: [Infertility over forty: Pros and cons of IVF].
abstract: The population attempting pregnancy and having babies is ageing. The declining fertility potential and the late age of motherhood are increasing significantly the number of patients over forty consulting infertility specialists. Assisted reproductive technologies (ART) cannot compensate the natural decline in fertility with age. In France, in public hospital, ART is free of charge for women until 43 years, over 43, social insurance does not reimburse ART. Hence, 43 years is the usual limit, but between 40 and 42 is ART useful? The answer varies according to physicians, couples or society. On medical level, the etiology of the infertility must be taken into account. If there is an explanation to infertility (male or tubal infertility) ART is better than abstention. If the infertility is only due to age the question is raised. In France, the reimbursement by the society of a technique with very low results is discussed. However efficacy is not absolutely compulsory in Medicine. On the opposite to give false hopes may be discussed too. To obtain a reasonable consensus is rather difficult.
authors: Centre hospitalier des 4 Villes, rue Lauer, 92210 Saint-Cloud, France. Electronic address: j.belaischallart@ch4v.fr.
authors: J
authors: J
authors: Belaisch-Allart
authors: Centre hospitalier des 4 Villes, rue Lauer, 92210 Saint-Cloud, France.
authors: V
authors: V
authors: Maget
authors: Centre hospitalier des 4 Villes, rue Lauer, 92210 Saint-Cloud, France.
authors: J-M
authors: JM
authors: Mayenga
authors: Centre hospitalier des 4 Villes, rue Lauer, 92210 Saint-Cloud, France.
authors: I
authors: I
authors: Grefenstette
authors: Centre hospitalier des 4 Villes, rue Lauer, 92210 Saint-Cloud, France.
authors: A
authors: A
authors: Chouraqui
authors: Centre hospitalier des 4 Villes, rue Lauer, 92210 Saint-Cloud, France.
authors: Y
authors: Y
authors: Belaid
authors: Centre hospitalier des 4 Villes, rue Lauer, 92210 Saint-Cloud, France.
authors: O
authors: O
authors: Kulski
mesh_terms: D000328:Adult; D000375:Aging; D000075202:Contraindications; D005260:Female; D005307:Fertilization in Vitro; D005602:France; D006801:Humans; D007246:Infertility / Q000209:etiology / Q000628:therapy*; D007247:Infertility, Female / Q000628:therapy; D007248:Infertility, Male / Q000628:therapy; D008297:Male; D011247:Pregnancy; D012051:Reimbursement Mechanisms; D027724:Reproductive Techniques, Assisted / Q000191:economics / Q000941:ethics; D016896:Treatment Outcome
keywords: Assistance médicale à la procréation; Assisted reproductive technologies; Femmes de 40ans; Fécondation in vitro; In vitro fertilization; Infertility; Infertilité; Women of 40 years