“Humanity is threatened”: faced with the increase in infertility, the warning from Montpellier professor Samir Hamamah

Infertility awareness week ends with an alarming finding: Professor Samir Hamamah, head of the reproductive biology unit at Montpellier University Hospital, author of a national report on the causes of infertility, the state of degradation throughout the world.

In France, infertility affects 3.3 million people, men and women.

Samir Hamamah, head of the reproductive biology unit at Montpellier University Hospital, submitted a report to the government last February on the causes of infertility.
Free Midi – Michael ESDOURRUBAILH

At the beginning of the year you presented a report to the government that should lead to the establishment of a national strategy to combat infertility. How can you raise awareness of the problem?

I’ll tell you a secret: ten days ago I was at a demonstration in California. One of Joe Biden’s advisers came to read a statement by Joe Biden on reproductive health and women’s health. The subject is now treated at the highest level. The projections are alarming: in 2100, we will no longer be 12 billion as demographers had predicted, but we will be 4 billion. Finally, Europe, the United States, Japan and South Korea have birth rates below the replacement level, which is 2.1 children per woman. What about global growth, including Africa? For two centuries, it has been declining. Even in poor countries. Take Sierra Leone as an example: the birth rate has gone from 6 children per woman to less than 4 children per woman.

For infertility or lifestyle questions?

For many reasons: there is an increase in infertility, respectively +0.3% and +0.4% per year in men and women, but also due to emerging diseases and social causes. Today, in France, the rate is 1.83 children per woman. Ten years ago, we were at 2.2. In Italy it is 1.2 today. Russia is at 0.9. Spain, Portugal, 1.3. Germany, 1.5.

We have to anticipate: today we talk a lot about drought, alteration of the ecosystem and loss of biodiversity, it is the living beings that are disappearing. I don’t see how plants and frogs would disappear without humans too.

What are the main causes of infertility?

There are three: medical causes, not to mention the 10% to 15% of unexplained causes. Environmental causes: every day, without knowing it, we are exposed to a hundred chemical molecules to which are added the disruptors present in cosmetic products, lipsticks, perfumes… I also ask the government to launch an awareness logo to inform on a collective and individual scale. Finally, there are the social causes, that is, the delay in the average age of the first childbirth. Twenty-five years ago, in France, it was 24 years, today, we are not far from 31 years because women are more and more long-term studies. As long as society does not provide women with the means to combine private and professional life, the average age at first childbirth will continue to decline. We “manufactured” a form of infertility that we could have prevented. Hence the interest of the review of bioethics laws last summer…

Reproductive health is a marker of general health in adulthood

Have men and women taken advantage of the possibility of preserving their oocytes and sperm, to counteract the hypothesis of a late pregnancy?

Between 29 and 37 years for women, 29 and 45 years for men, you can, if you wish, keep your gametes. At Montpellier University Hospital, we have an increase of +20% to +25% in activity due to non-medical social preservation. The ministry has just alerted the regional health agencies to issue exceptional authorizations to reduce waiting times. To do this, it is necessary to authorize more and more centers, both public and private. There are solutions that depend only on us, including environmental causes. The prevention program is beginning to bear fruit. But prevention does not start at age 29, you have to start in high school and not only talk about abortion and contraception when talking about sexual health, you also have to talk about reproductive health. Because it is also a marker of general health in adulthood.

Namely ?

Women who have premature ovarian failure will live 5 to 7 years less. Genomics platforms have made it possible to sequence many genes involved in cancers. I proposed, and it was accepted in the plan of the biomedicine agency 2022-2025, that we take care of the health of the mother in the case of egg donation, and of the father in the case of sperm donation.

Are there as many men as women involved?

Yes, a third of men and a third of women, not to mention idiopathic infertility, the causes of which are unknown, about 10% to 15%.

Are we on the right path to consciousness?

I tend to say yes, but not enough. The implementation of a national strategy to combat infertility should not be delayed, as a result of the report that I coordinated with twenty experts. It was time. This report is already translated worldwide.

Infertility is still considered a shameful disease

Is infertility still a drama today?

It is still considered a shameful disease. We don’t talk too much about it. But for those who experience it, it is as if the sky fell on their heads: married life is threatened, life refocuses around medical appointments. Yes, it is traumatic! It’s time to raise awareness about reproductive health, and that’s what to do on the occasion of this national week. This disease must be removed from anonymity. There are as many infertile people in the world as there are diabetics, but it is easier to talk about diabetes than about infertility. Because infertility affects people, God, the family, society.

There are too many of us on earth, isn’t this finally good news?

This will no longer be the case in the coming years, even in Africa. China will go from 1,500 million inhabitants to 750 million. Today, there are 70 million infertile Chinese. There are not enough IVF centers in the country. The city of Moscow alone has 82 IVF centers, while in France there are 103. Israel, 6 million inhabitants, has 30 IVF centers… Japan is at 1 child per woman, South Korea at 1.1… .countries will disappear. The geopolitical impact will be huge! We must preserve the human species, that’s what it’s all about. And I remind you that medically assisted procreation is not a magic wand: it has a 20% success rate.

Testimony: Audrey Huynh “was this hitchhiker who stays at the highway rest area”, she made a book of it

With “Infertile for the worst and for the best” (1), Audrey Huynh, a nurse from the Hérault, delivers the diary of six years of fighting infertility, marked by ten attempts at medically assisted procreation in total, including 5 IVF, 3 ovules donations… “I did not give a medical testimony, it is not the nurse who speaks. It is a diary that I really keep, so that my son knows his story,” explains the young woman, who could not upload her pregnancy project.

She is like many women: “At 20 years old I took two pills a day for fear of getting pregnant and I thought that having a child was within the reach of the first idiot who came along.” But she is just over 30 years old and suffers from ovarian failure, and she will discover in her medical cross that she also has endometriosis. Her partner, who turns 25 this year, endured, and the book also tells “a very beautiful love story.” Her friendships also, in the storms caused by misunderstandings and misunderstandings, she herself went “from the phase of anger and misunderstanding to that of resilience, I ended up accepting”, without making the decision to adopt a child.

“At one point, I was that hitchhiker who stays at the highway rest stop,” testifies Audrey Huynh, who writes for couples in the process of medically assisted procreation, but not only: “If the book can also be read by readers who are not directly affected by the problem… I am addressing them as well, because I have suffered so much from the clumsiness of those around me!”

In conclusion, in hindsight: “Having a child is not an end in itself.”

(1) To order “Infertile for the worst and the best”, editions with a semicolon (20 euros), you have to go through the author’s Instagram account, Infertil_mais_pas_que

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