Infertility: understanding the causes and exploring solutions

L’infertility affects nearly one in six couples worldwide, according to the World Health Organization (WHO). In France, this represents approximately 3.3 million people facing difficulties in conceiving a child. The causes are multiple — medical, environmental or lifestyle-related — and the consequences are often heavy, both personally and psychologically. Faced with this challenge, reproductive medicine has made immense progress, particularly in the United States, where the in vitro fertilisation (IVF) and the surrogacy offer new perspectives to parents-to-be.

1. What are the main causes of infertility?

Infertility can have many causes:

• In women ovulation disorders, ovarian insufficiency, endometriosis, fallopian tube abnormalities.
• In men low sperm count, morphological abnormalities, hormonal or genetic problems.
• Common factors advanced age, obesity, tobacco or alcohol consumption, chronic stress.
  In nearly 20 % of cases, infertility persists unexplained, which heightens the sense of frustration among the couples concerned.

2. The solutions proposed in France

France authorises several techniques of assisted reproductive technology (ART) :

• Ovarian stimulation and artificial insemination, suitable for the simplest cases.
• In vitro fertilisation (IVF), when natural fertilisation is impossible.
• Gamete donation (sperm or oocytes), in the event of irreversible infertility.

Since 2021, French law has opened medically assisted reproduction to single women and to female couples. However, certain options — such as surrogacy — remain prohibited, forcing the individuals concerned to turn abroad.

3. The United States: a pioneering model in reproductive medicine

In the United States, fertility clinics have some of the most advanced equipment in the world. The techniques used IVF with egg donation, of embryo selection (PGT-A) and of long-term cryopreservation display very high success rates.

Furthermore, many US states regulate the surrogacy in a clear and protective manner. This enables intended parents to secure legal parentage from birth, thereby avoiding the legal uncertainties encountered in other countries. This combination of high medical technology and a transparent legal framework explains why the United States attracts numerous French and European families facing infertility every year.

4. The psychological impact of infertility

Beyond the medical aspects, infertility is a real emotional ordeal. Couples or individuals affected often go through periods of doubt, guilt or even depression in the face of repeated failed attempts to conceive. This psychological strain is compounded by financial and administrative pressures, making the journey even more difficult to cope with. This is why many specialist centres, particularly in the United States, combine medical care with a structured psychological support to help future parents overcome these ordeals.

5. Comprehensive support for expectant parents

The fertility journey is not just a medical procedure: it involves a strong human and emotional dimension. In the United States, specialised agencies and clinics offer comprehensive support: personalised medical care, psychological support, and legal and logistical procedures. This holistic approach helps prospective parents to experience the process with greater peace of mind. Infertility is a complex ordeal, combining medical, emotional and sometimes legal challenges. While France already offers numerous medically assisted reproduction solutions, certain profiles — male same-sex couples, single men or couples facing repeated failures — have to look abroad. The United States thus emerges as a preferred choice, thanks to its medical expertise and protective legal framework.