The hidden stakes of oocyte preservation
The opening of private commercial centres for the self preservation of oocytes : It was one of the announcements by Catherine Vautrin during an interview for Femme Actuelle on 12th June 2025, on the subject of new measures in support of procreation. The measures aimed at combating the marked drop in birth rate which is affecting France. In 2024, the number of children per woman fell to 1.62, the lowest figure since the second world war…
The minister for Work and Health, Solidarity and Families also mentioned the introduction of a “reproductive health” feature in the free of charge “My Prevention Assessment” consultation, aimed at 18-25 year-olds. As well as a message sent by the French health system on those subjects to every French citizen during their 29th year, as well as the availability of a fertility assessment for all couples. She also announced her intention to develop centres for the self-preservation of oocytes, such that “Everyone should have access to a centre less than an hour away from their home”. It is in that context that she is considering authorising such an activity in commercial private centres, which is not currently permitted. In May 2024, Emmanuel Macron had already made the announcement in an interview for Elle magazine : “We are going to open private centres for the self-preservation of oocytes”.
What is meant by the self-preservation of oocytes ?
This procedure was initially developed to allow women who need to undergo heavy medical treatments (such as anti-cancer treatments) to “put aside” oocytes, so that they are not affected or destroyed by the treatments.
Since the August 2021 bioethics law, self-preservation has been made available to all women between the ages of 29 and 37 without any medical reason. Subsequently, they can, if they so wish, apply to use their preserved oocytes until their 45th birthday through an ART procedure (in vitro fertilisation, IVF, in such case becoming de facto obligatory).
Nowadays, this technique is put forward as a claimed “possibility for preserving fertility” against natural ageing and as a possibility for deferring till later an intended pregnancy. However, the procedure is laden with risk and does not in any way constitute a guarantee of maternity. It could even result in a loss of such chances for many women, since it encourages women to use ART, with its low success rate, and to delay, therefore increasing the probability of failure. Finally, it encourages women to consider later pregnancies, which are therefore higher risk.
Opening of new private centres ?
Currently, only public health establishments or non profit-making private establishments licensed to provide public hospital services, when they are so authorised, may undertake the collection and preservation of gametes.
In the event of a national shortage, dispensations are possible. This is already addressed by the framework defined by the 2021 bioethics law. When no licensed establishment is accessible in a département, a commercial private establishment may be authorised to practice this activity, subject to an assurance that it will not exceed the agreed tariffs[1].
An explosion in demand
With artificial procreation, as is often the case, the supply generates the demand, it is inevitable. Precisely, the demand is ever increasing. The Biomedicine Agency has recorded almost twenty thousand requests for the self-preservation of oocytes of which only four thousand could be executed, according to the data compiled until August 2023. 54 % of requests stem from the Ile-de-France region.
In an interview for Marie Claire, Marine Jeantet, the director of the Biomedicine Agency, rejoiced: “It is very popular with thirty year olds, it will become systematic. At a time when the centres are saturated and that complaints by women “turned down” and disappointed are abundant. In fact, this so-called right is in practice not accessible by all.
That is the reason why the Minister Catherine Vautrin announced that the self-preservation procedures should be reviewed in the next bioethics law, which is to be revised in 2028, at the latest. A mapping of the nation is in progress, the stated objective being that there should be a medically assisted procreation centre in virtually all regions. “That will constitute one of the missions for the steering committee which we shall create under the leadership of Pr. Samir Hamamah”.
Through amendments, the question of commercial centres was covered during the revision of the 2021 bioethics law, and rejected (apart from exceptional dispensations), in the name of respect for the principle of the unavailability of the human body.
A breach in the respect for the principle of the unavailability of the human body
The monopoly which restricts oocyte donations to public health establishments and to non profit-making organisations is the result of the debates around the first bioethics law in 1994. It is the concrete, operational translation, of the principle of non-patrimoniality of the human body, its constituent parts and its products.
In fact, the unavailability of the body is the nature of a right established out of range of any individual wishes. The human body is in fact a “non-commercial” asset, in accordance with the principle of unavailability of the human body established by the Civil Code which provides that “Everyone has a right to the respect for their body. The human body is inviolable. The human body, its constituent parts and products cannot be subject to a patrimonial right. Any conventions which confer a patrimonial value to the human body, its constituent parts or its products are null and void. No remuneration may be granted to anyone who submits to experimentation on their person, to the collection of parts of their body or the collection of its products”.
As a result, the exclusion of the commercial private sector is not limited to the donation of gametes but also concerns all other human body cells, tissues and organs. Certain procedures are authorised exceptionally (blood donations, grafts). However, “as perfectly expressed by the saying “The exception confirms the rule”, as soon as a possibility is established as an exception, the consequence is a dispensation against the principle. Therefore, these exceptional possibilities confirm the existence of a principle of unavailability of the human body. Such transfers are subject to respecting their gratuity and anonymity[2]“.
If a breach is opened for gametes, that deviation could well be extended to other parts and products of the human body and, by domino effect, destabilise the entire subject of donations.
There are many questions to be considered. For example, what happens if a woman “self-preserves” 10 oocytes in a private centre at the age of 31, then finally becomes pregnant at the age of 34 and a few years later gives birth naturally to several children, without resorting to ART with her partner ? Could her “unused” oocytes then be donated to the highest bidder ?
What would happen if a private company was responsible for the redistribution, according to its own matching or genetic criteria, of the sperm and oocytes which it collected ?
Precisely, in 2011, the general inspection of social affairs (IGAS) conducted a mission on the subject. It concluded by stating that a clear separation is needed between the collection, which may be accomplished by private centres ; and the qualification, preservation, and especially the matching and distribution, which must remain under the responsibility of an organisation with no financial links with the receiving couple.
The technique does not come under care but is a personal request
Self-preservation of oocytes is a long and costly procedure, with no guarantee of the results. Currently, the overall procedure (around 3,000 euros) is covered by health insurance. Only the preservation costs (45 euros per year) are due by the women.
The context, however, is of a person in good health, in principle not suffering from infertility. It is in effect a hijacking of the medical mission of the health system.
A procedure which will frequently be performed….for nothing
The experience abroad and several studies have confirmed that the procedure will often be performed and eventually remain unused. An American study by the New York Fertility Centre (2021) shows that over a ten-year period, only 38% of the women who preserved their oocytes between 2005 and 2009 eventually returned to request to use them.
Another study published by the UZ Brussel Human Reproduction Centre in Belgium (2023) shows that of 843 women who preserved their oocytes between 2009 and 2019, only 27% have already returned, i.e. 231 women. Among those, only half used their preserved oocytes. The others requested inter-uterine insemination or IVF with freshly collected oocytes.
An Israeli study shows the main reasons why women do not “return” to use their oocytes: in some cases due to spontaneous pregnancies or due to the absence of a partner, which dissuades them from proceeding with their project alone.
A procedure already planned to include oocytes in a donation system ?
Marie Claire magazine has voiced the idea that within a few years, ” significant stocks should be available, since on average, 60% of women do not use their own stock”. Therefore, it can be assumed that those women would be prepared to donate them. Marine Jeantet, the director of the Biomedicine Agency states: “It is my secret hope”.
How should that be interpreted ? How can one rejoice at the fact that women are offered techniques which are not free of risk for them, or which could even be harmful, and that in the end, they endure it all for nothing ? How can one accept that such costs be borne by national solidarity, through the health system acting as intermediary, diverted from its prime mission, and already suffering from a major lack of funding, with the intention of establishing a stock of oocytes ?
If subsequently, the woman has no need to make use of her preserved oocytes, she may decide to donate them to women waiting for a donation of gametes, provide them for medical research, or even simply terminate their preservation.
In its Advice 126 dated June 2017, the National Consultative Ethics Committee (CCNE) considered that “The latter solution does not appear to be acceptable if the oocyte preservation is funded by society”. Which in effect is now the case. It considered that it could “be desirable to introduce a condition for access to a self-preservation request, in the form of a consent to the donation of oocytes if they are not used. (…) This approach would increase the stock of oocytes available in the medium and long term.
New pressures on women and on couples
Whether one so wishes or not, this claimed new right exerts new pressures on women, who could feel that they are not giving themselves “the best possible chance” by not using what is available to them.
It should be noted that in order to avoid any possible pressure by an employer on employees, such as encouraging them to defer a pregnancy for professional reasons, the law provides that the costs relating to the self-preservation of gametes cannot be covered or compensated directly or indirectly by the company.
This technique also generates demand in couples who are not suffering from infertility, but who through such means, question their desire for a child and who end up “deferring until later”. We expected to be dealing with single women, who have not found a partner, but instead we are seeing women in partnerships, sometimes with their partner”, according to the department headed by Joëlle Belaish-Allart, a gynaecologist, specialising in fertility and President of the French National College of Obstetric Gynaecologists (CGNOF). “The proportion of women in couples is ever increasing, 20 % in 2023, 25 % in 2024”. This is confirmed by Dr. Stéphanie Huberlant-Balas, Head of the Clinic at the Nimes Hospital Obstetric Gynaecology and Reproductive Medicine department: “we are seeing stable couples jointly electing to delay their parenthood plans”. Finally, self-preservation is “a tool for managing matrimonial uncertainty” according to the analysis by Hélène Malmanche, a Paris midwife and doctor of anthropology.
Late pregnancies, paradoxical obligations
Today, we are aware that the delaying of the age of maternity is the first factor of infertility. The Report on the causes of infertility submitted to the Government in 2002 by Professor Hamamah insists on that point : “In France as in all industrialised nations, the rise in infertility is primarily the result of the delaying of the age of maternity. In four decades, the age of maternity has increased by five years. In 2019, French women had their first child at 29 years old on average. Since fertility gradually declines from 30 years of age, so-called “late” pregnancies inevitably increase the risk of infertility”.
However, self-preservation is precisely being offered to all women such that they enjoin the scheme. In an interview for Elle magazine, President Macron stipulated : “We are going to organise campaigns promoting the self-preservation of oocytes for all women who wish to have their children later”.
The new market of women’s wombs
This system being established – hormones, clinics, gamete banks – represents a new market based on women’s wombs. Behind the “deep-freeze option” which may seem trivial there is a real stake : the nature of the model of society which we wish to promote.
With the expected vulnerability due to the principle of unavailability of the human body, and the promotion of a procedure which may well prove ineffective, for the purpose of establishing stocks of oocytes, rich in “bio value”, with the opening of commercial private centres, human procreation is steadily degenerating towards a procreation market . Women’s wombs are becoming a resource for these “bio-economies” which are being established worldwide.
There is so much to be done, so much to say, to protect the woman of today, and even more for the woman of tomorrow, in the face of the grip being applied – hand in hand – by technology and the market on the human, and in particular the female body. This ethical and humanitarian stake should be a concern for ecologists and feminists by their ability to promote a policy preserving the ecology – ecosystems and temporality – of the female body.
What about the child in all this ?
Does cryopreservation have an impact on the health of the child to be ? Oocytes, which are the source of the first embryonic cell, experience a particular process throughout these procedures : with hormonal stimulation, they are “forced” to mature, then following a puncture, they are subjected to various transformations in order to remove the water from the cell, and replace it with “antifreeze” products. Then, the oocytes are stored in liquid nitrogen, sometimes for several years, before being “warmed up”, then fertilised in vitro, often by direct intrusion of a sperm (the so-called “ICSI” method).
If the oocytes are not used by the woman, but enjoin the donation process, the question of children’s rights is also a factor. Our nation – which has ratified the International Convention of Children’s Rights, which establishes the right, for any child, from birth, to a name, a nationality and, as far as possible, to know its parents and to be brought up by them – has gone back on its word. Through the donation of oocytes, our law which deliberately organises the conception of a child in a manner which erases the mother and merely allows the child to know the “identity” of the female donor, on reaching adulthood, is clearly in breach of that right.
Moreover, late pregnancies represent a higher risk both for the woman, and for the child, in particular through a greater risk of prematurity. Concerning pregnancies with oocyte donation, they also involve a greater risk of pre-eclampsia, a physiological phenomenon which sometimes causes a life-threatening emergency for the mother, and for the foetus.
Further reading :
Self-preservation of oocytes : Facing the reality – 15th December 2023
How to explain the fall in birth rate in France ? 23rd January 2025
Feminism should be defending women against the bioeconomy which is threatening their body – 8th March 2022
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