Use of infertility treatments in the French population

Background: Infertility is defined by WHO as “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse”. The first and second line treatments for infertility are simple hormonal stimulation and assisted reproductive technologies, respectively. The use of these treatments could concern a large proportion of couples but, in France as elsewhere, lack of data on simple hormonal stimulation is a major barrier to exploring this issue. Our objective was to explore use of infertility treatments in the French population. Methods: Using data from the French national health insurance system, a cohort (the EGB) was implemented in 2005. It includes 500,000 randomly selected participants and constitutes a representative sample of the French population. All health care consumption of these participants is prospectively recorded. For the present study, women participants aged 20-49 years between 2007 and 2017 were extracted (n = 190,312) and explored for use of infertility treatments. Results: In our representative sample of women aged 20-49 years, 4.21% [4.12-4.30] were treated for infertility between 2007 and 2017. Use of infertility treatments varied according to the womens’ age: 0.88% [0.81-0.95] at age 20-24; 3.34% [3.20-3.47] at 25-29; 4.35% [4.20-4.50] at 30-34; 3.30% [3.17-3.43] at 35-39; 1.84% [1.74-1.94] at 40-44; 0.34% [0.30-0.38] at 45-49. Further analysis will describe care pathways and explore the different treatments for infertility followed by each woman. The association between age and care pathways will be tested. Conclusions: Taking advantage of data from the French national health insurance system, our work explores for the first time use of infertility treatment in a large representative sample. It shows that infertility treatment has an important public health impact with more than 4% of women aged 20-49 years treated for infertility. Key messages: •Our work explores for the first time the use of all treatments for infertility by including not only assisted reproductive treatments but also simple hormonal stimulation. •Data from the French health insurance system are currently opening to research and are a promising source to address topics previously unexplored because of a lack of reliable medical care data