{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T10:14:52Z","timestamp":1778840092563,"version":"3.51.4"},"reference-count":26,"publisher":"CAIRN.INFO","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,15]]},"abstract":"<jats:p>L\u2019infertilit\u00e9 concerne aujourd\u2019hui pr\u00e8s d\u2019un couple sur six et touche plus de 3,3\u00a0millions de personnes en France. Elle s\u2019inscrit d\u00e9sormais dans un contexte d\u00e9mographique in\u00e9dit, marqu\u00e9 par une chute rapide de la f\u00e9condit\u00e9\u00a0: l\u2019indicateur conjoncturel est pass\u00e9 de 1,87 enfant par femme en\u00a02019 \u00e0 1,56 en\u00a02025, tandis que le nombre annuel de naissances atteint son niveau le plus bas depuis l\u2019apr\u00e8s-Seconde Guerre mondiale, conduisant \u00e0 un solde naturel n\u00e9gatif. Cette \u00e9volution conf\u00e8re \u00e0 l\u2019infertilit\u00e9 une dimension strat\u00e9gique majeure pour la sant\u00e9 publique et la coh\u00e9sion sociale. Loin d\u2019\u00eatre un simple probl\u00e8me m\u00e9dical individuel, l\u2019infertilit\u00e9 r\u00e9sulte de d\u00e9terminants multiples et \u00e9troitement intriqu\u00e9s\u00a0: biologiques, environnementaux, socio-\u00e9conomiques et comportementaux. L\u2019\u00e2ge demeure un facteur central, avec une diminution marqu\u00e9e de la fertilit\u00e9 f\u00e9minine d\u00e8s 30\u00a0ans et une alt\u00e9ration progressive de la qualit\u00e9 spermatique chez l\u2019homme apr\u00e8s 40\u00a0ans. Le report croissant de la parentalit\u00e9, favoris\u00e9 par l\u2019allongement des \u00e9tudes, l\u2019instabilit\u00e9 professionnelle, le co\u00fbt du logement et les difficult\u00e9s d\u2019acc\u00e8s aux modes de garde, accentue ces vuln\u00e9rabilit\u00e9s biologiques. Parall\u00e8lement, l\u2019exposition aux perturbateurs endocriniens, certaines pathologies fr\u00e9quentes (endom\u00e9triose, syndrome des ovaires polykystiques, diab\u00e8te) et des comportements tels que le tabagisme, la s\u00e9dentarit\u00e9 et l\u2019ob\u00e9sit\u00e9 contribuent significativement \u00e0 l\u2019hypofertilit\u00e9. La prise en charge demeure in\u00e9galitaire et insuffisamment adapt\u00e9e, notamment dans les parcours d\u2019assistance m\u00e9dicale \u00e0 la procr\u00e9ation. Une strat\u00e9gie nationale structur\u00e9e, fond\u00e9e sur la pr\u00e9vention, la recherche et l\u2019\u00e9galit\u00e9 d\u2019acc\u00e8s aux soins appara\u00eet aujourd\u2019hui indispensable.<\/jats:p>","DOI":"10.3917\/spub.262.0033","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T10:04:51Z","timestamp":1778839491000},"page":"33-39","source":"Crossref","is-referenced-by-count":0,"title":["L\u2019infertilit\u00e9\u00a0: un d\u00e9fi de sant\u00e9 publique et de soci\u00e9t\u00e9"],"prefix":"10.3917","volume":"vol. 38","author":[{"given":"Alexandre","family":"Vall\u00e9e","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Marc","family":"Ayoubi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2273","reference":[{"key":"rb1","unstructured":"1. INSERM. Infertilit\u00e9 [en ligne]. INSERM \u2013 La science pour la sant\u00e9 ; 2019 [visit\u00e9 le 21\/05\/2025]. Disponible sur : https:\/\/www.inserm.fr\/information-en-sante\/dossiers-information\/infertilite."},{"key":"rb2","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoac051"},{"key":"rb3","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2020.305781"},{"key":"rb4","unstructured":"4. INSEE. Natalit\u00e9 \u2013 F\u00e9condit\u00e9 \u2212 Tableaux de l\u2019\u00e9conomie fran\u00e7aise [en ligne]. INSEE ; 2020 [visit\u00e9 le 20\/05\/2025]. Disponible sur : https:\/\/www.insee.fr\/fr\/statistiques\/4277635?sommaire=4318291."},{"key":"rb5","unstructured":"5. INSEE. Bilan d\u00e9mographique 2024 \u2013 Insee Premi\u00e8re \u2013 2033 [en ligne]. INSEE ; 2025 [visit\u00e9 le 20\/05\/2025]. Disponible sur : https:\/\/www.insee.fr\/fr\/statistiques\/8327319."},{"key":"rb6","unstructured":"6. INSEE. Bilan d\u00e9mographique 2023 \u2013 Insee Premi\u00e8re \u2013 1978 [en ligne]. INSEE ; 2024 [visit\u00e9 le 21\/05\/2025]. Disponible sur : https:\/\/www.insee.fr\/fr\/statistiques\/7750004."},{"key":"rb7","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmi006"},{"key":"rb8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2017.03.111"},{"key":"rb9","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh304"},{"key":"rb10","doi-asserted-by":"publisher","DOI":"10.1002\/mrd.22963"},{"key":"rb11","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmx022"},{"key":"rb12","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/des415"},{"key":"rb13","doi-asserted-by":"crossref","unstructured":"13. Bongaarts J, Hodgson D. Socio-economic determinants of fertility. In: Bongaarts J, Hodgson D, \u00e9diteurs. Fertility transition in the developing world [en ligne]. Cham: Springer International Publishing; 2022 [visit\u00e9 le 23\/01\/2026]. pp. 51\u201362. 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