En France, la PMA repr\u00e9sente plus de 23 000 naissances chaque ann\u00e9e<\/a>. Les diff\u00e9rents types de PMA comprennent :<\/p>\nL\u2019ins\u00e9mination<\/h4>\n
Bien qu\u2019elle ne soit pas techniquement incluse dans les PMA, l\u2019ins\u00e9mination artificielle intervient lorsque le sperme (soit celui du p\u00e8re, soit celui d\u2019un donneur) est \u00ab nettoy\u00e9 \u00bb et filtr\u00e9 en laboratoire, afin de s\u00e9parer les spermatozo\u00efdes des autres composants. Ceux-ci sont ensuite transf\u00e9r\u00e9s au niveau du col de l\u2019ut\u00e9rus d\u2019une femme ou plus haut dans la cavit\u00e9 ut\u00e9rine. La probabilit\u00e9 que la conception fonctionne gr\u00e2ce \u00e0 cette m\u00e9thode est de 10% par mois pour les femmes de moins de 35 ans. Au-del\u00e0 de 35 ans, les taux de r\u00e9ussite de l\u2019ins\u00e9mination (r\u00e9alis\u00e9e en conjonction avec le stimulant \u00ab clomif\u00e8ne \u00bb pour l\u2019ovulation) diminuent comme suit : 9% entre 35 et 37 ans ; 7% entre 38 et 40 ans ; 4% entre 41 et 42 ans ; et 1% au-del\u00e0 de 42 ans. Les r\u00e9sultats d\u2019une ins\u00e9mination artificielle varient de fa\u00e7on significative selon l\u2019\u00e2ge et les origines de la st\u00e9rilit\u00e9.<\/p>\n
La f\u00e9condation In Vitro (FIV)<\/h4>\n
La FIV est une proc\u00e9dure pouvant \u00eatre utilis\u00e9e pour r\u00e9ussir \u00e0 concevoir dans les cas o\u00f9 certains facteurs emp\u00eachent les spermatozo\u00efdes de s\u2019implanter dans les ovules. La FIV survient lorsque le sperme et l\u2019ovule sont \u00ab combin\u00e9s \u00bb hors du corps, en laboratoire. Un ou plusieurs ovules est extrait chez la femme puis \u00ab combin\u00e9 \u00bb avec le sperme. Les ovules ayant \u00e9t\u00e9 f\u00e9cond\u00e9s (dits embryons) sont ensuite implant\u00e9s dans l\u2019ut\u00e9rus de la femme. A partir de ce moment, ils peuvent s\u2019implanter dans l\u2019endom\u00e8tre et commencer \u00e0 se d\u00e9velopper. Une grande partie des couples ayant des probl\u00e8mes de fertilit\u00e9 dus soit au facteur masculin, soit \u00e0 l\u2019endom\u00e9triose, ou encore pour raison inconnue, choisissent de recourir \u00e0 la FIV.<\/p>\n
Le nombre d\u2019ovules n\u00e9cessitant d\u2019\u00eatre extraits varie selon les recommandations du m\u00e9decin et l\u2019\u00e2ge de la femme. Plus l\u2019\u00e2ge avance, plus la qualit\u00e9 de l\u2019ovule diminue, ainsi la femme peut avoir besoin de l\u2019extraction de plus d\u2019ovules pour la proc\u00e9dure de FIV.<\/p>\n
Les femmes de moins de 38 ans ont de meilleures probabilit\u00e9s de r\u00e9ussite quand au moins 10 ovules sont extraits que lorsque seulement 3 \u00e0 6 ovules sont extraits. Environ 16% des femmes de moins de 35 ans arrivent \u00e0 donner naissance apr\u00e8s extraction d\u2019un ou deux ovules, contre 65% des femmes apr\u00e8s extraction de plus de 10 ovules. En ce qui concerne les femmes de 35 \u00e0 37 ans, ces pourcentages sont respectivement de 14 et 50.<\/p>\n
Alors que les probabilit\u00e9s de conception r\u00e9ussie par FIV varient d\u2019un couple \u00e0 l\u2019autre, on peut dire qu\u2019ils ont en moyenne entre 20 et 35% de probabilit\u00e9 de concevoir d\u00e8s le premier essai. Le couple fertile moyen (en d\u2019autres mots celui n\u2019ayant pas besoin de FIV) a 20% de chances de r\u00e9ussir \u00e0 concevoir d\u00e8s le premier mois tent\u00e9. Ainsi, les couples qui envisagent de recourir \u00e0 la FIV peuvent se rassurer en sachant que cette option leur offre autant, voire plus, de chances de concevoir que les couples moyens n\u2019ayant pas recours \u00e0 la PMA.<\/p>\n
Les proc\u00e9dures de FIV peuvent \u00eatre tr\u00e8s co\u00fbteuses, mais le montant qu\u2019un couple devra payer d\u00e9pendra de leur assurance. Aux Etats Unis, le co\u00fbt moyen d\u2019une proc\u00e9dure de FIV au cours de n\u2019importe quel cycle normal va de $12 000 \u00e0 $15 000.<\/p>\n
Le don de sperme ou d\u2019ovule<\/h4>\n
Si un couple s\u2019est r\u00e9sign\u00e9 au fait qu\u2019il pourrait y avoir des probl\u00e8mes de fertilit\u00e9 au niveau du sperme ou des ovules, ou si une maladie g\u00e9n\u00e9tique sp\u00e9cifique pouvant \u00eatre transmise \u00e0 l\u2019enfant est d\u00e9tect\u00e9e, il peut choisir de recourir \u00e0 la FIV en conjonction avec un don de sperme ou d\u2019ovule. Ces dons peuvent soit \u00eatre faits par une personne connue du couple, soit par une banque, qui testera rigoureusement les donneurs pour d\u00e9pister des probl\u00e8mes g\u00e9n\u00e9tiques, des maladies infectieuses, et les ant\u00e9c\u00e9dents m\u00e9dicaux.<\/p>\n
La maternit\u00e9 de substitution, ou le recours \u00e0 une m\u00e8re porteuse<\/h4>\n
S\u2019il existe un probl\u00e8me m\u00e9dical interdisant \u00e0 la femme de porter un enfant, un couple peut choisir d\u2019envisager le recours \u00e0 la maternit\u00e9 de substitution ou \u00e0 une m\u00e8re porteuse. Pour la maternit\u00e9 de substitution, l\u2019enfant sera port\u00e9 par la donneuse de l\u2019ovule, alors qu\u2019une m\u00e8re porteuse n\u2019a aucun lien g\u00e9n\u00e9tique avec le b\u00e9b\u00e9 et les ovules sont extraits de la m\u00e8re biologique, puis f\u00e9cond\u00e9s, et enfin implant\u00e9s dans l\u2019ut\u00e9rus de la m\u00e8re porteuse.<\/p>\n
Rappelez-vous que si vous commencez seulement \u00e0 envisager de concevoir un b\u00e9b\u00e9, toutes ces options sont encore \u00e0 mille lieues des inqui\u00e9tudes que vous pourriez avoir. Cependant, le fait d\u2019avoir une vue d\u2019ensemble compl\u00e8te de tout ce qu\u2019une femme peut vivre pendant une qu\u00eate de grossesse vous offre une connaissance tr\u00e8s utile de tout ce qu\u2019il peut arriver quand un couple d\u00e9cide de fonder une famille. Afin de couvrir toutes les options de l\u2019accueil d\u2019un enfant, la question de l\u2019adoption fera l\u2019objet de notre derni\u00e8re partie.<\/p>\n","protected":false},"excerpt":{"rendered":"
La Procr\u00e9ation m\u00e9dicalement assist\u00e9e, ou PMA, fait r\u00e9f\u00e9rence \u00e0 tout traitement par lequel les ovules […]<\/p>\n","protected":false},"author":9,"featured_media":3953,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[934,960],"tags":[336],"yoast_head":"\n
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