LDCs for all, GPA ... The answer to 10 questions on the Estates General of Bioethics.

"What world do we want for tomorrow? It is on this question that the General Estates of Bioethics are opening today, the first stage in the revision of the bioethics law that should take place at the end of the year. First part of the discussion: reproduction, embryonic development, as the press kit says. More poetic translation: realization of the desire of a child for all.

What is the difference between IVF and PMA?

For a long time, the problems of bioethics and fertility were summarized by IVF, In Vitro Fertilization, which is only one of the techniques of what is called the PMA, the Medically Assisted Procreation. The PMA is the set of clinical and biological practices, where medicine intervenes, more or less directly, in procreation. And in this area, the debate has raged for a few years, requiring urgent and delicate arbitrations.

But we are there ... The law imposes a revision of the rules of bioethics every 7 years. The previous one was from 2011. The next six media months will be resolutely ethical.

Why a revision on this subject?

This revision is necessary for several reasons: the advancement of science, the constant search can move quickly from dream to reality, even more when marketing can serve as a catalyst. It is also an area that is easily invoked in politics, hence the passion of the debates in the name of the great republican principle: "for all".

Why use these techniques?

A child for all couples who can not have one.

About one in six couples have difficulties to have children.

What are supernumerary embryos called?

If the problem is "mechanical", but both parents have eggs and sperm capable of fertilization, 1978 and the birth of Louise Brown, the first "baby test tube" will remain that of the birth of IVF, In Vitro Fertilization, which has not stopped since improve.

To the point that some spermatozoa are sufficient today to fertilize embryos few and we also know to avoid multiple pregnancies early. Indeed, the stimulation of the ovaries being more effective than the need, most couples have embryos in "too much". Few ethical issues with IVF; rather satisfactions, except the problem of these supernumerary embryos, whose research is badly needed. A little more clarity on the conditions of use will be welcome, because without news of the couple for 5 years, the center can put an end to embryo preservation.

Will the donation of sperm (and oocytes) remain anonymous?

If the man can not provide sperm, the sperm donation is there to solve the problem quite easily. Since a long time and without any real ethical problems, even if the specialized centers, the CECOS, alert regularly on the needs of donors. The situation will not settle with the recent news and the story of this young man who has found his biological father through an investigation, not within the reach of everyone, but effective. This adventure is likely to give the idea to others ... But it opens especially the discussion on the "justifiable" ethic of the anonymity which is for the moment the rule. Will donors be so generous tomorrow if some unknown children come to claim their obvious rights in the event of proven paternity? A file that was not specifically provided for in this revision, but that will inevitably invite itself.

For the woman who can not put eggs at the disposal of the maternity project, the oocyte donation (this is the stage where the egg is ready to be fertilized) exists and obeys the same ethical rules as the donation. sperm.

Can we put sperm or oocytes on the "side"?

For the man, it's simple and cheap. This consists of freezing semen flakes in nitrogen and making them available on demand. Collection cases, for example before chemotherapy or medical chemical castration, are numerous and well organized. Post-mortem use by the widow is another use to be debated.

For the woman, the freezing of oocytes for medical reasons is also perfectly possible in our country.

Can we keep oocytes for a future pregnancy, without medical reasons?

This preservation, for reasons of "life precaution" is prohibited. However, the demands are more numerous, because the desire for maternity is more and more frequent after 35 years. We know the difficulties at this age, hence the desire of many women, to stimulate before this age, and to have oocytes taken, which are then available to the future mother, as soon as she finds a potential father. Most of the women who do this go to Belgium and especially Spain, where, for several thousand Euros, some prescriptions complicit with French doctors (for the period during which the ovaries of the candidate are stimulated before the levy), the oocytes are removed and stored in liquid nitrogen.

The pressure is important for the review to address this problem.

Same-sex couples

For those who do not want to make an adoption but actively participate in the child project, several solutions exist.

The PMA for all?

For female couples who practice artificial insemination of one or other of the women, the technique is simple and the same as for a heterosexual couple where the man is sterile. The problem occurs when declaring the child, who can not have two legal "mothers"! Among the hot issues of this bioethical revision, the PMA for all is certainly the one that will be the most discussed since the Secretary of State for Gender Equality recently confirmed the campaign promise of Emmanuel Macron: in 2018, the LDCs for all women will be presented to Parliament.

Today, couples who want to do it officially go either to Belgium or Spain, and then find themselves in front of a legislative gap.

What is GPA?

For male couples, one of whom wants to be the biological father, there is only one option: surrogacy, gestational surrogacy, what used to be called "surrogate mothers". For the moment, the law is categorical, it is forbidden, and it is not expected that the legislative debate will be open.

In conclusion, many subjects, probably passionate, some of whom will inevitably descend on the street.

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