Message to French men and women aged 29: your biological clocks do not forgive, and from your age, fertility rates decrease, so it would be advisable for you to consider the option of preserving your eggs and sperm for future use, so you never have to say, "If only I had known...".
A letter with a more or less similar content will be sent from June to thousands of young French people about to turn thirty, as part of the "demographic rearmament" announced by President Emmanuel Macron and included among the 16 measures of the French Ministry of Health's plan against infertility.
"Having a child or not is a deeply personal decision," acknowledged Health Minister Stéphanie Rist at the plan's presentation. "But behind these intimate issues are collective decisions and public policies, whose role is to open up possibilities for citizens."
"This is not about increasing social pressure," emphasized Rist, anticipating criticism about the intrusive role of the state as a "nanny." "The letters we are going to send will contain information on sexual health and contraception, explain the possibilities for gamete preservation, and emphasize that fertility is a shared issue between men and women."
Although French women's fertility is above the European average (1.8 compared to 1.5 children per woman), alarms sounded at the end of 2025, the first year since World War II with more deaths than births. A total of 645,000 children were born that year in France, compared to 651,000 deaths recorded, leaving the generational replacement in doubt and exacerbating the population aging problem.
"The decline in the birth rate is a challenge for all of Europe," emphasized gynecologist Samir Hamamah, co-author of the report on the causes of the fertility decline that led to the French action plan. "In Italy, the situation is even more critical, with 1.2 children per woman, which could mean a population loss of 12 million compared to the current 60 million."
"One in eight couples has fertility problems," says Dr. Hamamah. The causes can be "medical, environmental, behavioral, and social," although one stands out above all, in his opinion: age, increasingly later, at which couples decide to have children.
In the last four decades, the age of first pregnancy in France has been delayed by five years. In 2019, the bar was set at 29 years, the age chosen deliberately for sending the pro-fertility letters this summer.
"For both men and women, the highest fertility occurs at 25 years old," recalls Professor Hamamah. "At this age, when the couple does not have an infertility problem, women have a fertilization success rate of 25% per cycle. At 35 years old, that rate drops to 12%, and at 40, it is already 6%."
The final message of the letters addressed to young French people has not yet been decided, but sources from the Ministry of Health revealed to Le Figaro that the content will focus on three points. The first will address the choice of having or not having a child, with information on sexual health and contraceptive methods. The second will inform about the biological clock of fertility and the differences between men and women. And lastly, there will be "information on the offer for gamete preservation."
The Ministry of Health plans to increase from 40 to 70 assisted reproduction centers that facilitate gamete cryopreservation, with the aim of "increasing their activity and reducing waiting times." The plan also proposes changes in the management, research, and innovation system for treating infertility due to medical causes.
Since the first report on the causes of infertility published in 2022, this roadmap was expected, causing mixed reactions. For Virginie Rio, from the BAMP collective - which brings together people with fertility problems - the term "demographic rearmament" sounds like an "unwanted mandate." Rio also questions the association between infertility and family policies: "It is not infertile people who will repopulate France."
Other experts warn of the need for a plan that is not strictly health-related but also social, addressing issues such as economic precariousness and housing, which lead many young couples to postpone their decision to have children, as well as the "positive" role that immigration can play in ensuring "generational replacement."