In May 2022, after deciding to have a baby, Clémence B and Sophie Riche went to see their gynecologist. The law had changed six months prior and lesbian couples in France, like B and Riche, were now entitled to the same free fertility treatments that heterosexual couples with infertility had had access to since the early 1990s.

They say their gynecologist warned them that there’d be long wait times for in-vitro fertilization (IVF) in France and encouraged them to instead seek treatment abroad. 

“Go to Belgium," Clémence B recalls being told. “You could be pregnant by the end of the year.” 

So, the couple took their doctor’s advice and travelled north. But they didn’t get pregnant that year. Nor was Belgium the only European country they’d have to travel to as they tried to realize their dream of becoming parents. 

Four years and tens of thousands of euros later, the couple from Lille are still not parents. They say they were inadequately prepared for how difficult IVF would be and were poorly advised about the costs and reimbursement processes. As a result, they’ve been left financially ruined. “We had savings,” says Clémence B, who agreed to talk to Fuller on condition that her last name not be used in full. “Now we don’t.”

Despite the universal right to “found a family,” declining fertility rates around the world and the documented “devastating” mental health impact of involuntary childlessness, access to fertility treatments (or what the medical community call assisted reproductive technology, ART) – even in some high-income countries – is still viewed as an expensive choice individuals need to shoulder on their own.

France stands out as an exception. A 2024 comparative map of policies across 49 countries and territories ranks France in the top 4, indicating it provides “excellent” access to safe and efficient fertility treatments. Today, all French women – with the exception of transgender women – can get state-funded fertility treatments up to the age of 43, regardless of any cause of infertility or marital status. 

With surrogacy (where a woman carries and delivers a baby for someone else) is illegal in France, fertility treatment is a key option for same-sex couples looking to get pregnant. And yet, Fuller learned that lesbian couples and single women continue to find it hardest to access fertility treatment. A shortage of sperm and egg donations has created wait times ranging from several months to several years, aging many women out of eligibility or forcing thousands to seek often more expensive reproductive healthcare abroad. 

“The law says we have the right,” says Clémence B. “But waiting three years isn't access to a right.” 

Surging demand 

It took Priscilla Heuveline, who first began fertility treatment in Belgium, 12 years to get pregnant. Remembering that time, the 40 year old says: “The trips were exhausting: four to five hours of driving. Once, I even did the injection [to stimulate ovulation] on the highway. You build your life around it [so] every failure is very, very difficult.”

She thought things would improve after access to fertility treatment was expanded in France, but Heuveline did not anticipate the surge in demand that would also follow. 

Between August 2021 when the law changed and December 2022, 15,000 women had sought an initial consultation for fertility treatment, compared to 2,000 heterosexual couples. 

In 2024, Catherine Guillemain, president of the sperm donor centers, Cecos, called the skyrocketing demand “a tsunami.” That year the average wait time for sperm (measured from the first fertility treatment appointment to first insemination) was 17 months and 24 months for donor eggs.

Faced with this reality, Heuveline contacted a private clinic in Spain. Within three months, she was undergoing an embryo transfer and nine months later, she’d given birth to a baby boy.

Heuveline says she spent about €3,500 (approximately $4,000) on that procedure, as well as on travel and accommodation. Better informed than Riche and Clémence B had been, she was able to get a partial reimbursement of her total costs. France is one of the few countries in Europe to offer such reimbursements. 

Today in France around 4% of babies, or one in every 25, are conceived through IVF, according to the French National Institute of Demographic Studies. And a poll of the French public, conducted in the months before the law changed, found that 67% of the representative sample were in favor of opening up fertility treatment access beyond heterosexual couples.

Yet lesbian women Fuller spoke to also describe encountering discrimination, ignorance or intrusive questioning by healthcare workers.

“Even now, after our son’s birth, I see that the ART process has left a psychological and physical impact on me," says Charline Durand, 35, who underwent treatment at a gamete (sperm and egg) donation center in the French city of Reims, and counts herself “lucky” that she and her wife were able to welcome their son in 2024 after an 18-month process. 

Durand tells Fuller that during a psychological consultation she was asked: “Will your child have a male reference in their life? What does that even mean?” Durand remembers replying. “Our child isn’t growing up in a lesbian-only world. We have male friends and family.” 

“Being judged like that felt absurd,” she says. “As a lesbian couple, having a child through ART in France isn’t easy, even when the medical treatment goes well.”

When Fuller asked the center in Reims about the incident, a spokesperson said they were concerned by the account as their psychologists were not expected to ask patients this, adding that they would be reviewing the case. 

Heuveline describes having a similar experience where a psychologist asked her how she would explain to her child “that there is no father” and “what each mother would be called?” 

“It was very intrusive. Questions heterosexual couples are rarely asked,” Heuveline says. “I don’t think medical staff are properly trained to support same-sex couples.” 

It is hard to know the frequency with which lesbian couples or single women have had to answer intrusive questions as they seek fertility treatment in France. There is, however, data confirming that some French LGBTQ+ people have experienced homophobia when accessing healthcare and other documented accounts of experiences like that of Durand and Heuveling. 

For example, last year the French independent human rights watchdog ruled that two lesbian couples had faced direct discrimination based on their sexual orientation when seeking fertility treatment at a public hospital.

According to the ruling, a doctor had explained to the couple that, due to the “values of the facility,” they would not receive care and were redirected elsewhere. The ruling, which names none of the parties, concluded that the institution had violated anti-discrimination laws and recommended staff training to ensure equal access to assisted reproduction services. 

In September 2021, €8 million ($9.3 million) was allocated to 33 public gamete donor centers in an effort to bring waiting times down to six months within a year. Marine Jeantet, head of the government’s French Biomedicine Agency, tells Fuller that those funds have been used to recruit staff and improve patient preparedness. However, 5 years in, inconsistencies remain. 

“We are analyzing best practices, because some centers have much shorter waiting times than others despite similar demand,” Jeantet says, but cautions: “Even in the best-case scenario, professionals say a minimum six-month wait is unavoidable.”

‘Taking the place of infertile couples’

Of all the demographic groups pursuing fertility treatment in France however, according to the government’s own data, “single women in particular [face] barriers.” 

Noëlle Bideau, a board member at Maman Solo, a French nonprofit that supports single women seeking assisted reproductive treatment, says single women “experience longer waiting times, multiple psychological appointments and intrusive questions about sexual orientation.” Maman Solo received nearly 100 complaints last year from members undergoing fertility treatment all across France, Bideau says. Many were women of color. 

A 26-year-old woman, who asked to remain anonymous to protect her privacy, describes receiving a letter from a private clinic in Reims. The letter tells her that sperm, which is controlled by the public gamete donor center in the city, “would only be available from the age of 29.” French law sets no minimum age for access, past adulthood.

Another single woman, 32, who also asked not to be named, underwent IVF at the same clinic. She says a doctor told her: “You are taking the place of infertile couples.” 

The woman showed Fuller forms she received from the public gamete donor center last December, which required a male partner be named, despite being registered as a solo patient. 

A spokesperson for the center declined to comment when asked about the younger woman’s story, citing medical confidentiality, but tells Fuller the documents have since been updated and that the matter will be reviewed with the clinical team.

Jeantet, head of the French Biomedicine Agency, tells Fuller it is not their role or mission to monitor gamete donor centers: “When we see problematic practices, we alert hospital directors, but we don’t have policing or sanction powers.”

A warning against commodification

If the government’s plans to send fertility-awareness letters to all 29-year-olds are anything to go by, France’s falling birth rates are causing concern among policymakers. In 2025, the country recorded more deaths than births for the first time since the end of World War II.

While safe and accessible fertility treatment is part of the solution, Anita Fincham tells Fuller that wait times for sperm and egg donors cannot be expanded overnight. 

“Opening the system to more people should come with increased resources. Otherwise, waiting times become unmanageable,” says Fincham, advocacy manager at Fertility Europe, a pan-European organization advocating for people facing infertility. However, “gametes are not a commodity and should not be treated like one.” 

In France, the use of gametes from a single donor is legally limited to the birth of five children, a measure intended to prevent large numbers of genetically related offspring. The case of the Dutch sperm donor who fathered 1,000 children underscores the need for strict regulations and the ethical issues surrounding donor oversight and transparency. 

Despite the challenges, there are some examples of best practice in France. The average wait for fertility treatment at Nancy University Regional Hospital is about seven months, compared to the national average of 17.7 months.

“Our short waiting times aren’t magic,” says Mikaël Agopiantz, head of fertility medicine at the Nancy ART center. “We recruit donors, communicate clearly and simplify procedures by removing unnecessary steps.” 

Agopiantz says importing sperm from other countries in Europe is another way they reduce delays, with most donations coming from Danish and Portuguese banks. Sperm donations from Spain are not accepted in France because Spanish law does not allow donor-conceived children to trace their origins.

“Women may choose to go to Spain, but we warn them their child won’t be able to access the donor’s identity,” says Jeantet.

Clémence B and Riche know this but are currently preparing for another embryo transfer in Spain. They’re also channeling their frustration into action with an online petition demanding the government takes steps to improve access. Since 2024, it has gathered some 7,000 signatures. 

“It’s completely abnormal to open a right and put no means behind it,” says Clémence B. “I will continue to speak out so that access to fertility treatment becomes real for everyone.”

Global context 

Across Europe, state funded IVF (when the sperm and egg are fertilized outside of a person’s body) and intrauterine insemination (IUI) do not always translate into timely, equitable care for all. In Sweden, single women have had legal access to assisted reproduction since 2016, yet research shows waiting times in parts of the public system can stretch to three to four years, pushing many there to seek private treatment abroad. 

Similar to France, waiting times for fertility treatment in public hospitals can reach 12 to 24 months in Spain and some regions of Portugal, and six to 12 months in at least 15 other European countries, including Denmark, according to comparative research.

How we made it

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