The new ethical challenges raised by the authorization of elective egg freezing in France since 2021

Since 2021, elective egg freezing (EEF) without medical indication has been authorized and fully reimbursed in France for women aged 29 to 37. While this regulatory change represents a significant advancement in reproductive rights, it also raises new ethical and organizational challenges. This study aimed to explore the ethical issues experienced by infertility specialists involved in the clinical implementation of EEF in France.

This prospective, qualitative, monocentric study was conducted in a university-based ART center. All physicians involved in EEF at the center were invited to participate in semi-structured interviews. Data were analyzed inductively using Grounded Theory methodology.

Eight practitioners participated. Four main themes emerged: (1) challenges in accessing EEF due to resource constraints and growing demand; (2) a new relationship between caregiver and patient in a context where care is no longer strictly medical; (3) a need to redefine the role of EEF in society, including the terminology used and funding mechanisms; and (4) questions about the future of EEF, including prioritization criteria, equitable access, and sustainability of the current model.

While EEF is widely supported by healthcare professionals, its integration into routine practice reveals tensions between autonomy, justice, beneficence, and public resource management. National guidelines, improved access to information, and further research-particularly incorporating women's perspectives-are essential to ensure ethically sound implementation.