In his latest book, La Tyrannie de la Reproduction ("The Tyranny of Reproduction"), René Frydman, a pioneer of reproductive medicine who assisted with the birth of France's first baby via in vitro fertilization in 1982, warns against the risk of having a baby at all costs as a result of recent medical advances.

In 1986, your first book described 'the irresistible desire for birth.' Your latest is entitled 'The Tyranny of Reproduction.' From 'desire' to 'tyranny,' what have you observed over all these years?

In 40 years, society has changed, and infertility problems are no longer quite the same. Today, the desire to have a child comes much later, and certain techniques have become more widespread. I'm thinking of treatments for male infertility, pre-implantation genetic testing and even egg freezing. In a way, this has all expanded the realm of possibilities and reinforced the belief that anything is possible.

This sometimes leads to a kind of stubbornness among some couples and some women; I've seen it in consultations. All the more so as, in our country, medically assisted reproduction [MAR] techniques are covered by social security [public health insurance], which is not the case elsewhere. Therefore, we're increasingly shifting from "I want a child" to "I'm entitled to one."

Meanwhile, you have spoken about a booming assisted reproduction market?

This is a very sensitive issue on a global scale. It's a little less so in France, where we've curbed the number of private and public in vitro fertilization (IVF) centers to a hundred or so. In some countries, there is an abundance of them, with no oversight, and it's become a business. Large groups have taken control of the market, setting up branches, franchises, profit targets, etc.

Who do you think is setting up this 'tyranny of reproduction'? Is it the doctors, the patients?

It's a combination. Doctors are faced with couples and single women who are constrained by their biology and sometimes lose themselves, becoming destabilized in this endless pursuit. They have to learn to say no. There are times when I've seen people come out of consultations relaxed, even though I've just told them it would be better to call the whole thing off. This can be a source of relief. Sometimes, you have to fight for it, and from time to time the doctor has to say, "we're stopping everything because it's bound to fail." And then, sometimes, a miracle happens and a pregnancy occurs.

After some 3,000 births, do these unexpected pregnancies still fill you with the same sense of wonder?

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