Access to assisted reproductive technologies (ART) for female couples and single women: ART professionals’ attitudes three years after the French law reform

Abstract Background Legal reforms expanding access to assisted reproductive technologies (ART) raise important ethical challenges regarding equitable access, including questions around the principles of autonomy, beneficence, non-maleficence, justice, and the potential persistence of differential practices beyond formal legal inclusion. This study aimed to evaluate whether a brief educational intervention could influence ART professionals’ attitudes toward providing care to single women and female couples three years after the French bioethics law reform. Methods We conducted a pre–post interventional study among 34 ART professionals. The intervention consisted of a 15-minute educational video addressing implicit bias and inclusive clinical practice. Participants evaluated seven clinical scenarios involving single women and female couples before and after the intervention. Changes in favorable decisions and reported practices were analyzed. Results Before the intervention, 90–100% of professionals supported access to ART in four scenarios, whereas 73–88% provided favorable responses in the remaining three. A slight, non-significant increase in favorable decisions was observed post-intervention. Professionals reported conducting psychosocial interviews more frequently for single women (65%) and female couples (56%) than for heterosexual couples (6%, p < 0.001). Conclusion Despite overall support for expanded access to ART, differential practices suggest persistent implicit biases and raise concerns about equity and justice in reproductive healthcare. Brief educational interventions alone may be insufficient, highlighting the need for broader ethical and structural approaches to ensure fair access to ART. These findings are discussed through the lens of biomedical ethics (Beauchamp and Childress’s four principles). Recommendations are proposed to improve equity of access and standardize psychosocial evaluation practices.