Translation, adaptation, and validation of a Moroccan version of the H-SCALE (Hypertension Self-Care Activity Level effects) for hypertensive patients.

Oocyte vitrification is now a well-established fertility preservation (FP) procedure. Initially intended for medical reason, primarily for patients facing cancer therapies [], it is also proposed for benign conditions that may affect ovarian reserve, such as endometriosis [] or autoimmune disorders []. Due to its effectiveness, this procedure has been extended to women who wish to delay childbearing for personal, professional, or social reasons. In such cases, this practice is referred to as ‘elective fertility preservation’ (EFP) [, ]. For over a decade, EFP has been widely available in different countries, offering women the option to extend their reproductive window [, ]. Indeed, intracytoplasmic sperm injection (ICSI) with warmed oocytes yields comparable results to those obtained with fresh oocytes [], but achieving a live birth is not guaranteed [] and remains strongly age-dependent [], as confirmed by a recent meta-regression analysis. This study revealed that the future conception rate following EFP ranges from 19 to 52% for women aged 40 or under 35, respectively [], with the best outcomes being observed in the 30–34 age group [, ]. Although EFP is a promising alternative for mitigating age-related infertility, performing it too early may increase the risk of not using the cryopreserved oocytes []. In many countries, access to EFP remains largely dependent on financial resources. In the USA, two oocyte-retrieval-cycles, which are often required to obtain 15–20 mature oocytes, cost approximately $15,000 []. In most countries, reimbursement for the procedure is indication-based, with EFP being rarely reimbursed, particularly given the relatively low utilization rate of oocytes []. Importantly, women who choose to delay motherhood are often financially stable, have a partner, and/or are career-driven [, ]. EFP allows women to proactively manage their fertility, which contributes to reproductive autonomy and promotes gender equality [–]. Beyond healthcare policy, EFP has sparked feminist debates about the tension between medical and commercial influence and reproductive autonomy. A recent study, showed that most of the American women interviewed pursued EFP in hopes of having a genetically related child, rather than prioritizing their careers, framing this choice as an act of "responsible" reproductive planning []. In France, the 2021 bioethics law legalized EFP for women aged 29 to 37 without limiting the number of oocyte retrieval cycles. France is also the first country to offer public reimbursement for EFP-related clinical and biological procedures associated, excluding annual storage fees. Only public centers, mainly within the CECOS (Centre Etude et Conservation des Œufs et Sperme humain) network are authorized to perform the EFP procedure. Based on the principle of social justice, this policy aimed to eliminate income-based disparities and ensure equitable access to EFP. This development raises important questions about whether the reimbursement framework influences the demographic profile of women accessing these services [].