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Infertility currently affects nearly one in six couples, representing more than 3.3 million people in France. Infertility now occurs in an unprecedented demographic context, marked by a rapid decline in fertility: the total fertility rate has fallen from 1.87 children per woman in 2019 to 1.56 in 2025, while the annual number of births has reached its lowest level since the post–Second World War period, resulting in a natural population decrease. This trend gives infertility major strategic significance for public health and social cohesion. Far from being a purely individual medical problem, infertility arises from multiple, closely interrelated determinants, including biological, environmental, socioeconomic, and behavioral factors. Age remains a central determinant, with a marked decline in female fertility from the age of 30 onward and a gradual deterioration in sperm quality in men after 40. The increasing postponement of parenthood, driven by longer educational trajectories, job insecurity, high housing costs, and limited access to childcare, further exacerbates these biological vulnerabilities. In parallel, exposure to endocrine-disrupting chemicals, common conditions such as endometriosis, polycystic ovary syndrome, and diabetes, as well as behaviors including smoking, physical inactivity, and obesity, significantly contribute to subfertility. Current care pathways remain unequal and insufficiently adapted, particularly for individuals undergoing assisted reproductive technologies. A structured national strategy based on prevention, research, and equal access to care is therefore urgently needed.