IVF offers hope in China, even for the government

It was a cold and dreary November morning, but one thing was promising for Guo Meiyan and her husband: They would finally have a chance to get married.

When Ms. Guo, 39, was pushed on a stretcher into the ward, where doctors transferred her harvested and fertilized eggs back to her uterus, she also felt fear.

“If the transplant fails, all the money we spent will be wasted, all the pain I have endured will be in vain, and we will have to start from scratch,” Guo said. , who traveled 125 miles from Beijing to Beijing, said. north of Zhangjiakou city. She and her husband lived in a hotel near the hospital for a month during the final stages of IVF.

They are among the hundreds of thousands of Chinese couples who turn to assisted reproductive technology each year after exhausting other options for getting pregnant. They travel from all over the country to big cities like Beijing in the hope of beating infertility rates. A lot of waiting in long line outside the hospital before sunrise, just for the sake of being consulted.

Now, the Chinese government wants to create the technology they created legal in 2001, more accessible. It has promised to cover some of the costs — often several thousand dollars per installment — under national health insurance. It’s one of more than a dozen policy measures Chinese officials are rolling out to tackle what they see as huge – the birth rate is so low. China’s population begins to decline.

China has reached this turning point earlier than other countries in its economic development, leading to what some demographers call the “old before rich” curse. As fewer children are born each year and China’s oldest people live longer, the government is forced to tackle a series of related challenges — a shrinking workforcea nascent pension system and a generation of young adults uninterested in having children.

Lin Haiwei, chief executive officer at Beijing Perfect Family Hospital, where Ms. Guo gave birth, said subsidies for assisted reproductive services such as IVF, a technology that fertilizes eggs with sperm in a lab, and embryo implantation in the uterus. procedure. Patients do their best to pay for fertility services. Some of them pooled loans from relatives. Farmers promise the fall harvest when they have money to pay.

But even with a clear need for assisted reproductive services, the number of patients who visit the hospital each year is still lower, Mr. Lin said. “The big picture is that people are less willing to have children,” he said.

This is the biggest challenge China faces as it tries to reverse a falling birth rate. Young people complain about the financial burden of having children and their own economic insecurity, while pushing back against traditional notions of a woman’s role in caring for the family. Many expressed a desire to focus on their careers, while others embraced the so-called “double income, childless” lifestyle.

Despite this hurdle, officials are trying to push up one of the world’s lowest birth rates. While experts say it’s almost impossible for China’s population to start growing again, the country can keep its birth rate steady. Ayo Wahlberg, an anthropologist at the University of Copenhagen, says making assisted reproductive technologies accessible to more people will help, just as it has helped in rich nations. than Denmark.

China recently promised to build at least one IVF facility for every 2.3 million to 3 million people by 2025. The country currently has 539 medical facilities and 27 approved sperm banks. to implement assisted reproductive technology. Each year these establishments provide more than one million cycles of IVF and other assisted reproductive services. About 300,000 babies were conceived.

Experts say these efforts are meaningful ways to help couples who want to have children. If China can reasonably scale its services, it could even serve as a model for other countries facing similar challenges with infertility. But whether it will do much to change China’s demographic trajectory is another question.

“The problem is it’s putting a bandage on the bleeding wound,” said Mr. Wahlberg, author of a book on fertility in China.

For couples like Wang Fang and her husband, IVF has changed their lives. Ms. Wang underwent two rounds of IVF in 2016 before giving birth to twins in 2017. Her husband’s first marriage ended in divorce because they were unable to have children.

Both Ms. Wang, a factory worker, and her husband, an electrician, took time off work during the pregnancy to prepare for the birth.

When the first IVF failed, the couple felt broken. They knew they might need a sperm donor, something Ms. Wang has kept secret from her family. Her parents blamed the couple’s fertility problems on her.

“In our homeland, if you don’t have children, you won’t be able to hold your head high,” Ms. Wang said. The second they did IVF, the 14-day waiting period to determine if it was successful was “like half a century,” she said.

As soon as they knew the results, they called everyone. Relatives offered to contribute with their savings to help cover expenses, in excess of $22,000, a large sum for a couple with a monthly household income of less than $1,200 when she Wang and her husband go to work.

“IVF is not a one-time deal, and we ran out of money after a large amount, so we had to borrow money to continue,” Ms. Wang said. If even some of those costs were covered by health insurance, as the government has said it will begin to do, “it would certainly help us and relieve some of the pressure.”

Each round of IVF can cost between $5,000 and $12,000, and many couples need up to four or five sessions; each round has a success rate of about 30 percent. Under the new government measures, health insurance will likely cover about half of the cost of an IVF session, said Lin at Beijing’s Perfect Family Hospital.

The policy is not yet in effect, its details are unclear, and the deadly outbreak of Covid could put things on hold. However, Mr. Lin remains optimistic that some version of the policy will be in place in the coming months.

But he’s also realistic about its impact. “It is hard to expect much growth in our industry as overall fertility rates and childbearing readiness are declining,” said Mr. Lin.

China has a complicated relationship with fertility. For three decades, officials have restricted families to only one child — sometimes with brutal means.

Today, infertility affects 18% of couples in China, compared with a global average of about 15%. The researchers cite several factors, including the fact that Chinese couples often wait to have children and the prevalence of abortions, which experts say could affect fertility. .

Su Yue, 32, has never longed to have children, but her husband and in-laws do. After the couple tried for several years, her mother-in-law gave them money to start IVF treatment. They succeeded last year.

Mrs. Su loves her son, whom she affectionately calls “Cookie”. But she says having a baby has cost her her job. She was breastfeeding while working remotely, but then her boss asked her to come to the office. As a career-minded millennial, she lamented having to resign.

“The most stressful thing about IVF was that I lost my job,” Ms. Su said.

Since the successful transplant in late November, Ms. Guo has comfortably returned home to Zhangjiakou. The hot pot restaurant owned by her husband and wife during the Lunar New Year is always crowded with customers. She still helps, and she found time to knit two baby blankets.

Most of the time, however, she tries to rest in bed, Ms. Guo said. “I feel nauseous and dizzy all the time.”


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