Beijing wants to fight shrinking population with subsidized IVF

This is the biggest challenge the country faces as it tries to reverse its declining birth rate. Young people lament the financial burden of having children and their own economic insecurity, and reject traditional notions of women as caretakers. Many have expressed a desire to focus on their careers, while others have embraced the “dual income, no kids” lifestyle.

Despite this hurdle, officials are trying to push up one of the lowest fertility rates in the world. While experts say it would be almost impossible for China’s population to grow again, the country could keep its birth rate stable. It would help make assisted reproductive technologies more accessible to more people, just as it has helped in wealthier countries like Denmark, said Ayo Wahlberg, an anthropologist at the University of Copenhagen.


The government recently pledged to build at least one facility offering IVF for every 2.3 to 3 million people by 2025. There are currently 539 medical institutions and 27 sperm banks licensed to perform assisted reproduction techniques. Each year, these facilities provide more than 1 million IVF cycles and other assisted fertility services. Around 300,000 babies are conceived.

Experts say these efforts make sense to help couples trying to have children. If the country can expand services in an affordable way, it could even be a model for other countries facing similar infertility problems. But whether it will do much to change its demographics is another question.

“The problem is that it puts a band-aid on a gushing sore,” said Wahlberg, author of a book on fertility in China.

For couples like Wang Fang and her husband, IVF has changed their lives. 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 could not have a child.

Guo Meiyan during an IVF embryo transfer at Beijing Perfect Family Hospital in November.

Guo Meiyan during an IVF embryo transfer at Beijing Perfect Family Hospital in November.Credit:Andrea Verdelli/The New York Times

Wang, a factory worker, and her husband, an electrician, quit their jobs during pregnancy to prepare for childbirth.

When the first round of IVF failed, the couple felt heartbroken. They learned they may need a sperm donor, which Wang has kept secret from the family. Her parents believe the couple’s fertility problems stemmed from them.

“If you don’t have kids in our hometown, you couldn’t keep your head up,” Wang said. The second time they did IVF, the 14-day wait to see if it was successful “felt like half a century,” she said.

As soon as they got the result, they all called. Relatives offered to use their savings to help cover costs, which exceeded $22,000 ($31,000), a huge sum for the couple, whose monthly household income was less than $1,200 when Wang and her husband worked .

“IVF is not a one-time deal, and after several big articles we ran out of money, so we had to borrow money to keep going,” Wang said. If even part of these costs had been covered by health insurance, as the government has announced, this would start now, “certainly that would have helped us and taken some of the pressure off”.

Each round of IVF can cost $5,000 to $12,000, and many couples have to do it four or five times. each round has a success rate of about 30 percent. Under the new government measures, health insurance would likely cover about half the cost of an IVF round, said Lin of Beijing Perfect Family Hospital.

The policy has not been implemented, its details are unclear and a deadly outbreak of COVID could delay things. Still, Lin is optimistic that a version of the policy will be rolled out in the coming months.

But he’s also realistic about his impact. “It’s certainly hard to expect much growth in our industry when the overall fertility rate and willingness to have children is shrinking,” Lin said.

China has a complicated relationship with fertility. For three decades, officials limited families to one child, sometimes through brutal measures.

Su Yue and her son are playing on the balcony of their home in Beijing.

Su Yue and her son are playing on the balcony of their home in Beijing.Credit:Andrea Verdelli/The New York Times

Today, 18 percent of couples are affected by infertility, compared to a global average of about 15 percent. The researchers cite several factors, including the fact that Chinese couples often wait until later to have children and the frequent use of abortions, which experts said could affect fertility.

Su Yue, 32, has never had a strong desire to have a baby, but her husband and in-laws have. After the couple tried for several years, their mother-in-law gave them money to start IVF treatment. You were successful last year.

Su loves her son, whom she affectionately calls “Cookie”. But she said the birth cost her job. She had been breastfeeding while telecommuting, but then her boss asked her to come into the office. As a career-conscious millennial, she laments having to quit.


“The most stressful thing about IVF is losing my job,” Su said.

Since her successful transplant in late November, Guo has been quiet at home in Zhangjiakou. The hot pot restaurant that she and her husband own has been busy during the current Lunar New Year period. She still helps out and found time to knit two mattress covers for the baby.

Most of the time, however, she tries to rest in bed, Guo said. “I feel nauseous and dizzy all the time.” Beijing wants to fight shrinking population with subsidized IVF

Callan Tansill

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