What can be learned from the Chinese experience in response to infertility

Abstract

Objectives

The aims of the study were to reviews the history of China's population policy since 2011, and draw lessons from the Chinese experience in response to infertility.

Methods

Data from the Chinese infertility status survey report (2009) and national statistical yearbooks (2009-2019) are used to assess the severity of infertility and reproductive centers shortage in China. Lessons from China was informed by a review of existing literature.

Results

The proportion of couples suffering from infertility in China increased to 12.5% (166.8 million in 2009) from just 6.89% (86.6 million in 1988) two decades earlier, while the number of reproductive centers was one for every 3.1 million citizens. The total costs per live birth for medically assisted reproduction in Chinese public fertility clinics was 30,000 yuan in 2012. Among infertile couples, unemployed patients accounted for the largest proportion (21.9% in 2014). Currently in China, health regulations permit oocyte donation only from infertility patients who have 20 or more mature oocytes, of which at least 15 must be kept for their own treatment.

Conclusion

It is necessary to integrate the reproductive health care of infertile people into the national public health service. In addition to relieving their economic burden, national policies should guide and support enterprises to guarantee employee medical leave for infertility. Growing numbers of bereaved older women who have lost their only child make it imperative to reconsider liberalizing the regulation of oocyte donation in China.

摘要

目的：回顾2011年以来中国的人口政策, 总结中国应对不孕症的经验教训。

方法：利用2009年《中国不孕症现状调查报告》和2009-2019年《国家统计年鉴》的数据评估中国不孕症和生殖中心短缺的严重程度。通过对现有的文献回顾, 得到来自中国的经验与教训。

结果：中国不孕不育夫妇的比例从20年前的6.89%（1988年为8660万）上升到12.5%（2009年为1.668亿）, 而每310万公民就只有一个生育中心。2012年, 中国公共生育门诊中辅助生殖的人均花费3万元。在不孕夫妇中, 失业患者所占比例最大（2014年为21.9%）。目前, 中国卫生法规只允许有20个或以上成熟卵子的不孕症患者捐献卵子, 其中至少15个必须保留用于自己的治疗。

结论：将不孕症患者的生殖保健纳入国家公共卫生服务体系是十分必要的。国家政策除了减轻不孕不育患者的经济负担外, 还应引导和支持企业保障员工不孕不育的病假。越来越多的失去独子的高龄妇女不得不考虑放宽中国卵细胞捐献的规定。

Keywords:

• Infertility
• reproductive technology
• oocyte donation

Author contribution

PZ contributed to the writing of this article and leaded the whole study, including getting funding source.

Disclosure statement

The author reports no declarations of interest. The author alone is responsible for the content and writing of the paper.

Additional information

Funding

Funding for this work came from Hunan Provincial Health and Family Planning Commission 2018 Annual Scientific Research Programme [B20180602].