Many places have announced that IVF will be included in medical insurance, and the spring of infertile couples is coming?
In November this year, Guangxi, following Beijing, announced that some of the treatment items in IVF could be reimbursed by medical insurance. This is undoubtedly good news for the infertile group who want to have children.
But in fact, in the process of infertile couples deciding to do IVF, it is far more than time, cost and physical pressure, their lives will also have a significant impact, and there are many unsolved problems in the process...
How many people need IVF
According to the National Reproductive Health Surveillance of Childbearing Age Populations initiated by Peking University Third Hospital, the infertility rate among people of childbearing age in mainland China rose from 11.9% in 2007 to 17.6% in 2020.
However, in the current infertility group, there are still a few who really go for IVF and persist until the end.
According to the National Health Commission, in recent years, the total number of assisted reproductive technology cycles in mainland China has exceeded 1 million per year, and the number of babies born has exceeded 300,000. If calculated according to the annual birth of about 10 million newborns, the proportion of IVF is only about 3%.
In the infertile population, female infertility caused by fallopian tube factors, male infertility, female ovarian failure, or unexplained infertility are generally recommended by doctors to choose IVF.
IVF is further divided into three generations. Among them, the most used is the first generation of IVF, which is mainly for female infertility such as blocked fallopian tubes and ovulation disorders. The second generation of IVF is symptomatic of male infertility problems such as oligospermia and asthenospermia. In the third generation of IVF, on the basis of the first two generations, the link of embryo genetic diagnosis is added, and the success rate is higher than that of the first two generations, but the cost is relatively higher and there are fewer hospitals to choose from. It is suitable for multiple miscarriages, multiple chromosomal abnormalities in test tubes, single-gene diseases, genetic diseases, and rare diseases.
From the determination of the treatment plan to the embryo transfer, a cycle of IVF only takes about 2 to 3 months. However, it can take a long time to figure out the options for a hospital, to the step-by-step tests, to the diagnosis of infertility, to the decision on the right plan for IVF.
In terms of infertility diagnosis and pre-treatment alone, women are much more complicated than men, such as monitoring ovulation, tubal patency, hormone tests, etc., which need to be carried out at different specific times before and after menstruation.
In the whole IVF process, in addition to accompaniment, the number of times men go to the hospital is generally about 3 times, while women need to participate in almost every step of the examination and treatment from beginning to end, and they often need to go to the hospital every day during the stimulation period alone.
There are very few lucky people who succeed in IVF once, and many more people need to face 2, 3 or even more efforts. If it fails, the embryo transfer needs to be repeated. If multiple fertilized eggs are not stored, ovulation induction and egg retrieval will be performed from scratch.
IVF is successful after 3 times, which is actually a normal thing.
A study published in 2020 showed that the success rate of the first generation of IVF in China was about 43%. In terms of age groups, less than 50% of the youngest age group under the age of 35 can be successfully delivered with a single transplant. If calculated according to the number of egg retrievals, the average rate of successful delivery of each egg retrieval is less than 30%, so in practice, it is common to have multiple eggs retrieved at one time.
The price of IVF has dissuaded many people
In the absence of medical insurance or insurance reimbursement, the first generation of IVF costs about 30,000-40,000 yuan per cycle, and the second generation is 50,000-70,000 yuan/cycle.
Most people need 2-3 attempts to succeed, with the steps starting with embryo transfer or ovulation induction repeated.
According to the "China Assisted Reproduction Research Report 2023", the reason why the most infertile couples give up assisted reproduction treatment is due to the price factor, which is as high as 55.7%. The second is that they are worried that the success rate of IVF is not high, and nearly 50% of people give up assisted reproduction for this reason.
The most accepted price is less than 30,000 yuan, which is not enough to do a cycle of the first generation of IVF.
In July this year, Beijing included 16 treatment items in IVF into the scope of medical insurance reimbursement. In November, Guangxi also announced that 12 treatment items in IVF could be reimbursed by medical insurance. In addition, Liaoning, Zhejiang and other provinces have also expressed their plans to include IVF in medical insurance.
The total cost of the medical insurance program is about 26,000 yuan in Beijing and 16,000 yuan in Guangxi. 70 per cent of these expenses are reimbursed for urban workers and 50 per cent for urban and rural residents.
This is certainly good news, but the scope of Medicare reimbursement is still limited. Even Beijing's medical insurance does not include imported drugs for ovulation induction.
Another restriction is that Guangxi's medical insurance is only limited to reimbursement for 2 cycles. In other words, if you fail to give birth twice and fail to have a baby on the second attempt, you will have to pay for it from the third time onwards.
The process of the test tube also brings considerable stress
In addition to the cost and success rate, there are many things to worry about in the process of doing IVF.
Let's just say that choosing a hospital and a doctor is really a science. Compared with the eagerness to seek children, the consideration of whether the hospital is close to home and convenient transportation should be put aside. Especially for infertile couples who have tried IVF, but have experienced multiple fetal arrests or miscarriages, and need to do third-generation IVF, the hospitals they can choose from are limited.
If you choose a private hospital, the service and environment are better, the queuing time will be less, and there are also star doctors. However, the problem with this comes increased costs.
Before IVF was included in Medicare, there was little difference between public and private costs. For example, in the research report of Southwest Securities, the price of the second-generation IVF in a private hospital in Beijing is a total of 43,106 yuan in a cycle. However, with the inclusion of assisted reproduction programs in Beijing and other places, the price difference of the out-of-pocket part will be more obvious.
There are even couples who choose to go abroad. Thailand, Japan, and the United States are all possible destinations. On Xiaohongshu, elderly IVF mothers with ovarian recession have seen doctors all over the world, from the mainland to Hong Kong, to Thailand, and to Japan. Hong Kong and Thailand are all high-dose hormones to induce ovulation, and finally chose Japan, the treatment is milder, the average age of consultation is 40 years old, and more experienced in ovulation induction for older Asian women.
In addition, many women who want to have children mention the problems of time, energy, and work leave during the IVF process. There are also cases where mothers who are preparing for pregnancy need to take frequent leave during the IVF period, and the leaders do not approve it, so they can only resign and find short-term jobs to make ends meet.
And women also need to bear a lot of physical discomfort during the IVF process. For example, ovulation induction drugs contain a lot of hormones, and many women will have dizziness and nausea side effects. Egg retrieval surgery is much more complicated than sperm retrieval surgery - each time it requires local anesthesia or even general anesthesia, which may cause ovarian hyperstimulation syndrome and may even cause high venous thrombosis in the lower extremities.
However, even if you have worked hard and invested time and money, the success of IVF depends to some extent on luck. As a result, more emotional stress also follows.
In addition, studies have shown that what significantly affects the quality of life and relationship of infertile groups is not the number of years and age of infertility, but gender, urban and rural areas, and whether they have received assisted reproductive technology.
Women generally bear more emotional stress than men during the IVF process. Women themselves also put more energy into it, and in addition to this, many women still feel that they need to take responsibility for childbearing. Especially older women, they are more likely to be highly stressed and have an inferiority complex about their bodies.
A blogger said, "The most painful thing about IVF is not the injection or egg retrieval, but the mood of a rollercoaster... I was particularly prone to sentimentality during the IVF, and I cried 2 times during the IVF (I rarely cried). On the 4th day of the first capsule, I was afraid of being told that the sac had not been raised, and I cried inexplicably after receiving a strange phone call."
IVF offers the possibility of fertility for the infertile community, but the process is bound to be full of stress, hardship and uncertainty. Especially for women, once they choose the test tube, they have to become warriors and move forward bravely on the road where they can't see the future. It is hoped that with the advancement of technology, women can have true reproductive freedom: they can have children if they want.
Author|Heather Design丨Dysprosium Lu Ruifeng Editor丨Chi Er
Produced by丨Tencent News Gu Yu Studio
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