A deep dive into the toilet advertisement: Is IVF a retreat after "no more"?

"The strength is better than this toilet

All peers"

Three generations of IVF give birth to a boy,

500,000 packs of dragon and phoenix fetuses,

Paid egg donation,

Surrogacy...

Why do small advertisements in public restrooms keep coming?

Watch the video:

Get the mind map in this issue

Transcript of the video

In the hospital toilet, we saw some advertisements like this: three generations of IVF to give birth to a boy, 500,000 packs of dragon and phoenix fetuses... In the women's toilets of major teaching buildings, in addition to the four or six levels of illegal advertisements and naked loans, there are also relevant information about paid egg donation and surrogacy. These two types of advertisements happen to be two links in the chain of assisted reproductive technology. Why does assisted reproductive technology give birth to so many black industries?

Many people think that children are not unaffordable, they can't afford to raise them, and they don't dare to have children easily without a certain amount of savings.

The "China Fertility Report" estimates that the average cost of raising a child to the age of 17 is 485,000 yuan. In this situation, the childbearing age has also been postponed again and again. But the older you get, the worse your fertility becomes. When you can give birth, you dare not give birth, and when you want to give birth, you may not be able to give birth again.

The infertility rate of couples of childbearing age in China has now climbed to about 18%, with a total of 50 million patients. The rapid growth of the infertile couples market has prompted the streets to be full of medical advertisements for assisted reproduction such as artificial insemination and IVF.

So now we're going to see what happens if you go for assisted reproduction.

1

Under normal circumstances, from a deep exchange between a man and a woman, to the successful union of sperm and egg, and finally to the implantation of the embryo. This process takes about half a month. If any of these links go wrong, assisted reproductive technology will need to be involved, and the time it takes can be extended to months or even years.

If you want to use assisted reproductive technology, the first mandatory requirement is that the documents are complete, such as an ID card, a marriage certificate, and a written commitment in line with the current family planning policy. Among them, not everyone has a marriage certificate.

According to the current regulations in mainland China, it is forbidden for single women or married but healthy women to freeze their eggs, and there is no provision for single men to freeze sperm, so single men can "save sperm for future fertility".

It is already an indisputable fact that the quality of sperm in men is declining. In assisted reproduction treatment, if a married man suffers from mild asthenospermia, oligospermia, and teratospermia from the beginning, this group of sperm army with poor comprehensive ability is destined to collapse under the protection of the female body, then AI technology is needed.

That is, artificial insemination (Artificial Insemination), the so-called artificial insemination, is to skip the step of in-depth communication between men and women, and inject sperm directly into the female reproductive tract in a "non-sexual" way to complete conception.

The specific operation is to separate the husband's sperm from the seminal plasma, take 0.3-0.5ml of sperm suspension, and use a catheter to directly deliver it to the vagina, cervix, uterine cavity or fallopian tube during the woman's ovulation period to improve the probability of insemination. Because the husband's sperm is used, it is called artificial insemination (AIH).

In extreme cases, men suffering from severe weakness, oligosity, deformity, and even azoospermia can also be artificially inseminated, but the sperm comes from the human sperm bank recognized by the National Health Commission. This is called artificial insemination with donor sperm (AID). The management of the mainland sperm bank is very strict, and there will be no situation where hundreds of children have the same father, and if you encounter a bad doctor, (Luo Xiang teacher material).

Of course, severe weak, oligospermia, and teratospermia can also choose to use their own sperm, which involves the second generation of IVF technology.

2

The main methods of assisted reproductive technology include artificial insemination and IVF. The full name of IVF is [in vitro fertilization-embryo transfer technology-IVF-ET]. The first, second, and third generation technologies we are familiar with are not stronger than the next, but are tailored to different needs. Ovaries (ovulation disorders), fallopian tubes (fallopian tube blockage), uterus (endometriosis), any female reproductive organ problems, can lead to infertility, at this time you can use the first generation of IVF technology.

Before IVF treatment, both men and women need to undergo a full set of examinations to confirm whether they are really infertile and whether assisted reproduction is necessary, and on the other hand, to determine whether they can use assisted reproduction. Since the entire pregnancy process is carried out in the woman's body, the physiological requirements for women are much higher than those for men, and there are more examination items.

After passing the physical examination, eligible couples can proceed to the next step - ovulation induction. In the normal physiological cycle, the ovaries will wake up 5-12 follicles every month, and only one can eventually mature, but during the IVF treatment cycle, the same batch of follicles will be artificially matured together.

Depending on the woman's physical condition, the duration of the ovulation induction program varies from 8 days to two months.

When 60% of the follicles in the same batch are larger than 17mm in diameter under the stimulation of the drug, it will come to the trigger day, and at about 8-10 o'clock in the evening, it will be [night injection], and it is also the last injection, and the follicles will be ripe and naturally discharged after 36 hours of night injection. Therefore, it is necessary to rush between 34-36 hours, when the follicle is at its most mature, and the time is exactly in the morning, leaving plenty of daylight time for follow-up operations.

[Egg retrieval] involves a 35 cm long and 1.2 mm diameter egg retrieval needle that is inserted into the vagina, pierced into the ovaries, punctures the follicles, and sucks away the mature eggs. This process takes about 10 minutes, and postoperative complications include bleeding, infection, organ damage, and ovarian hyperstimulation syndrome (OHSS), which are unavoidable in the regular medical process, and the hormone use and manual operation of illegal ovipositon retrieval institutions are unknown.

The fertilizability of the egg only exists for 12-24 hours, so the male cannot be idle when the female retrieves the eggs. Men are given a sterile cup to clean their hands and genitalia. After the sperm retrieval is completed, do not touch the rim and inner wall of the cup, and send it to the laboratory as soon as possible to meet the eggs.

This requires both men and women to go to the hospital together, with the advantage that the sperm is fresh, the quality and motility are better, and the men and women can encourage each other. However, if the man is unable to come to the site due to overtime and other reasons, it is necessary to take sperm in advance and freeze it on the same day.

There are several ways to retrieve sperm, such as testicular puncture or self-retrieval of sperm. If the sperm quality is poor, further assistance is usually required. At this time, it is the turn of the second generation of IVF technology - that is, the picture we often see - intracytoplasmic sperm injection (ICSI) technology to come into play. The doctor will select the sperm with good viability and function in advance, and inject the sperm into the oocyte under the microscope using an ultra-thin hollow needle in a petri dish to complete the artificial union.

Transfers can usually be performed on the third or fifth day of embryo development, depending on which embryo evaluation system is used by the hospital.

On the third day, fresh embryos are cultivated, which are divided into four grades: A, B, C, and D according to the number of blastomeres, symmetry, specific morphology and degree of fragmentation. The blastocyst is divided into 6 stages according to the degree of expansion of the blastocyst cavity, and the inner cell mass and trophoblast cells are graded and transplanted preferentially.

Some patients want to spend the money of one cycle to have two or even three children directly, so they will ask the doctor to implant multiple embryos at once. Indeed, there are also data showing that 70% of twins and 99% of triplets in the mainland population come from assisted reproduction. However, the risk of preterm to stillbirth increases by about 5 times in multiple pregnancies compared with singleton pregnancies, and increases the likelihood of complications in pregnant women. So according to the regulations, there can be no more than three embryo transfers. Embryos are mostly transferred directly into the uterus, but not necessarily immediately. It may continue to wander, so even an artificial embryo transfer cannot avoid the possibility of an ectopic pregnancy.

The formal treatment process involves transplanting into the uterus of the wife of the patient's couple, but if it is transplanted into someone else's uterus, it is surrogacy. The mainland clearly stipulates that surrogacy in any situation is illegal. Therefore, as long as the uterus is unable to carry embryos, or for any other reason, the only legal way to obtain a child is adoption.

In the assisted reproduction process, if it is found that the pregnancy is not successful two weeks after the transfer, the previously frozen embryos must be transferred again, but if the spare embryos do not meet the standard, or if the pregnancy is not successful until the end of the application, it is necessary to start again.

3

Physical examination, stimulation, egg retrieval, transplantation, the entire medical process is a test of the woman's body, the participants' psychology, and the family's financial resources.

A complete IVF-embryo transfer cycle takes 2-3 months, and the cost of each period is between 3-50,000 yuan, if calculated according to the success rate of 40%-50%, at least 2-3 cycles are needed, then the estimated total treatment price of the first generation of IVF is 6-150,000 yuan.

Starting in 2022, some projects of assisted reproduction will begin to be included in medical insurance, but it will take more time for the regulations to be implemented nationwide. At the same time, the cost of the third-generation IVF is even higher, and the cost of a single treatment is about 8 to 90,000 yuan.

Its full name is preimplantation genetic testing (PGT), that is, in the transfer process, the embryo is biopsied using PGT technology: first, the zona pellucida is perforated with a laser to avoid damage to the cells, and then the straw is passed through the outer layer of the "egg shell" like the baby's skin, and any one blastomere cell is sucked out for testing, and finally, the remaining blastomeres will continue to develop.

PGT is mainly aimed at couples who carry defective genes and is used to screen embryos for possible problems such as single-gene diseases and chromosomal abnormalities. It is true that the sex of the fetus can be determined using this technology, but the mainland explicitly prohibits the determination of the sex of the fetus that is not medically necessary.

It is precisely because assisted reproduction involves complex social and ethical issues that the management of assisted reproductive technology in the mainland is very strict, with a total of 536 medical institutions in the country, of which only 78 can carry out the third generation of technology, and the market in short supply has given birth to a series of gray industrial chains.

Some agencies advertise for the gimmick of having a baby baby, but in fact use cheaper first- or second-generation IVF technology and do not test the embryo before the transfer at all. By the time consumers learn about the status of their fetuses in the third trimester of pregnancy, these illegal establishments have long since been emptied.

I am Sun Gong, the investigator of this cooling report, and in this report, we use an assembly line to introduce the various processes of assisted reproductive technology, and the logical diagram has been placed in the network disk link.

Some international journals have pointed out that more than 20% of infertile patients must use assisted reproduction to solve fertility problems, and data show that the penetration rate of assisted reproduction industry in mainland China is less than 10%, that is, among the 10 million couples who need assisted reproduction, only less than 1 million couples have received treatment. They waited in the process, and some of the remaining 9 million couples were willing to wander the gray area in order to get a child. Anxiety, sadness, disappointment, joy, these common human emotions will slowly ferment in the experience of life. The more you care, the calmer you become, see you in the next cooldown report.

.data_color_scheme_dark{--weui-ORANGERED: #ff6146;--weui-BG-0: #111;--weui-BG-1: #1e1e1e;--weui-BG-2: #191919;--weui-BG-3: #202020;--weui-BG-4: #404040;--weui-BG-5: #2c2c2c;--weui-FG-0: rgba(255, 255, 255, .8);--weui-FG-HALF: rgba(255, 255, 255, .6);--weui-FG-1: rgba(255, 255, 255, .5);--weui-FG-2: rgba(255, 255, 255, .3);--weui-FG-3: rgba(255, 255, 255, .1);--weui-FG-4: rgba(255, 255, 255, .15);--weui-FG-5: rgba(255, 255, 255, .1);--weui-RED: #fa5151;--weui-REDORANGE: #ff6146;--weui-ORANGE: #c87d2f;--weui-YELLOW: #cc9c00;--weui-GREEN: #74a800;--weui-LIGHTGREEN: #3eb575;--weui-BRAND: #07c160;--weui-BLUE: #10aeff;--weui-INDIGO: #1196ff;--weui-PURPLE: #8183ff;--weui-WHITE: rgba(255, 255, 255, .8);--weui-LINK: #7d90a9;--weui-TEXTGREEN: #259c5c;--weui-FG: #fff;--weui-BG: #000;--weui-TAG-TEXT-RED: rgba(250, 81, 81, .6);--weui-TAG-BACKGROUND-RED: rgba(250, 81, 81, .1);--weui-TAG-TEXT-ORANGE: rgba(250, 157, 59, .6);--weui-TAG-BACKGROUND-ORANGE: rgba(250, 157, 59, .1);--weui-TAG-TEXT-GREEN: rgba(6, 174, 86, .6);--weui-TAG-BACKGROUND-GREEN: rgba(6, 174, 86, .1);--weui-TAG-TEXT-BLUE: rgba(16, 174, 255, .6);--weui-TAG-BACKGROUND-BLUE: rgba(16, 174, 255, .1);--weui-TAG-TEXT-BLACK: rgba(255, 255, 255, .5);--weui-TAG-BACKGROUND-BLACK: rgba(255, 255, 255, .05)}.data_color_scheme_dark{--weui-BTN-ACTIVE-MASK: rgba(255, 255, 255, .1)}.data_color_scheme_dark{--weui-BTN-DEFAULT-ACTIVE-BG: rgba(255, 255, 255, .126)}.data_color_scheme_dark{--weui-DIALOG-LINE-COLOR: rgba(255, 255, 255, .1)}.data_color_scheme_dark{--weui-BG-COLOR-ACTIVE: #373737}.data_color_scheme_dark{--weui-BG-6: rgba(255, 255, 255, .1);--weui-ACTIVE-MASK: rgba(255, 255, 255, .1)}.rich_media_content{color:#000000e5; font-size:17px; font-size:var(--articleFontsize); overflow:hidden; text-align:justify}.rich_media_content{color:#ffffffa6; color:var(--weui-FG-HALF)}.rich_media_content{position:relative; z-index:0}.wxw-img{vertical-align:bottom}@media(prefers-color-scheme:dark){body:not([data-weui-theme=light]) .rich_media_content img:not(.wx_img_placeholder){filter:brightness(.8)}}*{margin:0; padding:0}.rich_media_content *{max-width:100%!important; box-sizing:border-box!important;-webkit-box-sizing:border-box!important; word-wrap:break-word!important}.rich_media_content p{clear:both; min-height:1em}td p{margin:0; padding:0}@media screen and (min-width:1024px){body:not(.pages_skin_pc) :root{--appmsgPageGap: 20px}}:root{--articleFontsize: 17px}:root{--sab: env(safe-area-inset-bottom)}:root{--wxBorderAvatarRatio: 3}:root{--discussPageGap: 20px}:root{--appmsgPageGap: 20px}body,.wx-root,page{--weui-BTN-HEIGHT: 48;--weui-BTN-HEIGHT-MEDIUM: 40;--weui-BTN-HEIGHT-SMALL: 32}body,.wx-root{--weui-FG-1: rgba(0, 0, 0, .55);--weui-ORANGERED: #ff6146;--weui-BG-0: #ededed;--weui-BG-1: #f7f7f7;--weui-BG-2: #fff;--weui-BG-3: #f7f7f7;--weui-BG-4: #4c4c4c;--weui-BG-5: #fff;--weui-FG-0: rgba(0, 0, 0, .9);--weui-FG-HALF: rgba(0, 0, 0, .9);--weui-FG-1: rgba(0, 0, 0, .5);--weui-FG-2: rgba(0, 0, 0, .3);--weui-FG-3: rgba(0, 0, 0, .1);--weui-FG-4: rgba(0, 0, 0, .15);--weui-FG-5: rgba(0, 0, 0, .05);--weui-RED: #fa5151;--weui-REDORANGE: #ff6146;--weui-ORANGE: #fa9d3b;--weui-YELLOW: #ffc300;--weui-GREEN: #91d300;--weui-LIGHTGREEN: #95ec69;--weui-BRAND: #07c160;--weui-BLUE: #10aeff;--weui-INDIGO: #1485ee;--weui-PURPLE: #6467f0;--weui-WHITE: #fff;--weui-LINK: #576b95;--weui-TEXTGREEN: #06ae56;--weui-FG: #000;--weui-BG: #fff;--weui-TAG-TEXT-RED: rgba(250, 81, 81, .6);--weui-TAG-BACKGROUND-RED: rgba(250, 81, 81, .1);--weui-TAG-TEXT-ORANGE: #fa9d3b;--weui-TAG-BACKGROUND-ORANGE: rgba(250, 157, 59, .1);--weui-TAG-TEXT-GREEN: #06ae56; --weui-TAG-BACKGROUND-GREEN: rgba(6, 174, 86, .1);--weui-TAG-TEXT-BLUE: #10aeff;--weui-TAG-BACKGROUND-BLUE: rgba(16, 174, 255, .1);--weui-TAG-TEXT-BLACK: rgba(0, 0, 0, .5);--weui-TAG-BACKGROUND-BLACK: rgba(0, 0, 0, .05)}body,.wx-root{--weui-BG-6: rgba(0, 0, 0, .05);--weui-ACTIVE-MASK: rgba(0, 0, 0, .05)}@media screen and (min-width:1024px){body:not(.pages_skin_pc){background:#191919; background:var(--weui-BG-2)}}@media(prefers-color-scheme:dark){body:not([data-weui-theme=light]).my_comment_empty_data{background-color:#111}}.wx-root,body{--weui-BTN-ACTIVE-MASK: rgba(0, 0, 0, .1)}.wx-root,body{--weui-BTN-DEFAULT-ACTIVE-BG: #e6e6e6}.wx-root,body{--weui-DIALOG-LINE-COLOR: rgba(0, 0, 0, .1)}.wx-root,body{--weui-BG-COLOR-ACTIVE: #ececec}@media(prefers-color-scheme:dark){.wx-root:not([data-weui-theme=light]),body:not([data-weui-theme=light]){-- appmsgExtra-BG: #121212}}@media(prefers-color-scheme:dark){.wx-root:not([data-weui-theme=light]),body:not([data-weui-theme=light]){--weui-ORANGERED: #ff6146;--weui-BG-0: #111;--weui-BG-1: #1e1e1e;--weui-BG-2: #191919;--weui-BG-3: #202020;--weui-BG-4: #404040;--weui-BG-5: #2c2c2c;--weui-FG-0: rgba(255, 255, 255, .8);--weui-FG-HALF: rgba(255, 255, 255, .6);--weui-FG-1: rgba(255, 255, 255, .5);--weui-FG-2: rgba(255, 255, 255, .3);--weui-FG-3: rgba(255, 255, 255, .1);--weui-FG-4: rgba(255, 255, 255, .15);--weui-FG-5: rgba(255, 255, 255, .1);--weui-RED: #fa5151;--weui-REDORANGE: #ff6146;--weui-ORANGE: #c87d2f;--weui-YELLOW: #cc9c00;--weui-GREEN: #74a800;--weui-LIGHTGREEN: #3eb575;--weui-BRAND: #07c160;--weui-BLUE: #10aeff;--weui-INDIGO: #1196ff;--weui-PURPLE: #8183ff;--weui-WHITE: rgba(255, 255, 255, .8);--weui-LINK: #7d90a9;--weui-TEXTGREEN: #259c5c;--weui-FG: #fff;--weui-BG: #000;--weui-TAG-TEXT-RED: rgba(250, 81, 81, .6);-- weui-TAG-BACKGROUND-RED: rgba(250, 81, 81, .1);--weui-TAG-TEXT-ORANGE: rgba(250, 157, 59, .6);--weui-TAG-BACKGROUND-ORANGE: rgba(250, 157, 59, .1);--weui-TAG-TEXT-GREEN: rgba(6, 174, 86, .6);--weui-TAG-BACKGROUND-GREEN: rgba(6, 174, 86, .1);--weui-TAG-TEXT-BLUE: rgba(16, 174, 255, .6);--weui-TAG-BACKGROUND-BLUE: rgba(16, 174, 255, .1);--weui-TAG-TEXT-BLACK: rgba(255, 255, 255, .5);--weui-TAG-BACKGROUND-BLACK: rgba(255, 255, 255, .05)}}@media(prefers-color-scheme: dark){.wx-root:not([data-weui-theme=light]),body:not([data-weui-theme=light]){--weui-BTN-ACTIVE-MASK: rgba(255, 255, 255, .1)}}@media(prefers-color-scheme:dark){.wx-root:not([data-weui-theme=light]),body:not([data-weui-theme=light]){--weui-BTN-DEFAULT-ACTIVE-BG: rgba(255, 255, 255, .126)}}@media(prefers-color-scheme:dark){.wx-root:not([data-weui-theme=light]),body:not([data-weui-theme=light]){--weui-DIALOG-LINE-COLOR: rgba(255, 255, 255, .1)}}@media( prefers-color-scheme:dark){.wx-root:not([data-weui-theme=light]),body:not([data-weui-theme=light]){--weui-BG-COLOR-ACTIVE: #373737}}@media(prefers-color-scheme:dark){.wx-root:not([data-weui-theme=light]),body:not([data-weui-theme=light]){--weui-BG-6: rgba(255, 255, 255, .1);--weui-ACTIVE-MASK: rgba(255, 255, 255, .1)}}@media(prefers-color-scheme:dark){.wx-root:not([data-weui-theme=light]),body:not([data-weui-theme=light]){--discussInput-BG: rgba(255, 255, 255, .03)}}@media(prefers-color-scheme:dark){.wx-root:not([data-weui-theme=light]),body:not([data-weui-theme=light]){--nickName-FG: #959595}}.rich_media_content em{font-style:italic}

div.autoTypeSetting24psection > p,div.autoTypeSetting24psection > section{margin-bottom: 24px;}