On average, 8 couples have 1 pair having childbearing difficulties, and legislation is urgently needed to protect female fertility
According to data released by the China Population Association and the National Health Commission, the infertility rate of couples of childbearing age in China has risen to 12%-15%, and on average, 1 in 8 couples has difficulty giving birth.
With the declining fertility rate, women's fertility protection and assisted reproductive technology have attracted more and more attention.
On April 22, the 2021 Boao (First) Reproductive Health Medicine Forum was held in Boao, Hainan.
Huang Hefeng, an academician of the Chinese Academy of Sciences, said that the current technologies for fertility protection and fertility assistance are all important means to promote the health of our population.
The "14th Five-Year Plan" proposes to formulate a long-term population development strategy, optimize childbirth policies, and improve the population service system focusing on "one old and one small" to promote long-term balanced population development.
Among them, in terms of promoting the realization of an appropriate fertility level, enhancing the inclusiveness of the fertility policy; improving the whole process of prenatal and postnatal care services, strengthening pre-pregnancy health services during pregnancy and delivery, and improving the quality of the birth population.
In his speech, Dai Xuguang, president of the China Association for Childbirth and Childbearing Education, said that the "inclusive" fertility policy was proposed for the first time, which means that the fertility policy still has flexibility to adjust, and the connotation and extension of the fertility policy are constantly adjusted and optimized.
Women's fertility protection faces an awkward situation
With the decline in the global fertility rate and the prominence of the issue of delayed childbearing age, fertility protection has become a hot issue discussed in the industry.
The protection of female fertility refers to the early prevention and treatment of various factors that may cause the decline of female fertility, as well as some special protection or preservation measures, to help these people at risk of infertility or infertility, and to protect their reproductive endocrine function or preservation. Reproductive potential, in order to achieve the purpose of reproducing offspring.
Especially for women who need to postpone their childbearing age due to some reasons, or have malignant tumors before puberty, adolescence and reproductive period, and women who need to receive treatment before giving birth, they need to protect their fertility in advance. When there are fertility requirements, you can have as good fertility as possible.
“The protection of fertility is facing an embarrassing situation. The infertility rate of the population of childbearing age in our country is 12%-15%, and on average, one pair of children of childbearing age has difficulty in giving birth.” Dai Xuguang said in his speech that some people of childbearing age are affected by environmental conditions. Restrictions, temporarily not wanting, inconvenient or infertile, wanting to freeze sperm and eggs, and preserve fertility at the golden age, but it is not in compliance with the current regulations, so I have to choose to spend a lot of money on "underground" transactions or go abroad, which brings multiple levels of harm .
The extension of years of education and the postponement of marriage may lead to the "ageing effect of childbirth", and older age, concerns about physical conditions and the inability to give birth are also the main factors affecting fertility.
Dai Xuguang believes that it is necessary to pay attention to the protection of the fertility of people of childbearing age, do a good job of publicity and education on reproductive health, and promote the reserve and maintenance of fertility; provide standardized and high-quality diagnosis and treatment services for people of childbearing age in need, and use mature assisted reproductive technology to meet the needs of fertility. Demand; for older unmarried women, etc., explore the possibility of providing services such as egg freezing to help them still have the right and ability to bear children at the right time.
At present, relevant policies and regulations have been issued in localities.
Article 28 of the "Regulations on Population and Family Planning of Jilin Province" clearly stipulates that women who have reached the legal age of marriage and decide not to marry and have no children can adopt legal medical assisted reproduction techniques to give birth to a child.
Han Xiaohong, chairman of the Chinese Medical Doctor Association’s Physician Health Management and Physician Health Insurance Committee and chairman of Ciming Boao International Hospital, said at the forum: “The factors that cause the reproductive health dilemma are systemic, including environment, diet, physiology, and psychology. , Emotions, and many other factors. When communicating with assisted reproduction counterparts in the United States, Thailand, France, etc., they found that they were using systemic solutions to solve the aforementioned system problems, such as pre-psychological counseling and environmental diet interventions, which are different from those directly in China. The processes and techniques of technical means may be less time efficient than ours, and the success rate of the final result reflects its scientific and humane nature."
Assisted reproductive technology and international synchronization
In Hainan Free Trade Port, there is a unique medical tourism "experimental field"-Hainan Boao Lecheng International Medical Tourism Pioneer Zone.
The zone was established with the approval of the State Council in 2013. It is currently the only area in Mainland China where international innovative medical devices that have been marketed abroad but have not been listed in China can be used.
Today, the pilot zone has formed a cluster of industries such as assisted reproduction, tumor treatment, and medical aesthetics and anti-aging.
Under the "four franchise" policy preferences of franchised medical care, franchised research, franchising, and franchised international medical exchanges, assisted reproduction has become an important area for the formation of industrial clusters in the pioneer zone.
Assisted reproductive technology refers to the use of medical aids to make infertile couples pregnant, including artificial insemination (AI) and in vitro fertilization-embryo transfer (IVF-ET) and its derivative technologies (commonly known as "test tube baby").
Thanks to the policy of promoting the realization of the "three synchronizations" of medical technology, equipment, medicines and the international advanced level as soon as possible, foreign cutting-edge assisted reproductive technologies are also the first to be used in Hainan.
After more than 40 years of development, the "first, second, and third generation" IVF technology has been widely used.
Hu Bo, secretary-general of the Clinical New Technology Committee of the Chinese Hospital Association and chairman of Ciming Group, said in an interview with China Business News that the "third-generation" IVF technology is actually very mature and can detect the quality of embryos and avoid single-gene inheritance. Disease, select the most suitable embryo for implantation.
However, due to various factors such as policies, reproductive centers in China are very strict in terms of supervision, and formal reproductive centers are very standardized. To obtain a third-generation license, you need to go through national approval and inspection, which usually lasts about five years.
In 2019, China has 517 medical institutions approved to carry out human assisted reproductive technology, most of which are public medical institutions.
Hu Bo revealed that although many medical institutions have listed IVF centers, only about 15% have "third-generation" technology. Taking Hainan Province as an example, there are only two "third-generation" technology centers in total.
It is worth mentioning that under the epidemic situation, people's demand for assisted reproductive services is still strong, and the process of domestic assisted reproduction promotion and application has been accelerated.
Hu Bo said: "Due to the epidemic last year, some domestic patients with assisted reproductive needs needed safe and reliable centers. They could only consider performing operations in the country. Therefore, for our hospital, this is also a good promotion environment, services and technology. Opportunity."
Statistics show that by 2016, China will complete 700,000 assisted reproductive operations annually, and the technology has reached the international level, but the relatively large number of 48 million infertility patients, the market is still in a state of severe demand.
"Assisted reproduction should be developed in the direction of specialization, quality and industrialization, in line with the dual-cycle policy. However, the current promotion of assisted reproductive technology still depends on how the inclusive fertility policy is applied, and it should go from simple to complex, such as the early introduction of women The solution for the preservation of fertility.” Hu Bo said.
As a practitioner, Hu Bo said: “The state now enforces strong supervision over this industry, and pays attention to openness and control. Benefiting from the state’s open policy for Hainan’s medical tourism, our hospitals are synchronized under the condition that both software and hardware meet the standards. Approve the realization of the innovation of'first, second, and third generation' reproductive centers, while supervision puts forward higher requirements on reproductive centers. In the future, industry development must adhere to strong supervision and promote the legal application of assisted reproductive technologies. Hope that inclusive birth policies can be used Great breakthroughs have been made in the establishment of assisted reproductive centers and other aspects to help realize internal circulation."
Liu Hongyan, deputy director of the China Population and Development Research Center of the National Health Commission, emphasized: “Reproductive health technology is a double-edged sword, which can solve the problems of infertility and difficulty in giving birth to older women. However, if this technology is not used well, There will be a large-scale gender imbalance problem, and some people will make gender selection during the embryonic stage, so it is very important to use this technology well."
Author: HE Yue Shu