Edit | Yang
Since leaving 996 "Kao Gong ashore" three years ago, according to Shiya's plan, life has entered a new stage of giving birth to a baby. However, the implementation of the "plan to make a baby" for nearly two years was unsuccessful, and the poetry of the former strong woman began to get bored-why is it so easy for others to get pregnant, but it is so difficult for them?
After asking in a circle of friends, Shiya found that she was not a case. In the past, old colleagues of Internet vendors and close cousins all had similar troubles. "I didn't want to have children before, but now I want to have children but I can't ..."
In medicine, if you don't take any contraceptive measures for more than one year, your sexual life is normal and you don't get pregnant successfully, it's called infertility.
In modern society, infertility is not uncommon. With the change of people's concept of childbearing and lifestyle, the increase of work pressure and the continuous delay of women's childbearing age, infertility has become one of the main reproductive diseases that plague many couples of childbearing age.
According to the data of the National Bureau of Statistics, among the registered women in China, the proportion of women of non-optimal childbearing age aged 35 and above is increasing year by year, and the increasing trends of late marriage and late childbearing and infertility are increasingly highly coincident. From 1990 to 20 17, the average age of first pregnancy of pregnant women in China was delayed from 23.4 to 26.8, and there is a trend of further delay in recent years. The best childbearing age for women is 23-30 years old, which is not good news.
The Lancet, an authoritative medical journal, published in May, 20021,"The Lancet", a special report on women's reproductive, maternal, newborn, child and adolescent health in China, pointed out that the latest national epidemiological survey and analysis of reproductive health by Qiao Jie, an academician of the Third Hospital of Beijing Medical University, showed that from 2007 to 2020, the incidence of infertility in China increased from 12% to 6544.
According to many media reports, there are currently more than 40 million infertile patients in China.
At present, about 300,000 newborns born every year in China are "test-tube babies", and this number may continue to increase in the context of liberalizing the second and third births.
With a little attention, you will find that there are more twins around you than ever before.
Xiaoxiao's daughter has just entered the first grade. She told Xiaoxiao that there are four pairs of twins in her class, of which three pairs are twins and 1 pair are twin sisters. "But they all look different. I can recognize them at once! " Mix-It is easy to understand that these twins are probably test-tube babies-as long as there are enough fertilized eggs and the quality is good enough, in order to ensure the success rate, two or more fertilized eggs will be implanted at a time when making test tubes, and the probability of multiple births will be greatly increased.
Since 1978, the world's first test-tube baby was born, the number of test-tube babies has increased steadily every year. By the time robert edwards, the founder of 20 10 IVF technology, won the Nobel Prize, the number of IVF in the world had exceeded 5 million.
20 18, the 30th anniversary of the birth of this technology, the International Monitoring Committee of Assisted Reproductive Technology said that there are more than 8 million test-tube babies in the world. In recent years, IVF has shown a rapid growth trend. In China alone, as many as 300,000 test-tube babies are born every year.
The Lancet's Special Report on Female Reproductive, Maternal, Newborn, Child and Adolescent Health in China mentioned that assisted reproductive technology in China has developed rapidly for more than 30 years since the birth of the first test-tube baby in Chinese mainland in 1988. At present, the total number of cycles has exceeded 1 10,000 cycles/year, and the number of babies born has exceeded 300,000 cases/year. The success rate is basically close to that of developed countries in Europe and America.
Special Report on Maternal and Child Health in China, Cycle Number and Birth Outcome of Assisted Reproductive Technology Treatment in China, The Lancet (2009-20 17).
In the past decade, especially in the five years after the introduction of the second child policy, obstetrics clinics have been set up in hospitals all over the country, and the number of medical institutions approved to carry out human reproductive assisted technology has soared to more than 500. 202 1 After the implementation of the three-child policy, many provinces issued the Application Plan of Human Assisted Reproductive Technology (202 1-2025), all of which mentioned that new assisted reproductive institutions would be planned.
With the rapid growth of IVF, China people's traditional concept of "Don't wash your dirty linen in public" is gradually abandoned, and the public's acceptance of IVF is getting higher and higher.
The grandson of Fang Ayi's IVF twins is now in the third grade of primary school. At first, she resisted revealing that her grandson was obtained in vitro, and always felt that it would make her daughter a little "shameful". However, as more and more neighbors and old classmates asked her about her daughter's "experience" of having twins, Fang Yi simply broke the window paper and began to generously teach her the experience of making test tubes and the precautions during pregnancy.
"When the second child is not yet open, many people feel envious when they hear that they are test-tube twins, and they really want to have two. After the opening of the second child, people also think that twins are very successful once. Nowadays, young people all work overtime, eat takeout and stay up late. Their lives are irregular and their health is poor. Abortion and abortion are much more than before, so it is not surprising that they can't be born. Fortunately, the technology is getting more and more advanced now, so don't worry too much. Just believe in science. " Aunt Fang said.
But in Fang Yi's daughter Rong Rong's view, it's not enough to believe in science. You need enough money and time to fiddle with your body to see the dawn of victory.
Recalling the experience of making test tubes, Rong Rong said, "I don't want to experience it again."
After six years of pregnancy, Rong Rong never waited for her child. After praying to God and worshipping Buddha and conditioning with traditional Chinese medicine failed to improve, under the recommendation of colleagues, Rong Rong found the trafficker and hung up the expert number of a professor in the Sixth Affiliated Hospital of Sun Yat-sen University. After a series of examinations, we finally found out the cause of infertility-her premature ovarian failure and her husband's weak body belong to the type that is not easy to get pregnant. At the doctor's suggestion, Rong Rong started the road of IVF.
Because of premature ovarian failure, after ovulation for three times, the husband's sperm quality was not good, and the fertilized egg was not successfully synthesized. After spending money, I got ascites because of ovarian hyperstimulation. Unexpectedly, I didn't even have a chance to implant. Rong Rong cried for it several times. After crying, she dried her tears and continued to drink Chinese medicine to recuperate her body, preparing for the next ovulation and egg retrieval. Finally, Rong Rong took four eggs and successfully bred two fertilized eggs. Because the physical conditions are not suitable for transplantation, fertilized eggs can only be frozen. Then, she recuperated for half a year, and finally got the "two bars" on the first 12 day after implantation!
For women who do test tubes, the appearance of "two bars" does not represent the ultimate success. In fact, everything has just begun.
The joy brought by the "two bars" was quickly replaced by all kinds of worries, and the slightest movement of the body would be infinitely magnified by Rong Rong: does the stomach feel a little painful, is it the body's resistance to the embryo? There is reddish secretion on underwear, is the embryo going to fall off? Even after coughing a few times, she was worried about "will it shake off the embryo?" Although the HCG (Human Chorionic Gonadotropin) value of the blood test is good, and the doctor reassured Rong Rong, for the sake of safety, she simply asks for leave to stay in bed every day.
On the 42nd day, Rong Rong went to the toilet as usual, and suddenly he felt a big blood clot slipping out of his body. He looked down and saw that the toilet was all red, just like when he had his period. "it's over!" Rong Rong felt that the sky was falling and burst into tears. "The baby must have fallen!" Then the whole family quickly packed up and rushed to the hospital.
Fortunately, it was only a false alarm in the end. When she looked at the two small groups that could already hear the fetal heart with a B-ultrasound, she finally felt that the world was beautiful again. The doctor advised Rong Rong to stay in bed for the first time, and prescribed progesterone for nearly two months, with an injection every day. When he finally stopped hitting, Rong Rong felt his ass become as hard as a stone.
It is much more difficult to conceive twins than singletons, because the uterus is in the front position. At 30 weeks, Rong Rong began to stay in bed to protect the fetus. 36 weeks later, she gave birth to a pair of healthy twins by caesarean section. At this point, her test-tube trip finally won!
After the three-child policy came out, a friend joked that Rong Rong should respond to the call to have another child. Rong Rong said, I can't even think about it-"It's enough to make a test tube once!"
For every couple who do test tubes, especially their wives, they are almost under great economic and psychological pressure.
It is understood that including examination and treatment, the cost of IVF in public hospitals is generally between 38,000 yuan and 50,000 yuan; Private hospitals range from 40,000 yuan to 90,000 yuan according to service differences. More than half of patients need two or more times to succeed. According to the calculation that one promotion can be transplanted twice, some patients who are unsuccessful for more than three times will pay 65438+ 10,000 yuan more.
Secondly, a cycle of IVF requires patients to come to the hospital at least 10 to 20 times. Every time I come, I have to adjust the dosage, do B-ultrasound, take injections and draw blood, and so on. By June 5438+February 3, 20201,a total of 536 medical institutions in China were approved to carry out human reproductive assisted technology, mostly in first-and second-tier cities in economically developed provinces. Many patients can only choose to seek medical treatment in different places. For them, round-trip transportation, accommodation and lost time also account for a considerable part of their expenses. According to a survey, about half of them have to leave their jobs because they need treatment all the year round.
In recent years, the call for IVF to be included in medical insurance has been very high. On September 15, the National Medical Insurance Bureau replied to the "Proposal on Incorporating Infertility Adjuvant Treatment into National Medical Insurance to Increase Population Growth" put forward by Gao Li, a representative of the National People's Congress, which undoubtedly made many infertile patients see hope. At present, the medical insurance department has included eligible fertility support drugs such as bromocriptine, triptorelin and clomiphene citrate into the scope of payment. The National Medical Insurance Bureau also stated that in terms of diagnosis and treatment projects, on the basis of scientific calculation and full demonstration, the therapeutic assisted reproductive technology that medical insurance can afford will be gradually included in the scope of medical insurance payment according to procedures.
Is it the only way for infertile patients to choose IVF?
The answer is no.
At present, assisted reproductive technology mainly includes artificial insemination, gamete transfer and IVF (in vitro fertilization embryo transfer). However, among these three methods, the pregnancy rate of IVF is the highest, and the pregnancy rate of regular IVF specialists in first-tier cities in China can generally reach 50%. The pregnancy rate of artificial insemination and general drug treatment is low, in which the pregnancy rate of artificial insemination is about 20% and that of drug treatment is only about 15%. Therefore, many people tend to test-tube babies, hoping to "reach the designated position in one step".
Professor Liu Jianqiao, director of the Reproductive Medicine Center of the Third Affiliated Hospital of Guangzhou Medical University, made statistics. The Third Affiliated Hospital of Guangzhou Medical University receives more than 6,543.8+0,000 infertile couples every year, and nearly 6,543.8+0.2 million embryo transfer operations have been performed every year. Among these infertile couples, only about 10% really need assisted reproductive technology. "Don't worry too much, some couples who are temporarily infertile can get pregnant directly as long as they wait patiently, and some can get pregnant through medication or surgery. Only about 10% really needs to be a test-tube baby. "
Guangyi Third Hospital Reproductive Medicine Center
However, the reality is that although many reproductive experts regard IVF as the last step of assisted reproductive technology, when semen, oocytes, pelvic environment, especially fallopian tubes are abnormal, it is suggested that drugs or artificial insemination should be carried out before IVF, but many patients who meet the indications of infertility have no patience to carry out the first and second steps due to comprehensive consideration of factors such as economy and time, and often strongly ask doctors to directly carry out IVF surgery. They will even ask doctors to do the third-generation IVF technology, just because the third-generation technology is the most advanced at present.
"Algebraic differences only distinguish different technologies, and different technologies correspond to different indications. There is no problem that three generations are better than the first and second generations. " Dr Tan Ying from the Reproductive Medicine Center of Guangdong Reproductive Hospital said. The third generation of preimplantation genetic testing (PGT) is more based on gene chip and other technologies, aiming at abnormal chromosome number and structure, monogenic genetic diseases and so on. If there are no genetic diseases and rare diseases, there is no need for three generations of technology.
Li Yuan, director of the Reproductive Center of Beijing Chaoyang Hospital, found that the patient's age has a great relationship with the success rate of assisted reproduction. With the increase of female age, the pregnancy rate and live birth rate of assisted reproductive therapy decreased significantly. Compared with patients under 35 years old, the live birth rate of ART in patients aged 38-40 years old decreased by 50%.
Professor Liu Jianqiao believes that the younger the husband and wife, especially the older the woman, the higher the success rate. "For example, people under the age of 35 will do it for the first time. If the conditions are good, the success rate of only one embryo can reach 55%-60%. If two embryos are released, the success rate is above 60%. If the patient is 35-38 years old, the success rate may be only 40%; If you are over 40 years old, the success rate may be only over 20%; If you are over 45 years old, the success rate may be only 5%. "
This reminds people that it is too early to be a test-tube baby.
"I very much hope that couples of childbearing age will establish their own family planning as soon as possible. After they are ready to have children, they must first understand the basic knowledge of fertility. When their efforts for a year have no results, they should go to a regular obstetrics and gynecology or reproductive medicine center as early as possible to check which link of infertility is bothering your fertility problem. After that, the doctor will help you in a way that is as simple as possible and close to nature. When these methods are ineffective, take assisted reproductive technology as soon as possible, so that a healthy baby can be obtained with relatively little intervention. " When it comes to suggestions for infertile patients, Academician Qiaojie of the Third Hospital of Beijing Medical University said so.
(At the request of the interviewee, Shiya, Xiaoxiao and Rongrong are pseudonyms. )
end