The demand for assisted reproductive technology has soared, and about 300,000 test-tube babies are born every year in China. What do you think of this trend?

With the liberalization of the two-child and three-child birth policy, increasing the birth rate and improving the quality of the population as soon as possible is not only a family matter, but a major decision related to the fate and future of the country. In China, due to various factors, such as the rising incidence of infertility and the difficulty of childbearing among the elderly, it is more and more common that the fertility will not match the fertility results. More and more people who are willing to give birth try to give birth to offspring through artificial intervention. At present, China has become the country with the largest number of assisted reproductive cases every year in the world. About 300,000 test-tube babies are born every year in China, bringing happiness and hope to more families. The popularization of assisted reproductive technology is always accompanied by distress and misunderstanding from the public. In the future, eliminating cognitive misunderstandings and improving the security mechanism are new topics that must be faced in building a fertility-friendly society. 1 the neglected "infertility" population The data of the seventh national census show that the total fertility rate of women of childbearing age in China in 2020 is 1.3, which is at a low fertility level. In addition to "not wanting to be born" and "not daring to be born", "not being born" is also a problem faced by many families. At present, there is still a great demand for assisted reproduction in China, which is an important means to ensure the quantity and quality of our population. Ms. Han, a 34-year-old woman from Shandong, begged to have a baby 1 1 year. The process was bumpy, and her spirit and emotions were on the verge of collapse several times. Finally, she and her husband decided to turn to test-tube technology. In April this year, after a series of arduous processes such as ovulation induction, egg retrieval and transplantation, Ms. Han finally got pregnant. According to the latest epidemiological investigation and analysis of reproductive health in China by Academician Peking University Qiaojie, from 2007 to 2020, the incidence of infertility in China increased from 12% to 18%, and about 300,000 test-tube babies were born every year. According to statistics, at present, the total number of treatment cycles in China has exceeded 6.5438+0 million cycles/year, and the success rate has basically approached the level of developed countries in Europe and America, and there is a trend of moving towards a higher level. According to the data released by National Health Commission, by the end of June, 2020, a total of 523 medical institutions in China were approved to carry out assisted human reproduction technology. However, medical resources between different regions need to be further balanced. The number of cycles of IVF treatment per million people in Shanghai, Beijing and Guangdong is significantly higher than that in other regions, while the number of cycles in some underdeveloped regions is low. 20 16, the laboratory of Chongqing Institute of Genetics and Reproduction was opened to the media for the first time. In recent years, with the popularization of assisted reproductive technology, some chaos and misunderstandings have appeared frequently, posing a threat to public health and even social ethics. For example, an expert from the reproductive center of a well-known hospital in central China told the reporter that because the reproductive specialty of the hospital is among the best in the country, it has attracted many patients from neighboring provinces, and some private institutions have set up a number of reproductive centers next to the hospital with the idea of "famous brands". Some private organizations illegally select the sex of embryos in the name of IVF. Some patients do assisted reproduction mainly not to solve fertility difficulties, but to artificially obtain twins. Judging from the development of assisted reproductive technology, the public's concept of fertility generally tends to be scientific and rational. Li Rong, director of the Center for Obstetrics and Gynecology and Reproductive Medicine of Peking University Third Hospital and deputy director and director-general of the Reproductive Medicine Committee of the Chinese Medical Doctor Association, said that despite this, there are still many patients who have misunderstandings about reproductive assistive technology and should be paid attention to. 20 16 Chongqing opened the "test-tube baby" laboratory for the first time, and the staff operated the embryos under the microscope. Some infertile couples often take many detours before accepting assisted reproductive technology, including IVF, and many of them even ignore premarital examination and daily physical examination. Some clinicians said that some patients with poor economic conditions spent a lot of money to seek remedies and received informal treatment. When they went to the hospital for formal treatment, they found that the money had been spent. In addition, IVF technology is not "omnipotent". For example, after women are over 40 years old, the success rate will drop significantly, which shows the importance of early treatment. -Controlling multiple births has become international common sense. In recent years, experts in the field of reproduction have generally found that with the gradual liberalization of the birth policy, the public's expectations for IVF technology are constantly being adjusted. Because of the different stages of embryo development and the different success rate of transplantation, women are often transplanted 1 to 2 embryos at a time, which makes the probability of IVF giving birth to twins higher than that of natural pregnancy. More and more families hope to have "twins" or even "twins" by the opportunity of IVF. Li Rong introduced that it is recognized by academic circles that singleton pregnancy is safer than multiple pregnancy, so it has become international common sense to try to control the multiple pregnancy rate in assisted reproduction. -Don't blindly pursue new technologies. In recent years, many private assisted reproductive institutions and overseas institutions have advertised "three generations of test tubes" to attract customers. The third generation of IVF technology actually refers to the genetic testing before embryo implantation, which is mainly used to check chromosome abnormalities and identify family monogenic genetic diseases. "The' third generation test tube' has high technical requirements, and there are not many institutions qualified to carry out treatment in China. Moreover, gene diagnosis needs to obtain a small number of cells from embryos for testing, which may also pose certain potential risks to embryo safety. Therefore, couples who don't have a definite monogenic genetic disease or suspect chromosomal abnormalities don't have to blindly pursue the' third generation test tube'. They can adapt to local conditions according to the doctor's advice and make prenatal diagnosis according to the norms after pregnancy. " Li Rong said. 3 expect the law to be "high threshold" and subsidize "low threshold". According to the difficulty of treatment and different schemes, the cost of assisted reproductive technology ranges from tens of thousands to hundreds of thousands or even millions of yuan, which brings a heavy economic burden to families. Li Rong told reporters that in reproductive adjuvant therapy, the proportion of domestic ovulation-promoting drugs available for selection has gradually increased in the past two years, breaking the dominant situation of imported drugs in the past and saving patients about 20% of the cost. With the quality of reproductive medical centers all over the country getting higher and higher, more and more patients tend to see doctors nearby, and most of them who come to famous institutions are incurable diseases. As a result, high-quality medical resources are applied more efficiently. "At present, China's reproductive assistance technology has reached the international advanced level and accumulated rich clinical practice experience. Despite the continuous advancement of technology, there are still many unknown fields in medicine. " Li Rong said that among all infertile patients, about 5% to 10% patients have never found a clear cause. Even with assisted reproductive technology, some people still can't give birth smoothly. I hope the public can correctly understand the limitations and uncertainties of medicine. After talking with many couples who tried assisted reproduction for half a month, the reporter found that almost all the parties were under great economic and psychological pressure. About half of them are unemployed all the year round because of treatment, and their families are gloomy because of physical pain and pessimism. Therefore, it is particularly important for doctors and patients to advocate a healthy concept of fertility, improve support for the groups with fertility difficulties and increase psychological consultation and care for the groups with fertility difficulties. Although assisted reproductive technology has not been included in medical insurance at present, in some places, care for families with special difficulties is being carried out through public welfare assistance. For example, Zhejiang and Shaanxi have set up public welfare funds to give appropriate subsidies to special groups such as "families who have lost their independence" to receive assisted reproductive technology services. In recent years, some illegal organizations have taken advantage of such crooked ways as "surrogacy", and some rural areas even have the trend of "surrogacy to get rich", which poses a serious threat to women's physical and mental health and encourages bad social atmosphere. In April this year, the General Office of the State Council issued the notice of China Action Plan to Combat Human Trafficking (202 1-2030), proposing to severely crack down on illegal acts such as surrogacy.