Assisted fertility coverage facilitates path to parenthood

For years, Wang Xiaohua stared at her savings, watching the amount fall short of what one cycle of in vitro fertilization would cost. The gap felt like a wall between her and a baby she longed for.

Wang, who lives in the Ningxia Hui autonomous region, had undergone several rounds of fertility treatments without success. The emotional and financial strain of the treatments almost caused her to give up.

That changed last October, when Ningxia issued a new directive adding 13 assisted reproductive technology procedures to the region's basic medical insurance coverage.

After the policy took effect, Wang returned to Yinchuan Women and Children Healthcare Hospital for a second round of IVF. Now, she is expecting her first child.

"Before, every cycle felt like a heavy burden," she said during a follow-up appointment. "With insurance covering a large part, the pressure is much lower."

Wang is one of more than a million people across China who have benefited from the country's latest push to make fertility treatments more affordable and accessible.

In a telling shift in public health priorities, 31 provincial-level regions, as well as the Xinjiang Production and Construction Corps, have now implemented policies to include ART procedures in medical insurance schemes.

Before the policy changes, procedures such as IVF, intrauterine insemination and ovulation induction were financially out of reach for many couples. IVF alone could cost between 20,000 yuan ($2,774) and 50,000 yuan per cycle, and achieving pregnancy often requires multiple rounds.

Taking Ningxia as an example, since ART procedures began being covered by health insurance, 60 percent to 75 percent of related medical expenses can now be reimbursed.

Yao Hairong, director of the reproductive medicine center at the Yinchuan hospital, noted a clear increase in IVF cycles. In the first quarter of this year, the number of procedures carried out in the hospital increased by over 10 percent year-on-year.

In July 2022, a set of guidelines aimed at strengthening fertility support measures on the national level was issued by China's health authorities and other government agencies.

The document called on local governments to gradually include suitable childbirth pain relief and ART in public insurance coverage, taking into account factors such as the financial sustainability of the medical insurance fund and the standardization of related medical procedures.

On July 1, 2023, Beijing became the first region in China to include certain ART treatments in its basic medical insurance reimbursement scheme.

Since the policy was implemented, 53,800 insured individuals in the city have benefited from the coverage, reducing the financial burden on patients by approximately 406 million yuan.

ART offers a solution to those who are willing to have a child but are unable to have one.

"Some patients are unable to conceive naturally due to health reasons, or have undergone multiple failed IVF attempts," said Yang Xiaokui, director of the reproductive medicine department at Beijing Obstetrics and Gynecology Hospital.

"As they grow older, many consider giving up entirely. But now that these procedures are covered by insurance, costs have dropped by about 70 percent, giving many families renewed hope," she said.

As ART involves multiple stages, patients must frequently visit the hospital, investing significant time, energy and money while enduring financial and emotional stress, said Ren Chaolan, a doctor in Shandong province.

Yang Ping from Yantai, Shandong, had postponed seeking treatment, fearing the financial burden. After the province implemented its reimbursement program, she decided to give it a try.

"My husband and I received a 30,000 yuan reimbursement for our IVF treatment — an expense we would've had to cover ourselves before. We also got 6,523 yuan back for the hospital delivery, and recently received over 20,000 yuan as a maternity allowance," she said. Her child was born earlier this year.

"It's been a huge relief and has allowed me to stay home and focus on caring for our baby," Yang Ping said happily. For her, the program didn't just make the treatment affordable, but also gave her the confidence to try.

Beyond financial savings, the policy has also catalyzed broader systemic improvements.

"It has also prompted medical institutions to improve clinical expertise and service quality, thereby advancing the development of ART and helping address more complex fertility challenges," said Liu Xiaolin, an official from Gansu province's medical insurance bureau.

Responding to concerns about its impact on the sustainability of the public medical insurance fund, Wang Dawei from Beijing's medical insurance bureau said the policy was carefully designed to balance public demand with the fund's capacity, aiming to offer utmost support within realistic limits.

Yang Xiaokui noted that doctors will continue to follow strict medical guidelines.

"Insurance coverage won't change our standards — we won't recommend unnecessary treatment just because it's now reimbursed," she said.

Xinhua