With the changes in fertility needs and breakthroughs in assisted reproduction technology, in vitro fertilization (IVF, in vitro fertilization-embryo transfer) has become an important option for many infertile families. As one of the fastest growing countries in the world in assisted reproduction technology, China's IVF treatment has developed unique advantages in terms of technological maturity, clinical experience, and service model.
The core process and method of IVF treatment in China
The essence of IVF is “in vitro fertilization + embryo transfer”, which simulates the natural process of human fertilization, completes the combination of sperm and egg in the laboratory, and then transfers high-quality embryos back to the mother's uterus. Its standard treatment process can be divided into five major stages:
1. Pre-assessment and preparation (1-2 months)
Before treatment, a comprehensive physical examination needs to be completed, including ovarian function (AMH, basal follicle count), uterine environment (endometrial thickness, uterine cavity morphology), hormone levels (FSH, LH, E2) for the female partner, as well as semen analysis (sperm density, viability, morphology) for the male partner. Some patients are additionally screened for genetic disorders (e.g., chromosomal abnormalities) or infection indicators (e.g., TORCH). The doctor will formulate a personalized plan based on the test results.
2. Ovulation stimulation treatment (8-15 days)
Ovulation stimulation treatment (8-15 days) is used to stimulate the ovaries to develop multiple follicles (only 1 in a natural cycle) through medication. Commonly used medications include recombinant human follicle stimulating hormone (rFSH), urotensin (HMG), and so on. Regular ultrasound monitoring of follicle size and endothelial thickness is required during ovulation, and the drug dosage should be adjusted to avoid ovarian hyperstimulation (OHSS).
3. Egg retrieval and sperm retrieval (1 day)
When the follicle reaches 18-20mm in diameter, HCG is injected to trigger ovulation, and 36 hours later, eggs are retrieved by vaginal ultrasound-guided puncture (performed under local anesthesia, painless). Sperm retrieval at the same time for the male partner, testicular/epidymal puncture sperm retrieval (TESA/PESA) may be required in the presence of severe oligozoospermia.
4. Embryo culture and screening (3-7 days)
Fertilization of eggs and sperm is completed in the laboratory (conventional IVF or ICSI), and after formation of fertilized eggs, culture is continued to day 3 (cleavage stage embryos) or day 5-6 (blastocysts). Some patients will opt for preimplantation genetic testing (PGT) to screen for healthy embryos and reduce the risk of miscarriage or fetal abnormalities.
5. Embryo transfer and pregnancy test (1-2 weeks)
Choose fresh embryo transfer (3-5 days after egg collection) or frozen embryo transfer (need to be thawed first) according to the status of the woman's endometrium. The pregnancy is confirmed by blood HCG test 14 days after the transfer, and the fertility preservation treatment should be continued until about 12 weeks after the success.
China's Top IVF Recommended Hospitals
China's assisted reproduction organizations have strict qualification approval (557 approved organizations by 2023), of which the top hospitals are preferred by patients due to their high success rate, innovative technology and rich experience. The following are the institutions with outstanding overall strength:
1. Peking University Third Hospital (Peking University Third Hospital)
Status: The “birthplace” of assisted reproduction technology in China, where the first IVF baby was born in 1988.
Characteristics: covering conventional IVF, ICSI, PGT (three-generation IVF), egg freezing and other technologies, especially experienced in the field of assisted reproduction for elderly women (over 38 years old), repeated implantation failure (RIF). 2022 clinical pregnancy rate stabilized at 55%-60% (patients under 35 years old).
2. CITIC Xiangya Specialized Hospital of Reproduction and Genetics (Changsha)
Status: One of the largest assisted reproduction centers in the world, with over 40,000 cycles per year.
Characteristics: Taking advantage of the combination of “genetic disease diagnosis + assisted reproduction”, the PGT technology covers more than 1,000 kinds of genetic problems such as single-gene diseases and chromosomal disorders; the success rate of microscopic sperm retrieval (sperm retrieval from testes under the microscope) for male infertility reaches more than 60%.
3. Renji Hospital (North Hospital) affiliated to Shanghai Jiaotong University School of Medicine
Status: A benchmark for assisted reproduction in East China, certified as “National Training Base for Assisted Reproductive Technology” in 2022.
Specialties: specializing in endometrial tolerance improvement (e.g. thin endometrium treatment), recurrent miscarriage diagnosis and treatment; mature blastocyst culture technology, frozen embryo transfer pregnancy rate of more than 50%.
4.The Third Affiliated Hospital of Guangzhou Medical University (GAMU)
Position: the “leader” in assisted reproduction in South China; in 2019, it will complete China's first case of “self-ovulation in vitro fertilization for a 50-year-old woman”.
Characteristics: develops personalized ovulation protocols (e.g., mild stimulation, luteal phase ovulation) for patients with low ovarian response (POR); opens “second/third trimester senior outpatient clinic” to provide full-cycle management.
5. West China Second Hospital of Sichuan University (Chengdu)
Status: Technical highland in Southwest China, with more than 30,000 cycles per year and a comprehensive success rate that is among the highest in the country.
Characteristics: integrating the resources of gynecology, obstetrics and genetics, realizing one-stop service of “assisted conception-pregnancy-delivery”; remarkable efficacy in the field of endometriosis and polycystic ovary syndrome (PCOS) combined with infertility.
The core treatment method of IVF in China
With the iteration of technology, China IVF has developed from a single “conventional in vitro fertilization” to a system that includes a variety of precise technologies to meet different infertility needs:
1. Conventional IVF (first-generation in vitro fertilization)
Applicable people: female with blocked fallopian tube, ovulation disorder, endometriosis, etc.
Principle: co-cultivate eggs with optimized sperms and rely on sperms to naturally penetrate the eggs to complete fertilization.
2.ICSI (Intracytoplasmic Single Sperm Injection, second generation IVF)
Applicable people: severe oligospermia (sperm concentration <5 million/ml), acrosome abnormality, previous IVF fertilization failure.
Principle: Injecting single sperm directly into the egg cytoplasm through microscopic operation, bypassing the obstacle of natural fertilization and increasing the fertilization rate to more than 90%.
3.PGT (Pre-implantation Genetic Test, third generation IVF)
Applicable people:
Chromosomal abnormalities (e.g. balanced translocation, inversion);
Single gene genetic disease (e.g. thalassemia, spinal muscular atrophy SMA);
Repeated miscarriages (≥3 times) or repeated implantation failures (≥2 failed transplants);
Advanced age (≥38 years) or severe ovarian hypoplasia in the female partner.
Technology type:
PGT-A (aneuploidy screening): detects abnormal embryo chromosome number and reduces the risk of miscarriage;
PGT-M (single gene disease diagnosis): accurate screening for known disease-causing gene mutations;
PGT-SR (chromosome structural abnormality): for structural aberrations such as balanced translocation and inversion.
4. Other extended technologies
Egg freezing: to preserve fertility for tumor patients and women with delayed childbearing (China's frozen egg recovery rate is about 90%);
Blastocyst culture: extend embryo culture to day 5-6 to screen embryos with higher developmental potential (blastocyst transfer has a 20%-30% higher implantation rate than cleavage stage embryos);
Endometrial tolerance assay (ERA): determine the “implantation window” through genetic testing to improve the success rate of implantation (especially for patients with repeated implantation failures).
Five core advantages of IVF treatment in China
Compared with other countries, China's IVF treatment has formed unique competitiveness in terms of technology, service and cost:
1. Technical maturity is synchronized with the international level
Chinese head hospitals have mastered cutting-edge technologies such as PGT, ICSI, egg freezing, etc., and some laboratory indicators (e.g., blastocyst formation rate, embryo recovery rate) have reached the international leading level. At the same time, Chinese experts deeply participate in global academic exchanges on assisted reproduction (such as ESHRE European Society of Reproduction and Embryology), and the technology update is synchronized with the international level.
2. Success rates are among the highest in the world
The clinical pregnancy rate of patients under 35 years old in China's top institutions is generally 55%-60%, 40%-45% for patients between 38-40 years old, and 20%-30% for patients over 40 years old (data from some centers). Compared with the United States (average success rate of about 45%), China is more cost-effective in the treatment of elderly patients.
3. Outstanding ability to customize personalized programs
Chinese doctors pay more attention to “individualized treatment”, adjusting the dosage of ovulation-promoting drugs and transfer strategies (e.g., fresh/frozen embryo selection) according to the patient's age, ovarian function, and past medical history (e.g., history of abortion and surgery), and even combining with traditional Chinese medicine (TCM) to improve the endothelial tolerance.
4. Policy Support and Cost Advantages
Starting from 2023, Beijing, Guangdong and many other places have included some assisted reproduction programs (e.g. semen analysis, embryo culture) into medical insurance, reducing the burden on patients. The cost of a single cycle of IVF in China is about 30,000-80,000 RMB (including examination, ovulation, egg retrieval, and implantation), which is only 1/3-1/2 of that in the U.S.
5. Complete full-cycle service system
Head hospitals have generally established the whole-process management of “pretreatment - treatment - transplantation - fertility preservation - postpartum follow-up”, and some of the institutions have also provided psychological counseling, nutritional guidance and other auxiliary services to alleviate patients' anxiety and improve treatment compliance.
Conclusion
After more than 30 years of development, China's IVF technology has moved from “running with” to “running with”, and even “leading” in some areas. For infertile families, choosing regular hospitals and cooperating with doctors to formulate personalized plans are the keys to improving the success rate. With the breakthroughs in gene editing, mitochondrial transplantation and other new technologies, assisted reproduction will help more families realize their fertility dreams in the future - the miracle of life is happening here.