供给能力成为瓶颈：中国共有635家持牌ART机构，约每220万人1家；相比之下，美国约每73万人1家，日本约每20万人1家，而且资源高度集中在大城市。一次IVF周期通常要3万至5万元，若加做其他项目费用更高。成功率在35岁以下约40%，但40至41岁约13%，因此多次周期很常见。各地报销差异很大，从几千元到约可覆盖50%不等；去年城镇居民人均可支配收入约5.4万元，农村不足其一半。
不孕率从2007年的12%升至2020年的18%，但中国需要治疗的夫妇中，接受治疗者不到10%（美国约30%）。初婚平均年龄在2020年达28.7岁（十年前为24.9岁），许多患者如今已超过35岁。2024年一项研究估算，若扩大医保覆盖，至2050年累计或可新增最多6500万名新生儿，且ART每投入1元可带来约13元的终身经济回报，但每年透过IVF带来的出生约30万。海外方面，日本自2022年起报销70%，首尔在2024年几乎每6名新生儿就有1名与不孕治疗相关，但出生率仍持续下滑。
For six years, 38-year-old Chen Huaxi has pursued IVF, spending nearly 100,000 yuan (about $14,000). Liaoning added IVF to insurance, but covers only eight basic steps, excluding major costs such as imported drugs, genetic screening, and embryo freezing. Nearly a year after Beijing said assisted reproductive technology (ART) coverage was nationwide, many couples still find treatment unaffordable or simply out of reach, even as roughly 1 in 6 couples struggles to conceive.
Capacity is a bottleneck: China has 635 licensed ART clinics—about one per 2.2 million people—versus about one per 730,000 in the US and one per 200,000 in Japan, with services concentrated in big cities. One IVF cycle typically costs 30,000–50,000 yuan, and more with add-ons. Success rates are ~40% for women under 35 but ~13% at ages 40–41, so multiple cycles are common. Reimbursement ranges from a few thousand yuan to ~50%; urban disposable income averaged 54,000 yuan last year, and rural income was under half.
Infertility rose to 18% in 2020 from 12% in 2007, yet fewer than 10% of Chinese couples needing treatment receive it (vs ~30% in the US). First-marriage age reached 28.7 in 2020 (24.9 a decade earlier), and many patients are now over 35. A 2024 study estimated broader coverage could add up to 65 million births by 2050 and yield ~13 yuan in lifetime economic returns per yuan invested, but annual IVF births are about 300,000. Abroad, Japan began covering 70% in 2022 and Seoul saw nearly 1 in 6 newborns tied to infertility procedures in 2024, yet birth rates still fell.
