Peninsula Quan** reporter Gao Fang, Mu Weidong, Qi Juan.
This is the miracle of life, it is the inheritance, and it also carries the hope of countless people
At 23:47 on July 25, 1978, the world's first test-tube baby was born in the United Kingdom;At 8:56 on March 10, 1988, with a crisp cry, China's first test-tube baby was born ...... Beijing Third Clinical Medical CollegeTime flies, and the babies of the year are now mothers, watching their children grow up and begin to reproduce ......Life gives birth to a perfect cycle, and IVF technology has entered the third generation.
In November 2023, Guangxi will include some **sexually assisted reproductive medical services such as "egg retrieval" into the payment scope of basic medical insurance and work-related injury insurance**. "Beijing and Guangxi have included IVF in medical insurance" and other news quickly rushed to the hot search.
Recently, Qingdao issued a notice on the "Real-time Plan for Optimizing Fertility Policies in Qingdao to Promote Long-term Balanced Development of the Population", which clearly stated: "Encourage districts (cities) to subsidize families who really need to implement assisted reproductive technology." ”
There are experts, in the future, there will be more cities to include assisted reproductive technology in the scope of medical insurance reimbursement, to provide more protection and support for families with fertility needs, this measure is the implementation and support of the country's active fertility policy, reduce the economic burden of relevant families, and also help to promote the construction of a childbirth-friendly society.
According to the 2021 data released by the Chinese Population Association and the National Health Commission, the infertility rate in China has reached 12 18%, with an average of 1 in 6 couples being infertile. "IVF" has gradually become the mainstream method of assisted reproduction, and about 300,000 IVF babies are born in China every year. However, many families who try "IVF" still bear a lot of psychological and social pressure. Eliminating cognitive misunderstandings and allowing more IVF families to be seen and cared for is a new topic that must be faced in building a childbirth-friendly society.
This is my last way out On December 8, in the waiting room of the reproductive center of a tertiary hospital on Ningxia Road, 33-year-old Lin Jing took a freshly printed B ultrasound sheet and looked at it carefully, and the outline of a baby can be clearly seen from the medical image above, and the data below the image shows that it meets 12 weeks and 1 day, and the head and hips are 5 days long4cm……Lin Jing's face showed irrepressible happiness, and after two years of running, he finally achieved a phased victory.
Lin Jing, who lives in Jimo, is already the mother of a 9-year-old girl, and as early as 2015, when the two-child policy was fully liberalized, she and her husband discussed having another child. Three years ago, her mother was hospitalized, and Lin Jing's younger brother was working in other places, so she could only quit her job and go home to take care of her mother, and the idea of "having another child" became stronger.
During that time, Lin Jing was as busy as a spinning top, the hospital and home were two points and one line, and what she heard and saw in the ward was the discussion of "a child, who will support the elderly in the future".
After her mother's health improved, Lin Jing simply did not look for a job and officially put the plan to have a second child into practice. She took it for granted that she had already had a childbearing experience and that it would not be a problem to get pregnant again. But after more than half a year, there was no movement in natural conception, and she went to the hospital for a physical examination only to find out that the fallopian tubes were seriously blocked. "If you want to have a child, I guess you can only do IVF. The doctor told Lin Jing.
After a discussion in a "family meeting", the couple decided to try IVF. In fact, at that time, Lin Jing's heart was full of apprehension, "I saw someone on the Internet sharing their experience of doing IVF, and I felt terrible to have a lot of injections." ”
Under the introduction of relatives in the village, Lin Jing and her husband came to the reproductive center, and after salpingogram evaluation, they started a life-creating journey of IVF.
Laboratory culture of IVF embryos.
The first step is to take ovulation induction injections, two per day, which are prescribed by the doctor and taken home. It's a strange feeling to prick yourself with a needle. Lin Jing said, and then quietly waited for the follicles to mature, and went to the reproductive center every day or two to check the growth of the follicles.
During this period, I have to say that thanks to a good teammate. Every time he had a check-up, her husband drove Lin Jing from Jimo to the hospital early in the morning and then went to work in the city, "a full 40 kilometers each way." After the examination, Lin Jing took the subway or took a taxi back to Jimo, "Once, a patient sitting next to me was from Jiaonan, and every time she came to the hospital to drive, it was 45 kilometers, and she joked that it was 5 kilometers longer than me. ”
Finally waited for the follicles to mature, the doctor took out 8 follicles from Lin Jing's ovaries, combined with her husband's sperm, and cultured them into 4 blastocysts and 4 cell fetuses respectively, "The doctor said that the culture for 3 days is called a cell fetus, and the culture for 5 days is called a blastocyst, and the success rate of transferring blastocysts will be higher." With a blastocyst implanted in the uterus, Lin Jing's first IVF came to an end.
It's simple, it doesn't hurt at all. After going through the process, Lin Jing found that doing IVF was not as painful as others said.
Maybe because she was too relaxed, Lin Jing didn't take it too seriously after conception, and bought vegetables, cooked, and did housework as usual, but she didn't expect to have a miscarriage when she was two months pregnant. After recuperating for a few months, Lin Jing did another IVF, using the frozen blastocysts that were stored in the hospital last time. For 3 months, she can be said to have done nothing and prepared for pregnancy with peace of mind.
This time, Lin Jing received a B-ultrasound order reporting the safety of the fetus, and the whole family was looking forward to the arrival of this little life. "My daughter and I belong to horses, the object belongs to tigers, and Xiaobao was born as a dragon. Originally, we planned to have a tiger baby, because I was a tiger and had a good temper, and I basically depended on me ......for everything at homeSo far, Lin Jing has spent more than 60,000 yuan on IVF, but the child worth "a thousand gold" is no different for the family, "It is the same when born." ”
Li Ying, who was in the same clinic as Lin Jing, also ushered in a "good pregnancy" - she was 6 weeks pregnant.
Lin Jing (pseudonym) shows the B-ultrasound of IVF.
35-year-old Li Ying is the first time to welcome the arrival of a small life, she married late and had children late is a doctoral graduate, "I have been busy with my studies, I was 30 years old when I worked, and I waited for two years before I was looking for a marriage partner." ”
After getting married in 2020, Li Ying put pregnancy and childbirth on the agenda, but there has been no movement, and she went to the hospital for examination only to find that the cause of infertility was blocked fallopian tubes, "I took Chinese medicine for half a year last year, and I originally planned to be conservative**, but it had no effect." Li Ying compared IVF to her "last resort".
Fortunately, the reproductive center for IVF is relatively close to home, and it can be reached within a ten-minute walk. Queue up at 7 o'clock in the morning to do the inspection, and wait for the unit to arrive at basically 10 o'clock, which will not delay the work too much. The unit went to work at 9 o'clock, and every time she asked for leave, she only said that "she would be a little late".
Li Ying took a total of 12 follicles, 10 of which were available, 8 of which were of high quality, and 4 blastocysts were frozen. In order to increase the survival rate, Li Ying originally wanted to implant two blastocysts, "but the doctor thought I was a little thin and was afraid that I would not be able to bear it, so he suggested that only one blastocyst be implanted." ”
When the implantation was done, Li Ying listened to the doctor's introduction that there were cases of frozen blastocysts in 2017 that were now taken out for implantation and successfully pregnant, "It feels amazing, and modern medical technology is really advanced." ”
Laboratory jet lag culture system.
For the life event of "pregnancy", Li Ying, who graduated with a doctorate, has always taken out a rigorous style of study, and before each examination, she will first check the information on the Internet to see how she should deal with some conditions at this stage. When she arrived at the consultation room and found that the ** plan she had checked on the Internet and the doctor said it could match, she would be relieved.
As a mother for the first time, especially conceived through assisted reproductive technology, Li Ying is not as calm as Lin Jing, "In the future, when the child is 16 or 18 years old, I will solemnly tell him this secret." Li Ying said that she and her husband would not "publicize" this "secret", and only her parents knew that she was doing IVF. "Frozen embryos need to pay a storage fee of more than 1,200 yuan per year, and if you consider asking for another one after two years, you can 'just in case'. ”
The best state is to ignore it From half past seven in the morning, the attending physician Zheng Ye was non-stop, and he didn't even drink saliva in the morning. After 15 years of medical practice, she met many families seeking children in a room in the consultation room, and accompanied them through the long journey of seeking children until she saw them return home with their children.
Every patient is a story, some beautiful, some lengthy and twisty. Zheng Ye said.
Zheng Ye. "Sometimes I see some stories about IVF on the Internet, and some people describe the process of IVF as having a sense of 'ambition unpaid', "She always laughs at such stories," a bit exaggerated. ”
On July 25, 1978, the world's first test-tube baby was born in the United Kingdom, "Now the third-generation test-tube baby technology is very mature and can achieve eugenics." IVF is also now a very common means of assisted conception. Zheng Ye said, "Not everyone who does IVF needs hundreds of injections and a handful of medicine in the palm of your hand, it is just a very rare case, which is a bit over-'demonized' IVF technology." "Infertility sometimes needs to be carried out at the same time as the treatment of diseases in other parts of the body, so the medication is also 'thousands of people'. For example, some people are infertile because they have immune problems, and they should regulate their immunity before getting pregnant. Take medicine, intravenous drips, take five or six pills of immunity medicine every time, and put it on the palm of your hand to fill a pile. Zheng Ye explained a little helplessly.
What impressed Zheng Ye was a patient who came from Dongying for treatment. In 2016, she had eggs retrieved at Zheng Ye's hospital and froze several embryos, "I took three eggs and did two transfers, but I didn't get pregnant, she began to doubt and question my medical skills, and then transferred to the hospital." In 2022, she found Zheng Ye again.
It turned out that in the past 6 years, she has been traveling all over the country to seek a "good pregnancy", and has been to Weifang, Jinan, Beijing, Hebei and other places, but she has not succeeded. "Someone in her village had successfully done IVF with me, so she came back to me and was already very discouraged when she came. After the examination, I found that she had been 'doing IVF' everywhere for the past few years, and the condition of her ovaries was already very poor, and she was 39 years old, and it was very difficult to retrieve her eggs. ”
Fortunately, this patient's 2016 frozen embryos still remained in the hospital, "Before doing implantation, I put immunization, uterine cavity ......."All that can be checked has been checked, and all unfavorable factors have been eliminated. Zheng Ye admitted that he was not completely sure at that time, knowing that the probability of embryo survival was very low, but he still encouraged the patient: "Everything has a miracle." ”
After going all out, we ushered in a happy ending - "Dr. Zheng, I gave birth to a son. "Nothing makes Zheng Ye happier than receiving such a text message.
Origami can be used outside the operating room to relieve stress.
Older women are not the only ones who want to have children. Zheng Ye received a girl from Yantai, "At that time, she was only 26 years old, and the premature ovarian failure was very serious. Zheng Ye learned that this girl had 3 ovarian surgeries, and when she was in junior high school, she had a sudden abdominal pain, and went to the hospital to check that there were 10 cm cysts on both ovaries, and she had a removal operation;When I was in college**, I had another ovarian cyst removed;Shortly after getting married at the age of 24, the cyst was found again and cut for the third time.
After 3 surgeries, the ovaries were basically gone, and the process of removing the cyst was too damaging to the ovarians. "The most regrettable thing for Zheng Ye is that "the doctor knows that she has had two excision operations before, and if the patient is married and not pregnant, he should take conservative **, such as using puncture to remove the fluid in the cyst first, ensure the fertility conditions, and wait for the problem on the ovaries after giving birth." ”
Women who come to IVF are under too much pressure, and they are all vulnerable. The careful Zheng Ye noticed that what is more important than the ** body is the mental health of the people who seek children.
Many women who begged for children sat down at Zheng Ye's table, and the first thing they said was: "Doctor, I can't go on, it's too painful." As a doctor, Zheng Ye understands that diseases in other parts of the body, patients' emotions, psychological pressure, etc., may affect conception, "I often tell people who seek medical treatment: ignoring it is the best state." ”
As the saying goes, "there are three unfilial pieties, and no queen is greater". Countless people have gone through a lot of hardships to want a child, which shows the importance of childbirth for Chinese families. However, the process of pregnancy needs to be borne by women, but in the matter of childbirth, men and women are not equal, and women bear too much pressure, "In a year, I can always meet a few patients who have emotional breakdowns, not simply crying, but screaming ......."Zheng Ye said a little weakly.
When Zheng Ye first joined the company, the outside of the operating room was the rest room after the patient's egg retrieval, "Once, there was a patient who had more eggs retrieved at a time, and the pain and grievances were compounded, and he cried while sitting there. The lounge is separated from the corridor outside, and Zheng Ye can hear the patient's mother-in-law venting her frustration in the corridor, calling her daughter-in-law a "hen that doesn't lay eggs." Zheng Ye knows very well that the patient herself has no problem, and the infertility is because her husband has severe weak sperm, but in order to protect the man's face, the woman has always said that it is her own problem.
At that time, I was not married and had children, and I had just graduated as a little girl, and I didn't know how to comfort her, so I sat silently beside her with a tissue box. Zheng Ye still remembers that scene vividly.
When it comes to pregnancy, an emotionally stable teammate is too important. Zheng Ye had a case where the patient had been transplanted two or three times and was not pregnant, and every time he came to the doctor, he was silent, and her husband was chattering on the side and asking: "Doctor, what do the A and B on this list mean?"Are the follicles good this time?”
Even Zheng Ye, an outsider, can clearly feel the sense of oppression under the attention of every detail, "Her husband is so good at chattering, every time he comes to the doctor and sits in my room for a few minutes, I am almost a headache from his chatter, not to mention the people who get along with him day and night." ”
After learning that the pregnancy failed again, the patient cried on the spot, and slowly confided in Zheng Ye some family affairs, "The two live with their parents-in-law, and the husband's family of three surrounds her every day, like observing an animal, when to menstruate, what to eat, what time to sleep and what time to get up, all have strict control." Zheng Ye then understood that women are too depressed and emotionally stressed, which makes it difficult to conceive, "Such cases cannot be solved by medical skills, which requires psychological **."
Later, when the husband came to pick up his wife, when he saw Zheng Ye, he asked, "Doctor, why aren't you pregnant?"Zheng Ye said to him very seriously: "This is also the ...... issue I want to discuss with you."”
As a woman, Zheng Ye has a stronger sense of substitution for female patients who are seeking children, and has a layer of caring filters. Every time she has a consultation, she will always observe their emotions, some miscarriage history and other private information, and will guide the other party to speak out on her own. If the other party is hesitant, she will ask again in private, and she will mark the "untrue" content written in the medical record.
Walking here, they are all scared and afraid, and the first step is to give them support. Zheng Ye said.
The answer given by metaphor On December 8, in a consultation room with Zheng Ye, the chief physician Tang Xiuming was receiving treatment. Tang Xiuming came here when the fertility center was established in 1999, and this year marks her 24th year of working here. "The number of outpatient visits per month is almost more than 2,000, and I work six days a week, and I see 70 or 80 patients a day. Tang Xiu counted his workload year after year. 
Tang Xiuming. "One of the most difficult cases I was diagnosed with was that she had endometrial cancer. Tang Xiuming remembers the patient who lives on the West Coast, because of cancer, the endometrium has been scraped repeatedly, and it is very thin.
The inner membrane is the land of the embryo, and the land is too barren. "When giving this patient **, Tang Xiuming's focus is to let the uterus grow endometrium. "Most people use estrogen, but patients with this kind of endometrial cancer dare not give her a large amount of estrogen. Tang Xiuming joined forces with Dr. **, and after more than a year of hard work, he finally received a good news message from the patient: "Dr. Tang, I gave birth to a son!."”
Child-seekers with diseases can still be solved with medical skills, but it is elderly women who often make Tang Xiuming feel "powerless".
There was a patient number, she was in her forties when she came to the consultation, and when she did a physical examination, she was found to have uterine adenomyoma, and the doctor told her that she was going to have surgery. Tang Xiuming has seen many elderly women who want to do IVF, and there is a misunderstanding: "They think it's very simple to have a child, but I didn't want it before." ”
From the cases received, Tang Xiuming clearly saw that some Kochi women in the city are often relatively ignorant about childbearing, "They don't know that the fertility rate of advanced age is declining significantly." On the contrary, in the countryside, women know to have children early. ”
Tang Xiuming was deeply impressed by an elderly female patient, "When she came to me that day, there was only one follicle, and I was forced to take this egg." "You know, the test shows that there is a follicle, but there are not necessarily eggs in it. Tang Xiuming used an analogy to try to explain this truth to the other party: "You see a house from a distance, and there are not necessarily people living in it. ”
Consult patients and join group chats for more invisible help.
According to statistics, women over the age of 38 may need 16 eggs to get a chromosomally normal embryo, "and preoperative examination is required before egg retrieval." I didn't do anything, how can I have surgery right away?The patient didn't listen to Tang Xiuming's persuasion, and shouted to complain: "I finally got an egg!."”
Fertility is complex, and some questions are difficult to explain to patients in one or two sentences with a clear answer – why are you not pregnant? After many years of medical practice, in the face of the "100,000 whys" raised by patients, Tang Xiuming also summed up his own methods, and used figurative sentences to explain one or two to patients: "You need to regulate the intima first, which is very important." The inner membrane is like soil, and if the seeds are sprinkled on the cement floor, they will not grow crops." For example, I look good at you, but I don't know if you're sick or not......."
Half of the people who come to the clinic are from the periphery of the city. "Because the hospitals with IVF technical qualifications are concentrated in Qingdao, Laixi, Jimo, and West Coast ......In recent years, inter-regional transportation such as high-speed rail, bullet trains, and subways has become more and more convenient, providing convenient travel paths for people around the urban area.
Of course, there are also people who come from thousands of miles to do IVF, "not only in Shandong Province, but also from other provinces, such as Northeast China, Hainan, Jiangsu and other places, come to our hospital for IVF." Most of them were introduced by relatives and friends, and they witnessed the decision to "want a child" on the long journey.
Tang Xiuming received a couple from the Northeast, "In order to accompany his wife to do IVF, the couple rented a house near the hospital. They are also ordinary families, and they don't have much savings, and their husbands usually do odd jobs in the neighborhood to earn money, and do some work such as helping cooks in restaurants. ”
It is not easy to conceive, and the medical staff of the reproductive center express their consistent humanistic care with love, carefulness and patience.
At Tang Xiuming's fertility center, details of a service called "37 Caring" can be found everywhere. For example, the rinse saline and hysteroscopic uterine distension fluid before egg retrieval for patients will be warmed to 37;At the ** station, you can see a variety of signs that scan the code to enter the patient group, "love at first sight", "night needle group", etc., and you can get answers from medical staff in the group in time if you have any questionsOrigami materials are even provided outside the operating room to relieve stress while waiting for surgery.
When IVF is successfully conceived and 12 weeks of pregnancy is completed, the patient will be transferred to the obstetrics, which is Tang Xiuming's happiest moment, and she will send her blessings on the spot: "Happy graduation!".And she often receives good news messages, red-skinned eggs, and candy, which make Tang Xiuming realize the meaning of her work: "Being a reproductive doctor is a blessed good thing." If you can help a family have a child, it is the icing on the cake, and many people will really miss you for a lifetime. ”
At the request of the interviewee, Lin Jing and Li Ying are pseudonyms in the article).
Link to the expansion of IVF demand "In vitro fertilization-embryo transfer technology in assisted reproductive technology is commonly known as IVF. At present, China's assisted reproductive technology is developing very rapidly, and the overall technical services and technical level that can be provided have reached the international advanced level. On December 10, Li Yufeng, president of the Reproductive Medicine Center of the Affiliated Hospital of Qingdao University, introduced.
As of December 31, 2022, there are 559 implementation institutions and 29 human sperm banks in China that carry out human assisted reproductive technology, which can meet the needs of infertility patients.
Li Yufeng (middle), President of the Reproductive Medicine Center of the Affiliated Hospital of Qingdao University, is undergoing uterine and abdominal surgery.
On the other hand, in recent years, the number of people who have the need for IVF has been expanding. In modern society, the work pressure, life pressure, and environment that both spouses face at the same time can be the cause of reduced fertility. In addition, late marriage and late childbearing have also become a trend, and increasing age is an important factor affecting fertility.
Relevant data show that about 300,000 test-tube babies are born in China every year. The Reproductive Medicine Center of the Affiliated Hospital of Qingdao University is the earliest medical institution in China to carry out clinical and scientific research work on human assisted reproductive technology, "At present, our hospital has given birth to a total of 8,689 IVF babies. At the same time, Dean Li Yufeng pointed out that "at present, the proportion of people doing IVF in China is rising, with an average age of 33 to 35 years old. ”
As society continues to raise awareness of the importance of fertility, assisted reproductive technology will become more widely accepted as a means of better support for infertility and fertility such as frozen embryos for couples who marry later and have children later. Dean Li Yufeng pointed out that in the future, the penetration rate of assisted reproductive technology in clinical practice will increase year by year, and it will be more widely accepted and clinically applied.
IVF offers the possibility of fertility for the infertile community, but the process is bound to be full of stress, hardship and uncertainty. According to the "China Assisted Reproduction Research Report 2023", the reason why the most infertile couples give up assisted reproduction** is due to the ** factor, and the proportion is as high as 557%。The second is that they are worried that the success rate of IVF is not high, and nearly 50% of people give up assisted reproduction for this reason. When many places include IVF projects in medical insurance, it can be said that many families with birth difficulties have ushered in spring.