Beyond Medication: Addressing Awareness and Systemic Barriers in Assisted Reproductive Technology Amid China's Low Fertility Crisis

China's total fertility rate has dropped to1.09Left and Right,2025Year of Birth Population792Ten thousand, with fertility rates in some regions even lower; at the same time, approximately18%One in six couples of childbearing age face fertility challenges, equivalent to one in every six couples requiring medical assistance. The coexistence of low fertility levels and the continuously growing demand for assisted reproductive technologies presents the most realistic picture of China's current population and reproductive health landscape.

Against this backdrop, the "15th Five-Year Plan" outline clearly identifies the construction of a fertility-friendly society as a key task. From issuing childcare subsidies and improving maternity leave systems, to promoting the standardized and orderly application of assisted reproductive technologies and strengthening medical cost coverage, the policy toolkit is transitioning from "burden reduction" to multi-dimensional support.

Of course, apart from the introduction and implementation of a series of policies supporting childbirth, we have found that there are still some misconceptions among young people regarding childbirth, family, and career. Particularly, many women hope to consider childbirth only after their careers are stable, without realizing that female ovarian function begins to decline from...28Beginning to gradually decline after the age of...35Fertility Halved After Age,40The natural pregnancy rate is less than5%。

Recently, in an interview, Managing Director of Merck Healthcare China, Andreas Mohr, frankly stated: "Fertility assessment and the early detection and treatment of infertility are still gaps in awareness that need to be bridged in market education. Therefore, the biggest issue is not technology or medication, but awareness."

In Mu An's view, addressing this situation requires collaborative efforts from the government, enterprises, and society. At the government level, there should be further promotion of public education on assisted reproductive knowledge, and fertility testing should be incorporated into routine physical examinations or pre-marital check-up systems. At the enterprise level, companies can draw on the experience of pioneers, such as fertility-friendly businesses providing employees with flexible working hours, reimbursement for childbirth and assisted reproduction costs, and other substantive support. On the societal level, cooperation between media and medical institutions needs to be promoted to eliminate the stigma associated with assisted reproduction. As awareness gradually increases, a fertility-friendly society can truly transform from policy text into benefits for every family.

Market Realities and Cognitive Gaps

The growth potential of China's assisted reproductive market is primarily driven by the global social trend of delayed marriage and childbirth. "Many women are choosing not to marry or to delay marriage. This is not only happening in China but also occurring worldwide," noted Andreas Mohr, emphasizing that this trend is closely related to changes in socio-economic structures—women, concerned about income and living costs, often prioritize career development. The industry’s role is not to reverse this trend but to help women make more rational reproductive plans within this new rhythm.

The real bottleneck lies in cognition. Mu An emphasized: "Data shows that as physiological age gradually increases, people's fertility capacity progressively decreases. If many women fully recognized this when making fertility decisions, they might plan their fertility and career more prudently. But many women today fail to realize this."

This information asymmetry is one of the important issues facing society today.

Compared with international experience,Chinese women generally pay attention to fertility relatively late, which can be seen fromThe age at which Chinese women first undergo fertility testing has been determined. In Europe, doctors typically recommend35Women over the age of trying to conceive naturally6Months without success lead to testing; whereas in China, many people only consider seeking medical help after trying to conceive for one or two years due to various factors. This pattern not only increases personal costs but also adds pressure on the healthcare system. According to Mu An-de: "The media can play a very important role in raising awareness among Chinese men and women about fertility testing and preservation, as well as the early detection and treatment of infertility."

From an industry perspective, the lack of proper awareness signifies a vast market education opportunity. Andreas Mohr pointed out that medication alone cannot address the root issue. "As a leader in reproductive healthcare, Merck bears responsibility in this area. Currently, there are approximately120010,000 babies were born through in vitro fertilization, of which600"Tens of thousands have benefited from Merck's drugs." He repeatedly emphasized that the responsibility lies not only in providing products but also in helping the public establish a scientific perspective on fertility.

This is precisely the unique role that leading companies play in the market. Mu Ander stated, "Many women still lack knowledge about fertility, so we have collaborated with various sectors of society, including foundations, doctors, and healthcare professionals, to enhance women's awareness of reproductive health."

Industry participants must clearly recognize that cognitive education is not a public welfare initiative but an infrastructure. When more women and couples realize that fertility is a limited resource that requires advance planning, the demand for screening, diagnosis, treatment, preservation, and other aspects will grow simultaneously.

Mu Ander's judgment is that if he can really help in this aspect, it will truly bring changes to the lives of patients and the general public. This kind of change is the underlying logic for the long-term growth of the assisted reproductive industry.

Multi-party Collaboration under Government Leadership

The "15th Five-Year Plan" outline deploys the construction of a "childbearing-friendly society" in a dedicated chapter for the first time, marking the elevation of fertility support from scattered policies to a national strategy. The outline explicitly requires "optimizing fertility support policies and incentive measures, effectively reducing the costs of family childbirth, upbringing, and education, striving to stabilize the scale of newborns, and promoting long-term balanced population development." From "burden reduction" to "empowerment," the underlying logic of the policy is undergoing a profound transformation.

In terms of specific measures, the outline constructs a multi-dimensional support system: child-rearing subsidies and individual tax deductions alleviate economic pressure; the expansion of maternity insurance covers more people; the full implementation of maternity leave systems encourages flexible work arrangements; and the standardized application of assisted reproductive technology strengthens medical insurance coverage. This combination aims to address funding, time, and service dimensions simultaneously.

Regarding the government's strategic deployment, Mu An-de also expressed high approval: the government's strong promotion of childbirth is very clear. He specifically cited population forecast data, saying: "By2040In that year, each of us will need to support an elderly person. There are also predictions that by...2100Year, China's total population may only be8100 million. I think what the government is doing now is very important."

Mu An-de clearly proposed the triple responsibility of corporate participation in fertility governance. The first is product accessibility. "We need to work closely with the government to promote product registration and improve patient access. Recently, we have also discussed several of our products with relevant government departments, exploring how to enable more couples in China, primarily women, to access our products more quickly while also enhancing their affordability."

The second responsibility is to enhance public awareness of fertility-related diseases. Mu Ande emphasized: "As a global leader in the field of assisted reproductive technology, we have a responsibility to help increase public awareness. Only when people truly understand the importance of fertility can policy benefits be translated into actual willingness and actions to have children."

The third level of responsibility is to lead by example as an employer. Merck Group has launched a global employee benefits program for assisted reproduction, under which eligible employees can enjoy up to...17Reimbursement of expenses amounting to ten thousand yuan. Mu An-de stated, "We can set an example in how we treat our employees and the benefits we provide." He called on other companies to join this initiative.

Mu An'de particularly emphasized the importance of corporate culture transformation. In his view, companies do not necessarily need to offer high reimbursement; starting with low-cost methods can be equally effective. "At the very least, they can offer flexible working arrangements for women, which does not require a large cost. When female employees need to take leave to see a doctor due to childbirth issues, they might feel uncomfortable, but at Merck, this is absolutely not a taboo topic. My attitude has always been, you don’t need to get my approval—just go see the doctor. Managers need to empower women, and even empower their husbands. No need to ask, just go."

In Mu An's view, China's assisted reproductive industry is currently at a critical period of ecological-driven development.Future efforts need to focus on three aspects: cognitive education transitioning from scattered investments to integration into public systems; a multi-level payment system evolving from single medical insurance support to diversified sharing through commercial insurance and corporate supplementary insurance; and cross-departmental collaborative governance moving from isolated policy implementation to comprehensive service alignment.