Why China's IVF Push Is Failing to Boost Birth Rates

13 December 2025 • • min read

Table of Contents

Summery

While China has promoted IVF insurance coverage to boost birth rates, actual implementation is limited, often covering only basic procedures and leaving expensive necessities like drugs and screening out-of-pocket.
There is a severe shortage of clinics (1 per 2.2 million people), and costs remain prohibitive relative to average incomes, with rural and poorer populations facing the biggest barriers.
Rising infertility and later marriages are driving demand, but experts warn that even with subsidies, IVF is unlikely to reverse the population decline, mirroring failures in Japan and South Korea.

For six years, Chen Huaxi has navigated the emotional and financial labyrinth of infertility, spending nearly 100,000 yuan ($14,000) on treatments in a desperate bid to conceive. When news broke that her home province of Liaoning would add in vitro fertilization (IVF) to its medical insurance program, the 38 year old shop owner felt a brief surge of optimism. However, that hope quickly evaporated when she realized the coverage was strictly limited to eight basic procedures. Critical and costly elements of the process, such as imported medications, genetic screening, and embryo freezing, remained entirely out of pocket. For Chen, who has already suffered through two failed cycles, the policy change did little to alleviate the crushing financial burden, leaving her unsure if she can afford to continue.

This disconnect between policy announcements and on the ground reality highlights a significant hurdle in China's demographic strategy. As the country faces a shrinking population and rising infertility, the government has signaled that assisted reproductive technologies (ART) should be covered by public insurance. Yet, nearly a year after Beijing announced nationwide availability for this coverage, implementation remains patchy and often unaffordable. Reimbursement rules vary wildly across provinces, with poorer regions covering fewer procedures and reimbursing a smaller share of the costs compared to wealthier areas. Access is further complicated by a severe shortage of licensed clinics; China has only one clinic for every 2.2 million people, compared to one per 730,000 in the US. These scarce resources are heavily concentrated in major metropolitan areas, forcing couples from smaller towns to travel long distances for treatment.

The financial stakes for these couples are incredibly high relative to their earnings. A single IVF cycle typically costs between 30,000 and 50,000 yuan, a figure that effectively wipes out the average urban resident's annual disposable income of 54,000 yuan. The biological reality that success rates drop significantly with age—from 40% for women under 35 to just 13% for those over 40—means that most couples will require multiple expensive cycles to succeed. Economists argue that failing to support these couples is a missed economic opportunity, as every yuan invested in ART could generate 13 yuan in long term returns. However, experts warn that IVF is not a silver bullet; neighboring Japan and South Korea have heavily subsidized treatments yet continue to see record low fertility rates, suggesting that medical interventions alone cannot reverse deep seated demographic trends.