Facing Over 40 Million Infertile Patients: What Can We Do?

"Not wanting to have children when able, struggling to conceive when ready, risking miscarriage after conception, and facing the possibility of birth defects even if the pregnancy is carried to term." This is a somewhat cruel quip, yet it truly reflects the helplessness in the face of modern reproductive challenges for those of childbearing age.

Reproductive Medicine Needs Space to Embrace Humanistic Care

National statistics show that China's total fertility rate has plummeted from around 6 in the 1970s to a mere 1.0 in 2023, far below the replacement level [1].

At the same time, reproductive health issues have become increasingly prominent: the infertility rate among childbearing couples in China has risen from 2.5%–3% two decades ago to 12.5%–15% today, with the number of patients exceeding 40 million [2].

From a global perspective, a 2023 World Health Organization report pointed out that between 1990 and 2021, 17.5% of the world's adult population suffered from infertility, and the 12-month "period prevalence rate" of failing to conceive reached as high as 12.6%, showing an upward trend [3].

As fertility issues become a global public health focus, more and more clinical researchers in reproductive medicine are shifting their focus from basic research to "stepping beside patients" and carrying out reforms in clinical diagnosis and treatment pathways as well as service processes.

In 2025, Director Pang Wenjuan officially joined the Reproductive Medicine Center of Jiahui International Hospital. A senior reproductive medicine specialist with more than a decade of experience in military hospitals, she used to shuttle between high-intensity outpatient clinics and surgeries day in and day out, skillfully handling various complex and difficult infertility cases, and was accustomed to making quick judgments and treatment decisions within limited time.

But now, in a new environment, she has chosen to slow down and rethink the essence of the role of a "doctor".

Director Pang Wenjuan explained to us that in many hospitals, despite continuous investment in research and technological upgrades, the actual patient experience is often overly rational. Efficiency has to come at the cost of certain humanistic atmosphere—an extremely high number of outpatients leaves doctors with no time for in-depth communication; standardized processes make it difficult to provide personalized follow-up for each patient; and it is even harder to help them cope with anxiety during treatment fluctuations.

Hospitals often focus on "completing a surgery" rather than "accompanying a family".

Against this backdrop, the Reproductive Medicine Center of Jiahui International Hospital, a pioneer among international hospitals, is attempting to integrate "humanistic services" with "precision medicine" to meet the needs of patients with high service demands.

For example, Director Pang cited that in many hospitals, due to environmental and medical resource constraints, patients often have to wait for a long time and make multiple visits to advance diagnosis step by step. In contrast, at the Reproductive Medicine Center of Jiahui International Hospital, after effective communication with patients, more comprehensive assessments of endometrial receptivity and tests such as sperm DNA fragmentation index (DFI) and seminal plasma biochemistry can be provided.

Time-lapse dynamic culture systems are adopted for all embryo culture, which monitor embryonic development in real time and combine AI algorithms to establish a more rigorous embryo evaluation system.

Single blastocyst transfer is prioritized to effectively reduce the risk of multiple pregnancies; in case of embryo transfer failure, the Jiahui Reproductive Medicine Center proposes active intervention strategies, from three-dimensional ultrasound uterine cavity assessment to hysteroscopy to address uterine cavity conditions, providing a more favorable uterine microenvironment for embryo implantation.

From completing relevant examinations of immunity, thrombosis, endocrinology and metabolism to integrating with traditional Chinese medicine physical therapy, a more stable maternal environment is created for embryonic development.

In addition, multiple assessments of nutrition, psychology and physiology are provided, without forcing patients to immediately enter the next treatment cycle. This design reduces the mental stress of patients caused by "rushing for the cycle".

A Former Public Hospital Doctor’s New Goals at Jiahui

The bold and challenging Director Pang Wenjuan has set new goals for herself and embraced new challenges at this new starting point.

To this end, she plans to not only focus on the details of clinical diagnosis and treatment, but also promote a complete set of future-oriented fertility-related service systems at Jiahui.

Several key services she has envisioned and set about advancing are attempting to break the fragmented and one-point limitations of traditional reproductive medicine, providing patients with more continuous and personalized support from prevention to intervention, and from technology to emotional care.

For instance, in response to the growing attention of more young women to fertility preservation, Director Pang proposed the establishment of a Fertility Preservation Decision-Making Clinic, specifically for women aged 25 to 35 who have no immediate fertility plans.

Through scientific assessment of ovarian reserve function (such as AMH and AFC tests), combined with professional legal consulting and popularization of egg freezing knowledge, it helps them make rational and well-prepared decisions during their prime childbearing years.

This not only respects individual choice but also reflects the forward-looking vision of medical institutions in life and health management.

Director Pang Wenjuan has a clear and firm positioning of her role—not only a skilled reproductive doctor, but also a practitioner willing to accompany patients and drive industry progress. The new challenges she has set for herself not only bring emotional companionship to patients but also continuously promote more forward-looking professional practices.

Therefore, in the face of clinical challenges such as endometrial receptivity, repeated implantation failure (RIF) and recurrent spontaneous abortion (RSA), Director Pang Wenjuan leads her team to continuously explore more precise diagnosis and treatment strategies.

01 Repeated Implantation Failure (RIF)

For patients with repeated implantation failure, she uses endometrial receptivity testing (ERT) to accurately identify the individualized window of embryo implantation by analyzing the expression levels of more than 100 related genes in endometrial tissue, thus providing a scientific basis for grasping the timing of embryo transfer.

At the same time, with the help of three-dimensional ultrasound and hemodynamic assessment, doctors can more comprehensively judge uterine cavity morphology, endometrial thickness, blood perfusion and peristaltic rhythm, enhancing the dynamic grasp of endometrial status.

In the intervention of thin endometrium, she is also actively promoting the clinical application and exploration of new treatment methods such as growth hormone (GH) administration, intrauterine perfusion of granulocyte colony-stimulating factor (G-CSF) and intrauterine perfusion of platelet-rich plasma (PRP).

02 Polycystic Ovary Syndrome (PCOS)

For patients with polycystic ovary syndrome (PCOS), Director Pang advocates the organic integration of risk identification, ovarian stimulation strategies and metabolic management.

Through pre-treatment weight management, OGTT screening, replacement of standardized long protocols with antagonist protocols and PPOS protocols, individualized Gn dose adjustment and other methods, the risk of OHSS is effectively reduced. In addition, the Jiahui Medical APP platform is used to continuously monitor potential postoperative OHSS symptoms in patients, building a truly full-cycle and interdisciplinary management pathway.

She proposed the construction of a PCOS Full-Cycle Management Pathway, ranging from metabolic status assessment before pregnancy preparation, nutritional and exercise intervention during ovarian stimulation, to continuous follow-up after successful pregnancy.

She hopes to connect various departments, integrate the strength of nutritionists, sports medicine experts and remote health management teams, and realize online and offline integrated whole-process support with the help of Jiahui's mature internet hospital platform.

03 Endometriosis

In the assisted reproduction management of patients with endometriosis, she attaches particular importance to precise preoperative lesion assessment and postoperative fertility protection.

The reproductive and gynecology teams use MRI combined with TRUS to assess deeply infiltrating lesions, and cooperate with AMH and AFC dual indicators to evaluate ovarian reserve, optimize the timing and method of surgical intervention, and escort fertility preservation.

At the same time, through technical means such as mild stimulation protocols, dual trigger and traditional Chinese medicine physical therapy, a more systematic response strategy is proposed for the common problem of poor ovarian response in such patients after surgery.

In addition, Jiahui has a very sound multidisciplinary team (MDT) cooperation mechanism.

Director Pang Wenjuan gave an example that in her recent consultation with an expatriate couple, in addition to explaining in detail the differences between Chinese and foreign IVF protocols, the hospital's Overseas Medical Department can also assist in providing fertility demand consulting and psychological assessment for fertility preservation (there are also overseas patients coming to China for treatment, such as a recent patient from Bangladesh who requested IVF at Jiahui).

In addition, when she encounters patients with endometriosis complicated with infertility, she can immediately collaborate with the gynecology and pain departments to formulate a surgery-IVF connection plan, instead of a one-way referral model. This has also allowed Director Pang to transition from the previous "working alone" to now carrying out more systematic scientific research with the support of the team.

These comprehensive supports have shifted Director Pang's work focus from "firefighting" to prevention. For example, from the initial consultation, individualized ovarian stimulation protocols are customized based on age, AMH, antral follicle count (AFC) and BMI, with active pre-treatment. From lifestyle adjustments to psychological construction, patients receive more complete and systematic clinical benefits.

Against this backdrop, Director Pang Wenjuan hopes to establish a long-term health support pathway from assisted reproduction to parenting, covering psychological counseling during treatment, nutritional and metabolic intervention, immune intervention, and health record management after the child's birth.

Through regular follow-up and data recording, it not only helps patients face each treatment choice, but also continues to track the growth and development of offspring after successful delivery, providing scientific support for the family's future fertility planning.

Professionalism as the Foundation, Philosophy as the Light, Moving Toward a New Future Together

After joining Jiahui International Hospital, Director Pang Wenjuan's biggest feeling is that "the relationship between doctors and patients has changed".

She said: "Jiahui is a choice I have watched and thought about for a long time." What truly attracted her is not only advanced equipment, but also the philosophy upheld by this hospital—placing people at the center of medical care.

Here, she truly felt for the first time that a doctor is not only there to "complete a treatment", but can also listen to patients' troubles, understand the worries behind the disease, and truly act as a companion to walk through a period of life with patients.

An appointment-based outpatient model is adopted here, where each patient has ample time to communicate, ask questions and express themselves, instead of hurrying into the consulting room and ending the conversation quickly.

Diagnosis and treatment are conducted in independent consulting rooms, which are private and quiet, with nursing staff providing one-on-one full-process follow-up. Many patients say a memorable sentence after their first consultation: "For the first time, I feel that seeing a doctor can be a reassuring experience."

What touches her most is that Jiahui has also specially set up an Embryo Consultation Clinic.

She explained: "Patients undergoing IVF are extremely anxious on the day they come to see their embryos after oocyte retrieval, as nervous as waiting for the college entrance examination results. Since embryos can only be observed under a high-power microscope, we used to only tell patients the number of embryos and their morphological grades. What patients could see was just a string of numbers in the medical record, and it was difficult for them to imagine what the embryos actually look like. But now, through a video link system, they can watch dynamic images of embryonic development right in the consulting room.

Abstract embryos become concrete in an instant, and patients can see the development of their babies with their own eyes, gaining great physical and mental support."

For Director Pang, these seemingly small arrangements actually constitute the gentlest and most powerful part of reproductive medicine.

"Jiahui allows doctors to slow down their hearts because it truly puts patients before processes."

She once treated a female patient who had repeatedly failed IVF and was on the verge of emotional collapse. She took the initiative to contact a psychologist for her, adjusted her medication and treatment rhythm, and patiently accompanied her through the emotional low point. Eventually, the patient became pregnant smoothly.

"At that moment, I realized that what we do is not only to help people get pregnant, but also to safeguard their confidence and hope."

Pang Wenjuan has always believed that the future of reproductive medicine must be more than just technology.

"This industry is not short of equipment or surgical skills, but it is too easy to ignore the 'human' part," she said. "What we need to do is to understand each family's decision, respect their rhythm, and accompany them through this special journey with professionalism and warmth."

These clinical efforts all point to a more long-term goal—making assisted reproduction not just a technical intervention, but a health journey from "assisted conception" to "parenting".

Director Pang Wenjuan hopes that in the future, Jiahui can combine AI modeling with cycle big data to further realize the use of technology to serve precision diagnosis and treatment; at the same time, continue to promote multi-dimensional integrated services such as telemedicine, psychological support, nutritional intervention, and integration of traditional Chinese and Western medicine, and truly establish a fertility health support system centered on families and running through treatment and prognosis.

"I hope Jiahui has not only good doctors and advanced equipment, but also a great philosophy."

She is actively exploring the application of AI in the field of assisted reproduction, such as integrating patients' ovarian function, lifestyle and disease background to generate individualized diagnosis and treatment suggestions; using embryo image and clinical outcome data to carry out machine learning modeling, providing more accurate judgment basis for patients with repeated implantation failure.

This is not only an extension of medical services, but also a concrete embodiment of Jiahui's "family-centered" philosophy. In this model, patients are not only successful cases in statistical indicators, but also flesh-and-blood people with emotions and anxieties.

It is this combination of scientific and precise diagnosis and treatment, as well as warm companionship, that makes the Reproductive Medicine Center of Jiahui International Hospital the strongest and most stable harbor for alleviating the mental burden of infertile patients.

"Professionalism is our foundation, and philosophy is the light that illuminates our direction." In her view, only by deeply cultivating professionalism while adhering to people-oriented care can assisted reproduction go beyond just "getting pregnant" and truly guard the completeness and hope of a family.

She believes that technology and humanistic care are not conflicting. Only with both cutting-edge technology and gentle companionship can medical care truly return to its most original meaning.

#Infertility #ReproductiveMedicine #PrecisionMedicine #HumanisticCare #FertilityPreservation #EmbryoTransfer #EndometrialReceptivity #RSA #PCOS #Endometriosis #MDT #TimelapseEmbryoCulture #AIinReproductiveHealth #JiahuiInternationalHospital