It was a chilly and overcast morning in November, however one stuffed with promise for Guo Meiyan and her husband: They’d lastly get an opportunity to start out a household.

As Ms. Guo, 39, was wheeled on a gurney right into a hospital room the place a health care provider transferred her eggs, which had been harvested and fertilized, again into her uterus, she additionally felt a way of dread.

“If the transplant isn’t profitable, all the cash we spent might be wasted, all of the ache I endured might be wasted, and we must begin over once more,” mentioned Ms. Guo, who had traveled 125 miles to Beijing from the northern metropolis of Zhangjiakou. She and her husband had been residing in accommodations to be close to the hospital for a month throughout the ultimate stage of the in vitro fertilization course of.

They’re amongst a whole lot of 1000’s of Chinese language {couples} who flip to assisted reproductive expertise yearly after exhausting different choices to get pregnant. They journey from all corners of the nation to large cities like Beijing within the hopes of beating the percentages of infertility. Many wait in long lines outdoors hospitals earlier than dawn, only for the opportunity of a session.

Now, the Chinese language authorities desires to make the expertise, which it made legal in 2001, extra accessible. It has promised to cowl a number of the value — sometimes a number of thousand {dollars} for every spherical — underneath nationwide medical insurance coverage. It’s considered one of greater than a dozen coverage measures that Chinese language officers are throwing at what they see as a really large drawback — a fertility fee so low that China’s population has started to shrink.

China has arrived at this turning level prior to different nations at its stage of financial improvement, resulting in what some demographers consult with because the curse of “getting previous earlier than getting wealthy.” As fewer infants are born every year and China’s oldest individuals reside longer, the federal government is being compelled to deal with a collection of related challenges — a shrinking labor force, a fledgling pension system and a era of younger individuals who aren’t excited about having infants.

Subsidizing fertility companies like I.V.F., a expertise that fertilizes eggs with sperm in a lab and transplants an embryo into the womb, is “a giant deal,” mentioned Lin Haiwei, the chief government at Beijing Excellent Household Hospital, the place Ms. Guo had her process. Sufferers go to nice lengths to pay for fertility companies. A few of them pool loans from kin. Farmers time their appointments with the autumn harvest once they have cash to pay.

However whilst there’s a clear demand for fertility companies, Mr. Lin mentioned, the variety of sufferers visiting the hospital is decrease every year. “The massive image is that individuals are much less keen to have youngsters,” he mentioned.

That is the only greatest problem going through China because it tries to reverse its falling birthrate. Younger individuals complain in regards to the monetary burden of getting youngsters and their very own financial uncertainty, and push again on conventional concepts in regards to the lady’s function as a caretaker at residence. Many have expressed a want to concentrate on their careers, whereas others have embraced a life-style generally known as “double revenue, no children.”

Regardless of this hurdle, officers try to push up one of many lowest fertility charges on this planet. Whereas consultants say it might be almost unimaginable for China’s inhabitants to start out rising once more, the nation might maintain its birthrate regular. Making assisted reproductive applied sciences accessible to extra individuals would assist, simply because it has helped in wealthier nations like Denmark, mentioned Ayo Wahlberg, an anthropologist on the College of Copenhagen.

China just lately promised to construct no less than one facility providing I.V.F. for each 2.3 million to a few million individuals by 2025. It presently has 539 medical establishments and 27 sperm banks which were permitted to hold out assisted reproductive expertise. Every year these amenities present greater than a million cycles of I.V.F. and different assisted fertility companies. Round 300,000 infants are conceived.

Specialists say these efforts are significant methods to assist {couples} who wish to have youngsters. If China can scale up the companies in an reasonably priced approach, it might even be a mannequin for different nations which are going through related challenges with infertility. However whether or not it’s going to do a lot to vary China’s demographic trajectory is one other query.

“The issue is that it’s placing a Band-Assist on a gushing wound,” mentioned Mr. Wahlberg, who’s the creator of a ebook on fertility in China.

For {couples} like Wang Fang and her husband, I.V.F. modified their lives. Ms. Wang went via two rounds of I.V.F. in 2016 earlier than she gave delivery to twins in 2017. Her husband’s first marriage resulted in divorce as a result of they had been unable to have a toddler.

Each Ms. Wang, a manufacturing facility employee, and her husband, an electrician, stop their jobs throughout the being pregnant to organize for the delivery.

When the primary spherical of I.V.F. failed, the couple felt damaged. They discovered that they may want a sperm donor, one thing that Ms. Wang has stored a secret from the household. Her mother and father suppose the couple’s fertility points had been resulting from her.

“In our hometown, in the event you don’t have youngsters, you wouldn’t be capable of maintain your head excessive,” Ms. Wang mentioned. The second time they did I.V.F., the 14-day ready interval to find out if it was profitable “felt like a half a century,” she mentioned.

As quickly as they discovered the result, they known as everybody. Family supplied to pitch in with their financial savings to assist cowl the prices, which exceeded $22,000, an enormous sum for the couple, whose month-to-month family revenue was lower than $1,200 when Ms. Wang and her husband had been working.

“I.V.F. isn’t a one-time deal, and we ran out of our cash after a number of large objects, so we needed to borrow cash to proceed,” Ms. Wang mentioned. If even a few of these prices had been coated by medical insurance coverage, as the federal government has mentioned it’s going to now begin doing, “it might definitely have helped us and relieved some stress.”

Every spherical of I.V.F. can value $5,000 to $12,000, and plenty of {couples} must do it as many as 4 or 5 occasions; every spherical has a hit fee of roughly 30 %. Below the brand new authorities measures, medical insurance coverage would seemingly cowl about half the price of a spherical of I.V.F., mentioned Mr. Lin at Beijing Excellent Household Hospital.

The coverage has not been enforce, its particulars are unclear and a lethal outbreak of Covid might delay issues. Nonetheless, Mr. Lin is optimistic that some model of the coverage might be put into place within the coming months.

However he’s additionally sensible about its impression. “It’s definitely laborious to count on a lot progress in our business when the general fertility fee and the willingness to have youngsters are shrinking,” Mr. Lin mentioned.

China has a sophisticated relationship with fertility. For 3 many years, officers restricted households to at least one little one — typically via brutal measures.

Right this moment, infertility impacts 18 % of {couples} in China, in contrast with a worldwide common of round 15 %. Researchers cite a number of components, together with the truth that Chinese language {couples} usually wait till later to have youngsters and the widespread use of abortions, which consultants have mentioned might have an effect on fertility.

Su Yue, 32, by no means had a robust want to have a child, however her husband and in-laws did. After the couple tried for a number of years, her mother-in-law gave them cash to start out I.V.F. therapy. They had been profitable final 12 months.

Ms. Su loves her son, whom she refers to affectionately as “Cookie.” However she mentioned giving delivery had value her her job. She had been breastfeeding whereas working remotely, however then her boss required her to return into the workplace. As a career-minded millennial, she laments having to resign.

“Essentially the most disturbing factor about I.V.F. is that I misplaced my job,” Ms. Su mentioned.

Since her transplant, which was profitable, in late November, Ms. Guo has been taking it straightforward again at residence in Zhangjiakou. The new pot restaurant that she and her husband personal has been busy throughout the present Lunar New Yr interval. She nonetheless helps out, and he or she has discovered time to knit two mattress quilts for the infant.

Largely, although, she tries to relaxation in mattress, Ms. Guo mentioned. “I really feel sick and dizzy on a regular basis.”