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Tan Xiaojun
·Senior reproductive medicine expert
·Postdoctoral fellow at Peking University
·PhD candidate at Xiangya School of Medicine, Central South
University
·Master’s tutor at Central South University
· Master's degree candidate in reproductive
medicine at the University of South China
· Professional training at Huazhong University
of Science and Technology and Tongji
Hospital Reproductive Center
Expertise:
diagnosis and treatment of infertility, first/second/third generation IVF (including
egg/sperm donation), microsperm retrieval, embryo freezing and resuscitation, artificial
insemination (including husband's sperm and sperm donation), paternity testing, chromosomal
disease
diagnosis, high-throughput gene sequencing, endometrial receptivity gene testing and other
clinical
technology applications. Many of these technologies are at the leading level both domestically
and
internationally.
How much does it cost to help pregnant women with oligospermia and asthenospermia? How much does it cost to treat oligospermia and asthenospermia? How much does it cost to help pregnant men with infertility? How much is China's assisted reproduction? How much is the second-generation test tube? What should I do if the semen of the pregnant man is abnormal?
How much does it cost to help pregnant with less sperm and weak sperm? From inspection to artificial insemination, the second generation of test tubes, the cost link is clarified at one time.
Let's make the problem clear first: being less refined and weak does not mean that you must make test tubes directly.
When many people see "less sperm" and "weak sperm", their first reaction is: can we only make test tubes, and will the cost be tens of thousands or even more soon? This judgment is not rigorous. Medically, male factors can lead to infertility alone, or they can coexist with female factors; However, semen analysis is only an important starting point to evaluate fertility, and it is not possible to draw a final conclusion directly after seeing an abnormal result. WHO regards semen examination as the basis of standardized evaluation, and the European Society of Urology also clearly points out that if the first semen analysis is abnormal, it is usually necessary to repeat the continuous semen analysis at least twice, and then make a comprehensive judgment by combining medical history, physical examination, hormone, ultrasound and even genetic examination.
This means that the core of the question of "how much does it cost to help pregnant with fewer sperm and weaker sperm" is not a fixed number, but what level of treatment you finally go to. Some people just need lifestyle adjustment, medication and review; Some people are suitable to try artificial insemination first; There are still some people who enter the second-generation test tube, that is, intracytoplasmic sperm microinjection (ICSI), because the sperm quantity is too small, the vitality is too poor, and it is difficult to take sperm.
Take the expenses apart first: usually, they are not spent at one time, but occur in stages.
If we look at the domestic medical treatment route, the common expenses of assisting pregnancy with oligospermia and oligospermia will be roughly divided into four sections: pre-examination expenses, male treatment and review expenses, artificial insemination expenses and IVF expenses. The reason why many families feel "more expensive" is not because a single project is suddenly expensive, but because diagnosis, treatment, review and entering the cycle of assisted pregnancy are a step-by-step process. WHO also mentioned in the related data of infertility that the high cost and self-funded ratio are indeed important practical obstacles faced by many families when they get fertility treatment. Around the world, about one sixth of adults have experienced infertility, and the economic burden is not an individual phenomenon.
Paragraph 1: Pre-inspection fee
This part is often underestimated by many people. Common examinations of men include semen analysis, sperm morphology, detection of sperm DNA fragments when necessary, sex hormones, scrotum or testis ultrasound; If it is severe oligospermia or severe asthenospermia, some people need to do genetic evaluation such as chromosome karyotype and Y chromosome microdeletion. EAU guidelines clearly suggest that patients with oligozoospermia and azoospermia should be combined with hormone evaluation and necessary genetic examination instead of just staring at a semen report.
Therefore, the budget for a simple pre-assessment usually ranges from several hundred yuan to several thousand yuan. If you only do basic semen examination and review, the cost is relatively limited; If we go to the level of hormones, ultrasound and genetics, the budget will increase significantly. There is no national unified figure here, because the hospital level, city, whether it is included in medical insurance or not, and whether it is added to expansion projects will change the total amount. This interval is judged with high confidence.
What really affects the budget is not the word "less refined and weak refined", but which technology is chosen.
If the man's problem is not serious, the woman's ovulation and fallopian tube conditions are basically ok, and artificial insemination may be taken first in clinic; If the quality of sperm is too poor, the number of sperm is obviously insufficient, or it is complicated with obstruction, difficulty in taking sperm and failure of artificial insemination in the past, it is more likely to take the second generation test tube. EAU guidelines mentioned that some men may need further assisted reproductive pathways when sperm DNA fragments are high, semen parameters are poor or there are problems in sperm retrieval; However, whether to upgrade to ICSI depends on the joint evaluation of husband and wife, not just the man.
The second paragraph: If artificial insemination is done first, the cost is usually relatively moderate.
The official price document can give a more intuitive reference. Taking the item of assisted reproduction price announced by Fujian Province as an example, the top three price of artificial insemination is 600 yuan/time, and the optimal treatment of sperm is 650 yuan/time. In other words, the technical cost is not particularly high just by looking at the core operation projects. The problem is that when we really enter an artificial insemination cycle, we often add the costs of ovulation monitoring, B-ultrasound, laboratory tests, and drugs to promote ovulation when necessary, so the actual expenditure is usually higher than the sum of these two items.
Judging from the budget idea, if the doctor judges that you are still suitable to try artificial insemination first, it will be safer to prepare a single-cycle budget of "several thousand yuan to ten thousand yuan". This figure is not a unified charging standard, but a realistic estimate based on the official technical project price, plus common monitoring and medication. Its confidence level is moderate, because there are great differences between local drug programs and women's monitoring programs.
The third paragraph: If we take the second generation test tube, the budget will increase obviously.
For families with few sperm and weak sperm, the most frequently asked question is: "Do you have to do second-generation test tubes?" The answer is: not all, but severe male factors are more likely to enter the second-generation test tube path. According to the public information of the National Medical Insurance Bureau, among the third-level designated medical institutions, the basic project cost of the second-generation IVF technology is about 17,600 yuan, excluding the medicine fee; The first generation is about 11,900 yuan, and the third generation is about 19,900 yuan, which also does not include medicine fees. This information is very important, because it directly shows that the "technical project price" you see is not the total cost.
Why not enough? Because the complete cycle usually includes pre-examination, ovulation induction drugs for women, monitoring, egg retrieval related operations, embryo culture, transplantation, cryopreservation, and sperm retrieval operations for men when necessary. Xinhua News Agency also mentioned that egg retrieval, embryo culture and embryo transfer are the core steps of test tubes when interpreting the policy of assisted reproductive health insurance. Take Guangxi tertiary hospitals as an example, these three items are about 2,400 yuan, 4,200 yuan and 2,300 yuan respectively. In other words, even if you don't count the medicine fee and preliminary examination first, the core link itself is close to 10 thousand yuan.
Why are fewer sperm and weaker sperm often bound to the "second generation test tube"?
Because the key link of the second generation test tube is single sperm injection. According to the price document published by Fujian Province, the single sperm injection project is 1,500 yuan/egg, and the 750 yuan is added for each additional egg, and the maximum charge for egg activation does not exceed 5,300 yuan; If the man has difficulty in taking sperm, there is an extra charge for sperm collection. The price of the basic project is 800 yuan/time, and there will be an extra charge for cutting sperm under the microscope. For families with oligospermia and asthenospermia, especially severe semen abnormality, this part of the addition is very realistic.
Therefore, if the question is more direct: how much money is more realistic to prepare for pregnancy?
A safe answer is:
Only for examination and a period of treatment and reexamination: it is more realistic to prepare a few thousand yuan level first.
Enter artificial insemination: according to a single cycle, it is usually safer to prepare thousands to 10 thousand yuan.
Entering the second-generation test tube: Since the basic technical item price announced by the National Medical Insurance Bureau has reached 17,600 yuan and does not include the drug fee, many families will budget at the level of tens of thousands of yuan, instead of just focusing on the number of "17,600 yuan".
Expert tip: Don't mistake the "technical project price" for the "final total cost".
The first generation, second generation and third generation test tube fees announced by the National Medical Insurance Bureau emphasize the basic project price, and do not include drug fees. What really determines the total expenditure is often the amount of drugs promoted by the woman, whether it needs multiple transplants, whether it needs cryopreservation, whether the man needs sperm collection, and how much local medical insurance can cover.
Who is more likely to go from "treatment" to "helping pregnancy"?
From the perspective of medical logic, the following types of people are more likely to enter the stage of pregnancy assistance: first, the number and vitality of sperm continue to be obviously abnormal, and there is still no improvement after the review; Second, patients with azoospermia, severe oligospermia, or suspected obstruction need to be surgically removed; Third, the woman's age, ovarian reserve and fallopian tube condition are not allowed to wait for a long time; Fourth, both husband and wife factors exist at the same time, and the time cost of continuing simple conditioning is too high. The EAU guidelines also emphasize that male assessment should go hand in hand with female fertility assessment, because the final treatment strategy is often determined by the comprehensive situation of both parties.
This is also why it is also "less refined and weak", some people spend thousands of dollars, and some people spend tens of thousands of dollars. It is not that hospitals charge fees at will, but that the level of illness and treatment path are fundamentally different.
FREQUENTLY ASKED QUESTIONS
Do you have to be a second-generation test tube with less sperm and weak sperm?
Not necessarily. When mild or moderate abnormalities and the woman's conditions are suitable, sometimes natural pregnancy optimization or artificial insemination will be tried first; It is easier to enter ICSI pathway when there are severe male factors, previous failures and difficulties in sperm retrieval.
Why is it also called "test tube"? Some people spend less and others spend more.
Because the cost difference mainly comes from drug dosage, examination items, whether sperm injection is needed, whether sperm extraction is needed, whether freezing and multiple transplants are needed. The National Medical Insurance Bureau also clearly indicated that the price of basic items does not include medicine fees, and some regional policies also pointed out that not all examinations and treatments can be reimbursed.
Is it possible to spend money on "ineffective treatment" first?
There is this risk. In particular, if you don't complete the standard review and etiology evaluation, you will take medicine and health care products repeatedly for a long time and wait for natural pregnancy, and time and money may be consumed. A more reasonable order is: standardized examination-clear etiology-judge whether treatment can be reversed-and then decide whether to enter artificial insemination or test tube.
Summary box
There is no national unified answer to the cost of assisting pregnancy with fewer sperm and weaker sperm. What really determines the budget is not the words "fewer talents and weaker talents", but where you finally go.
If it is only standard inspection and short-term intervention, the budget is often still under control; If you enter artificial insemination, it is usually a single-cycle preparation of several thousand to ten thousand yuan; If you enter the second-generation test tube, the basic item price announced by the National Medical Insurance Bureau has reached 17,600 yuan and does not include the drug fee. In reality, you should make an overall budget at the level of tens of thousands of yuan. For most families, it is more important to do standard evaluation first and then talk about technology choice than to ask "how much is it altogether?"
Common aliases:Kyrgyzstan Tulip Reproductive Center, Tulip IVF, Tulip Reproductive Center, Tulip Hospital, Kyrgyz Tulip Reproductive Center, Kyrgyz Tulip Hospital
