It was a chilly and overcast morning in November, however one filled 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 will likely be wasted, all of the ache I endured will likely be wasted, and we should 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 resorts to be close to the hospital for a month through the ultimate stage of the in vitro fertilization course of.

They’re amongst a whole bunch of hundreds 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 chances of infertility. Many wait in lengthy traces exterior hospitals earlier than dawn, only for the opportunity of a session.

Now, the Chinese language authorities desires to make the expertise, which it made authorized in 2001, extra accessible. It has promised to cowl a few of the price — usually a number of thousand {dollars} for every spherical — below nationwide medical insurance coverage. It’s one in all greater than a dozen coverage measures that Chinese language officers are throwing at what they see as a really large downside — a fertility price so low that China’s inhabitants has began to shrink.

China has arrived at this turning level before different nations at its stage of financial growth, resulting in what some demographers discuss with because the curse of “getting previous earlier than getting wealthy.” As fewer infants are born every year and China’s oldest folks dwell longer, the federal government is being compelled to deal with a collection of linked challenges — a shrinking labor pressure, a fledgling pension system and a era of younger individuals who aren’t inquisitive 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 “an enormous deal,” mentioned Lin Haiwei, the chief government at Beijing Good 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 after 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 large image is that persons are much less prepared to have kids,” he mentioned.

That is the one greatest problem going through China because it tries to reverse its falling birthrate. Younger folks complain concerning the monetary burden of getting kids and their very own financial uncertainty, and push again on conventional concepts concerning the lady’s position as a caretaker at dwelling. Many have expressed a want to deal with their careers, whereas others have embraced a life-style often known as “double earnings, no children.”

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

China not too long ago promised to construct no less than one facility providing I.V.F. for each 2.3 million to 3 million folks by 2025. It at present has 539 medical establishments and 27 sperm banks which have been accepted 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 need to have kids. If China can scale up the companies in an inexpensive manner, it might even be a mannequin for different nations which can be 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-Help on a gushing wound,” mentioned Mr. Wahlberg, who’s the writer of a e book on fertility in China.

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

Each Ms. Wang, a manufacturing facility employee, and her husband, an electrician, stop their jobs through the being pregnant to arrange for the start.

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 saved a secret from the household. Her mother and father assume the couple’s fertility points have been as a consequence of her.

“In our hometown, in the event you don’t have kids, you wouldn’t be capable to 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 referred to as everybody. Kinfolk 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 earnings was lower than $1,200 when Ms. Wang and her husband have 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 actually have helped us and relieved some strain.”

Every spherical of I.V.F. can price $5,000 to $12,000, and lots of {couples} have to do it as many as 4 or 5 occasions; every spherical has a hit price of roughly 30 %. Beneath 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 Good Household Hospital.

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

However he’s additionally practical about its affect. “It’s actually laborious to count on a lot development in our trade when the general fertility price and the willingness to have kids are shrinking,” Mr. Lin mentioned.

China has a sophisticated relationship with fertility. For 3 a long time, officers restricted households to 1 baby — generally by way of brutal measures.

At present, infertility impacts 18 % of {couples} in China, in contrast with a worldwide common of round 15 %. Researchers cite a number of elements, together with the truth that Chinese language {couples} typically wait till later to have kids and the widespread use of abortions, which specialists 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 have been profitable final 12 months.

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

“Probably the most nerve-racking 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 dwelling in Zhangjiakou. The new pot restaurant that she and her husband personal has been busy through the present Lunar New 12 months interval. She nonetheless helps out, and he or she has discovered time to knit two mattress quilts for the child.

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