BEIJING -- China's decision to allow all married couples to have two children is driving a surge in demand for fertility treatment among older women, putting heavy pressure on clinics and breaking down past sensitivities, and even shame, about the issue.
The rise in in vitro fertilization points to the deferred dreams of many parents who long wanted a second child, but were prevented by a strict population control policy in place for more than 30 years.
That, in turn, is shifting prevailing attitudes in China regarding fertility treatments -- formerly a matter of such sensitivity that couples were reluctant to tell even their parents or other family members that they were having trouble conceiving.
"More and more women are coming to ask to have their second child," said Dr. Liu Jiaen, who runs a private hospital in Beijing treating infertility through in vitro fertilization, in which an egg and sperm are combined in a laboratory dish and the resulting embryo transferred to a woman's uterus.
Liu estimated that the number of women coming to him for in vitro fertilization had risen by 20 percent since the relaxation of the policy, which came into effect at the start of the year. Before, the average age of his patients was about 35. Now most of them are older than 40, and some of the women are fast approaching 50, he said.
"They have a very low chance to get pregnant, so they are in a hurry. They really want to have a child as soon as possible," he said.
Chen Yun is 39 and was in the hospital waiting to have the procedure for the first time. She and her husband already have a 7-year-old son, and their families are encouraging them to have a second child.
Chen said she hoped having a brother or sister would make their son happier, more responsible and less self-absorbed.
"We had siblings when we were children. I had a younger sister and we felt very happy when playing together," she said. "Now that every couple has one child, two generations -- parents and grandparents -- take care of the child. They give the only child too much attention." If her son has a younger brother or sister to look out for, he may not "think too much about himself like a little emperor," Chen said.
Over the past two decades, in vitro fertilization technology has developed rapidly in China, where about 10 percent of couples are estimated to need the procedure to conceive. In 2014, 700,000 women had in vitro fertilization treatments, according to the health commission's Women's and Children's Department, which said in a statement that demand for all types of fertility treatment had risen, including the use of traditional Chinese medicine.
"Currently, fertility centers at renowned medical organizations in Beijing and Shanghai and other cities are under increased pressure for treatments," the department said.
Previously, China limited most urban couples to one child and rural couples to two if their first was a girl. There were exceptions for ethnic minorities, and city dwellers could break the policy if they were willing to pay a fee calculated at several times a household's annual income.
While authorities credit the policy, introduced in 1979, with preventing 400 million extra births, many demographers argue the fertility rate would have fallen anyway as China's economy developed and education levels rose.
Intended to curb a surging population, the policy has been blamed for skewing China's demographics by reducing the size of the future workforce at a time when children and society face increasing demands from the growing ranks of the elderly. It also inflated the ratio of boys to girls as female fetuses were selectively aborted, while compelling many women to have forced abortions or give up their second children for adoption, leaving many families devastated.
The National Health and Family Planning Commission said in November that 90 million women would become eligible to have a second child following the policy change. Authorities expect that will add 30 million people to the country's labor force by 2050.
Calls have also gone out for a loosening of China's adoption law, which states that only couples with no children can adopt, while also allowing couples with one child to adopt a disabled child or an orphan.
The Ministry of Civil Affairs said there were 109,000 children available for adoption in the custody of governmental institutions, 90 percent of whom were disabled and 60 percent severely disabled.
Zhang Mingsuo, a professor at Zhengzhou University's School of Public Administration, said few Chinese couples were willing to adopt disabled children "because they worry about the possible heavy medical expense."
Information for this article was contributed by Yu Bing of The Associated Press.
A Section on 05/30/2016