Infertility in China: Culture, society and a need for fertility counselling

Abstract

With a high rate of infertility, it is important to understand the context of fertility and family planning in China, to inform the necessity of supportive care. A literature review was undertaken to explore the societal constructs informing perspectives of childbearing, family planning and infertility, alongside Chinese considerations of fertility treatments, including assisted reproductive technologies and fertility counselling. In China, childbearing attitudes and behaviours are shaped by tensions between traditional cultural values of the filial piety originating from Confucianism, the history of strict family planning policy, the recent termination of one-child policy and the socioeconomic circumstance. For infertile Chinese individuals, the inability to meet these childbearing expectations gives rise to significant pressure and consequent psychological distress, particularly depressive symptoms. Demographic factors such as gender, education, income and geographical location have been found to influence prevalence and degree of depression in infertile Chinese men and women. These difficulties are compounded by barriers of cultural acceptance, legislative restrictions and availability of resources for alternative options such as adoption and surrogacy. It is important that these fertility sociocultural factors are taken into consideration when assisting Chinese patients to access and utilise fertility treatment services.