"For Taiwanese people, the Year of the Dragon does increase the desire for childbirth, and we can clearly feel the trend of an increased number of women wanting to conceive in the clinic," said Dr. Pan Xian-An, Associate Professor and attending physician at National Cheng Kung University College of Medicine. Generally, the optimal pregnancy period for women is between 25 and 35 years old. However, the current social situation is seeing a growing number of women marrying at a later age, hoping to enjoy their couple life after marriage. Coupled with economic factors and the unfavorable parenting environment in Taiwan, many people repeatedly postpone their plans for having children only to face difficulties when they finally decide to conceive. The reason behind this is that ovarian function starts declining around the age of 35 and rapidly decreases after the age of 38. The decline in egg quality not only leads to difficulties in getting pregnant but also increases the chances of chromosomal abnormalities in advanced maternal age pregnancies.

 

Infertility can be defined based on age: for women younger than 35 years old, if they have regular sexual intercourse 2 to 3 times per week for one year without contraception and still fail to conceive, it is recommended for both the male and female partners to undergo medical examinations. If both partners' fertility functions are normal, the recommended approach is to adopt the "333 strategy": three cycles of taking ovulation-inducing medication, followed by three rounds of artificial insemination, and finally retrieving three mature follicles for in vitro fertilization (IVF).

 

Dr. Pan Hsien-An, who devised the 333 strategy, explains that during the second phase of the strategy (artificial insemination), ovulation induction is required. If there are more than three mature follicles, it is recommended to proceed with in vitro fertilization (IVF). This approach not only reduces the likelihood of multiple pregnancies and lowers costs but also enhances the chances of pregnancy. Most importantly, it saves unnecessary time and steps, allowing for the optimal timing to increase the chances of conception.

                                  

The changing societal mindset has led to an increasing number of psychological factors that may contribute to infertility, in addition to physiological issues. Many career women experience difficulties conceiving due to family and work-related pressures. For instance, a woman in her early thirties, whose husband is an only child, faced immense pressure from her eager-to-have-grandchildren mother-in-law, who often expressed concern during their sleepovers. Furthermore, being a doctor herself, she had to cope with the dual pressures of carrying on the family line and maintaining her professional career. Despite seeking assistance from medical technology, they struggled to conceive successfully. However, after creating a space for themselves and finding some respite from external pressures, they were able to conceive within six months.

                                

Dr. Pan Hsien-An emphasized that in the field of medicine, around 10% of infertility cases fall under the category of "unexplained infertility," where medical reasons cannot be identified. Therefore, the psychological state of relaxation in women undergoing fertility treatment has gradually become an important consideration for doctors. Dr. Pan further pointed out that despite significant advancements in medical technology, the success rate of in vitro fertilization (IVF) remains higher for younger women. For those under 35 years old, the pregnancy rate through treatment is still around 50%, while for women aged 35 to 38, it ranges from 35% to 40%. Beyond the age of 40, the rate drops to only about 12% to 15%. Hence, seeking medical assistance at an earlier stage is more beneficial for treatment progress.

In the past, infertile women often had to endure the pain of injections during treatment, which was a source of great distress. However, with improvements in injectable medications, increased purity, and enhanced potency, the dosage of injections can be reduced, significantly minimizing the discomfort. Additionally, progesterone supplementation after embryo implantation has shifted to gel-based formulations that can be self-administered vaginally at home. These advancements in medical technology have eliminated the need for painful muscle injections, saving women time and energy. Dr. Pan referred to this approach as "humanized reproductive medicine."

 

Dr. Pan Hsien-An advises that once the female body, including the ovaries, begins to age, it becomes increasingly difficult to conceive. He suggests that individuals with plans for childbirth should do so at a younger age. For those facing infertility issues, seeking consultation from specialized doctors and undergoing detailed examinations are crucial in order to develop personalized and suitable treatment strategies. The combination of the Dragon Year baby boom and incentives for childbirth may potentially inject a much-needed boost to Taiwan's declining birth rate.