Promoting Women’s Health and Building a Fertility-Friendly Society

Merck KGaA, Germany

Executive Summary

The global landscape of women’s health and fertility support is undergoing a strategic transformation, shifting from mere medical interventions to integrated solutions, from disease treatment to preventive care, and from focusing on individual health to optimizing the social environment.

First, the principle of prevention first is guiding early intervention in women’s health. Internationally, thyroid function screening has been widely incorporated into routine preconception and prenatal care, with many countries lowering screening thresholds to improve early detection rates. Global experience also shows that ovarian reserve assessment has become a recommended health management measure for women over 35.Second, diversified support systems, such as financial subsidies and commercial insurance, have become key enablers of assisted reproductive services (ARS). Developed countries have enhanced ARS accessibility through public health insurance, private insurance, and corporate benefits.

Third, the international community is working to improve paid maternity and parental leave policies, promote flexible work arrangements, and support corporate fertility-friendly initiatives. Efforts are also being made to eliminate the social stigma surrounding infertility, establish community support networks, and foster a societal consensus that supports childbirth, thereby creating a comprehensive fertility-friendly social environment.Against the backdrop of profound demographic shifts, China faces multiple challenges, including population decline, declining fertility rates, and increasing health concerns related to female reproduction. These challenges are mainly reflected in two aspects: deficiencies in the women’s health management system and imbalances in the development of the assisted reproductive service system.

Thyroid diseases, which are highly prevalent among women, have a significant impact on fertility and pregnancy outcomes. However, public awareness remains low, and thyroid function screening has yet to be systematically integrated into basic healthcare services and routine health checkups. Additionally, the lack of standardized mechanisms for ovarian reserve assessment results in limited awareness among older reproductive-age women regarding their fertility potential, leading to missed optimal conception windows and exacerbating infertility issues.

Despite the large scale of China’s ARS system, it faces three major challenges. First, low patient consultation rates and delayed diagnosis severely affect treatment outcomes. Second, the absence of a national-level quality control framework compromises service quality and patient safety. Third, there is no systematic, multidisciplinary collaboration for fertility preservation in special patient groups, such as those with cancer, causing many to miss critical opportunities for reproductive protection. Although the national policy framework has been continuously refined and ARS has been included in health insurance coverage across most provinces, workplace support for women of reproductive age remains inadequate. Furthermore, persistent public misconceptions and social stigma surrounding infertility contribute to a societal environment that discourages childbirth.

Based on global trends and China’s current situation, this report proposes the following policy recommendations:

First, improve the early intervention system for women’s health. It is recommended to include thyroid function screening as a basic health management program for reproductive-age women, encourage enterprises and institutions to incorporate thyroid function testing into female employee health checkups, and establish an ovarian reserve assessment and counseling service system to achieve early detection and early intervention, thereby protecting women’s reproductive health.

Second, optimize the assisted reproductive service system. It is recommended to establish a national quality control framework for assisted reproduction, improve the tiered diagnosis and referral mechanism, strengthen multidisciplinary collaboration in fertility preservation for special patient groups, enhance treatment success rates, and optimize resource allocation efficiency.

Third, build a diversified fertility support system. It is recommended to improve financial subsidy policies for assisted reproduction, strengthen public education and psychological support for infertility, encourage enterprises to create fertility-friendly workplaces, eliminate barriers to childbirth, and enhance reproductive willingness.

As a global leader in technological innovation, Merck is committed to advancing early intervention in women’s health, improving the quality of assisted reproductive services, and leading corporate fertility-friendly practices. Through concrete actions, we support the Chinese government’s policy objectives of promoting women's health and building a fertility-friendly society, contributing to the advancement of women’s health and fertility initiatives in China, and supporting the implementation of the Healthy China strategy and long-term demographic balance.

Against the backdrop of profound demographic shifts, the international community has adopted a more systematic and holistic policy approach to women’s health and fertility support. Currently, China faces multiple challenges, including population decline, declining fertility rates, and increasing health concerns related to female reproduction. This report examines these issues from two dimensions: women’s health and fertility support, aiming to contribute corporate insights to China’s efforts in promoting women’s health and building a fertility-friendly society.

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