Peking University Third Hospital Reproductive Center Founded in 1984: The Starting Point and History of Assisted Reproductive Technology in China

1984: A Key Turning Point in China's Assisted Reproductive Technology Field

In 1984, a critical turning point emerged in the field of assisted reproductive technology (ART) in China. That year, the Third Hospital of Beijing Medical University (now Peking University Third Hospital) officially established its Reproductive Medicine Center, led by Professor Zhang Lizhu. The backdrop to this event was the rapidly growing demand for infertility diagnosis and treatment within the country, alongside the swift advancement of international ART. Prior to this, infertility treatment in China relied primarily on traditional gynecological and andrological methods, leaving the field of ART virtually blank. The founding of the Reproductive Center at Peking University Third Hospital marked the beginning of China's ART journey from nothing, laying the organizational foundation and talent pool for the subsequent standardized development of ART in the country.

Founding Time and Background of the Peking University Third Hospital Reproductive Center

Founding Time

The predecessor of the Peking University Third Hospital Reproductive Center (Peking University Third Hospital Reproductive Medicine Center) was the Family Planning Research Laboratory of the Third Hospital of Beijing Medical University, established in 1984. It was officially renamed the Reproductive Medicine Center in 1992. The center was founded under the leadership of Professor Zhang Lizhu, a renowned Chinese obstetrician-gynecologist and a pioneer in reproductive medicine.

Founding Background

• In the early 1980s, international ART developed rapidly, with the world's first test-tube baby born in the UK in 1978.
• China had a large population of infertility patients, with limited effectiveness of traditional treatments and urgent patient needs.
• Professor Zhang Lizhu's team had accumulated years of research experience in female infertility and reproductive endocrinology.
• National health policies began to focus on basic research and clinical translation in the fields of reproductive health and family planning.

Development History and Milestones of Assisted Reproductive Technology

From 1984 to the Present: Discipline Development and Clinical Features

Discipline Development

• Formed a complete disciplinary system covering female infertility, male infertility, reproductive endocrinology, embryology, and genetics.
• Established a leading domestic embryology laboratory and reproductive medicine research platform.
• Undertaken numerous scientific research projects, including the National Natural Science Foundation of China and key R&D programs of the Ministry of Science and Technology.
• Trained a large number of professionals in the ART field, including reproductive medicine, embryology, and genetic counseling.

Clinical Features

• Individualized ovulation induction protocols: Precise plans based on patient age, ovarian reserve, and endocrine status.
• Multidisciplinary team (MDT) model: Collaborative diagnosis and treatment involving reproductive gynecology, reproductive andrology, embryology laboratory, and genetic counseling.
• Advanced maternal age management: Specialized evaluation and intervention processes for women over 35.
• Recurrent pregnancy loss diagnosis and treatment: Multi-dimensional etiological screening including immune, coagulation, and genetic factors.

Easily Overlooked Details: The True Background of the 1984 Founding

What many people do not know is that when the center was first established in 1984, its main focus was basic research on family planning and female infertility. Research conditions were very limited at the time, and the equipment and techniques for the embryology laboratory had to be explored independently. Lacking mature experience, Professor Zhang Lizhu's team relied on a solid foundation in reproductive physiology and repeated experiments, ultimately achieving the successful delivery of the first test-tube baby in mainland China in 1988. During this process, the team made numerous localized improvements in areas such as follicle monitoring, egg retrieval timing, embryo culture medium preparation, and transfer techniques.

Another easily overlooked detail is that the research laboratory established in 1984 was not initially named the "Reproductive Center." Its function underwent a gradual transformation from basic research to clinical application. This transformation process was closely related to the gradual improvement of China's ART management policies. After the national government issued relevant technical regulations in 1992, the center was officially renamed the Reproductive Medicine Center, entering a phase of standardized development.

Differences in Diagnosis and Treatment for Patients of Different Ages

Common Questions and Clarifications about Assisted Reproductive Technology

Frequently Asked Questions about the Founding Time of the Peking University Third Hospital Reproductive Center

1. When was the Peking University Third Hospital Reproductive Center established? Its predecessor (Family Planning Research Laboratory) was established in 1984, and it was officially renamed the Reproductive Medicine Center in 1992.
2. What was the main research direction at the time of its founding in 1984? Primarily basic research on female infertility and reproductive endocrinology, while also exploring in-vitro fertilization and embryo transfer techniques.
3. Who led the establishment of the center? Professor Zhang Lizhu, one of the founders of assisted reproductive technology in China.
4. What was the first major breakthrough after the center's establishment? The completion of the first test-tube baby in mainland China in 1988.
5. What is the significance of the 1984 founding for the development of ART in China? It marked the beginning of ART from scratch in China and established the first systematic research platform.

Clarifying Misconceptions about Assisted Reproductive Technology

• Misconception 1: IVF is suitable for all infertility patients. In reality, indications must be determined based on the specific cause; some patients can achieve natural pregnancy through medication or surgery.
• Misconception 2: Age is not an issue; IVF guarantees success. Age is a core factor affecting ART success rates, as increasing female age is directly linked to declining egg quality.
• Misconception 3: ART leads to higher birth defect rates. Large-scale studies show no significant difference in birth defect rates between conventional IVF and natural pregnancies, though advanced age and genetic factors increase risk.
• Misconception 4: An earlier center founding date means better technology. The founding date reflects historical accumulation, but technical level and success rates depend on a comprehensive evaluation of equipment, team, management, and other factors.

Observations from Practitioners: Some Realities about the Development of Assisted Reproductive Technology

Having worked in the ART field for many years, several noteworthy phenomena have been observed:

• Patients' awareness of ART is improving, but information asymmetry remains a problem. Many patients lack basic understanding of ovulation induction protocols, embryo culture, and genetic testing, leading to unrealistic expectations.
• The center established in 1984 has influenced many later reproductive centers in China through its technical systems and management models. From talent training to quality control, there are valuable experiences to learn from.
• The core driving force behind ART development comes from clinical demand, but the real driver of technological progress is the accumulation of basic research. From 1984 to 2024, over four decades, China's ART has evolved from complete reliance on imports to achieving international leadership in some areas, closely tied to sustained research investment.
• In practice, it has been found that patients often misunderstand the concept of "success rate." Success rate is a statistical concept influenced by multiple factors such as age, etiology, ovarian reserve, and embryo quality, and cannot be simply equated with individual treatment outcomes.

When is Assisted Reproductive Technology Treatment Appropriate?

• Female infertility due to tubal factors (e.g., tubal blockage, hydrosalpinx, adhesions).
• Male infertility (e.g., severe oligoasthenospermia, azoospermia).
• Ovulation disorders unresponsive to ovulation induction treatment for 3-6 cycles.
• Infertility related to endometriosis.
• Unexplained infertility after 1 year of trying to conceive (6 months for women ≥ 35 years).
• Genetic diseases requiring Preimplantation Genetic Testing (PGT).
• Previous recurrent pregnancy loss where ART intervention is deemed suitable after etiological screening.

When is Assisted Reproductive Technology Treatment Inappropriate?

• The female has severe internal or surgical diseases that make pregnancy intolerable (e.g., severe heart disease, renal failure, severe pulmonary hypertension).
• The uterus lacks the function for pregnancy (e.g., severe intrauterine adhesions, severe uterine cavity distortion due to adenomyosis that cannot be surgically corrected).
• Uncontrolled mental illness or cognitive impairment preventing cooperation with treatment.
• Presence of severe mother-to-child transmission diseases that cannot be blocked by medical means (e.g., HIV carriers without viral suppression).
• Irresolvable conflicts between the couple regarding ethics, law, or religion.

Specific Process of Assisted Reproductive Technology Treatment

1. Initial Evaluation: Detailed medical history, physical examination, basic fertility assessment (AMH, FSH, LH, antral follicle count, semen analysis).
2. Pre-treatment and Optimization: Correcting endocrine abnormalities, improving nutritional status, managing underlying conditions (e.g., thyroid dysfunction, blood glucose abnormalities).
3. Ovulation Induction Protocol Design: Choosing an individualized protocol (long protocol, short protocol, antagonist protocol, mild stimulation protocol, etc.) based on age, ovarian reserve, BMI, and other factors.
4. Follicle Monitoring and Egg Retrieval: Monitoring follicle development via transvaginal ultrasound and serum hormone levels, administering HCG or GnRH agonist trigger at the appropriate time, and retrieving eggs 36 hours later.
5. Embryo Culture and Testing: Performing in-vitro fertilization (conventional IVF or ICSI) 4-6 hours after egg retrieval, culturing to day 3-6. Performing embryo genetic testing (PGT) as indicated.
6. Embryo Transfer: Transferring the embryo(s) into the uterine cavity at the appropriate time (fresh or frozen-thawed cycle).
7. Luteal Phase Support and Pregnancy Confirmation: Using medications like progesterone to support luteal function after transfer, and checking blood hCG 12-14 days later to confirm pregnancy.

What is Needed to Prepare for Assisted Reproductive Technology Treatment?

• Document Preparation: ID cards of both spouses, marriage certificate (required by some centers), and previous medical records.
• Test Preparation: The female needs to complete tests including AMH, FSH, LH, estradiol, thyroid function, infectious disease screening, and chromosome karyotype; the male needs semen analysis, infectious disease screening, and chromosome karyotype.
• Physical Preparation: Maintain a regular routine, balanced nutrition, moderate exercise; take folic acid supplements (female); quit smoking and alcohol; control weight (BMI 18.5-24.0).
• Psychological Preparation: Understand the basic process, success rates, and potential risks of ART to avoid excessive anxiety.

How Long Does Assisted Reproductive Technology Treatment Take?

• One Complete Cycle: From initial evaluation to pregnancy confirmation typically takes 4-6 weeks (fresh cycle) or 8-12 weeks (frozen-thawed cycle).
• Ovulation Induction Phase: 8-14 days, requiring daily injections of ovulation-inducing medications and regular monitoring.
• Embryo Culture Phase: 3-6 days (depending on culture duration and whether genetic testing is performed).
• Post-Transfer Waiting Period: 12-14 days waiting for pregnancy confirmation.
• Total Time: From initial evaluation to completing one full cycle usually takes 2-3 months (including preliminary tests and preparation).

What are the Risks of Assisted Reproductive Technology Treatment?

• Ovarian Hyperstimulation Syndrome (OHSS): Over-response to ovulation-inducing medications, causing symptoms like bloating, nausea, and decreased urine output; severe cases require hospitalization.
• Multiple Pregnancy: Transferring multiple embryos increases the risk of multiple pregnancies, which is associated with complications like preterm birth, low birth weight, and gestational hypertension.
• Risks Related to Egg Retrieval Surgery: Including bleeding, infection, and injury to adjacent organs, with an incidence of about 0.1%-0.5%.
• Embryo Transfer Failure: The most common risk in ART treatment, related to factors such as embryo quality, endometrial receptivity, and maternal condition.
• Ectopic Pregnancy: Incidence is about 2%-5%, higher than natural pregnancy (1%-2%).
• Birth Defects: The rate of birth defects with conventional IVF is not significantly different from natural pregnancy, but advanced age and genetic factors increase the risk.

How to Determine if Assisted Reproductive Technology Treatment is Right for You

• Medical Evaluation: Determine if there are indications for ART through a comprehensive fertility assessment (AMH, FSH, LH, antral follicle count, semen analysis, chromosome karyotype, etc.).
• Age Factor: Female age is a core factor affecting success rates; evaluation is recommended as early as possible for women over 35.
• Previous Treatment History: If pregnancy has not occurred after 1 year of regular attempts (6 months for women ≥ 35), or if there is a history of recurrent pregnancy loss or genetic diseases, ART evaluation is recommended.
• Psychological and Financial Preparation: ART treatment is a lengthy process requiring significant financial investment and psychological resilience.

Key Points to Note in the Patient Decision-Making Process

• Choose a Legitimate Institution: ART treatment must be performed at a medical institution approved by the National Health Commission.
• View Success Rates Rationally: Success rate is a statistical concept; individual results are influenced by multiple factors. Avoid being misled by promises of high success rates.
• Emphasize Pre-treatment Tests: A comprehensive fertility assessment is the foundation for developing a reasonable treatment plan. Do not skip necessary tests.
• Pay Attention to Embryology Lab Quality: The technical level of the embryology laboratory is a key factor affecting ART success rates, but patients often overlook it.
• Prepare for Multiple Cycles: Some patients may need 2-3 or more cycles to achieve pregnancy. Plan time and budget accordingly.

Risk Reminder: The Realities of Assisted Reproductive Technology Treatment

Assisted reproductive technology treatment is an invasive medical procedure with clear medical risks. Patients should fully understand the following before choosing treatment:

• Ovulation-inducing medications can lead to Ovarian Hyperstimulation Syndrome (OHSS), with an incidence of about 3%-8%; moderate to severe OHSS requires hospitalization.
• Egg retrieval surgery carries risks of bleeding, infection, and injury to adjacent organs, with an incidence of about 0.1%-0.5%.
• The incidence of ectopic pregnancy after embryo transfer is about 2%-5%, higher than natural pregnancy.
• The rate of multiple pregnancy is about 20%-30% (when transferring 2 embryos), significantly increasing the risk of maternal and infant complications.
• ART treatment cannot guarantee 100% pregnancy success. The single-cycle success rate is about 40%-60% (for women < 35 years), and it decreases with increasing age.