Bai F, et al. - Researchers sought to determine the current status of assisted reproductive technology (ART) service availability, efficacy, and safety in mainland China. They identified this study to be the first national report on ART status in mainland China. They conducted a cross-sectional nationwide survey in 2018 collecting data concerning ART treatments, performed from January 1 to December 31, 2016, in 445 ART clinics located in 31 provinces of mainland China. Three hundred twenty-three in vitro fertilization (IVF) clinics reported providing 906,840 cycles, involving 375,770 conventional IVF cycles, 154,948 intracytoplasmic sperm injection (ICSI) cycles, 367,146 frozen embryo transfer (FET) thawing cycles, and 8,976 preimplantation genetic diagnosis (PGD) treatment cycles. Four hundred forty-three clinics reported a total of 161,376 artificial (ie intrauterine) insemination (AI) cycles, with 126,872 cycles using the husband’s semen (AIH) and 34,504 using donor semen (AID). This suggests an undertaking of 906,840 in vitro fertilization cycles in mainland China with a population of over 1.3 billion inhabitants; they observed an increase in cycles per million inhabitants (C/M) from 360 in 2013 to 657 in 2016, nationwide. Conventional IVF treatment had the clinical pregnancy rate (PR) of 23.2% per oocyte retrieval cycle, the delivery rate (DR) of 18.7% per oocyte retrieval cycle and resulted in 27.9% twin delivery among the total deliveries. The PR, DR, and TDR were 20.5%, 16.7%, and 27.2%, respectively, for ICSI cycles, were 48.2%, 37.6%, and 24.2%, respectively, for FET per thawing cycles, were 38.1%, 29.7% and 4.2%, respectively, for PGD per diagnosis cycles. The PR and DR were 13.3% and 10.5%, respectively, for AIH cycles and were 24.3% and 21.1%, respectively, for AID cycles. They observed reporting of a low rate of birth defects, which might be confounded by variations in birth follow-up methods, statistical timing and record taking. Observations revealed significant improvement in ART service availability in recent years in mainland China. Although China exhibits significant imbalances in ART service provision due to it being a vast country, the main efficacy and safety indicators were close to those of western countries.