Sperm bank, fulfillment and unfulfilled dreams of procreation
Reporter/Peng Dani
At the Human Sperm Bank of the Third Hospital of Peking University, the recruited sperm donors were interviewed in the reception room and the counseling room, and then taken to the sperm collection room next to the bank. The room, which is less than 5 square meters, has only a sofa and a small table. Volunteers will have their sperm specimens passed directly to the lab through a small window after the sperm collection, and those who pass the sperm test will also undergo a number of medical examinations to make sure they don't have any genetic diseases, sexually transmitted diseases or bacterial infections.
After passing the layers of screening, sperm donors formally enter the donation process, where they are required to complete about 20ml or 40 tubes of semen collection in seven or eight donations over the next few months. The collected sperm, after being processed and numbered, is put into liquid nitrogen at -196 degrees Celsius for storage. A complete donation is finalized six months later when the donor is tested again for HIV and is negative. The storage room, which looks like dozens of large, dark-green tin cans, holds tens of thousands of sperm ready to be resuscitated and waiting for life to be conceived.
Despite the fact that the sperm bank at Beihang Third Hospital officially opened in 2016, the business here has grown by leaps and bounds, relying on the hospital's reproductive medicine department, which is ranked No. 1 in the country. However, for those in the country who have the desire to have children, the existence of the sperm bank may just be a thirst quencher due to a number of policy and legal obstacles.
Supply exceeds demand and sperm shortage exists at the same time
About 30 million couples in China suffer from the inability to have children, and the average incidence of infertility among couples of the right age ranges from 10 percent to 15 percent. But Jiang Hui, chairman of the Chinese Medical Association's Men's Science Branch and chief urologist at Peking University's Third Hospital, emphasized that this is data from 20 years ago, and that nowadays, affected by factors such as late marriage, food health problems, and the fast pace of life with long hours of overtime work, we all feel that the incidence of infertility is on the way up, even though there is no updated data from epidemiological surveys yet.
Infertility can be caused by a variety of male factors, such as lack of sperm motility, malformed sperm, and blockage of the vas deferens that prevents proper transportation of sperm to the fallopian tubes. Among the many factors, about 10% of male infertility originates from the hopeless situation that drugs or even surgery can not help, the testicles do not produce sperm, as Jiang Hui said, there is no seed in the ground, you can not do anything about it. This is the time for those 0.5ml tubes of frozen semen in human sperm banks to make their debut.
The first human sperm bank dates back to the 1960s in the United States, when donating sperm was a small, quick way for college students to earn some pocket money, until the AIDS epidemic began 20 years later, when sperm banks were forced to step out of an unregulated gray area, and the high cost of extensive testing and screening led to the withdrawal of medical institutions and their replacement by commercial ones. Almost at the same time, China's human sperm banks began to land in Hunan, Beijing and other provinces and cities. China's human sperm banks are strictly guarded against commercialization, according to domestic regulations.
For a couple to use sperm from a sperm bank, the fertility center requires the man to undergo a testicular puncture test at the men's department to determine that he is not fertile, and then also conduct a test for the woman to decide what type of reproductive assistance to use for conception, and the couple is required to sign a commitment letter stating that they have not violated state regulations related to family planning.
Relying on these collected sperm, the birth of a new life can be achieved in two ways: when the woman's fertility is not defective, artificial insemination with donor insemination (AID) can be used, i.e., injecting the processed male semen directly into the cervical canal of the woman's uterus; if the woman is also defective in her fertility or if she fails in three attempts of AID, then she will have to opt for the in vitro fertilization with donor insemination (IVF), which is used to remove eggs through ovulation stimulation, and then to inject them into her uterine cervix. After the eggs are removed through ovulation, the sperm and egg are combined outside the body, and then the fertilized eggs are transplanted back into the woman's uterus.
There are currently 26 approved sperm banks across the country. Their existence provides a possibility for families in which the male partner suffers from azoospermia or weak sperm to realize their desire to have children. The sperm bank of the Third Hospital of North Medicine, whose assisted reproduction technology ranks among the best in the country, has been in full operation since 2016, supplying sperm exclusively to the hospital's reproduction center. The latter's AID assisted reproduction has been growing rapidly at a rate of 50 to 60 percent per year, with 2,000 cases carried out in 2018 and 3,000 to 4,000 expected to be completed this year.
But Jiang Hui still feels the pressure of running a sperm bank. The sperm bank's investment in each donor is about 10,000 yuan, including more than 5,000 yuan of donor subsidies and the cost of chromosomes, sexually transmitted diseases, semen and other tests, not to mention the site, personnel and these expenses; and the sperm bank's operating model is very single, due to insufficient publicity and other reasons, the number of self-sperm preservation that can directly bring in revenue is extremely limited. To the sperm bank of the North Medical Third Hospital, for example, here a year to collect more than 10,000 sperm, the number of self-preservation but less than 200 people, the proportion is extremely limited, the United States sperm bank this proportion to be as high as 80%.
Self-sperm preservation refers to fertility preservation for those who don't want to have children for a while, or who are engaged in high-risk occupations, such as chemotherapy or radiation therapy that damages sperm. To add insult to injury, to avoid inbreeding and social and ethical hazards, a donor in China can only impregnate a maximum of five women with his or her sperm, compared with much less stringent standards in Europe and the United States, where, for example, the same sperm can be used to produce up to 25 babies. China's stringent standards mean that the cost per sperm is much higher.
A semen specimen collected by a human sperm bank. Photograph/Ran Wen
Largely contrary to widespread fears of a sperm shortage, the sperm stored in sperm banks actually outstrips demand. in 2016, the country's 24 sperm banks*** preserved 200,000 copies of sperm, with only half of them actually coming out of storage; of the 190,000 frozen in 2017, only 90,000 were put to use.
Although the sperm bank does not have the problem of sperm shortage at the moment, the source of sperm is also really not optimistic. On the one hand, the more than 5,000 yuan of subsidies used to recruit volunteers is increasingly difficult. Jiang Hui said that in the past to give college students 5,000 yuan, he thought it was a lot of money. Now for this amount of money before and after to run about ten times, they are not willing to come. On the other hand, the qualified donor selection rate is also declining year by year. In Hunan province alone, for example, the donor qualification rate has dropped from 46 percent in 2006 to 18 percent in 2015, according to statistics.
The decline in sperm quality is an unsolved problem faced worldwide. The fifth edition of the Laboratory Manual for the Examination and Processing of Human Semen, released by the World Health Organization (WHO) in 2010, has voluntarily lowered the qualifying standards for semen compared to the previous edition. Reproductive medicine expert and member of the Chinese Academy of Sciences Huang Hofeng said that in the early 1980s, when she was just attending college, a semen was only allowed to have a 20 percent deformity rate, while the current fifth edition is now tolerant of a 96 percent deformity rate. At present, however, China's sperm banks still refer to the WHO's fourth edition, so some experts have called for the admission criteria to be adjusted in line with the trend.
Overseas sperm selection is a long way to go
While the domestic sperm bank supply exceeds the demand, some new women in China are still seeking overseas sperm selection.
These women, mostly executives at Fortune 500 companies or senior white-collar workers at some Internet giants, have yet to find a suitable partner but are well past their prime reproductive years, according to media reports. They go overseas to select the sperm to give birth to children, optional genes are excellent, a look like Dubai Prince Hamadan, black hair, nose high, deep eyes; a former U.S. Marine Corps members, with an MBA, Juris Doctor degree. The mixed-race baby was born with big round eyes, brown hair and snow-white skin.
However, for many more women who are not in traditional marriages and lack strong financial resources, their dream of having a baby is still quite far away. 2003, the former Ministry of Health's "Guidelines for Assisted Human Reproduction Techniques" explicitly prohibited the practice of assisted human reproduction techniques on couples and singles who don't comply with the country's population and family planning laws and regulations. For now, the majority of Chinese women's ability to have children legally still depends on whether or not they are in an active marriage under the Marriage Law.
Behind the trend of going overseas for sperm selection and birth control is the reality of the barriers to the use of assisted reproductive technology by single Chinese women at home. Ma Yinan, a professor at Peking University's law school and vice president of the Marriage and Family Law Research Society of the China Law Society, pointed out that international conventions and several domestic legal provisions explicitly protect the reproductive rights of single women, but these seemingly beautiful but vague regulations do not imply substantive empowerment.
Existing laws and policies restricting the reproductive rights of single women not only create barriers to obtaining sperm, but even if they bypass the domestic legal process by purchasing sperm from outside the country to get pregnant, out-of-wedlock births are still subject to many restrictions in China. For example, according to provincial Population and Family Planning Regulations, those who give birth to children without following traditional marriage registration procedures often face various restrictions and penalties, such as the need to renew marriage certificates in some places, the need to pay social maintenance fees in others, and the need to pay fines or even be dismissed from their workplaces.During the two sessions of the National People's Congress in 2019, National People's Congress deputy and deputy secretary-general of the Huizhou Municipal Government of Guangdong Province, Huang Xiaohua, called for the following protect the reproductive rights of unmarried women, abolish discriminatory policies and unconditionally register children born out of wedlock.
The growing demand for sperm banks has been driven by factors such as the widespread postponement of marriage and childbearing in some countries, which has made it impossible for people to have children, and the gradual acceptance and legalization of the reproductive rights of lesbian and single women. But policies still differ from country to country. While anonymous donations are illegal in the UK and the Netherlands, only anonymous donations are accepted in France and Spain; there are no restrictions on donor compensation in the US, but most European countries can only reimburse volunteers for their costs; and sperm-assisted conception is not permitted for single women and lesbians in China and France, but not in Denmark or the US.
The reproductive needs of single women and lesbian couples, along with the restrictions that some countries place on such nontraditional forms of marriage, have allowed international commercial sperm banks such as Denmark's Cryos to find a niche thanks to the Internet, dry-ice technology, and global courier carriers, which allow buyers to place orders online and ship them to local fertility centers. It's big business.
Completing a donation costs merchants about $100 to pay the donor, whose sperm can be divided into five small tubes that sell for between $500 and $1,000 each, according to a 2017 report by The Economist; the global sperm-banking business could be as large as $5 billion by 2025. It's a highly competitive market, with some sperm banks promising the highest-quality sperm and others flaunting the level of detail in their donor information.
Cryos, based in Denmark's second-largest city, Aarhus, is the world's largest sperm bank, and today the vast majority of orders come online and are shipped to more than 100 countries. Browsing its Web page, you might mistake it for a dating site, where donors are labeled by their education, height, appearance, occupation and can even be heard through a small recording of his voice. Such marketing techniques allude to the portrait of its customer base Cryos founder OleSchou pointed out in an interview with China News Weekly that 60 percent of its buyers are single women who are a bit flustered, impatient, and very picky, and who need to find good quality sperm quickly; they are well-educated, and are engaged in professions such as doctors, engineers, and lawyers, and are focused on their careers; they have the material means to have children. They have the material conditions and strong social resources to have children, and are ready to take on the responsibility of parenting on their own, and although they are usually already a little late, they still want to catch the last train of childbearing before it's too late.
OleSchou says his sperm bank also has Chinese buyers, but, because of a strict regulatory regime, while they can order online, they can only have their sperm shipped to clinics in neighboring countries, such as Cambodia and Singapore, where they undergo fertility treatments before returning to their home countries to give birth.
I'm ready to go for IVF (babies). So many sperm banks, Cryos, European, Fairfax, California, and cheap, just take your pick. Really big number of Master(M.A.) or even Phd(Dr.) who are 180+ tall, you can see the photos. A netizen who is apparently a potential buyer of overseas sperm banks said, but her financial strength should not be underestimated: I personally have four houses in second-tier provincial capitals, adding up to more than 600 square meters, and no less than 150,000 U.S. dollars in liquidity, plus my parents are supportive of it, and there are also more than ten years of girlfriends, to make this decision and we are also in the process of immigration. But for the vast majority of women, in addition to the need to cross the aforementioned legal threshold, how many women have such favorable material conditions, can afford to choose overseas sperm birth. Such completion of procreation remains a luxury available to a small minority.
It has become a global trend to recognize the reproductive rights of single women. But if it is to be realized domestically, it will obviously take a long process. Ma Yinan said it is entirely possible that technological advances will create a new type of family structure, and that non-traditional childbearing should not be denied out of fear of change. As for concerns such as whether it is beneficial for children to grow up in a pluralistic family and whether giving single women or lesbians the right to procreate will affect traditional family structures, he believes the key lies in how to solve the resulting problems, rather than banning them altogether.
Originally from: China Newsweek