What is the role of a sperm bank? Fulfilled and Unfulfilled Childbirth Dreams

Sperm banks: oversupply and sperm shortage coexist

Sperm banks, fulfilled and unfulfilled fertility dreams

Our reporter/Peng Danni

At the Human Sperm Bank of Peking University Third Hospital, the recruited sperm donors communicated and had a brief interview about donation in the reception room and consultation room, and then were taken to the sperm collection room next to them. This room of less than 5 square meters has only a sofa and a small table. After the volunteers collect the sperm, the sperm samples will be transferred directly to the laboratory through a small window. Volunteers who pass the sperm test will also undergo multiple physical examinations to ensure that there are no genetic diseases, sexually transmitted diseases, bacterial infections and other problems.

After passing layers of screening, sperm donors officially enter the donation process. They need to complete the collection of approximately 20ml or 40 tubes of semen in seven or eight donations in the next few months. The collected sperm are processed, numbered, and stored in liquid nitrogen at minus 196 degrees. Half a year later, when the donor is tested for HIV again and comes back negative, a complete donation is considered complete. The storage room looks like just dozens of large dark green tin cans, but it contains tens of thousands of sperm that can be revived at any time and wait to give birth to life.

Although the sperm bank of Peking University Third Hospital was officially opened in 2016, relying on the hospital’s reproductive medicine department, which ranks first in the country, the sperm bank business here has developed rapidly. However, for those people who want to have children in China, due to some policy and legal obstacles, the existence of sperm banks may only quench their thirst.

Oversupply and sperm shortage coexist

About 30 million couples in China suffer from infertility. Among couples of the right age, the average incidence of infertility is Between 10%~15%. However, Jiang Hui, chairman of the Andrology Branch of the Chinese Medical Association and chief physician of the Department of Urology at Peking University Third Hospital, stressed that this was data from 20 years ago. Today, due to factors such as late marriage, food health problems, fast pace of life, and long-term overtime work, Although there are no updated epidemiological survey data, everyone feels that the incidence of infertility is rising.

There are many conditions leading to infertility due to male reasons, such as insufficient sperm motility, sperm deformity, blockage of the vas deferens and the inability to transport sperm to the fallopian tube normally. Among many factors, about 10% of male infertility stems from a hopeless situation where drugs or even surgery are ineffective. The testicles do not produce sperm. As Jiang Hui said, there is nothing you can do if there are no seeds in the ground. At this time, it is time for those 0.5ml small tubes of frozen semen in the human sperm bank to appear.

The establishment of the first human sperm bank can be traced back to the 1960s in the United States. At that time, sperm donation was a small business for college students to make quick pocket money. It was not until the AIDS epidemic began 20 years later that sperm banks were forced to Gradually moving out of the gray area of ??non-standardization, and with the high costs associated with large-scale testing and screening, medical institutions began to withdraw and were replaced by commercial institutions. At almost the same time, China’s human sperm banks began to be established in Hunan, Beijing and other provinces and cities. According to domestic regulations, commercialization of human sperm banks in China is strictly prohibited.

A couple wants to use sperm from a sperm bank. The reproductive center requires the man to undergo a testicular puncture examination at the andrology department. After confirming that he is not fertile, the woman must also be examined to determine which reproductive assistance method to use. To conceive, both husband and wife must also sign a commitment letter stating that they have not violated relevant national family planning regulations.

Relying on these collected sperm, the birth of new life can be done in two ways: when the woman’s fertility is not defective, artificial insemination (AID) can be used, and the treated male can be The semen is directly injected into the woman's cervical canal; if the woman also has fertility defects, or three attempts at AID have failed, the only option is in vitro fertilization (IVF). After the eggs are retrieved through ovulation induction, the sperm and eggs are combined in vitro. The fertilized eggs are then transplanted back into the woman's uterus.

Currently, there are 26 approved sperm banks across the country. Their existence provides families whose men suffer from azoospermia or asthenozoospermia with the possibility of realizing their fertility wishes. The assisted reproductive technology of Peking University Third Hospital ranks among the best in the country. Since its official operation in 2016, its sperm bank has exclusively supplied sperm to the reproductive center within the hospital. The latter's AID assisted reproduction is growing rapidly at an annual rate of 50% to 60%. 2,000 cases were carried out in 2018 and 3,000 to 4,000 cases are expected to be completed this year.

But Jiang Hui still feels the pressure of running a sperm bank. The sperm bank invests about 10,000 yuan per donor, including a donation subsidy of more than 5,000 yuan and the cost of chromosome, STD, semen and other examinations, not to mention the expenses of venue and personnel; and the operation model of the sperm bank It is very simple. Due to lack of publicity and other reasons, the number of self-semen preservation that can directly bring income is extremely limited. Take the sperm bank of Peking University Third Hospital as an example. It can collect more than 10,000 sperms a year, but the number of people who save their own sperm is less than 200. The proportion is extremely limited. In sperm banks in the United States, this proportion is as high as 80%.

Self-sperm preservation refers to fertility preservation for those who do not want to have children for the time being, or who are engaged in high-risk occupations or whose sperm is damaged by chemotherapy or radiotherapy.

To make matters worse, in order to avoid inbreeding and social ethical risks, one donor's sperm in China can only impregnate up to five women. In comparison, European and American countries are much more relaxed. For example, the same sperm source in the United States can be used for pregnancy. Give birth to 25 babies. China's strict usage standards mean the cost of each sperm is even higher.

Semen samples collected by human sperm banks. Photography/Ran Wen

Contrary to people’s common concerns about sperm shortage, the supply of sperm stored in sperm banks actually exceeds demand. In 2016, 200,000 sperms were stored in 24 sperm banks across the country, but only half of them were actually shipped out; in 2017, only 90,000 of the 190,000 sperms frozen were put into use.

Although the sperm bank does not currently have a sperm shortage problem, the source of sperm is indeed not optimistic. On the one hand, it is increasingly difficult to recruit volunteers with a subsidy of more than 5,000 yuan. Jiang Hui said that when he used to give 5,000 yuan to college students, he thought it was a lot of money. Now I have to make more than ten trips for this little money, but they are not willing to come. On the other hand, the selection rate of qualified donors is also declining year by year. Taking Hunan Province as an example, according to statistics, the qualifying rate of donors has dropped from 46% in 2006 to 18% in 2015.

The decline in sperm quality is an unsolvable problem faced by the whole world. The fifth edition of the "Laboratory Manual for the Examination and Processing of Human Semen" released by the World Health Organization (WHO) in 2010 proactively lowered the qualification standards for semen compared with the previous edition. Huang Hefeng, a reproductive medicine expert and academician of the Chinese Academy of Sciences, said that in the early 1980s when she first went to college, a semen only allowed a 20% deformity rate, but now the fifth edition can tolerate a 96% deformity rate. However, at present, the selection criteria for sperm banks in China still refer to the fourth edition of the WHO. Therefore, some experts call for the selection criteria for sperm banks to be adjusted accordingly.

The road to overseas sperm selection to have children is long and difficult

When the supply of domestic sperm banks exceeds demand, some new Chinese women are still looking to go overseas to select sperm to have children.

According to media reports, most of these people are executives from Fortune 500 companies or senior white-collar workers from some Internet giants. They have not yet found a suitable partner but are almost past the best age for childbearing. part. They went overseas to select sperm to have children, and the selected genes were all excellent. One looked exactly like Prince Harmandan of Dubai, with black hair, a high nose, and deep eyes; the other was a former member of the U.S. Marine Corps with an MBA and law degrees. Ph.D. The mixed-race baby was born with big round eyes, brown hair and snow-white skin.

However, for more women who have not entered traditional marriage and lack strong financial strength, their dream of having children is still quite far away. In 2003, the former Ministry of Health's "Human Assisted Reproductive Technology Specifications" clearly stipulated that it was prohibited to implement human assisted reproductive technology for couples and single women who did not comply with the national population and family planning laws and regulations. At present, whether the vast majority of Chinese women can legally give birth still depends on whether they enter into a subsisting marriage in accordance with the Marriage Law.

Behind the choice of sperm to have children overseas are the practical barriers for single Chinese women to use assisted reproductive technology in China. Ma Yinan, a professor at Peking University Law School and vice president of the Marriage and Family Law Research Society of the China Law Society, pointed out that international conventions and many domestic legal provisions clearly protect the reproductive rights of single women, but these seemingly beautiful but vague regulations do not mean that substantial empowerment.

The current legal and policy restrictions on the reproductive rights of single women not only set up obstacles for them to obtain sperm. Even if they bypass domestic legal procedures and purchase sperm from abroad to become pregnant, non-marital childbirth is still faced in the country. Many restrictions. For example, according to the "Population and Family Planning Regulations" of each province, parties who have children who do not follow traditional marriage registration procedures often face various restrictions and punitive measures. For example, in some places, they need to apply for a new marriage certificate, and some need to pay social support fees. Some are fined or even fired from their workplace. During the National People's Congress and the Chinese People's Political Consultative Conference in 2019, Huang Xihua, a deputy to the National People's Congress and deputy secretary-general of the Huizhou Municipal Government in Guangdong Province, called for the protection of unmarried women's reproductive rights, the abolition of discriminatory policies, and the unconditional registration of household registration for children born out of wedlock.

In some countries, people generally delay the age of marriage and childbearing, resulting in infertility, and the gradual recognition and legalization of the reproductive rights of lesbians and single women, among other factors, have promoted the increasing demand for sperm banks. However, there are still differences in policies between countries. In the United Kingdom and the Netherlands, anonymous donations are illegal, while in France and Spain, only anonymous donations are accepted; the United States has no restrictions on donor remuneration, but most European countries can only compensate volunteers for the costs incurred; China and France Single women and lesbians are not allowed to undergo donor sperm-assisted conception, while Denmark and the United States have no such restrictions.

The fertility needs of single women and lesbian couples, as well as the fertility regulations in some countries for non-traditional forms of marriage, have allowed international commercial sperm banks such as Denmark’s Cryos to find market space. Thanks to the Internet and dry ice With technology and global express shipping companies, buyers can place orders directly online and have them shipped to local reproductive centers. This is big business.

According to a 2017 report by The Economist, merchants need to pay the donor approximately US$100 to complete a donation. His sperm can be divided into 5 small tubes, and each tube is sold for between 500 and 500 US dollars. Between US$1,000; before 2025, the scale of the global sperm banking business will reach US$5 billion. It's a highly competitive market, with some sperm banks promising the highest quality sperm and others showing off the level of detail they have about their donors.

Cryos, located in Aarhus, Denmark's second largest city, is the world's largest sperm bank. Today, the vast majority of orders come from online and are shipped to more than 100 countries. Browsing its webpage, you might mistake it for a dating site, where the donor is tagged with his education, height, appearance, occupation, and even his voice can be heard through a short recording of him. Such marketing techniques coincide with the portrait of its customer base. Cryos founder Ole Schou pointed out in an interview with China News Weekly that 60% of its buyers are single women. They are a little panicked, impatient, and very picky and need to find someone quickly. They have high-quality sperm; they are well-educated, and their careers include doctors, engineers, lawyers, etc., focusing on career development; they have the material conditions and strong social resources to have children, and are ready to take on the responsibility of raising children on their own, even though It’s usually a little late, but you still want to catch the last train of childbearing before it’s too late.

OleSchou said that his sperm bank also has Chinese buyers. However, due to the strict regulatory system, although they can order online, they can only transport the sperm to clinics in neighboring countries, such as Cambodia and Singapore. , they receive pregnancy treatment in these countries and then return to their home countries to give birth.

I am ready for in vitro fertilization (in vitro fertilization). There are so many sperm banks, Cryos, European, Fairfax, California, and the prices are cheap, you can just pick one. There are really a lot of Masters and even PhDs who are 18 tall, as you can see in the photos. A netizen who is obviously a potential buyer of overseas sperm banks said, but her financial strength should not be underestimated: I personally own four houses in second-tier provincial capital cities, with a total area of ??more than 600 square meters and no less than 150,000 US dollars. We made this decision only with the liquidity, the support of our parents, and the girlfriend who has been with us for more than ten years, and we are still applying for immigration. But for the vast majority of women, in addition to having to cross the aforementioned legal threshold, how many women have such favorable material conditions and can afford to select sperm to have children overseas. Having children in this way is still a luxury that only a small number of people can enjoy.

Recognizing the reproductive rights of single women has become a global trend. But if it is to be realized domestically, it will obviously take a long time. Ma Yinan said that it is entirely possible that technological progress will create a new type of family structure, and that non-traditional childbearing cannot be refused out of fear of change. As for whether it is beneficial for children to grow up in plural families, and whether granting reproductive rights to single women or lesbians will impact the traditional family structure, he believes that the key lies in how to solve the resulting problems, rather than blindly prohibiting it.

Original text from: China News Weekly