Sperm bank, realized and unrealized fertility dream
Our reporter/Peng
In the human sperm bank of Peking University Third Hospital, the recruited sperm donors had a simple interview in the reception room and consultation room, and then were taken to the next sperm collection room. This room, which is less than 5 square meters, only has a sofa and a small table. After sperm collection, volunteers will directly transfer sperm samples to the laboratory through the small window. Volunteers who pass the sperm test will also undergo a number of physical examinations to ensure that there are no genetic diseases, sexually transmitted diseases and bacterial infections.
After layers of screening, sperm donors formally enter the donation process. In the next few months, they need to collect about 20 ml or 40 tubes of semen in seven or eight donations. After processing and numbering, the collected sperm were stored in-196 degree liquid nitrogen. Half a year later, when the donor is tested negative for HIV again, a complete donation is over. The storeroom looks like dozens of dark green tin cans, but it contains thousands of sperm that can be resurrected at any time and wait for life.
Although the sperm bank of the Third Hospital of Beijing Medical University was officially put into operation in 20 16, the sperm bank business here has developed rapidly relying on the number one reproductive medicine department in China. However, for those who are willing to have children in China, due to some policy and legal obstacles, the existence of sperm bank may be just to quench their thirst.
Supply exceeds demand and lean shortage coexist.
About 30 million couples in China suffer from infertility. In school-age couples, the average incidence of infertility is between 10% and 15%. However, Jiang Hui, chairman of the andrology branch of Chinese Medical Association and chief physician of urology department of Peking University Third Hospital, stressed that this data was 20 years ago. Now, affected by factors such as late marriage, food hygiene problems, fast pace of life and long-term overtime work, although there is no updated epidemiological survey data, everyone feels that the incidence of infertility is rising all the way.
There are many cases of male infertility, such as insufficient sperm motility, sperm malformation, blocked vas deferens, and inability to transport sperm to fallopian tubes. Among many factors, about 10% of male infertility comes from the hopeless situation that drugs and even surgery can't do anything. As Jiang Hui said, you can't do anything without seeds in the field. At this time, it is time for frozen semen in 0.5ml small test tubes in human sperm bank to appear.
The establishment of the first human sperm bank can be traced back to the United States in the 1960s. At that time, donating sperm was a small business for college students to earn pocket money quickly. It was not until 20 years later that the epidemic of AIDS forced the sperm bank out of the irregular gray area. With the high cost of testing and screening, medical institutions began to quit and were replaced by commercial institutions. Almost at the same time, China human sperm bank began to land in Hunan, Beijing and other provinces and cities. According to domestic regulations, commercialization of human sperm bank in China is strictly prohibited.
A couple want to use sperm from the sperm bank. The reproductive center requires the man to go to the andrology department for a testicular puncture. After confirming that you are infertile, you should also check the woman to decide what kind of reproductive assistance method to use to conceive. Husband and wife also need to sign a letter of commitment stating that they have not violated the relevant family planning regulations of the state.
With these collected sperm, a new life can be born in two ways: when the woman's fertility is not defective, artificial insemination with donor sperm can be used, that is, the treated male semen can be directly injected into the female cervical canal; If the woman also has birth defects, or three times of assistance have failed, then IVF technology can only be chosen. After ovulation induction, sperm and egg are combined in vitro, and then the fertilized egg is transplanted back to the female uterus.
At present, 26 sperm banks have been approved nationwide. Their existence makes it possible for families with male azoospermia and asthenospermia to realize their fertility wishes. The assisted reproductive technology of the Third Hospital of Beijing Medical University ranks among the best in China. Since its official operation on 20 16, its sperm bank has been devoted to providing sperm for the reproductive center in the hospital. The assisted reproduction of the latter is increasing rapidly at the rate of 50%~60% every year. In 20 18, 2,000 cases were launched, and it is estimated that 3,000 to 4,000 cases will be completed this year.
But Jiang Hui still feels the pressure to operate the sperm bank. The investment of sperm bank for each sperm donor is about 1 10,000 yuan, including more than 5,000 yuan of sperm donation subsidy and the cost of chromosome, venereal disease and semen examination, not to mention the cost of venue and personnel; However, the operation mode of sperm bank is very single, and due to insufficient publicity and other reasons, the number of autologous sperm that can directly bring income is extremely limited. Take the sperm bank of the Third Hospital of Beijing Medical University as an example. More than 1 10,000 sperm can be collected here a year, but less than 200 sperm are self-preserved, which is extremely limited. The proportion of American sperm banks is as high as 80%.
Autosperm preservation refers to the fertility preservation of people who don't want children for the time being, or those who are engaged in high-risk occupations, such as chemotherapy, radiotherapy and other people who have damaged sperm. To make matters worse, in order to avoid inbreeding and social and ethical risks, a donor's sperm in China can only make up to five women pregnant. In contrast, European and American countries are much more relaxed. For example, the same sperm source in the United States can provide 25 babies. China's strict usage standards mean that the cost per sperm is higher.
Semen samples collected from human sperm bank. Photography/Wen Ran
Contrary to people's general concern about the shortage of sperm, the supply of sperm stored in the sperm bank actually exceeds the demand. In 20 16, 24 sperm banks in China kept 200,000 sperm, but only half of them actually left the bank. Of the 9,000 sperm frozen in 20 17 years, only 90,000 were put into use.
Although there is no shortage of sperm in the sperm bank at present, the source of sperm is really not optimistic. On the one hand, it is increasingly difficult to recruit volunteers who subsidize more than 5,000 yuan. Jiang Hui said that he once gave college students 5,000 yuan, which he thought was a lot of money. Now they have to run back and forth for more than a dozen times for this money, and they don't want to come. On the other hand, the selection rate of qualified donors is also decreasing year by year. Taking Hunan Province as an example, according to statistics, the qualified rate of donors dropped from 46% in 2006 to 20 15 18%.
The decline of sperm quality is an unsolved problem facing the whole world. Compared with the previous edition, the fifth edition of "Laboratory Manual for Human Semen Examination and Processing" issued by the World Health Organization (WHO) on 20 10 actively lowered the qualification standard of semen. Huang Hefeng, an expert in reproductive medicine and an academician of the Chinese Academy of Sciences, said that when she first went to college in the early 1980s, only 20% of a semen was allowed to be deformed, and now the fifth edition can tolerate 96% of the abnormalities. However, at present, the selection criteria of sperm bank in China still refer to the fourth edition of WHO. Therefore, some experts call for the selection criteria of sperm bank to be adjusted accordingly.
The road to overseas sperm selection is long and difficult.
In the case that the supply of sperm banks in China exceeds the demand, some new women in China are still seeking sperm selection overseas.
According to media reports, most of these people are executives of Fortune 500 companies or senior white-collar workers of some Internet giants. They didn't find a suitable partner, but they passed the best childbearing age. They choose sperm overseas, and the genes they can choose are excellent. A prince of haman dan who looks like Dubai, with black hair, high nose and deep eyes; One is a former member of the United States Marine Corps, with an MBA degree and a doctorate in law. The mixed-race baby born has big round eyes, brown hair and snow-white skin.
However, for more women who have not entered the traditional marriage and lack strong economic strength, the dream of giving birth is still quite far away. In 2003, the former Ministry of Health's Technical Specification for Human Assisted Reproductive Technology clearly stipulated that it was forbidden to implement human assisted reproductive technology for couples and single women who did not meet the national population and family planning laws and regulations. At present, whether the vast majority of women in China can legally give birth still depends on whether she enters the surviving marriage relationship according to the marriage law.
Behind the choice of sperm abroad is the practical barrier for domestic single women to use assisted reproductive technology in China. Ma Yinan, a professor at Peking University Law School and vice president of china law society Marriage and Family Law Research Association, pointed out that international conventions and many domestic legal provisions expressly protect the reproductive rights of single women, but these seemingly beautiful but vague provisions do not mean substantive empowerment.
The restrictions on the reproductive rights of single women by current laws and policies not only set obstacles for them to obtain sperm, but also face many restrictions in China even if they bypass domestic legal procedures and buy sperm from abroad to get pregnant. For example, according to the population and family planning regulations of various provinces, parties who do not follow the traditional marriage registration procedures often face various restrictions and punishment measures. For example, some places have to reissue marriage certificates, some have to pay social support fees, and some have to be fined or even expelled from their work units. 20 19 During the National People's Congress, Huang Xihua, Deputy Secretary-General of Huizhou Municipal Government, called for the protection of unmarried women's reproductive rights, the abolition of discriminatory policies and the unconditional registration of children born out of wedlock.
In some countries, people generally delay marriage and childbearing age, so that they can't have children. The gradual recognition and legalization of reproductive rights of lesbians and single women has promoted the increasing demand for sperm banks. However, there are still differences in national policies. In Britain and the Netherlands, anonymous donations are illegal, while in France and Spain, only anonymous donations are accepted; The United States has no restrictions on the remuneration of donors, but most European countries can only compensate the expenses of volunteers; In China and France, single women and lesbians are not allowed to undergo assisted fertilization, while in Denmark and the United States, there is no such restriction.
The reproductive needs of single women and lesbian couples, as well as the restrictions on this non-traditional marriage in some countries, have made international commercial sperm banks such as Kreos in Denmark find market space. Thanks to the Internet, dry ice technology and global express transportation companies, buyers can place orders directly online and then transport them to local reproductive centers. This is a big business.
According to the Economist's report in 20 17, the price a merchant needs to pay to a donor is about 100, and his sperm can be divided into five small tubes, each of which costs between $500 and 1000. Before 2025, the global sperm bank business scale is as high as 5 billion US dollars. This is a highly competitive market. Some sperm banks promise to provide the highest quality sperm, while others show off the details of their donors.
Kreos, located in Aarhus, the second largest city in Denmark, is the largest sperm bank in the world. Today, most orders come from the Internet and are shipped to more than 100 countries. If you browse its website, you may mistakenly think that it is a dating website, where the donor is labeled with education, height, appearance, occupation and so on, and even his voice can be heard through a short recording. This marketing technique coincides with the portrait of its customer group. OleSchou, the founder of Cryos, pointed out in an interview with China Newsweek that 60% of its buyers are single women, who are flustered, impatient and very picky, and need to find high-quality sperm quickly. They are well-educated, and their occupations include doctors, engineers and lawyers. Pay attention to career development; They have the material conditions and strong social resources to have children, and they are also ready to bear the responsibility of raising children alone. Although it is usually a little late, they still want to catch the last bus of childbirth before it is too late.
OleSchou said that his sperm bank also has buyers from China. However, due to the strict supervision system, although they can place orders online, they can only transport their sperm to clinics in neighboring countries, such as Cambodia and Singapore, where they receive pregnancy treatment and then return to China to give birth.
I'm going to make a test tube (baby). There are so many sperm banks in coles, Europe, Fairfax and California, and the prices are also cheap. Take your pick. Really many masters (masters) and even doctors (doctors) with a height of 180+ can see photos. A netizen who is obviously a potential buyer of overseas sperm bank said, but her economic strength should not be underestimated: I personally have four houses in second-tier provincial capital cities, which add up to more than 600 square meters, with no less than $6.5438 +0.5 million in working capital, plus the support of my parents and my girlfriend who has been with me for more than ten years, before making this decision, and we are still doing immigration. But for the vast majority of women, besides crossing the threshold of the aforementioned laws, how many women have such superior material conditions and can afford to choose sperm overseas? Completing childbirth in this way is still a luxury that a small number of people can enjoy.
It has become a world trend to recognize the reproductive rights of single women. But if it is to be realized in China, it obviously needs a long process. Ma Yinan said that it is entirely possible for technological progress to create a new family structure, and we should not refuse to recognize non-traditional births for fear of change. As for whether it is beneficial for children to grow up in a multi-family and whether giving single women or lesbians reproductive rights will impact the traditional family structure, he believes that the key lies in how to solve the problems arising from it, rather than blindly prohibiting it.
Original from: China Newsweek.