Fast-forward to 2011. It’s a sunny day in May, the relentless kind that sees people scurrying for the shade of roadside trees and the borrowed air-conditioning of corner shops. I jump off bus 405 as it stops along Furong Road, a congested six-lane thoroughfare, which, much like the Xiangjiang River, splits Changsha north to south. Just off Furong, Xiangya Road is its usual bustling self as cars honk and pedestrians push past pharmacies, food stalls, clothes shops, vegetable stands, shoe-shiners, and fortune tellers. It is my first day of fieldwork on a project about sperm banking in China, although not my first time on Xiangya Road. Indeed, I know what to expect as I approach 84 Xiangya Road where the fifteen-story CITIC-Xiangya Reproductive and Genetic Hospital lies, home to one of the world’s largest sperm banks and fertility clinics. Even so, I’m astounded. Hordes of people are milling around the entrance, a much larger crowd than I had seen on previous visits. Most of them are there to seek fertility treatment, clutching their queuing tickets as they wait their turn to be called to the triage desk that manages inquiries from new patients. I squeeze my way through the crowds outside and enter the hospital lobby. The cacophony is thunderous. Patients are impatiently asking when their turn might come while white-coated doctors and pink-coated nurses somehow go about their daily routines, weaving through the throngs as they do. Two men are wheeling a large tank of liquid nitrogen toward the elevator, pleading for headway as they inch forward. Nothing stands still as I ponder how best to make my way to the sperm bank on the fourth floor. Let one of my sperm donor informants take it from here:
Figure 1. Crowds congregate outside the CITIC-Xiangya Reproductive and Genetic Hospital.
You know this hospital . . . it is full of infertile couples . . . actually they are ten times more than we donors. We could also see their faces and that would make us feel anxious. Ehh, usually I get upstairs by foot not elevator because the elevator is always full and cannot hold me. . . . When I arrived here [on the fourth floor], I thought this place is not exactly what I thought the donor room would be. First of all, this is too small, too crowded and full of people. I thought there would only be a few boys who would want to be a donor but I . . . what I found was a room especially for donors but I couldn’t find a seat, it was too full! (twenty-one-year-old student, Changsha)
From crude and uneasy beginnings sperm banking has become a routine part of China’s pervasive and restrictive reproductive complex within the space of thirty years. Today, there are twenty-three sperm banks spread out across China’s twenty-two provinces, the biggest of which screen some two thousand to four thousand potential donors each year.1 Those who qualify donate ten to fifteen times over a six-month period in return for the satisfaction of being able to help involuntarily childless couples as well as monetary compensation for their inconvenience. The first baby conceived from frozen donor sperm in China was born in 1983 in Changsha, but the provincial government in Hunan prohibited the practice of artificial insemination in 1989. This ban has since been overturned, and in 2003 it was superseded by national legislation, which, for the first time, legalized and regulated the provision of assisted reproductive technologies (ARTs), including sperm banking and assisted insemination by donor (AID). It is thus especially in the last ten years that sperm banking has become routinized in China with the closure of “rogue” banks and the establishing of strict licensing requirements and operating procedures. Routinization notwithstanding, with an estimated one to two million azoospermic men in China (men who are unable to produce their own sperm), the demand for donor sperm remains insatiable. China’s twenty-three sperm banks simply cannot keep up, spurring the directors to publicly lament chronic shortages and even warn of a national “sperm crisis” (jingzi weiji). As we will learn, this crisis is related firstly to an apparent national decline in sperm quality. The possible causes—lifestyle changes and the toxic effects of environmental pollution—have become matters of concern and objects of scientific research in China and elsewhere. And secondly, the crisis is related to chronic national shortages of donor sperm (amounting to a “state of emergency”) despite the efforts of sperm banks to mobilize potential donors on university campuses throughout the country. Faced with such a crisis, sperm banks in China have their work cut out for them.
The routinization of sperm banking in China has by no means been inevitable, fraught as it has been with paradoxes, hurdles, setbacks, crises, injunctions, taboos, limits, and reservations. To begin with, the condition for which sperm banking and AID were being developed to address in the 1980s, namely infertility, was and remains contested in China. As Judith Farquhar has argued, in many Chinese fu ke (women’s medicine) clinics in the early 1980s, infertility was not seen to result “from a permanent structural abnormality of the body but rather from an (often subtle) deficiency of normal physiological functions” (Farquhar, 1991, p. 374). An inability to conceive children was of course nothing new in China in the 1980s and various treatments aimed at redressing such diagnosed deficiencies were available from practitioners of traditional Chinese medicine. And so, when the likes of Lu Guangxiu in Changsha and Zhang Lizhu in Beijing began developing reproductive technologies in the early 1980s, biomedical interpretations of infertility had to contend with deficiency interpretations treated by practitioners of Chinese medicine in fu ke clinics. Some doctors resisted “the hegemonic medical models” (Handwerker, 1998, pp. 193–97) and encouraged patients to visit traditional Chinese practitioners.2 To this day, couples’ quests for conception often include visits to both Chinese and biomedical clinics, just as practices in these clinics often combine diagnostics and/or therapies from both versions. Moreover, while the subspecialty of fu ke within Chinese medicine has an ancient history and a normative focus on the reproductive body, Everett Zhang has shown that the first nan ke (men’s medicine) clinic did not emerge in China until 1983, thanks not so much to a biomedical concern with male infertility, as with the newly biomedicalized problem of impotence (Zhang, 2007; 2015). Notwithstanding the availability of microscope-aided sperm count tests since the early 1980s, childlessness was (and remains) exceptionally gendered with women more often than not bearing its burdens even when male factor infertility is the more likely culprit.
Secondly, Zhang Lizhu and Lu Guangxiu began experimenting with reproductive technologies at exactly the same time that an unprecedented effort to engineer national fertility was being rolled out across China. Over the course of the late 1970s and 1980s, China’s reproductive complex was configured to resolutely restrict fertility (Greenhalgh, 2008; Greenhalgh & Winckler, 2005). Indeed, China’s so-called “one-child policy” is one of its most internationally recognizable features today, even if it has since been tweaked into a “two-child policy.”3 Launched in the late 1970s by late chairman of the Communist Party, Deng Xiaoping, China’s family planning policies enforced birth control through a series of targets set at regional and local levels aimed at lowering China’s high fertility rate, which was considered a hindrance to economic development. Family planning authorities were charged with meeting such targets through the provision of contraception, sterilization, and abortion services as well as through the fining of couples who exceeded their quota of children—targets that have at times been forcibly realized. Attempts to develop reproductive technologies in order to promote fertility in the 1980s were predictably seen by some state officials and scientists as conflicting with ongoing efforts to stringently prevent births (see Handwerker, 2002; chapter 1). In the chapters that follow, we will learn how assisted reproductive technologies, including sperm banking, eventually settled alongside ligation operations, abortions, and maternal and infant health care as technologies of birth control within China’s restrictive reproductive complex. Indeed, the perceived contradiction between the one-child policy and ARTs is so great that I shared my sperm donor informant’s sense of astonishment at the vast numbers of infertile couples and potential donors upon visiting the sperm bank in Changsha for the first time in 2007.
Thirdly, as already noted, the decade-long Cultural Revolution (1966–1976) had had a destructive impact