By Du Qiongfang, Global Times
Even after Chinese authorities loosened birth policies to increase the population and tackle the dire shortage of China’s labor force, the national birth rate has failed to rise by much, as many Chinese families simply cannot afford to have a second child. Meanwhile, a proportion of Chinese families are in fact desperate to have a child but are physically unable to because of infertility. Statistics show that about one in eight couples in China cannot have babies, the Beijing News reported in May. Five percent of these couples must use a donor’s sperm to conceive, Jiang Feng, senior andrology specialist and director of the Human Sperm Bank of Fudan University told Global Times.
Of semen and sperm
A research report on the status of infertility in China issued by the health authorities shows that the infertility rate in China has risen to between 12.5 and 15 percent in 2016 from 2.5 to 3 percent in 1996. The number of infertile patients in China was over 40 million in 2016, according to a 2016 report by huanqiu.com.
Domestic clinical statistics show that 40 percent of infertility cases are due to male infertility and 10 percent are due to combined male-female problems, voc.com.cn reported in 2015.
Thus, couples suffering from male fertility often resort to sperm banks in order to create offspring. However, any mention of “sperm” tends to remind Chinese people that “sexual intercourse” must be involved. This is the primary reason why sperm donations are still a very controversial topic in China.
Hence, the Human Sperm Bank of Fudan University started trial operations five months ago but only received around 100 applicant donors even though their sperm bank offers a 5,000-yuan ($723) subsidy.
According to Jiang Feng, many Chinese donors are young men who need the 5,000-yuan compensation or people who are going to get married and wish to receive a free physical health check of their own fertility.
Chinese still have many misunderstandings about the methods such sperm banks employ to collect male sperm. Some imagine that pornographic videos and smut magazines are required to excite donors; actually, the three-square-meter room for collecting sperm at Fudan’s sperm bank – in which male donors are asked to masturbate – contains no such materials.
With trial operations starting in June of this year, Fudan’s sperm bank became the second sperm bank in the city after the Shanghai Human Sperm Bank, which was the first sperm bank in Shanghai, set up in 2003.
According to Jiang Feng, the significance of establishing a human sperm bank lies in three aspects. “The first aspect is for the sake of couples suffering from infertility who need sperm to conceive, as well as patients with hereditary diseases who hope to have healthy offspring.
The second type of patients are those need to preserve their sperm, such as patients diagnosed with cancers who would like to preserve their sperm before chemotherapy and radiotherapy, because such therapies can harm human fertility. The third reason for establishing a human sperm bank is for scientific research of semen and sperm.”
Different from the Shanghai Human Sperm Bank and other sperm banks across China, Fudan’s sperm bank is the first in the country that guides bearing and rearing better-quality children by using genomic screening, which ensures more control of the “intrinsic health” of sperm and minimizes the transmission of major disease-related genetic variants to offspring through sperms.
At the moment, the criteria for judging sperm health depends on conventional indicators such as sperm count, vitality, morphology of sperm and the amount of semen. Thus, even among qualified donated specimens, a certain percentage of miscarriages and birth defects will occur.
The reason for this is that the current genetic analyses of sperm remains at the level of chromosome detection. The screening method for mutations in common genetic diseases that is popularized abroad is not widely adopted in China. Doctors and researchers at Fudan’s sperm bank instead dedicate themselves to the breakthroughs at the genetic level. Among the 20,000 genetic loci currently recognized by humans, they will carry out large-scale screening for pathogenic loci in donors’ sperms.
“The reasons for setting up a second sperm bank in Shanghai is that local patients have more requirements on sperm. In the past, the requirement was only matching one’s blood type. But now, patient requirements include hobbies, height, weight, face shape, ear shape and even if they have double eyelids or not. Due to such increasing requirements, there is not enough room for selection in a single sperm bank in the city,” Jiang said.
According to Jiang, a deaf couple once consulted about using donated sperm to conceive, because both the husband and wife were deaf and they wanted a healthy child. So they required sperm from a donor whose sperm had undergone a deaf gene screening, because even people who appear healthy can carry this gene. Although the wife was deaf, as long as the male donor’s sperm did not carry the gene, she could have a healthy baby if using test-tube baby therapy and genetic testing of her fertilized eggs.
Another aspect of the new Fudan sperm bank that differs from other sperm banks across China is that all applicants at Fudan will receive psychological health assessments before they donate sperm for the first time.
Since some psychological and mental illness have genetic risks, the sperm bank will assess and evaluate donor characteristics, personality, social skills, thinking ability and other psychological characteristics and behaviors to offer quantitative evaluation and accurately screen donors with problems in mental and psychological health, reducing the possibility of psychological and mental illness transmitted to their offspring through inheritance.
Men with 60 million sperm per milliliter of semen are accepted, though men are usually fertile with only 15 million sperm per milliliter of semen. In order for the indicators of semen to meet the special standards of sperm donors, only less than 10 percent of all qualified applicants remained after screening.
But Jiang pointed out that not being qualified for sperm donation doesn’t mean it is difficult for applicant to realize natural pregnancy. The standards for sperm donations are much higher than the standards of normal healthy sperm in various criteria, including sperm quantity and motility. It is because qualified semen needs to experience a series of procedures, such as being frozen and resuscitation, before it can be provided to the user.
Thus, requirements on donated sperm in motility and other indicators are much higher. However, the natural fertility process is often much simpler. Therefore, a donor who has successfully experienced the process of having a child can fail in sperm donation.
Although the pass rate of donors is less than 10 percent at the sperm bank, it is similar to the pass rate in overseas countries. “So Chinese men’s fertility is no weaker than that of foreign men,” Jiang said.
Right to know
According to the donor recruitment conditions of Fudan sperm bank, the applicant must be an adult male Chinese citizen aged between 22 and 45 who will be living in Shanghai in the following year to assure he can regularly visit the sperm bank. Usually a donor must donate sperm 10 times to accomplish 10 units of successful sperm donations at three- to five-day intervals.
Donors will be screened for inherited illnesses, infectious diseases and other potential risks. The applicants should have no family history of genetic diseases, color blindness or infectious diseases such as Hepatitis B. Since the sperm stored at the sperm bank is being offered to infertile couples who have various special requirements on the donors such as height, weight and looks, donors taller than 165 centimeters are preferred. But donors shorter than that height, and even bald donors, are also welcomed to donate, since their sperm can be used for scientific research.
A more serious issue about sperm donations is whether descendants of donors have the right to know who their fathers are and, more importantly to many Chinese people, whether they can inherit their property later. In China, each donor’s sperm can only be used to help at most five women to conceive (compared to 25 babies per 800,000 citizens in the US).
Recipients of their sperm are chosen according to geographical diversity. The applicants at Fudan sperm bank should not have donated sperm at any other sperm bank.
When the donor finishes the entire procedure, including 10 successful donations, he will receive a subsidy of 5,000 yuan. Since HIV/AIDS has a certain period of incubation, the first batch of sperm will receive HIV testing six months later. The Fudan sperm bank will provide sperm to Shanghai’s several reproductive centers as early as half a year later.
The semen will be preserved in a medium solution inside a glass bottle and kept in a liquid nitrogen tank with temperatures set at -196 C. The pH value of the mixture will be regulated between 7.2 and 7.4. When sperm is needed, frozen semen can be melted and used for artificial insemination. At the moment, only about 100 donors have donated sperm at this particular sperm bank, although its storage capacity can handle 100,000 units of sperm.