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Coming to the sperm rescue
(Shanghai Star)
Updated: 2004-10-20 11:26

"Sperm shortage will always exist in China," said Li Zheng, a doctor and expert in the Department of Andrology at Renji Hospital in discussing the widespread social attention paid to the city's notorious sperm shortage. Li's words can also be reversed: demand for sperm in China will always be excessive.

A doctor puts into a fridge a sperm sample. [newsphoto]
More than 300 couples are already on the waiting list for sperm and invitro fertilization (IVF) at Renji Hospital, even though this kind of procedure will not be available until authorized by the government at the end of the year. In September, Renji Hospital underwent an examination and appraisal of its IVF technology, conducted by the State Ministry of Health, after it applied for the IVF licences. Another four local hospitals, including Ruijin Hospital, No. 1 Maternity and Infant Health Hospital and International Maternity and Infant Hospital, are also on the applicant list.

"IVF in China can be traced back about twenty years. There are about three to five hospitals offering IVF procedures in every Chinese province," said Li. "Presently hospitals are required to reapply for IVF licences after official examination as the government tries to implement a standardized and regulated system. However, the passage of legislation has fallen behind the rate of IVF activity in China."

It is expected that official approval of IVF procedures, to be granted within the next few months, will allow IVF procedures to begin again in Shanghai.

Sperm in trouble

According to an authoritative survey, about 10 per cent of the city's three million couples of childbearing age are infertile, one third due to male infertility. Further, among every 100 cases of aspermia - sperm shortage - between one to five men have severe infertility, Li said. Most of these men would have to rely on IVF technology to have children.

The Shanghai Municipality Human Sperm Bank was approved by the Ministry of Health in March 2003, the only institution of its kind to receive such approval. It is affiliated with Renji Hospital and has conducted exploratory research into sperm storage and IVF technology since the late 1980s.

Li, who serves as director of the sperm bank, said it has 8,000 sperm samples at present, but 200,000 are needed.

"We expected about 20 men to come and donate their sperm every month, but only about 10 have done so," he said. "Chinese men are usually reluctant to donate sperm, or even to talk about it, perhaps due to our conservative social traditions. That's why I expect that a sperm shortage will always exist in China."

To make matters worse, not all the donor's sperm is suitable for use in IVF. According to regulations covering the administration of human sperm banks, issued by the Ministry of Health, donated seminal fluid should be healthy, free of infectious disease and of high sperm density. Even if the sperm satisfies these conditions it should only be used to fertilize a maximum of five different women. "The proportion of donors who meet these quite strict conditions is presently about one in five," Li said.

Student donors

In the past month, Li and his colleagues have given lectures in universities in Shanghai, including Fudan and Tongji, about the sperm crisis in an attempt to raise awareness among students. It is reported that more than 300 students have contacted the Human Sperm Bank about donation. The bank now has 20-30 student donors a month.

"Our lectures are successful and popular on campus," said Li. "Many students attended my lectures, both boys and girls."

The lectures not only attracted new donors but also contributed to sex education.

"We can donate blood and stem cells, why not sperm?" said a university student surnamed Zhang. "I would be happy if my donation helped one family."

Nowadays, college students have become a major source of sperm donation in Shanghai, accounting for 70 per cent of the city's donors. Married men account for the remainder. "They tend to be more open-minded about making donations than the older generation," Li said, adding that additional contributions from other parts of the community also need encouragement.

"Sperm donation could be considered a lofty act because it benefits infertile couples," said a graduate student, surnamed Wang, from Shanghai Second Medical University.

He said that as medical students, he and his peers were more likely to understand the meaning of sperm donation and to participate in it. "As far as I know, many younger college students would like to donate, though others are restrained by our traditions and the ethical codes of our society."

Besides sperm, he has also donated blood, though he has not revealed any of this to his family who live in East China's Shandong Province. "But my girlfriend agreed to it," he said.

The first step in the procedure is for the donor's sperm to be collected and examined, with the name and status of the donor being checked. After the lab examination, the sperm is frozen and given a code number while it awaits an HIV check. Roughly six months later, when the testing process is completed, the identities of acceptable donors are enciphered. The sperm is then ready to be selected and used, with reference being made to blood types and facial and bodily features.

"Some foreigners have called me and expressed a willingness to donate sperm to our bank, but the rules stipulate that only Chinese citizens are permitted to donate in China," Li said.

Storage service

A sperm storage service designed as a system of "reproduction insurance" is being planned by privately-funded Wenzhong Hospital in Shanghai.

According to Dr. Fa Yifang, the hospital's chief of staff, the service would mainly target men aged between 20 to 25, the age when physical fitness is typically at its peak.

"Relatively fewer people choose to have children at this stage in their lives, when they're busy with school careers. Even among this group however, external factors such as environmental pollution, chemicals and microwaves can cause a deterioration in sperm quality," said Fang.

The Shanghai Municipal Human Sperm Bank also offers a sperm storage service for individuals seeking reproduction insurance, in addition to its principal function of providing healthy sperm to infertile couples. It is reported that 10 people have already decided to store their sperm in this way.

Li considers this kind of service to be quite risky: "Sperm storage is not the same as saving money in a bank. It is possible to store sperm and later discover it is not able to fertilize an egg after years of refrigeration, especially if it was not of especially high quality to begin with."

Li explained that human sperm banks had to sign detailed contracts with their clients to avoid potential conflicts over disappointment in the future.

Although the Human Sperm Bank was approved last year and quickly began to offer a sperm storage service, most residents were initially lukewarm about the idea of reproduction insurance. Most attention was focused on those who had become infertile after medical procedures or accidents, with the service regarded as a good way to reduce infertility risks. The idea of ordinary young people storing their healthiest sperm for future fertilization was a novel one, and approval by local government was unprecedented.

There have been increasing indications that sperm quality within the general population is deteriorating. An authoritative global survey shows that sperm density has decreased by 50 per cent since 1940 and continues to decline by a percentage point each year. It has even been predicted that the decline in sperm quality could ultimately lead to a worldwide fertility crisis.

Li expressed doubts about the more alarmist forecasts, saying they were not supported by the most comprehensive statistics available, although the patterns of modern living had affected sperm quality to some extent. He argued that the most effective way of addressing the sperm shortage problem was through public education.

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