The easing of China’s one-child policy was a godsend to Zhang Yinzhe and his wife, Xu Mengsha, who had decided they wanted to use in vitro fertilization (IVF) to freeze an embryo in the hope of one day having a second child.
However, most IVF procedures are restricted in China to couples who are infertile and surging demand at overwhelmed reproductive clinics since the policy was relaxed two years ago would have meant months of waiting.
So the Beijing couple flew to Thailand, part of a wave of Chinese spilling overseas into Southeast Asia, the US and elsewhere in a test-tube baby boom.
Photo: AFP
“There is an old saying in China: ‘A son and daughter complete the family,’” said Zhang, a 31-year-old airline pilot.
Zhang spoke after a consultation at Bangkok’s Piyavate Hospital, its walls festooned with Mandarin-language posters on IVF as other Chinese patients waited their turn.
Definitive numbers on China’s share of the assisted reproduction tourism sector are unclear, but its spending was estimated by the state-linked Qianzhan Industry Research Institute to have grown 22 percent annually to US$1.4 billion last year. Further rapid growth is expected.
Overseas clinics are adding Mandarin-speaking staff, Chinese-language Web sites and increasingly marketing to Chinese seeking a second or even third child.
Chinese government figures estimated that 90 million women became eligible for another child once the family planning policy was relaxed, and more second children were delivered last year than firstborns.
However, Chinese couples have increasingly been having children later in life, past their reproductive primes, and might require help from science.
About 12 percent of the childbearing population are unable to conceive naturally, according to Chinese studies, yet China only has about 400 licensed IVF clinics, where waiting lists can approach one year.
IVF involves combining egg and sperm in a lab and implanting any viable embryos into the womb.
The one-child policy caused birth rates to plummet, and China eased it to ensure a big enough future workforce to support its fast-aging population.
However, it still bans or restricts fertility options like egg donations, surrogate motherhood, gender selection and freezing embryos for later use, partly over fears that opening the floodgates could spark a population explosion.
Only about 500,000 Chinese IVF procedures took place in 2016, health officials estimated, far short of what fertility doctors have said is required.
“There is big demand in China, but we can’t handle it here,” said Qian Richeng (千日成), director of reproductive medicine at Shanghai’s 10th People’s Hospital.
So Chinese are booking tickets to Thailand, Malaysia, Cambodia and even Russia.
IVF treatments cost about 30,000 yuan (US$4,612) in China, but can be several times that abroad, where many Chinese feel they can find higher-quality care.
Zhang wants IVF partly to screen for genetic defects, something restricted at home.
“That’s a lot of money for a Chinese family, but compared to the health of my next generation, I should spend it,” he said.
Piyavate Hospital fertility specialist Chartree Saenghiranwatana said the clinic has been “getting increasing demand from Chinese patients the past year or two,” and is recruiting Mandarin-speaking doctors and nurses.
Some Thai clinics have said up to 80 percent of their customers are Chinese.
“A new industrial chain is forming, for reproduction, in Southeast Asia,” said Yu Wei Siang (余衛湘), the Singaporean founder and chairman of Borderless Healthcare Group Inc.
The firm has created a video conferencing platform on which Chinese patients can consult fertility experts around the world, aided by Mandarin-speaking interpreters.
It is also establishing sperm and egg banks in countries including Thailand, Australia and the US, primarily for Chinese clients, complete with a smartphone app allowing them to monitor their “fertility assets” almost like a bank account.
Two years ago, Chinese patients were sixth or seventh in the ranks of foreign patients traveling to Thailand for medical tourism, but are to be the largest group this year, Yu said.
Besides infertility or the desire for a larger family, the Chinese preference for male heirs sends some couples abroad in search of clinics that will perform gender screening — although that is technically illegal in most countries — and Chinese LGBT couples are also packing their bags.
Li Na, who is from central China, went through expensive IVF procedures in Shanghai, Hong Kong and the US. All failed.
However, the 41-year-old and her husband hit the jackpot in Thailand, and now have twin girls through a surrogate mother there and a boy through IVF.
Li has parlayed the experience into a side career as a consultant to other Chinese couples seeking the same joy she felt.
“I couldn’t stop crying when I flew down to Thailand to pick them up,” Li said. “It was hard to believe they were mine.”
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