Good Quality. Ayo Wahlberg
in 1980, that is, to have access to sperm in the laboratory for in vitro research purposes. However, it was one thing to know how to cryopreserve sperm; when it came to human sperm, getting the sperm proved to be quite a challenge in Changsha. The director of the sperm bank in Changsha today, Fan Liqing, worked closely with Lu in the 1980s and he explained to me what they saw as their primary obstacle in the early days:
At that time, the technical conditions were not the biggest problem. The problem was how to overcome the ideas of ordinary people, because during that time, all the people were still conservative and they were very sensitive when talking about sex. So it was very hard to collect semen to establish our sperm bank. We tried to find people with a good educational background in the university. But everyone declined. I remember we talked with an old professor, and because during that time, we still lived in quite poor life conditions, we said that if you can donate sperm, we can provide some compensation for you. The guy said, “I’d rather beg than donate sperm!” So it was very hard for people to accept it.
Lu concurs: “China had just undergone the Cultural Revolution, so collecting sperm was like a dirty thing. So when I built the sperm bank [in 1980] we did everything covertly and it was very difficult to collect sperm.” Initially, Lu and Fan tried to collect “leftover sperm” from outpatients, but quickly found that there were no such leftovers. Consequently, Lu discussed her quandary with her husband and asked whether he would be willing to provide sperm for research purposes. “He agreed immediately!” and indeed one day in early 1981, when Lu wanted to do some research, she brought sperm samples from her husband and put them on her desk:
When one of the vice directors [of the Xiangya Medical College] had a look at the sperm samples and asked where I got them from I replied that they were from the outpatients, but the vice director responded that they can’t be from outpatients because they are of good quality! [laughter] So I said: “This is from my husband; you are male teachers, but you can’t donate any sperm for research purposes?” So from that time on, our male teachers also donated their sperm for research, like volunteers.
Once they had mastered the art of freezing and thawing sperm (on which more in a later section), the next step was to secure donors who would be willing to donate their sperm for reproductive purposes rather than solely for research. One of Lu’s colleagues, who had worked in the countryside like so many others during the Cultural Revolution, suggested that they pay a visit to a steel factory to ask whether workers there would be willing to donate. When this did not pan out (the workers refused to provide sperm samples), they moved on to a mine in a mountainous region of Hunan. “We had to take a bus first and then change to a train and we had to bring the liquid nitrogen . . . carrying it by hand, it was very hard at that time.” This time they succeeded in convincing workers to participate in a physical examination that included the provision of a sperm sample for analysis and possible donation in return for a small compensation fee. “We collected like forty people’s, more than forty people’s sperm samples and brought them back to Changsha.” This group of men became in effect China’s first frozen sperm donors.
Then, in early 1982, with donor sperm in their bank’s tanks, Lu Huilin contacted the man who had originally written to him asking about sperm banks for humans (see the introduction). The man arrived in Changsha with his wife and after two attempts at insemination—“we didn’t know when the best time for ovulation was so I had to read in a book about contraception, which described at what time in a cycle contraception was needed, so I guessed this is the ovulation time [laughter] because there is no information in other books”—in January 1983 Lu Guangxiu and her team succeeded in using frozen donor sperm to secure the birth of a healthy baby boy for the first time in China. Bearing in mind the moral disapproval they met from many of their medical colleagues, Lu Huilin decided to keep news of this achievement a secret.
Meanwhile, in Beijing Zhang Lizhu was busy trying to develop a method for retrieving eggs. As noted earlier, Zhang had traveled to Copenhagen in 1980 to speak at the UN Women’s Conference. Upon being asked whether she had learned about in vitro fertilization on this trip, she responded: “I went abroad in 1980 with some women’s groups to visit many places. However, our visit at the time didn’t consider test tube baby technology at all. What we looked at was how to do female health care, how to do family planning—meaning abortions and birth control—as well as learning about condoms and intrauterine devices; therefore we didn’t really keep up with the trends at the time” (Zhang, Interview 2). Instead, once she did begin focusing her attention on the infertility problems of her patients, she embarked on her own forms of experimentation. Lu had been astonished when her father had asked her “Do you know how to get an oocyte?” since she had worked as a surgeon rather than an obstetrician or gynecologist. Zhang, on the other hand, had experience from working with her patients. She recalls how she began working to locate and retrieve oocytes:
There were test tube babies elsewhere in the world at this time. The first test tube baby was born in 1978 in the U.K. At that time they were all using laparoscopic surgery to retrieve eggs. Once the laparoscope was put in, the surface of the ovary could be seen, and the ovary follicle could be seen too, which was the place the needle needed to penetrate. However, in China we couldn’t do the same because the surface of the ovary couldn’t be seen at all using a laparoscope [due to tissue damage from tuberculosis in some cases, or difficulties in manipulating the laparoscope]. So the only method we had at the time was retrieving ova by hand while treating pelvic cavity disease. Manually reaching the ovary follicle and judging by instinct where to insert the needle, sucking the ovarian follicular fluid out, and then finding the ova in the ovarian follicular fluid. Therefore we used a different strategy by finding ova in the ovarian follicular fluid we retrieved, and learned more about the ova. (Zhang, Interview 2)
Jiang has argued that we should take this account of an “indigenous method” with a grain of salt, since the fact was that laparoscopy was a difficult technique for anyone to learn, let alone in China where clinical and laboratory conditions were so poor in the early 1980s (Jiang, 2015, pp. 46-47). There were not many patients who were willing to undergo experimental procedures solely for egg retrieval.6 Instead, patients were asked if they would agree to egg retrieval for research purposes once open pelvic surgery for a medical indication had been safely completed.
Lu Guangxiu’s initial attempts to secure oocytes during this time were also through surgery, because as she told me “we didn’t know how to do laparoscopy.” Zhang has recounted how in these early years “we [started] from not being able to identify ova” just as Lu has recalled, “I didn’t know what the eggs looked like at that time.” As a result, there was a lot of trial and error involved. For Lu, this involved countless trips throughout Changsha to hospitals that carried out surgery for the treatment of gynecological disease to ask for assistance in getting oocytes:
Egg retrieval had been done in Xiangya hospital; however, as they didn’t support our work, and I was refused permission to go into the surgery room I had to go to other hospitals for eggs. I sometimes rode a bicycle and carried a bucket as I visited many hospitals in Changsha. But I had little chance to get eggs, since sometimes we couldn’t find follicles in ovarian tissues. Besides, it was also very hard for me to recognize eggs, as human eggs were different from mouse eggs. That’s why I set up a sperm bank at that time, because I couldn’t tell whether the eggs were mature or immature when I got eggs, so I had to fertilize all the eggs [and see which were mature enough]. So I set up a sperm bank in order to fertilize the eggs once I got them. Without ovulation induction, it was very difficult at that time.
Zhang, on the other hand, was familiar with and had direct access to the departments at the Third Hospital that carried out routine open pelvic surgery for a variety of conditions. Yet, she would also have trouble finding willing patients, and when she did there were numerous practical challenges related to timing operations such that they coincided with ovulation. Without a sperm bank of her own in Beijing, Zhang relied on the husbands of her infertile patients to provide sperm samples, not all of whom agreed to do so. Moreover, Zhang was initially hampered by not having seen a human egg before, having only microscopically observed pig and mouse eggs.
The early 1980s were truly experimental years for assisted reproduction in China. Those scientists who became interested in reproductive technologies had to devise ways of