Good Quality. Ayo Wahlberg
“doctor,” or “administrator” generically.
Scientific Articles and Reports
Scientific articles and reports were collected with a focus on infertility, andrology, and epidemiology in China. I have in particular collected studies that were designed to assess infertility rates, aggregate sperm quality, and the toxic effects of pollution on sperm quality. As a supplement to these studies, I participated in a total of seven workshops and conferences on assisted reproduction in China held in Beijing, Shanghai, Guangzhou, and Changsha, which gave insights into some of the challenges facing fertility clinics and sperm banks in China as ARTs are scaled up on hitherto unimaginable numbers. I listened to talks, participated in discussions, and collected PowerPoint presentations at these events while also organizing site visits with contacts that I met. Thanks to my research grant, together with the Hunan Sperm Bank, we were able to organize the first ever national conference on social and ethical challenges in sperm banking in China in 2012, at which representatives from all of China’s (at the time) fifteen sperm banks as well as from Europe attended and presented. These conferences and workshops have been important fieldwork activities for me as well, since the discussions and debates that I participated in provided further insights into the daily workings of sperm banking. Finally, thanks to my grant I have been able to organize a series of researcher exchanges with Chinese sperm bank staff visiting Europe and vice versa, allowing me to spend more time with them than is often possible within the constraints of hectic daily life in a sperm bank or fertility clinic.
Laws, Regulations, and Guidelines
As became clear to me from the very outset of my study, ARTs are inextricable from the laws, regulations, and guidelines that have shaped reproduction in China in so many fundamental ways. China’s Marriage Law, Law on Maternal and Infant Health Care, Regulation on Assisted Reproductive Technologies, to name a few, have each played a pivotal role in the molding of sperm banking into the particular form it has in China. At the level of the clinic or sperm bank, guidelines, regulations, standard operating procedures (SOPs), and protocols shape work practices and daily routines. I therefore spent a considerable amount of time collecting a complete set of repro-regulations in China, as these provided crucial information on how certain practices are permissible while others are prohibited.
Newspaper Articles and Media Stories
Finally, I also put together a database of newspaper articles and media stories specifically on sperm banking, sperm donation, and infertility in China. While not systematic, I have nonetheless amassed a comprehensive collection of news stories from both Chinese-language and English-language news outlets. News reports can help us understand how certain issues emerge as matters of concern in a given setting. I have read these media reports not to gain some kind of “accurate” picture of sperm banking in China, but rather to see which kinds of issues have surrounded routinized sperm banking and donation in China today. I use the full names of reproductive scientists who are cited in media reports while also attributing the quote to the appropriate news story. Thanks to my grant I was able to enlist my research assistants to help with the task of translating some of the central scientific, legislative, and media documents that I have amassed.
The resulting dataset of field notes, interview transcriptions, scientific articles, media reports, laws, regulations, as well as laboratory protocols forms the basis of the analysis that follows in this book. It is this data that has allowed me to piece together the routes of routinization that sperm banking has followed in China. All of this has been necessary for me to get to grips with the socio-historical processes, the daily micro-practices, and the uses of donor sperm that have shaped the routinization of sperm banking in China (and vice versa), which is to say the emergence of a certain style of sperm banking in China. What I have learned over the last years is the importance of mapping out and analyzing country-specific (indeed at times clinic-specific) routes of routinization when it comes to medical technologies. As I have already underscored, sperm banking is not a medical technology that was imported into China through processes of globalization; rather, it was developed and routinized in China through the work of scientists, laboratory technicians, infertile men, donors, doctors, nurses, and many others, just as it has been in other countries around the world. To be sure, this routinization has of course engendered and worked through global flows of expertise, equipment, standardized protocols, and people (my own research included). However, in China, it is as components of such routinization that global flows must be accounted for rather than the other way around. Regardless of where sperm banking was “invented” or how much technology is “transferred” across borders, the processes by which it became routinized have been far from inevitable, highly localized, very experimental to begin with, and fraught with specific obstacles, constraints, and challenges. Even in countries where the building up of ART sectors has relied extensively on international expertise (see Hörbst, 2012; Inhorn, 2015), I maintain that further analytical traction can be gained from asking how ARTs are routinized within as opposed to imported into a particular country. In China, sperm banking, AID, and other forms of ART have traversed the continuum from experiment to standard care practice as arduously as they have in any other place.
GOOD QUALITY
Very early on in the research process it became apparent to me that the concept of quality—in various guises—would be central to my study (see Wahlberg 2008; 2010; 2014a). Sperm banking is saturated with vital assessment, a task that would not be possible without the concept of quality. In China, sperm banks must promote population quality (renkou suzhi); they recruit high-quality (suzhi gao) donors from university campuses; assess the sperm quality (jingzi zhiliang) of up to four thousand individuals per year; adhere to good laboratory practices (GLPs) and standard operating procedures (SOPs) in order to assure a good quality (zhiliang hao) supply of sperm; and provide donor sperm to infertile couples with the aim of improving their quality of life (shenghuo zhiliang) and happiness. As my research wore on, it also became clear that it was not only the vitality of men and their sperm cells that were on trial, so too was the vitality of the nation, not least against a backdrop of national crises and perceived anthropogenic threats to this vitality (see also Dow, 2016). I have tracked these various notions of quality as ethnographic tropes in my efforts to understand and map out the style of sperm banking that has emerged in China over the course of the last three decades. Vital quality is that which makes good life possible in China today, yet it is this same vital quality that is considered to be under constant threat in a time of compressed modernization (cf. Kyung-Sup, 1999) and “sperm crisis.”
Each of the chapters that follow addresses some aspect of the vital assessments that organize sperm banking in China today. In some respects, my assemblage ethnography was guided by attempts to follow the concept of “quality” around as it circulated in different forms—as imaginary, technical specification, interpellation form, regulatory requirement, or marker of vitality. What the concept of quality does is allow for classifications along good–bad continuums, which in turn are stabilized through the guidelines, procedures, and practices that keep sperm banks operating. Yet these same classifications are open to contestation and query, for example, when donor screening criteria are debated; when negotiations about sperm quality standards are initiated; when quality assurances are questioned; or when quality assessments rely on the judgment of individual laboratory staff working at the bench (see also Mohr & Hoeyer, 2012).
The first chapter chronicles the difficult birth of ARTs in China through the 1980s and 1990s, showing how ideas of improving population quality acted as a persuasive “alibi” for those pioneers working to develop fertility technologies at a time when contraception rather than conception was at the top of the political agenda. From difficult beginnings in the 1980s, ARTs have now settled firmly within China’s restrictive reproductive complex, which in turn has allowed it to grow into a thriving sector. China is now home to some of the world’s largest fertility clinics and sperm banks. Since 2003, it has also been one of the most strictly regulated ART sectors in the world, as it has had to conform to national family planning regulations. As always in China, the sheer scale of operations is astounding. When keeping in mind that an estimated 10 percent of couples have trouble conceiving “naturally” in China, the potential demand for ART is hardly matched anywhere else in the world.
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