Strug­gling to start a fam­ily

As sperm counts drop in China, the fer­til­ity busi­ness booms.

The Star Malaysia - Star2 - - Family -

ON A re­cent af­ter­noon, a vis­i­tor from north­ern China took a smoke break out­side the Bei­jing Per­fect Fam­ily Hospi­tal. Cig­a­rettes were one rea­son he had come to the cap­i­tal: he reck­ons his nico­tine habit played a part in dam­ag­ing his fer­til­ity.

The 38-year-old con­struc­tion busi­ness­man, who asked to be iden­ti­fied by his last name, Zhang, worked hard to build a busi­ness with his wife, who is 35.

But when they were fi­nally ready to have kids, it was a strug­gle. So the Zhangs be­came one more cou­ple among mil­lions of Chi­nese to turn to an as­sisted re­pro­duc­tive-health mar­ket that has the po­ten­tial to be worth about US$15bil (RM64.3bil).

A para­dox has emerged in China: As the coun­try fi­nally re­laxes its one-child pol­icy, fac­tors like lower sperm counts, later preg­nan­cies and other health bar­ri­ers are mak­ing it harder for many to get preg­nant. As a re­sult, busi­nesses from China to Aus­tralia, and even Cal­i­for­nia are lin­ing up to help – and profit from – the grow­ing mar­ket of hope­ful prospec­tive par­ents.

Fam­i­lies in the world’s most pop­u­lous coun­try are will­ing to pay top dol­lar for fer­til­ity ther­a­pies. Zhang said his pack­age for IVF, or in vitro fer­til­i­sa­tion, was 100,000 yuan (RM63,000) for each round.

“Now that our eco­nomic con­di­tions are bet­ter, we all want chil­dren but it’s hard for a lot of us,” he said, puff­ing on his sec­ond ci­garette. “All the years of smok­ing and drink­ing and busi­ness din­ners take a toll. It’s dif­fi­cult for me and my wife to con­ceive nat­u­rally and we needed help.”

Chang­ing life­styles

For decades, cou­ples in ur­ban China were only al­lowed to have one child, but the coun­try, which is try­ing to boost its shrink­ing work­force, now al­lows two.

China’s mar­ket for IVF alone was worth US$670mil (RM2.9mil) in 2016 and is ex­pected to surge to US$1.5bil (RM6.4bil) in 2022, ac­cord­ing to BIS Re­search.

As­sum­ing that 65% of in­fer­tile cou­ples choose to seek treat­ment, the to­tal as­sisted re­pro­duc­tive health mar­ket could some­day be worth about 107bil yuan (RM68­bil) us­ing an av­er­age cost of as much as 40,000 yuan (RM25,000), bro­ker­age firm Hua Chuang Se­cu­ri­ties Co es­ti­mates.

Sperm counts (mea­sured by the num­ber of sperm per mil­li­liter) dropped very sig­nif­i­cantly from 100 mil­lion in the early 1970s to as low as 20 mil­lion in 2012 in China, ac­cord­ing to Yanzhong Huang, se­nior fel­low for global health at the Coun­cil on For­eign Re­la­tions. The higher stress lev­els ac­com­pa­ny­ing eco­nomic devel­op­ment, pol­lu­tion, late mar­riage and late child­birth, smok­ing and al­co­hol use could be con­tribut­ing fac­tors, he said.

A study in cen­tral China showed that only about 18% of those tested had healthy enough se­men to be sperm donors in 2015. That num­ber had been much higher at 56% in 2001, ac­cord­ing to the study, which was pub­lished this year in the med­i­cal jour­nal Fer­til­ity & Steril­ity.

Many Chi­nese women, mean­while, are choos­ing to have chil­dren later as they pur­sue their ca­reers. Yet the de­sire to have bi­o­log­i­cal chil­dren looms large, and that’s driv­ing de­mand for ser­vices like IVF.

Vir­tus Health Ltd, an Aus­tralian com­pany that of­fers fer­til­ity treat­ments, re­ceives reg­u­lar ap­proaches from Chi­nese firms look­ing for part­ner­ships, but get­ting a lo­cal li­cense is dif­fi­cult. So, Vir­tus works with med­i­cal tourism agen­cies in China that help pa­tients get to its Aus­tralian and Sin­ga­pore clin­ics. Thou­sands of miles away, Mark Sur­rey, co-founder and med­i­cal di­rec­tor of the South­ern Cal­i­for­nia Re­pro­duc­tive Cen­ter in Bev­erly Hills, says about 20% of its pa­tients came from China over the past year.

“There are in­creas­ing num­bers of peo­ple in China who have the so­cioe­co­nomic means to choose what kind of re­pro­duc­tive tech­nol­ogy that they would like,” Sur­rey said.

Among other ser­vices, the cen­tre’s Cal­i­for­nia-based clin­ics of­fer tests to learn the gen­der of the em­bryo. Such ser­vices can be par­tic­u­larly at­trac­tive to pa­tients from main­land China, where gen­der se­lec­tion is banned.

Lo­cal mar­ket

At home, China’s “pub­lic fa­cil­i­ties are cur­rently quite over­bur­dened, which sig­nif­i­cantly im­pacts the pa­tient ex­pe­ri­ence”, said Roberta Lip­son, chief ex­ec­u­tive of­fi­cer at United Fam­ily Health­care.

Her com­pany has been con­duct­ing IVF and fer­til­ity ser­vices in the north­ern city of Tian­jin for over two years, with clin­i­cal ex­per­tise from around China, as well as from the UK and Aus­tralia.

“We hope to get li­censed in our other cities through­out China to pro­vide a more con­ve­nient op­tion for pri­vate pa­tients,” Lip­son said in an e-mail.

Still, Chi­nese pa­tients face a num­ber of reg­u­la­tory hur­dles at home. Sin­gle women, for in­stance, aren’t al­lowed to freeze their eggs in the coun­try. Such re­stric­tions have many pa­tients con­sid­er­ing trips abroad.

“Reg­u­la­tions make it dif­fi­cult to en­ter the mar­ket,” said Ma­soud Af­nan, di­rec­tor of fer­til­ity ser­vices and gen­eral man­ager of Tian­jin United Fam­ily Hospi­tal.

Clin­ics “need a full IVF clinic, with the re­quired num­ber of staff, to do IUI for two years. This is an ex­pen­sive op­tion to just do IUI,” said Af­nan, re­fer­ring to in­trauter­ine in­sem­i­na­tion, a fer­til­ity treat­ment that places sperm di­rectly into the uterus.

As of last year, the coun­try had 451 sperm banks and med­i­cal in­sti­tu­tions li­censed to pro­vide re­pro­duc­tive care, the Na­tional Health and Fam­ily Plan­ning Com­mis­sion es­ti­mates. But that’s out­paced by de­mand in a coun­try of 1.4 bil­lion peo­ple.

“As­sisted re­pro­duc­tion has be­come one of the fastest-grow­ing, high-po­ten­tial fields in China’s med­i­cal mar­ket,” an­a­lysts with Haitong Se­cu­ri­ties wrote in a Jan­uary re­port.

Over­seas hospi­tal oper­a­tors like IHH Health­care Bhd, which is listed in Malaysia and Sin­ga­pore, Thai­land’s Bum­run­grad Hospi­tal PCL and Bangkok Dusit Med­i­cal Ser­vices PCL are among those likely to ben­e­fit from in­creased pa­tron­age from Chi­nese pa­tients, said Laura Nel­son Car­ney, an an­a­lyst with San­ford C. Bern­stein.

Zhang, stand­ing on the busy and nar­row street in down­town Bei­jing, said he knows many others with sim­i­lar trou­bles. “Our friends can talk about it openly,” he said. “Many of them used IVF.”

The process re­quires mul­ti­ple vis­its to Bei­jing: They vis­ited in Novem­ber for the ex­trac­tion of eggs and sperm, and again in March for prepa­ra­tions. Still, he will likely con­sider hav­ing two chil­dren, if the first at­tempt doesn’t re­sult in twins. – Bloomberg

Chi­nese cou­ples are seek­ing med­i­cal help to over­come their dif­fi­cul­ties in con­ceiv­ing ba­bies. — AFP

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