Good Quality. Ayo Wahlberg

and other architects of the so-called “one-child-policy,” fertility was the problem that needed to be addressed (Greenhalgh, 2008). The technique of IVF alone has brought an estimated 5 million babies into the world globally (in China, some 200,000),¹ while it is said that the one-child policy has prevented some 140 million births in China.

      It is worth remembering that, as Martin Johnson and colleagues (2010; see also Johnson, 2011) have shown, Edwards and Steptoe faced numerous setbacks during the early days of their research on IVF in the United Kingdom. They were refused funding by the Medical Research Council in the early 1970s in a scientific climate where research into infertility “was accorded a low priority” (Johnson et al., 2010, p. 2158) when compared to contraception and abortion. Similarly, beginning in the early 1980s, reproductive scientists Lu Guangxiu, Zhang Lizhu, and He Cuihua also faced many setbacks (albeit eventually securing government funding for their research in 1986) in a country where concerns about overpopulation were immediately national rather than global.

      What, then, were the conditions that allowed assisted reproductive technologies (ARTs) to be developed in China during the exact same period that one of the world’s most comprehensive family planning policies aimed at preventing birth was being rolled out? First of all, in what follows, we will see how ARTs would have be molded into a suitable form to fit within China’s restrictive reproductive complex before they could gain formal authorization through national law as late as 2003. In doing so, these technologies eventually settled alongside contraception, sterilization, and abortion as just another technology of birth control. This might seem counterintuitive, seeing as birth control is most often defined as fertile couples’ active efforts to prevent unwanted pregnancies as a matter of (in China, state-stipulated) family planning. Nonetheless, as we will see, for ARTs to be legalized, infertile couples would have to be subject to the same kinds of family planning restrictions as fertile couples. We can say that for increasing numbers of infertile couples in China, birth control can be defined as an active effort to achieve wanted pregnancies using ARTs in order to have one child in strict accordance with family planning policies. Moreover, since China’s reproductive complex came to be configured around the dual objectives of controlling population growth and improving population quality, the medical genetic potentials of reproductive technologies were actively mobilized from the outset in China, as highlighted by Lu Guangxiu in this chapter’s opening quotation.

      Secondly, I will show how even if ARTs such as sperm banking or IVF were invented in the United States and United Kingdom, this did not relieve scientists of a need for experimentation in China, and hence we should not view their development and routinization as an “importation of Western reproductive technologies” (Handwerker, 2002, p. 310; cf. Inhorn, 2003). Instead, we need to trace the transformation of such technologies from pioneering to mundane within China (rather than across borders). By tracing the ways in which ARTs came to be accepted in China we gain insights into the particular form—what we might think of as “one-child ART”²—they have taken (cf. Knecht, Beck, and Klotz, 2012).

      I begin by looking at how two of the pioneers of reproductive science in China—Lu Guangxiu in Changsha and Zhang Lizhu in Beijing—began experimenting with assisted reproduction, eventually embarking on a collegial yet competitive race to achieve the country’s first test tube baby, culminating in the birth of Zheng Mengzu in March 1988 in Beijing, closely followed by a baby girl in Changhsa three months later. Their recollections, recorded in interviews, are interwoven to capture a sense of the pioneering spirit that carried their efforts forward. I will use Zhang and Lu as narrators of the story of the difficult birth of ARTs in China. As we will see, there is a certain style to nostalgic remembering when legacies have already been consolidated, allowing for playful self-deprecation as a means of emphasizing the hurdles and challenges that had to be overcome. Zhang and Lu’s personal recollections are balanced against additional interviews with some of the other scientists as well as Ministry of Health officials who were active in reproductive research and policy through the 1980s and 1990s; participation in a series of workshops and conferences on assisted reproduction in China held in Beijing, Shanghai, and Changsha, which gave insights into the history of ART in these cities; as well as on secondary archival sources. Accounting for the birth and routinization of sperm banking in China requires accounting for the development of IVF since, as we saw in the introduction, China’s first sperm bank was established by Lu Guangxiu in Changsha to facilitate lab research on in vitro fertilization. Therefore this chapter chronicles the rise of both forms of reproductive technology.

      ORIGIN STORIES

       Helping You Have a Healthy Little Angel

      Our hospital is the first modern large-scale reproductive and genetics hospital in China, and a model for putting technological developments to practical use. . . . From 1980 it was under the direction of Professor Lu Huilin, the founder of the study of medical genetics in China. Professor Lu Guangxiu was the first to begin developing human-assisted reproduction research and clinical medical work in China. In 1980, the Human Reproductive Engineering Research Department, a platform for human-assisted reproductive technology, was founded. . . . [T]his was the first center in China to begin studying human ovum development, external maturation of ovum, and in vitro fertilization. Projects became national key scientific projects of the Seventh Five-Year Plan. There are world-class equipment and a very talented team. The center has made great achievements in the area of assisted reproduction and preimplantation diagnosis in the past twenty years. . . . Founded in 1981, the technological instruction center of the National Sperm Bank of the Ministry of Health was China’s first sperm bank, with a very talented team, advanced quality control equipment, computer-based data management, and the ability to preserve 120,000 frozen sperm samples. (Hospital presentation flyer, CITIC-Xiangya Reproductive and Genetic Hospital)

      Scientific teams, clinics, and indeed countries often engage in a race to be the first when it comes to “new” or “frontier” technologies; whether in the United Kingdom or in India there is prestige to be won from achieving a first in the ever-growing field of reproductive technologies (Bharadwaj, 2002; Franklin & Roberts, 2006). Global firsts (such as Louise Brown or Dolly the sheep) are perhaps the most prestigious, but by no means at the cost of national firsts. In China, as already noted, two scientists have in particular been recognized, not least through national awards and prizes, as the pioneers of ART—Zhang Lizhu of Beijing’s Medical University Third Hospital and Lu Guangxiu of the CITIC-Xiangya Reproductive and Genetic Hospital in Changsha. If ARTs are completely routinized today in China, they were very much experimental technologies in 1980, which was a pivotal post–Cultural Revolution year for reproductive science in China. It was in 1980 that the Human Reproductive Engineering Research Department was founded at the Xiangya Medical College in Changsha by Lu Huilin, father of Lu Guangxiu. It was also in that year that Zhang Lizhu, a trained gynecologist, returned to prominence as invited speaker on China’s one-child policy and related public health issues at the United Nation’s Second World Conference on Women held in Copenhagen.

      Yet, Zhang and Lu arrived at assisted reproduction along very different paths, as endocrinologist and geneticist respectively. Having studied gynecology in Shanghai, New York, and Baltimore through the 1940s, Zhang took up her first position as resident gynecological physician at the Marie Curie Hospital in London in 1949.³ She returned to China in 1951, eventually becoming the director of Gynecology and Obstetrics at the Peking University Third Hospital in 1958. During the 1960s, her endocrinological research was focused on the increasing numbers of patients reporting menstrual irregularity. By 1965, as the Cultural Revolution began, Zhang’s international background was turned against her. She was demoted from her position as director and sent to work in the countryside for a year where she trained so-called “barefoot doctors,” followed by a job as hospital janitor at the Third Hospital back in Beijing.⁴ Zhang was able to resume her work as clinician and researcher only once the Cultural Revolution had ended in 1978, in a newly established endocrinology laboratory at the Third Hospital. This change in fortune was directly linked to the Four Modernizations program that Deng Xiaoping had launched that year to repair some of the many setbacks that agriculture, industry, defense, and science and technology had suffered during the Cultural Revolution. Zhang picked up where she had left off, concentrating on her patients’ menstrual irregularities, a specialization that would