She was waiting for her husband of two years to finish a checkup at Peking University No3 Hospital.
“We have visited various hospitals and tried everything, even herbal medicines, butnothing has worked,” she said.
The couple from Tangshan in Hebei province decided to try assisted reproductivetechnology (ART) after Li heard about a neighbor who had a baby through IVF.
“I want two babies,” she said, greeting her husband as he emerged from the doctor’sroom with a hopeful smile. “The best thing would be to have a girl and a boy.”
Exploiting loopholes
Reproductive health expert Qiao estimates that at least 10 percent of the peoplesuffering from infertility nationwide need the help of IVF treatments, which can cost up to50,000 yuan (7,500).
To meet such a demand, authorities have so far approved applications to start runningART services from more than 200 clinics nationwide. However, experts say the number isstill far from enough, fueling a rise in illegal operations, sometimes at established hospitals.
Although no official figures exist on how many unlicensed centers are up and runningnationwide, Wu Jian, a graduate from Shandong University’s law school who researchedthe state of IVF technology in China as part of his studies, said he believes they are nowwidespread.
“After more than 20 years of IVF being practiced in China, it is already a maturetechnology that is not difficult to use,” he said. “Also, the money involved helps lureunauthorized institutions into taking the risk.”
Patients at unlicensed clinics are often couples sent there by surrogacy agencies, whosepractices are a legal gray area in China but technically outlawed.
“You can tell how widely available illegal services are by looking at the advertisementsof surrogacy agents on the Internet,” said Yang Fang, a professor of medical ethics at AnhuiMedical University.
“As most authorized hospitals don’t provide such services, agents can only arrangepatients to have IVF treatments at hospitals without the necessary license,” she said.
China Surrogacy, an agency based in Beijing, offers one package for 380,000 yuan onits website.
A member of staff told China Daily by phone that the company can arrange surrogamothers and IVF treatments “at one of the best hospitals” in the capital, although herefused to name the hospital.
Yang explained that public health departments do not have effective ways to regulatethe ART industry and close down the illegal services because they “only have the right tosupervise authorized hospitals”.
“Many of (the illegal centers) are registered as companies instead of hospitals,” sheadded.
Unlicensed clinics have also been a boon for families looking to have a second childwithout the required permit from the family planning authorities.
A 39-year-old woman who insisted on being identified by her online nickname,Zhi Zu, revealed she and her husband already have a son of 17 but now plan to exploitloopholes in the system to have a second child.
“We’re not worried about money,” said the mother, who hails from Northeast China’sLiaoning province but explained she is receiving IVF treatment at Beijing Jia’en Hospital.
“I bought a fake birth permit … and after the child is born I will buy him or herhukou (permanent residency),” she said.
Hospitals offering IVF treatments are required to check a patient’s identity card,marriage certificate and birth permit, although a system to check the authenticity of birthpermits is yet to be put in place.
Teng at the Shanghai maternity hospital explained that his staff member will contactfamily planning officials in the patient’s hometown for confirmation if they are suspicious.
“However, if the fake looks just like the real thing, most employees won’t think to check,”
he said.
Zhi Zu said she is not alone in wanting a second child; a trend she says is due to a factthat people want bigger families when they become wealthier.
Many parents have joined in with a chat group she set up on QQ, a popular Chinesemessaging service, about her situation. Other topics being discussed include the growingnumber of people opting for gender screening, which is illegal in China, and the possibilityof having twins through IVF.
Gender screening can only be done with the latest ART equipment, which is availableat only a dozen hospitals nationwide, said Teng, explaining: “It’s not possible for patientsto do that at a licensed clinic.”
Question of control
Government bureaus responsible for supervising healthcare and industries havelaunched several crackdowns on illegal ART services. However, the fundamental problem,say experts, lies with the absence of any criminal or civil law that punishes owners ofunlicensed practices.
Following the initial boom in IVF in the late 1990s, the Ministry of Health in 2001released its first directives stipulating the ethics of IVF and the rules of qualification andprocedure. The next year, an authorization system was established. Today, hospitals clearedto offer IVF treatments are strictly evaluated and receive regular inspections by officials.
“Unfortunately, the rules that are in place have not proved practical,” said Sun Muyi, aprofessor of medical ethics at Southeast University in Nanjing, capital of Jiangsu province.
The number of hospitals that can obtain an IVF license from the ministry is strictlycontrolled and some in the industry say that by approving more applications, officialscould take a big step toward solving the problem of illegal services.
Yet, Sun disagreed and said only a strong deterrent will work.
“This is serious,” he added. “The abuse of IVF could affect our next generation.
Improper operations increase the risk of birth defects in babies, while being able to choosethe sex could impact the gender balance.”