Infertility is a relatively common medical complaint, which is increasingly becoming prevalent in the modern world, due to greater levels of stress, poor diets, and alterations in rates of alcohol and drug abuse.

Insufficient sperm count is a frequent cause of infertility in males. The problem of poor sperm count in China has paved the way for a multimillion dollar industry which provides solutions for infertility. The reproductive health industry is now estimated to be worth 15 billion dollars—representing a significant amount of investment by individuals for infertility treatments.

Alterations to the one-child policy

With the one-child policy being implemented for several years in China, fertility rates were stable and relatively predictable. Despite this policy gradually being relaxed, reproductive rates have failed to rise proportionally. This is primarily due to evolving lifestyles, which include greater levels of stress, conceiving children later in life and rising concentrations of toxic pollutants in the environment.

Foreign infiltration of companies

These changes have created a gap in the supply of reproductive health services, enabling entrepreneurs from foreign countries to establish assisted reproductive services in China. The need for infiltration of foreign companies providing reproductive health services is summarised by Roberta Lipson, CEO of United Family Healthcare who comments that, “public facilities are currently quite overburdened, which significantly impacts the patient experience.” Increasing supply of these services may allow demand to be matched and patient expectations to be better met.

Virtus Health, a company based in Australia that specialises in fertility solutions, is constantly faced with offers of partnerships with firms based in China. However, obtaining a license has proven to be tedious, and therefore this company collaborates with medical tourism agencies to direct potential customers to their clinics in Australia and Singapore. It also expertly caters to its Chinese client base by hiring healthcare professionals, who can fluently converse in Chinese and translating the content of their website into Chinese.

Whilst services may be obtained locally, several residents may also visit foreign countries in order to access services that may not be provided locally. Mark Surrey, co-founder of the Southern California Reproductive Centre in Los Angeles, comments that, “there are increasing numbers of people in China who have the socio-economic means to choose what kind of reproductive technology that they would like.”

Surrey stated that approximately 20% of the centre’s patients had come from China. These individuals may not only be seeking treatment for infertility – but, may also be interested in services such as determining the gender of the embryo. As gender selection is not enabled in certain parts of China, such services may be particularly appealing.

Lifestyle choices contributing to infertility

Recently, a 38-year-old businessman named Zhang, visited the Beijing Perfect Family Hospital. Zhang and his wife, 35, have faced issues conceiving children – and Zhang believes one of the primary reasons for his infertility could be due to him smoking cigarettes. Smoking has been scientifically linked to the deterioration in sperm quality, with male smokers having an increased likelihood of having a lower sperm count and volume.

As a result of increased difficulty with conceiving children, greater numbers of individuals are turning towards assisted reproductive techniques such as in vitro fertilisation (IVF). The primary cause of concern with IVF is its extravagant cost with one round costing up to $14,700. This may limit its accessibility by individuals from lower income groups and therefore create inequality in the distribution of this service. The market for IVF solely was estimated to be worth about “$670 million in 2016”and is projected to increase to “$1.5 billion in 2022”.

Male infertility is not only an urgent concern in terms of inability to conceive children, but it also poses considerable risks to an individual’s health. For instance, males with a lower sperm count have a greater risk of prostate cancer and lower life expectancy. In 2015, only 18% of males tested qualified as healthy sperm donors, whilst it was approximately 56% in 2001, according to a study published in Fertility and Sterility.

There are also numerous legal restrictions in China which prevent new companies from establishing and successfully penetrating the fertility market. For instance, cryopreservation of eggs is not allowed in China which limits infertility treatments.

Masoud Afnan, a general manager at Tianjin United Family Hospital, comments further on these barriers stating that services need a full IVF clinic – with the required number of staff – to do IUI for 2 years. This is an expensive option to just do IUI.” Intrauterine insemination is a popular assisted reproductive technique, but requires extensive manpower to ensure integrity of the process. To increase local use of reproductive health services, more resources need to be acquired and legal restrictions altered – in order to provide the full spectrum of fertility treatments. MIMS

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