Rapid advancements in assisted reproductive technologies (ARTs) have created new possibilities for family formation. A plethora of anthropological studies have revealed the ways in which ARTs have redefined kinship relations, stratified access to ARTs, and ethical concerns that arise in complex socioeconomic, cultural, political, religious, legal, and moral contexts. Little is known, however, about assisted reproduction in China, the world’s most populous country. China has been undergoing a massive and stringent social engineering project aimed to limit population growth. In Good Quality, Ayo Wahlberg provides a rich and fine-grained ethnographic account of assisted reproduction in China, focusing on how state population politics and sociocultural configurations have shaped the practice of sperm banking.
According to Wahlberg, sperm banking has become routinized in China since 2003, when ARTs were legalized. China has a population of about 1.4 billion, and there are an estimated one to two million azoospermic men (men who are unable to produce sperm) in the country. While the demand for donor sperm is high, China’s 23 sperm banks have been unable to keep up, leading to a national “sperm crisis.” Good Quality goes behind the crisis to reveal the routinization of sperm banking within China’s “restrictive reproductive complex.” Wahlberg defines routinization as “a socio-historical process through which habituated regimes of daily micro-practices coalesce, thereby shaping a medical technology and its uses” (p. 11). During eight years of field research between 2007 and 2014, primarily in China’s largest and oldest sperm bank in Changsha, Wahlberg interviewed scientists, sperm bank managers, doctors, laboratory technicians, nurses, and donor recruiters, as well as sperm donors and infertile couples. He also closely observed the process of sperm banking and donation, from donor recruitment visits to university campuses, to medical screening of potential donors, to analysis of sperm quality in the laboratories, to consultations with infertile couples.
Good Quality starts with the “difficult birth of ARTs” in China through the 1980s and 1990s, revealing how two pioneering reproductive scientists, Lu Guangxiu in Changsha and Zhang Lizhu in Beijing, experimented with assisted reproduction in crude conditions and succeeded with the birth of China’s first test tube babies in 1988. ARTs were developed in China right after the Chinese government initiated its massive birth-planning policy, popularly known as the “one-child policy.” State ambition to limit the fertility rate stood in stark contrast to the desire of the pioneers of ARTs to make them available to infertile couples. To win state support for ARTs, the scientists strategically framed reproductive technologies as a means to help improve population quality, appealing to the birth-planning policy’s eugenic aspects.
The book goes on to reveal how the eugenics agenda of the birth-planning policy has shaped the practice and regulation of assisted reproduction. In addition to infertility treatment, donor sperm is also available to men who suffer from genetic diseases that can be transmitted to their offspring, thus negatively affecting the quality of the population. Meanwhile, a fear of consanguine marriages between donor offspring, another threat to population quality, led to the restriction of a maximum of five women’s pregnancies per sperm donor.
After delineating the sociopolitical and legal configurations behind the birth and routinization of sperm banking, Wahlberg turns the discussion to how sperm banks have served as a “sanctuary of vitality” amid increasing concerns around food safety, pollution, rising infertility, and declining population quality. Although it is hard to verify claims of rising infertility rates and declining sperm quality, these claims have become accepted in China as scientific givens. Wahlberg introduces the concept of “exposed biologies,” a side effect of modernization, to explain how exposures to industrial chemicals and modern lifestyles have been linked to a “socially diagnosed” sperm crisis. Sperm banks, therefore, become “a repository of quality-controlled vitality.”
Good Quality follows with a detailed account of the practices of sperm donor recruitment and donation. Due to a shortage of donors, sperm banks rely on recruiters to mobilize university students, their primary target group, to become sperm donors. Using flyers, messages on social media, and face-to-face conversations in male university dormitories, recruiters have developed various strategies, such as appealing to the compassion of potential donors and offering financial compensation and free health checks, to encourage and entice students to donate. Consequently, in contrast to sperm donation in European and American sperm banks, mass donation has occurred in China. Wahlberg recorded in his observations that between 28 and 88 sperm donors per day attended donation sessions in a single sperm bank (p. 123).
Once sperm donors are recruited, sperm banks employ “technologies of assurance,” “a configuration of strategies and techniques within which certain persons, activities, and/or objects come to be vouched for over others” (p. 136). From advising potential donors on how best to prepare themselves for donation, to analyzing sperm quality in laboratories, to screening potential donors to prevent transmission of genetic and infectious disease from donor to recipient, sperm banks follow a series of quality control procedures.
Anonymity and secrecy are considered essential by both recipient couples and donors. Due to a stigma attached to male infertility and a desire to continue the patrilineal family line, recipient couples keep their use of donor sperm a secret from all but a small number of family members and friends as a way to manage reputations. Likewise, donors emphasize the necessity of confidentiality to avoid any trouble late in life should a donor child appear to disrupt their future family life. As a result, sperm donation in China operates as a double-blind system.
Good Quality is a delight to read. Wahlberg successfully demonstrates how particular sociopolitical and cultural configurations have rendered sperm banking a unique Chinese experience. Good Quality makes a significant contribution to anthropological studies of assisted reproduction, science and technology studies, and studies of China’s reproductive politics. While Wahlberg emphasizes that his focus is on the making of sperm banking (p. 11), this important book should encourage further studies on various aspects of assisted reproduction in China, such as the experience of infertile couples and the complex decision making leading to the practice of assisted reproduction.