Having suffered the loss of their only daughter, a university student who was killed in a traffic accident, a couple in their late forties from central China’s Hungan Province saw little hope of being able to have another child on their own.
But the couple did have a baby – thanks to a surrogate mother implanted with the couple’s egg and sperm in a procedure performed at the Human Reproduction Institute under the Xiangya Medical School of Hunan Zhongnan University and approved by the Hunan Provincial Family Planning Commission. The baby is expected to be born in July.
This couple’s child may be one of the last babies born in China under such circumstances, however, as new Ministry of Health regulations take effect on August 1 that ban gestational surrogacy, eliminating this option for older couples and couples where the wife has a damaged or missing uterus.
Why did the Ministry of Health issue its new Regulations Concerning Human-Assisted Reproduction Technology? The regulations were deliberated by eight sessions of experts in various fields to try to match human-assisted reproduction technology with the social ethics, morality and laws of China, a spokesman for the ministry said.
The gestational surrogacy enabled by human-assisted reproduction technology was found to embody unavoidable social and ethical issues. In terms of genetics, the newborn baby belongs to the individuals who provided the sperm and egg, but it is very difficult to judge who legally is the real mother of the baby. No standards exist to cover such questions as: What kind of woman should serves as a surrogate? Does the age of the surrogate matter? Who will be responsible for a miscarriage or defects in the baby? What’s to be done if the surrogate mother becomes critically ill?
“We understand the feeling of parents. But what should we do if these questions arise?” he said.
Another regulation was issued at the same time on March 5 on sperm banks which now must be associated with medical institutions. Sperm used in assisted human reproduction from anyone other than the husband must be supplied through a sperm bank approved by the Ministry of Health. The regulation also bans the marketing of sperms, eggs and embryos.
“The two ordinances were issued just at the right time and will play a sound role in standardizing the human-assisted reproduction industry,” the spokesman said.
Why has China banned gestational surrogacy and not other forms of “test-tube” babies? Because gestational surrogacy involves so many more complicated legal, ethical and moral problems, according to Professor Zhu Guijing of the Tongji Hospital.
Concerns include the question of whose baby it really is, multi-parent families in which the relationship between the infant and other family members is unclear, and single-parent families. A woman of childbearing age might also seek a surrogate to keep her figure or avoid birth pains. The Tongji Hospital has reported such a case.
Many medical experts in China hailed the ban, but others criticized the regulation as arbitrary.
“Such a ban should already have been in place,” said Chen Gui’an, director of the Reproduction Center of No. 3 Hospital affiliated with the Beijing University of Medical Science. Her hospital has performed several operations involving surrogate mothers.
According to Chen, all gestational surrogacy involves money. If the practice is not kept under control, a potentially chaotic situation exists in which some people might turn to making a living by bearing the children of others.
Chen would also remind women considering serving as surrogates of the dangers involved. Although 95 percent of women make it through pregnancy and labor safety, medical problems do exist that include some risk. Who will take the responsibility for the surrogate should something go wrong, she asked.
As to the fact that the ban will deprive many couples of the right to becoming parents, Chen used the analogy of someone suffering from terminal cancer to make her point:
“The cancer will deprive the patient of his life although nobody wishes that to happen. This is similar to the case of those who cannot conceive a child because of a damaged or missing uterus. They are deprived of being mothers, which is a matter of regret for the whole family. But since the state has laws and rules against gestational surrogacy, the couples should respect them.”
But Fan Liqing, vice director of the Human Reproduction Engineering Institute of the Zhongnan University Xiangya Medical School has a different view. “All people are on equal footing. Why should we deprive those patients of the right to have their own children when medical means can remedy the situation?”
In regard to the money transaction involved, Fan said: “Since it is voluntary, there’s no problem. Some people need the child, and others need the money.”
Fan argued that all things new have problems at the early stage of their development.
“We should work to find the solutions to these problems. We don’t give up eating for fear of choking. What we need are restrictions – not a complete ban,” he said.
Zhang Yulan, director of the Gynaecology and Obstetrics under the Harbin No. 2 Clinical Medical College who last year performed surgery involving gestational surrogacy, shared Fan’s view.
“A complete ban doesn’t help patients nor does it aid research in reproduction science. The best solution is to locate the problems and to regulate them instead of resorting to a ban,” she said.
But the director of the Science Education Department under the Ministry of Health counters that only a few people will be affected by the ban. An estimated 10-15 percent of Chinese couples suffer some kind of reproduction dysfunction, and only 10 percent of this population needs the help of human-reproduction technology, he said.
“The views of the experts who disagree with the ban may be technically correct, but the current legislation needs to be given a chance.”