Paying thousands of yuan to have a boy or twin girls carried by yourself or a surrogate mother, which is illegal but accessible in the Chinese mainland via in vitro fertilization (IVF) treatment, has grown into a mature underground market.
The underground IVF trade has witnessed a new round of growth after China announced that it would allow all couples to have a second child, as many older women who now want a second child are unable to conceive naturally, China has no egg banks and the trading of eggs is illegal in hospitals.
The supply and demand gap in infertility treatments also contributed to the booming market. China has given 432 hospitals permissions to use assisted reproductive technology (ART), with around 700,000 procedures performed per year, the China News Service reported in March.
The demand is huge in part because more than 40 million people of child-bearing age are infertile, accounting for 12.5 percent of all people of reproductive age, according to the National Health and Family Planning Commission (NHFPC).
Underground boom
By searching the phrases "test tube boy" and "egg donor" one can find hundreds of online chat groups based in different cities, most of which are run by agents in the underground market.
Standard IVF treatment starts from 90,000 yuan ($13,000), but for twin boys, the price is 120,000 yuan higher and surrogacy will take 600,000 yuan more, a Guangzhou-based agent told the Global Times.
In hospitals, IVF treatment normally costs around 30,000 yuan, Li Mei, the head of the advanced laboratory of the Reproductive Hospital affiliated to Shandong University, told the Global Times on Wednesday.
"Or you can pay 850,000 yuan to guarantee a boy delivered by a healthy surrogate," said the agent, adding that they have been cooperating with several top hospitals for years and the treatment could be done in those hospitals.
When asked whether the service is safe from being busted by local police and the health authorities, a customer service worker at a Wuhan-based "IVF center" told the Global Times reporter that getting in trouble is "impossible."
"We have being doing this for years and everything has been taken good care of, including the 'related departments.'"
The center named "True Love" was established in 2008 and provides services including egg and sperm trading, surrogacy and IVF treatments priced from 70,000 yuan to 1.2 million yuan.
For those who want to choose their baby's sex, use donated eggs or a surrogate, as well as those refused by hospital because they are not legally recognized as a couple, such as gay people, they can only turn to the underground market or go abroad, said Li.
Separately, buyable eggs are also the reason why couples turn to the underground market, as more women of child-bearing age are suffering from ovarian failure, she added.
Egg donors' information, such as their age, height, health condition and education background were posted together with the prices of their eggs under the Guangzhou agent's WeChat account.
The demand is huge and underground clinics or agents can always find a qualified doctor if they offer high payments, Li added.
Law dilemma
China currently only has two regulations for the infertility industry which were both enacted from 2001, one on ART and the other on the management of sperm banks.
According to the ART regulations, the maximum fine for unlicensed medical practices is 10,000 yuan.
Though underground agents and doctors could be given years in jail for illegal business operation and illegal medical practices, convictions are rare, which makes a nonsense of the deterrent, Yang Huilin, a lawyer from the Guangzhou office of Yingke Law Firm, told the Global Times on Wednesday.
Apart from voices calling for harsher punishment, some doctors and lawyers are advocating legalized surrogacy in China. "The reality is that many women need surrogacy and eggs because they want a baby even though their physical condition is not good enough. They will do it anyway and it must be regulated to ensure their safety," said Li.
Though China removed in December 2015 the article banning surrogacy and the trade of eggs, sperms and embryos from a draft amendment to the Law on Population and Family Planning Law, the country's top health authorities have stressed that they did not open the market and such services are still banned.
Surrogacy is allowed in many countries including the UK, Ireland, Denmark and Belgium, where the surrogate mother is not paid or only paid for reasonable expenses, while France, Germany, Italy, Spain, Portugal and Bulgaria prohibit all forms of surrogacy, the BBC reported in August 2014.
