into a “two-child policy.”3 Launched in the late 1970s by late chairman of the Communist Party, Deng Xiaoping, China’s family planning policies enforced birth control through a series of targets set at regional and local levels aimed at lowering China’s high fertility rate, which was considered a hindrance to economic development. Family planning authorities were charged with meeting such targets through the provision of contraception, sterilization, and abortion services as well as through the fining of couples who exceeded their quota of children—targets that have at times been forcibly realized. Attempts to develop reproductive technologies in order to promote fertility in the 1980s were predictably seen by some state officials and scientists as conflicting with ongoing efforts to stringently prevent births (see Handwerker, 2002; chapter 1). In the chapters that follow, we will learn how assisted reproductive technologies, including sperm banking, eventually settled alongside ligation operations, abortions, and maternal and infant health care as technologies of birth control within China’s restrictive reproductive complex. Indeed, the perceived contradiction between the one-child policy and ARTs is so great that I shared my sperm donor informant’s sense of astonishment at the vast numbers of infertile couples and potential donors upon visiting the sperm bank in Changsha for the first time in 2007.
Thirdly, as already noted, the decade-long Cultural Revolution (1966–1976) had had a destructive impact on scientific research in China, with scientists and teachers among those elite groups that were persecuted by the Red Guards (see Dikötter, 1998). Conditions for carrying out laboratory research in the early 1980s were crude, just as access to national or international research findings was sparse. And, as if these challenges weren’t enough, the fact that requisite research experiments required the soliciting and collection of sperm and eggs made matters more complicated. While eggs would eventually be medically procured in connection with certain forms of surgical procedures carried out in hospitals, “manual” sperm collection was surrounded by taboo, considered “dirty,” immoral, and harmful. Indeed, the one proverb I would hear repeated most often during my fieldwork was “one drop of sperm is the same as ten drops of blood” (yi di jing shi di xue), albeit more often than not by donors laughing at the “old-fashioned” views of their parents and grandparents. The proverb has its origins in Chinese medical texts, which conceptualize semen (jing) as a vital essence that should be preserved to maintain health (Shapiro, 1998). In the early years of sperm banking, finding voluntary donors was a constant struggle and scientists had to delicately negotiate already scarce laboratory access from skeptical and disapproving colleagues in order to carry out all but clandestine research on gamete fertilization and embryo development. The 1980s were truly trying years for experimentation with reproductive technologies in China.
And finally, during the 1990s, improvement of population quality became an equally important demographic goal for the Communist Party in China (Greenhalgh, 2010). Family planning slogans, commonly seen displayed on billboards throughout the country, were adjusted accordingly to proclaim “Control population growth, raise the quality of the population” or “In raising the quality of the population, family planning is of vital importance.” This time it was medical doctors in charge of genetic counseling and prenatal care who were given the task of “improving the quality of the newborn population” (P. R. China 1994, Article 1) through premarital health checks as well as prenatal screening and testing as means to prevent the birth of children “suffering from a genetic disease of a serious nature” or “a defect of a serious nature” (ibid., Articles 18 and 19; see also Sleeboom-Faulkner, 2010a & b; Zhu 2013; chapter 2). With this law, family planning in China expanded its responsibility beyond limiting the number of children being born to assuring the quality and health of newborns. When ARTs were legalized in 2003, regulations stipulated that fertility clinics “must obey national population and family planning legislation and policies,” which included “promot[ing] population quality” (MoH, 2003a, pp. B1, E1). As a result, sperm banking in China is today an ART and an SRT (selective reproductive technology), by which I mean a technology used not only to assist involuntarily childless couples to conceive, but also to prevent or promote the birth of certain kinds of children (Gammeltoft & Wahlberg, 2014). In the face of a looming national “sperm crisis,” sperm banking has been seen as a way to achieve better population quality through the selective recruitment of “high-quality” (suzhi gao) donors.
At the same time, however, fears about the detrimental impact of consanguineous marriage on population quality have emerged as a hindrance to the business model of Chinese sperm banks. Chinese regulations strictly limit the number of women who can give birth to a child with sperm from a single donor to five. The most common explanation I heard for this “restrictive” limit is that it reduces the risk of unwitting consanguineous marriage (which in turn is seen to increase the risk of birth defects) while also reducing the risk of unwittingly spreading a genetic disease (should a sperm donor turn out to have a late-onset genetic disorder that was not caught through standard screening procedures). China’s five-women’s-pregnancies limit coupled with the sheer demographic and epidemiological scale of male infertility has generated unique and arduous daily routines in Chinese sperm banks, which need to recruit and screen substantially more (potential) donors than Western sperm banks do to serve similar numbers of families.4 At the same time, infertile couples will often have to wait two to three years before being able to access donor sperm because of a chronic “state of emergency” at sperm banks.
And so, to get to grips with how a medical technology like sperm banking came to be an established practice in China over the past three decades or so, we need to understand how this practice has been shaped by (among many other conditions) the crude laboratory conditions available in China throughout the 1980s (and indeed into the 1990s), the co-circulation of deficiency and biomedicalized interpretations of infertility in clinics and among infertile couples, a family planning program designed to prevent rather than promote birth, taboos around sex and masturbation, and anxieties about possible unwitting consanguineous marriages between donor siblings. Only then can we account for the unique form of sperm banking that we find in China today.
SPERM BANKING IN CHINA
In what follows, I will show how sperm banking came to be a routinized part of China’s restrictive reproductive complex. It is the making of sperm banking rather than the experience of donors or couples undergoing AID that is the object of my ethnography. As such, Good Quality is what I would call an assemblage ethnography, combining not so much multisited (Marcus, 1995) as a site-multiplied tracking strategy with a cartographic partiality toward, again not so much “the world system” that multisited ethnography was originally proposed as a methodological response to,5 as the configurations found within infrastructures, assemblages, complexes, or dispositifs on the part of the ethnographer. These interrelated concepts have been proposed by social scientists in recent decades to try to capture the ways in which particular juridical, medical, social, economic, cultural, and institutional configurations are consolidated over time and in particular places. Michel Foucault spoke of what he called a dispositif or apparatus: “a thoroughly heterogeneous ensemble consisting of discourses, institutions, architectural forms, regulatory decisions, laws, administrative measures, scientific statements, philosophical, moral, and philanthropic propositions. . . . Such are the elements of the apparatus. The apparatus itself is the system of relations that can be established between these elements” (Foucault, 1977). As examples, we have, a decade later in 1989, and invoking American president Dwight Eisenhower’s notion of a “military-industrial complex” from 1961, historian of science David Turnbull arguing that the development of a malaria vaccine through an Australia–Papua New Guinea collaboration in the 1980s could only take place as a “consequence of a complex of technical, social, economic, and political factors” (Turnbull, 1989, p. 283). Within the field of contemporary American health care, anthropologist Sharon Kaufman has likewise mobilized Arnold Relman’s (1980) writings on America’s “new medical-industrial complex” to examine the “increasing encroachment of the private sector into research, technology development, therapeutics, and insurance reimbursement” (Kaufman, 2015, p. 54). Similarly, in her analysis of the development of a repro-tech
