IVF the Chinese Way: Zhang Lizhu and Post-Mao Human in Vitro Fertilization Research

Abstract

In 1988, the first human baby conceived through in vitro fertilization (IVF) technology in mainland China was born at the Peking Medical College Third Hospital in Beijing. The Chinese media soon celebrated the IVF achievement for its scientific modernity, as well as for its indigenous design, which was deemed suitable for Chinese infertile women. By tracing the project director Zhang Lizhu's professional, social, and technological experiences as the IVF project proceeded at the Third Hospital, I examine the sociopolitical justifications of the project and the technological strategies of the final IVF design. Sociopolitically, state funding for IVF in the mid-1980s, a time of governmental promulgation of the one-child policy, was predicated upon melding eugenic motives into the IVF program as a rationalization for fertility treatment. Technologically, what was claimed to be “indigenous” IVF design was actually a technical shortcut to quick success contrived to bypass challenging protocols established in developed countries. The case reveals that the IVF project and its representations in the reform era, though predominantly characterized by a sociotechnical pragmatism, still carried a hint of Maoist romanticism that celebrated worker innovation and indigenous self-reliance. Zhang's IVF program thus offered a pivotal transitional process through which the sociotechnical imaginaries of biomedical reproductive modernity began to form in 1980s China.

Keywords:

• in vitro fertilization
• sociotechnical imaginaries
• one-child policy
• eugenics
• China

Acknowledgments

I wish to thank Jane Maienschein and Zuoyue Wang for introducing this interesting topic at the outset and for discussions along the way. The manuscript has benefited from comments and editorial suggestions from Maienschein, Angela Creager, Erica O'Neil, and the editors of this journal, especially Wu Chia-Ling and three anonymous referees, as well as from discussions with Sigrid Schmalzer, Benjamin Elman, Christine Luk, and Gongcheng Jiang. The Embryo Project Encyclopedia at the Center for Biology and Society, Arizona State University, provided crucial financial support for research in Beijing, and the D. Kim Foundation for the History of Science and Technology in East Asia provided a fellowship that allowed time for writing. Hearty thanks go to Xiong Weimin and Sun Chengsheng, who have hosted my research visits at the Institute for the History of Natural Sciences, Chinese Academy of Sciences, and to Zhang Lizhu and Liu Ping, who kindly granted interviews. My gratitude also goes to Jennifer Liu, Christine Luk, and Xuan Geng for the workshops, conference panels, and class lectures they organized that offered opportunities to discuss this project at earlier stages.

Notes

 1 For a comparison with the Zionist representation of the pioneering IVF doctors in Israel, see Birenbaum-Carmeli 1997.

 2 I conduct the case study mainly using historical perspectives on the original innovation process and admittedly focus more on the research and research policy aspects and less on the various social and ethical implications of the widening use of assisted reproductive technology in China. However, Lisa Handwerker has provided a range of elegant studies on the profound social impact of the spread of IVF clinics during the reform era (1993, 1995, 1998, 2002). For bioethical and policy issues of reproductive technology in Taiwan, see Wu 2002 and 2012.

 3 Besides the works I cite directly here, other informative works include Suttmeier 1987, Lampton 1987, and Simon and Goldman 1989.

 4 For an excellent review of the wealth of scholarship on the issue of assisted reproductive technology, see Thompson 2005, 55–78.

 5 Wang Yihui (王逸慧, 1899–1958) studied surgery at the medical school of the University of Cincinnati in 1926. He later transferred to Johns Hopkins University Medical School for specialty training in gynecology. In 1928, he went back to Peking Union Medical College Hospital and became a pivotal figure in the gynecology department. He was said to be discontented with discrimination toward Chinese physicians by their foreign colleagues, and he left Peking in 1935. In 1937, he started to work at his alma mater, St. Johns University Medical School (Chen and He 1988: 115–17).

 6 Tang has worked on macromolecular crystallography, among other topics, at Peking University since the early 1950s and was made a national academician in 1980. See Wei and Li 2011: 199–202.

 7 Zhang published these tests and results only in the 1980s and 1990s, together with other, more recent research. See Zhang, Liu, and Yang 1981b and Zhang 1993.

 8 Acupuncture-assisted ovarian cyst surgery had been performed at the Third Hospital since 1970. US president Richard Nixon even attended one of Zhang's operations during his 1972 visit to China. Zhang et al. 1981a; Wolpe 1985: 411.

 9 In her anthropological study of the stigmatization of Chinese infertile women in the early 1990s, Handwerker has quoted several such letters that accorded with Confucian patrilineal notions of the female's primary social and familial responsibility in reproduction. See Handwerker 1993, especially 166–69.

10 It is fair to say that few men practice gynecology in contemporary China. A prevailing distaste for intimate physical contact between opposite sexes in clinics probably provides a partial explanation. The large proportion of female doctors and workers in Chinese gynecology and in IVF research is unique compared with the male-dominated gynecological workplace in England, Australia, the United States, Israel, and India. It is possible that IVF research and clinical practice in China thus had differentially gendered practices, and interested scholars might find that the booming IVF industry in China offers fruitful cases for analysis.

11 Liu Ping, interview by the author, 29 June 2010, Beijing; Zhang Lizhu, interview by the author, 30 June 2010, Beijing.

12 Liu interview; also see Wang 2011: 1881–82.

13 Although it may appear equally unlikely that IVF infertility treatment might significantly increase the Chinese population—a huge denominator to begin with—such concerns were nevertheless expressed in both direct and indirect ways to the doctors at the Third Hospital, while their investigations became increasingly publicized. As Handwerker points out (2002: 304), in the early 1990s fertility treatment doctors had to justify their work both to medical colleagues in other specialized fields and to the general public, because of the perceived conflicts between their work and population control policy.

14 Covers of the magazine Zhongguo Funv (Women of China) published between 1965 and 1985 showed that depictions of women transitioned from emphasizing worker identity to emphasizing roles within the family.

15 A saying from Mencius, an important early Confucian scholar, has perpetuated in Chinese society for more than two thousand years: “There are three acts that are considered unfilial; the foremost is not to have offspring.” Although Mencius was harshly criticized and subverted during the Cultural Revolution, the emphasis on the reproductive role of the individual, and especially of women, was never eradicated and reemerged during the reform era. Parallel to the redirection of social attention toward the reproductive role of women, the redirection of the focus of manhood from militant masculinity to sexual desire has been cogently shown in Everett Zhang's studies of the nature of sexual repression in the Maoist era and the evolution of men's medicine during the reform era (2005, 2007).

16 The revised policy allows, for example, a second birth in rural areas if the firstborn is a female. See Greenhalgh 2008: 299–306.

17 Even the 1982 governmental document Directions in Furthering the Work of Family Planning, which symbolized the start of a period of the strictest implementation of the one-child policy, encouraged “fewer births” and “good births” instead of “no births.”

18 The legitimization for the first birth was more explicitly stated in the Population and Family Planning Law enacted in 2001, stating that “citizens have the right to reproduction” in Article 17 and that the state “advocates one child per couple” in Article 18. In the Detailed Rules for the Implementation of the Regulation on the Administration of Family Planning Technical Services issued in the same year, infertility treatment was listed along with fertility and contraception as legitimate family planning services under state regulation.

19 The vital importance of population quality was premised on the idea that all citizens, through their physical and moral development, shared responsibility for the future of the nation, and this was increasingly invoked in the developmental discourses of the 1980s. See Murphy 2004.

20 Changing practices of modifying environmental and physical conditions to cultivate offspring with better qualities reaches back to late Imperial China in the sixteenth century. Unlike the counterpart eugenics in the West, the term yousheng brings out quite positive connotations in Chinese. Some scholars in China objected to the translation of yousheng as “eugenics” and proposed instead “healthy birth,” “quality birth,” or “Well-Bear and Well-Rear.” For convention's sake, this article uses eugenics, yet readers should be aware that the Chinese understanding of eugenics has major practical differences from the Galtonian negative eugenics and, with its emphasis on hygiene and obstetrics, is more similar to the medical practices of early twentieth-century France. See Dikötter 1998 and An 2001.

21 Zhang interview.

22 In fact, the partnership between the British developmental biologist Robert Geoffrey Edwards and the British gynecological surgeon Patrick Christopher Steptoe that eventually achieved the first human baby through IVF technology was initially formed because of Steptoe's expertise in laparoscopy, which offered the possibility of transferring gametes from fallopian tubes without excessive trauma. See Jiang 2011b.

23 Steptoe himself took a long time to convince other gynecologists to extensively use laparoscopy because of the fastidiousness of its technique. In order to train others, in 1967 Steptoe published a whole monograph to describe the use of laparoscopy in gynecology. Edwards and Steptoe 1980: 73–77; Steptoe 1967.

24 Liu interview; Niu 2010: 28. In a conference held at the University of Illinois, Urbana-Champaign, in November 2010, anthropologist Charis Thompson, who did extensive fieldwork in Chinese reproductive clinics, commented that the US physicians who visited China in the 1980s also reported that they observed excessive amounts of adhesions in the abdominal tissues of Chinese tuberculosis patients.

25 Liu interview.

26 Liu interview.

27 Liu interview; Zhang interview; Jiang 2011a.

28 The child's name, Mengzhu (萌珠), literarily means the germination of a pearl, which connotes successful birth of a girl.

29 One report had the subtitle “Western (yang) Machines Could Not Compete with Indigenous (tu) Method” (Niu 2010: 28).

30 Zhang interview.

31 Liu interview.

32 The emphasis on using an indigenous method was probably unique in IVF innovation compared with other countries that developed IVF after Britain and Australia, although both Indian and Israeli doctors mentioned the hard work and, for the latter, the teamwork of local actors in their representations. See Birenbaum-Carmeli 1997 and Bharadwaj 2002.

33 Zhang interview.

Additional information

Notes on contributors

Lijing Jiang

Lijing Jiang is a D. Kim postdoctoral fellow at the Department of East Asian Studies, Princeton University. She received her PhD in biology and society from Arizona State University in 2013. She is currently working on a book manuscript on the history of cell death and aging research in the twentieth century. She also has a second book project on the history of modern biology in China with particular focus on the role of the goldfish as an experimental organism.