Like Su, many Chinese people have a strong preference for a baby’s sex. Influenced by traditional beliefs that persist in some Chinese regions, especially rural areas, many families prefer sons over daughters.
According to China’s National Bureau of Statistics, the sex ratio at birth, measured by the number of male births to 100 female births, stood at 108.5 in 1982, well above the international standard of 107. It kept rising since then and peaked at 118.6 in 2005. Though it kept declining in the following years, it remained above 110. In 2020, it was 111.3, the lowest since the early 1990s.
Su said that according to her understanding, the vast majority of those who get third-generation IVF in Thailand want a son, and only around one in 10 want a girl.
But those who cannot go overseas turn to unlicensed clinics, attracted by advertisements which claim to allow people to “customize your baby.”
“Just do third-generation IVF, guys. It’s good,” Chen Ting, who had a son through third-generation IVF, posted online. She told NewsChina that she wanted a son. In the clinic where she received the operation, she met a woman who wanted the same.
“She’d already had three daughters,” Chen said.
Su claimed one of her friends underwent third-generation IVF in an unlicensed clinic.
“She was put into a black van with her eyes covered. She couldn’t have any electronic devices. She didn’t know where the van went and since the egg retrieval needs general anesthesia, she didn’t see her doctor’s face throughout the operation, and she didn’t know their name,” Su said. “The entire process was closed up tight... You didn’t know whether the doctor put something in your body or took something out, like a kidney,” Su added.
On the pretext of wanting the procedure, a NewsChina reporter contacted several unlicensed clinics, most of whom said they have their own labs and contract doctors from public hospitals. One of the clinics told NewsChina it employs a renowned assisted reproductive physician from a top hospital in Beijing at an annual salary of at least 2.6 million yuan (US$386,910). The person boasted their success rate for third-generation IVF was around 80 percent, much higher than public hospitals (50-60 percent) and that their clients include pop stars and online celebrities. But when the reporter proposed visiting their lab, he refused, saying it was too far away.
“Underground clinics come with enormous risks, because they can’t guarantee standard operations and may even overuse drugs. Besides, egg retrieval may harm the mother or could cause lethal hemorrhaging and infection,” an assisted reproduction physician at a top-level hospital in Beijing who declined to give her name told NewsChina. “From what I understand, these clinics shift around to avoid detection, and some even do the procedures in a dingy shed,” she said.
Others act as agents to sell coveted appointments for third-generation IVF at licensed hospitals. One told NewsChina on condition of anonymity that he acts on behalf of three Beijing hospitals that have approval to do third-generation IVF, priced at 188,000-238,000 yuan (US$28,923-36,615). A client first pays a deposit of 50,000 yuan (US$7,692) and the second payment comes after they register at a maternity hospital for birth services. The rest is paid two days before the egg retrieval. The agent said it is extremely hard to get a slot at a licensed hospital if one does not meet the requirements. On the black market, an appointment just to register with a licensed hospital costs 88,000 yuan (US$13,539).
The agent said that public hospitals can help with sex selection “secretly,” but he refused to reveal more details.
Most of the underground clinics NewsChina contacted said they sign a contract with their clients. “What on earth are you worrying about? We will sign a contract with you,” one of the agents said in response to NewsChina’s questions.
However, contracts like this do not protect clients. A case published on legal website China Judgments Online in May 2021 showed that a court in Beijing did not support a plaintiff’s claim for compensation after alleging the third-generation IVF she had at an unlicensed clinic failed due to malpractice.
Ruling that sex selection by technology does not conform to China’s laws and regulations and will lead to a more imbalanced gender ratio, the court voided the contract between the plaintiff and the clinic, saying both sides are responsible. The court ruled the clinic must refund some of the plaintiff’s money but rejected a demand for additional compensation.
“Chinese laws do not protect the interests of mothers-to-be unless the sued clinic has truly caused them physical harm,” Guo Lei, a lawyer at Beijing Zunping Law Firm told NewsChina, adding that Chinese laws do not yet cover issues related to illegal assisted reproduction, let alone clarify the responsibilities. This gap means that underground clinics pay little for violating the law.