ROBERT SIEGEL, host:
From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.
MELISSA BLOCK, host:
And I'm Melissa Block.
Today, our series Beginnings, about women and childbirth, brings us a story about in vitro fertilization. In the U.S., the number of babies born through artificial reproductive technology doubled over the last decade, but that's nothing compared to what's been going on in China, where there has been an explosion of IVF centers.
NPR's Andrea Hsu has a profile of one such center. Its story traces the growth of IVF in a country better known for its one-child policy.
Unidentified Woman #1: (Foreign language spoken)
ANDREA HSU: At 8:30 in the morning, a line weaves through the lobby and out the front door of the Shanghai JIAI Genetics and IVF Institute. It's like this every day. Next to the lobby is a waiting room, which looks and sounds as much like a train station as it does a medical office.
There's an electronic board on the wall, but instead of destinations and times, it flashes the names of patients, telling them which room to go to and which doctor to see.
Dr. WEIPENG ZHAO (Unit Director, JIAI Genetics and IVF Institute): In the morning time and the afternoon time, every day is very crowded.
HSU: Weipeng Zhao heads the center. He's 71. Two decades ago, he was a well-known surgeon in China and in the prime of his career when he was sent to the National Institutes of Health on a scientific exchange. He later landed at the Genetics and IVF Institute in Fairfax, Virginia, just outside Washington, D.C.
He remembers talking to the company's founder, Joe Schulman, about China's economic growth.
Dr. ZHAO: He said, why we don't go to China? I say, yes, you have to go. This is opportunity.
HSU: That was about 15 years ago. IVF was being done in China in government-run hospitals, but the numbers were small and equipment was scarce. Chinese officials were eager to have U.S. help in setting up IVF clinics, ones that would be stocked with Western technology.
Given the extreme measures China had taken to slow its population growth, this came as a surprise to many.
Dr. ZHAO: Because they're saying this is a family planning country. You want doing the infertility treatment? No.
HSU: It was a reasonable reaction. China's introduction of strict population control policies in 1978 led to forced abortions and sterilizations. Over the years, many families have paid substantial fines for violating the policies.
Still, by the mid '90s, there was government support for IVF, the idea being every family should have one child. And thus, an industry was born.
Dr. CHEN HUA (Obstetrician-Gynecologist): (Foreign language spoken)
HSU: Now, Shanghai JIAI is in its 13th year and busier and more profitable than ever.
Chen Hua is an obstetrician-gynecologist here. She sees about 40 patients a day.
Dr. HUA: (Through Translator) We have many families in China who are childless, so they need a child even more.
HSU: It's not that the infertility rate in China is especially high. And it's not a rush of couples doing IVF just to have twins to get around the one-child policy, not to say that doesn't happen. Anywhere in the world, it's estimated that approximately 10 to 15 percent of couples suffer from infertility. Think about the size of China's population and do the math.
Thirty-four-year old Wang Zhongqing has tried for several years to get pregnant. She's gone to three different hospitals but was told her case was too complicated. She desperately hopes she'll get help here.
Ms. WANG ZHONGQING: (Through Translator) Not having a child, you feel the pressure. My classmates' children are so big already, 8 or 9 years old.
HSU: And pressure from family is the greatest of all.
Ms. ZHONGQING: (Through Translator) They're always pushing: Go get looked at. How come you haven't gone yet? They're so anxious.
HSU: At JIAI, the cost of a typical IVF cycle - that's one attempt at getting pregnant - runs about $4,500. With rising incomes in China, it's something that a growing number of people can afford, and it's almost a given that parents help out.
Unidentified Woman #2: (Through Translator) Maybe China's different from other countries. We Chinese pour everything into the next generation.
Unidentified Woman #3: (Foreign language spoken)
Unidentified Woman #4: Okay. We're finished.
HSU: One floor up, lab technicians finish the first of 15 egg retrievals they'll do this morning. Within minutes, they're on to the next patient.
Mr. ANDY DORFMANN (Director, Embryology Laboratory, Genetics & IVF Institute): It's actually a terrific lab back here.
HSU: Andy Dorfmann is director of the embryology lab back home in Virginia. Many of the Chinese techs have trained in his lab, and he comes to Shanghai a couple times a year to make sure they're on track.
Mr. DORFMANN: So will you transfer these on day three or day five?
Unidentified Woman #5: Three.
Mr. DORFMANN: Three, OK.
HSU: The Shanghai lab is largely the same setup as the one in the U.S. but with six times the volume. So the embryologists are extremely careful about double-checking names.
Mr. DORFMANN: The pace here is so high, and the number of patients that they're seeing, the throughput is so high.
HSU: When the Chinese staff go to Virginia, they can hardly believe what they see. Han Jinlan is an OB-GYN. She ran the day-to-day operations at JIAI until last year.
Dr. HAN JINLAN (Obstetrician-Gynecologist): (Through Translator) Last time I went to America, there were at most two patients sitting on the sofas. Only when one left did the next one go in. They weren't all standing in a line.
HSU: In Shanghai, on the other hand, the lines keep getting longer and longer.
Dr. JINLAN: (Through Translator) In 1998, we had sofas for everyone. Then we switched to chairs, then to stools. Now, we have people sitting in the stairwell.
The productivity in Shanghai has meant big paydays for the staff. They get monthly bonuses based on the revenue their departments bring in.
This pay-for-performance would have been unthinkable in Weipeng Zhao's time as a surgeon in China. Today, it's part of his strategy for keeping JIAI competitive, as IVF centers pop up all around.
Dr. ZHAO: Last month, I showed our board member the one Shanghai map. We are in the Shanghai downtown area. Surrounding us, 10.
HSU: Ten more IVF clinics in Shanghai alone. Throughout China, there are now several hundred government-licensed clinics. Some of them with newer, more spacious facilities.
Dr. ZHAO: The patient always criticize us: Hah, you are joint venture medical center, but you don't have the VIP service. Yes, we don't have yet. We don't have the space.
HSU: Somehow, though, space will be found. And as long as China's economy continues to deliver, the market for IVF will grow one baby at a time.
Andrea Hsu, NPR News.
BLOCK: And our series continues online with The Baby Project. Nine women from across the United States are blogging about their final weeks of pregnancy, and later this summer about their first few weeks of parenthood. You can meet them at npr.org.
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