Good Quality. Ayo Wahlberg

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СКАЧАТЬ teams, clinics, and indeed countries often engage in a race to be the first when it comes to “new” or “frontier” technologies; whether in the United Kingdom or in India there is prestige to be won from achieving a first in the ever-growing field of reproductive technologies (Bharadwaj, 2002; Franklin & Roberts, 2006). Global firsts (such as Louise Brown or Dolly the sheep) are perhaps the most prestigious, but by no means at the cost of national firsts. In China, as already noted, two scientists have in particular been recognized, not least through national awards and prizes, as the pioneers of ART—Zhang Lizhu of Beijing’s Medical University Third Hospital and Lu Guangxiu of the CITIC-Xiangya Reproductive and Genetic Hospital in Changsha. If ARTs are completely routinized today in China, they were very much experimental technologies in 1980, which was a pivotal post–Cultural Revolution year for reproductive science in China. It was in 1980 that the Human Reproductive Engineering Research Department was founded at the Xiangya Medical College in Changsha by Lu Huilin, father of Lu Guangxiu. It was also in that year that Zhang Lizhu, a trained gynecologist, returned to prominence as invited speaker on China’s one-child policy and related public health issues at the United Nation’s Second World Conference on Women held in Copenhagen.

      Yet, Zhang and Lu arrived at assisted reproduction along very different paths, as endocrinologist and geneticist respectively. Having studied gynecology in Shanghai, New York, and Baltimore through the 1940s, Zhang took up her first position as resident gynecological physician at the Marie Curie Hospital in London in 1949.³ She returned to China in 1951, eventually becoming the director of Gynecology and Obstetrics at the Peking University Third Hospital in 1958. During the 1960s, her endocrinological research was focused on the increasing numbers of patients reporting menstrual irregularity. By 1965, as the Cultural Revolution began, Zhang’s international background was turned against her. She was demoted from her position as director and sent to work in the countryside for a year where she trained so-called “barefoot doctors,” followed by a job as hospital janitor at the Third Hospital back in Beijing.⁴ Zhang was able to resume her work as clinician and researcher only once the Cultural Revolution had ended in 1978, in a newly established endocrinology laboratory at the Third Hospital. This change in fortune was directly linked to the Four Modernizations program that Deng Xiaoping had launched that year to repair some of the many setbacks that agriculture, industry, defense, and science and technology had suffered during the Cultural Revolution. Zhang picked up where she had left off, concentrating on her patients’ menstrual irregularities, a specialization that would inevitably draw her into the field of infertility, as she recalled in an interview with the Chinese Obstetrics and Gynecology forum:

      My expertise was in reproductive endocrinology. When I treated patients with period issues in the 1980s, I found that many of them not only wanted to cure their period problems, but also mainly wanted to get pregnant. A lot of them had been married for over two years but still couldn’t get pregnant. Therefore I began to look into what was causing their infertility. After research and analysis I found out it was due to blocked fallopian tubes. In most cases this was the major problem. Blocked fallopian tubes were mainly an issue in China, which was completely different from other counties. In China 31.3 percent of female infertility was caused by tuberculosis. We proved that they had tuberculosis through research and biopsy. So this cause was not necessarily the same as in other counties. The main clinical manifestation was pelvic adhesions, and the surface of the ovary couldn’t even be seen. (Zhang, Interview 1)

      Lu, on the other hand, was introduced to the field of ART by her father Lu Huilin, one of the founders of medical genetics in China. Lu Huilin had traveled to the United States in 1924 to further his education at Columbia University, studying under Thomas Hunt Morgan and Edmund Beecher Wilson for a master’s degree in genetics. Armed with a number of Morgan’s works, such as Human Inheritance (1924) and Evolution and Genetics (1925), Lu returned to China in 1929. Disrupted by illness and the Japan-China war (1937–1945), Lu eventually set about translating Morgan’s texts in the late 1940s with a view to spreading his theories to a Chinese audience. In 1950, he published a book on the theory of the gene and Mendelian inheritance and began teaching this theory at the medical college in Changsha. He was widely criticized in a newly communist China, which officially favored the now discredited ideas of Russian scientist Trofim Lysenko on the heritability of acquired characteristics (see Lamoreaux, 2016). Lu’s studies and teaching were interrupted as the Cultural Revolution took hold in the 1960s. As a result, he shifted his attention to medical genetics in the 1970s, forming a research group in Changsha that would develop prenatal diagnosis and genetic counseling techniques. It was this group that would be formally institutionalized in 1980 as the Human Reproductive Engineering Research Department of the Xiangya Medical College. And thus Lu Huilin’s interest in reproductive technologies began to take shape. His initial excitement upon hearing news of Louise Brown some months after her birth in 1979 was sparked by the possibilities of utilizing IVF not so much to overcome infertility as to avoid transmission of genetic diseases.⁵ It was at this time, in the late 1970s, that Lu Huilin’s daughter, Lu Guangxiu, would unknowingly be enlisted in China’s efforts to develop reproductive technologies. As she explained in an interview in her office surrounded by a forest of indoor plants one late afternoon in May 2011:

Figure 3. Lu Guangxiu and her father, medical geneticist Professor Lu Huilin. (Photo courtesy of Lu Guangxiu.)

      I was a surgeon in Guangdong in 1979, and at that time, because my father’s health was not very good, I came back to Changsha to take care of him. During that time, he posed a question to me, asking: “Do you know how we can get an oocyte?” I was astonished to get this question! Because I had never observed any oocytes during ultrasound and the technical equipment was also very poor at that time. So, as a surgeon, I answered, “Maybe you have to open the abdomen to get this oocyte.” I also wondered why he would ask this question. When I came back to Changsha, I had become a teacher of anatomy. In those days, I could teach for half of the year and have my own time for the other half of the year. Being a surgeon was hectic every day, so I was used to the old busy days. I felt I had too much free time in Changsha and I hadn’t many things to do. So I asked my father why he asked this question and he said that he would like to try for an IVF baby. I then said, “Why don’t you let me have a try?” But my father said that I am a surgeon and so I lack basic knowledge of this research and he would think about it. After several days, he gave me some examples of what preparations I would make if I was going to be engaged in this research, such as the equipment, technology, and knowledge; so all these things, I had to begin from scratch. “You will encounter many difficulties and you have to overcome them,” he told me. I thought about it and accepted it and began the research.

      Lu Huilin sent his daughter to Beijing on a three-month study trip in 1980 to learn how to fertilize eggs and culture embryos from cows, rats, and mice. Lu Guangxiu’s sister was studying at Beijing University at the time and had many friends and classmates working at the Chinese Academy of Sciences in the field of genetics. So, whereas Zhang Lizhu’s attention had been drawn to infertility by the patients she encountered as a clinical gynecologist, Lu Guangxiu was introduced to reproductive science by her medical geneticist father whose initial interests focused on the use of reproductive technologies to engineer and improve the strength of China’s population. This intersection of clinical infertility and medical genetics, as we will see, turned out to be propitious for the development of ART in China. As they set out to develop reproductive technologies in the early 1980s, one of the first hurdles faced by Zhang and Lu (much like all other early reproductive science pioneers) was how to get a hold of human gametes.

      GETTING GAMETES

      While artificial insemination (AI) using donor sperm has a long history, it was not until the first techniques for viable cryopreservation of sperm were developed in the 1950s that sperm banks —repositories of frozen sperm samples—became feasible (see Swanson, 2012). Working with animal sperm in 1949, a group of British researchers led by Chris Polge “made the discovery that glycerol had the remarkable property of protecting living cells from СКАЧАТЬ