Women's right to choice a hard egg to crack

The case of a single woman who is suing a Beijing hospital for its refusal to freeze her eggs drew national attention and topped Internet searches into 2020.

The hospital said it turned down the request of Teresa Xu, 31, because she doesn’t have a marriage certificate.

The hoo-ha became a timely reminder for single women heading home for the Spring Festival this month that they face endless queries about when they are going to get married, settle down and have children. Some women actually plan overseas trips to avoid busybody relatives.

Xu’s case is believed to be the first of its kind in China, though the issue of whether unmarried women are entitled to assisted reproductive treatment has long been hotly debated. Many in China still cling to the belief that only married couples should have children and women with a “ticking clock” shouldn’t be allowed to freeze their eggs just because they aren’t ready to marry.

In 2015, popular actress Xu Jinglei triggered widespread discussion after she revealed that she had had nine of her eggs frozen two years earlier, at age 39, in the United States. Her action prompted others to go overseas for assisted reproduction. Others, like Teresa Xu, considered overseas treatment but was stopped by higher costs and the language barrier.

Various surveys on whether a single woman should be allowed to freeze her eggs have been conducted, and the responses have been overwhelmingly positive. In one survey by social media platform Weibo in November, just before Xu’s case hit the headlines, about 16,000 of 18,000 voters voiced support.

Chinese company Ctrip, whose chief executive is a woman, shocked many but won public support when it initiated a corporate policy to fund mid-to-high-level female managers on overseas trips to freeze their eggs. The company said it would help employees to find a better work-life balance.

At the time, Xu Jinglei said her decision to freeze her eggs “was the only way for me to rectify my decision of not having babies now if I later come to regret the decision.” Disappointed by criticism of her action, Xu said: “Now there is a new creature in the world called the single Chinese woman.”

Now 44 and still unmarried, she hasn’t used her frozen eggs.

Egg freezing, or oocyte cryopreservation, is classified as a supplementary in vitro fertilization (IVF) treatment in China. There is no specific law banning single women — or any woman for that matter — from freezing their eggs, but a National Health Commission regulation states that only two groups of people are eligible for assisted reproductive treatments such as freezing eggs or IVF: infertile married couples or people who face severe diseases such as cancer and want to insure their reproductive abilities after taking chemotherapy.

In late December, freelance editor Teresa Xu stood outside the court after the first session on her case was adjourned and spoke to the press.

“I’m standing here with the weight of the expectations of many single women,” she told reporters. 

Her case began in November 2018, when she went to a Beijing hospital to get a check-up before freezing her eggs. After she failed to provide a marriage certificate, her request was declined. Calling it an affront to her reproductive rights as an unmarried woman, Xu decided to sue.

The court heard her case more than a year later, in a close-door session. The hospital spokesman told the press that the facility was merely complying with government regulations on assisted reproductive treatments.

Xu’s lawyer said the case will probably drag on for a long time. She said her client is “cautiously positive” about the outcome and “hopes her case will inspire more public debate and eventually lead to changes in government policies.”

Xu sees her crusade in simple terms. 

“I simply want my eggs to be frozen,” she explained. “Reproductive rights for single women should be returned to us.”

Legal experts are less positive than her about the outcome, given the lack of corroborating law on the subject. 

“It’s hard to see her winning the case based on current law and regulations, but the case, especially with such national attention and debate, could be a consideration for future changes by legislators, though it could take years,” said Jason Yao, a retired law professor and lawyer.

He added that various laws, including marriage law and the law on the protection of women’s rights, include broad clauses stating that all women have the right to choose whether or not to have children and that the rights of children born out of wedlock are equal to those born to married couples. 

“The law may be outdated because matters like freezing eggs are very new things,” Yao said. “Legislators would have to consider a lot of issues in changing the regulations, such as legal ownership of the eggs and illegal sales of eggs.”

In about 2014, Shanghai was scheduled to open the first egg bank in China after many years of efforts and attention. Nothing has been heard of it since. 

To safeguard patients’ health and rights, hospitals are very restrictive in their egg-freezing procedures, even for eligible patients. No more than 10 eggs can be taken in one appointment, and patients are allowed to use the eggs of someone else only if a willing donor has surplus eggs after treatment.

In this legal vacuum, a black market for eggs has thrived, leading many women seeking to sell eggs to suffer from malpractice in illegal clinics. There have been many crackdowns on illegal clinics around China. 

Some people hoped that the government’s 2016 decision to allow all couples to have two children, ending 40 years of the “one-child policy,” would usher in a new era of relaxed rules on assisted reproduction. 

There are more than 200 million unmarried adults in China, with more than 77 million living alone. The number of people getting married has continued to decline and the average age of marriage has continued to increase. In 2017, 10.6 million people tied the knot, 7 percent down from 2016.

Over the years, several National People’s Congress deputies have submitted proposals to increase the access to assisted reproductive technologies. According to the current regulations, not only single women but also older married couples are banned from such procedures.

In 2017, health authorities replied to one deputy’s proposal to “open up restrictions on reproductive rights for single women” by stating that relevant health departments would “pay close attention” to technologies such as freezing eggs and do feasibility studies. Nothing yet has come of that.

Overall public opinion is becoming more open-minded about single mothers, a status considered morally decadent not many decades ago. 

But even that choice is fraught with bureaucratic red tape. A single mother requires a birth certificate to register a child’s hukou, or official residency, and a birth certificate depends on a marriage certificate. Without hukou, the child is prevented from going to public school or obtaining a passport.

Hurdles don’t stop women who are determined to exercise their right of choice.

Single Liz Wang, 32, has just bought tickets to Bangkok for the Lunar New Year holiday, which starts on January 24. She’s not going to Thailand to enjoy the beaches or the zesty cuisine. She is going, with five like-minded friends on a group discount, to get her eggs frozen.

Wang said she first thought of the idea when she turned 28 and had just broken up with her boyfriend.

Feeling the clock ticking, she took heed when a friend mentioned egg-freezing.

“I didn’t want to rush into a marriage just because I need to have a child,” she said. “I was worried that when I finally met Mr Right, it might be too late for me to conceive.”

She added: “It took me a long time to make up my mind, and I didn’t tell anyone because back then, even just three years ago, I felt that people were not as open-minded as they are now. The preparation took a long time and a lot of money, but I can say now that it is one of the best decisions I’ve ever made in my life.”

Thailand has been a popular medical tourism destination for Chinese. Some clinics there report that 80 percent of foreign patients are from China, and many are now staffed by Chinese-speaking nurses and provide brochures in Chinese.

Patients seeking egg-freezing treatment are still a small percentage overall, but the numbers are expected to grow quickly — and not just in Thailand but also in Japan, Russia and the US.

“Chinese patients have more than doubled since they hired me two years ago,” said a Chinese-American woman surnamed Zhao, who works as a consultant at a US medical clinic. “Most are older couples, but the number of single Chinese women is rising quickly.”

Zhao was hired part-time by the clinic two years ago as the number of Chinese clients rose. She has set up various Chinese social media accounts to explain available procedures and costs, and answer questions.

“It’s not technically legal nor illegal,” she said, “so we don’t want to advertise too broadly. We mostly function by word of mouth.”