Third-Party Reproduction in China: Why Many Travel Abroad

Summary: Third-Party Reproduction in China

In China, the government is increasing investment and subsidies in IVF to combat a decreasing population. As of early 2025, all 31 provincial-level regions on the Chinese mainland have brought assisted reproduction services under basic medical insurance.[1] China is reported to have 539 medical institutions approved to offer assisted reproductive technology (ART) and 27 sperm banks as of June 2021. Together, they are reported to carry out more than one million IVF cycles annually resulting in 300,000 babies per year, according to experts from the country’s National Clinical Research Center for Obstetrics and Gynecology.[2]

Despite this, Chinese regulations issued by the Ministry of Health for medical institutions restrict third party reproduction. China’s National Health Commission (formerly the National Health and Family Planning Commission) forbids any kind of commercialized egg donation and supply, and only women undergoing IVF are allowed to legally donate extra eggs [3]. Embryo donation and surrogacy are not allowed [4]. For this reason, many Chinese intended parents seek treatment abroad.

As demand for ART rises and policies expanding state insurance coverage of fertility treatment continue to roll out, the government has been reported to be considering changes to the restrictions on third party reproduction.[5]

Is Egg Donation Legal in China?

While there is no law on ART in China, in practice, commercialized donation is against regulations. In 2001 and 2003, the Chinese Ministry of Health passed regulations on ART, which apply to all medical facilities and doctors and are enforced through inspections by the Ministry of Health. These regulations forbid commercialized egg or sperm donation. Sperm donation is permitted through sperm banks licensed by the Ministry of Health [6]. The number of sperm banks is restricted by province. Egg donation is allowed only by women who are undergoing IVF treatment for themselves as explained in the section below.

The Ministry of Health administrative measures, norms, and ethical principles prohibit medical institutions and medical staff from performing surrogacy, with violations punished by fines to the institution (capped at 30,000 yuan), administrative sanctions for the individual, and possible criminal liability if a crime has been committed [7]. However, these rules do not sanction intended parents. The relevant measures are:

• Article 3 and article 22 of the 2001 Administrative Measures for Assisted Human Reproductive Technology (人类辅助生殖技术管理办法)

• Article 3 of the 2003 Norms of Assisted Human Reproductive Technology (人类辅助生殖技术规范)

• Article 3(5) of the 2003 Ethical Principles of Assisted Human Reproductive Technology and Human Sperm Bank (人类辅助生殖技术和人类精子库伦理原则)

It is important to note that all regulations to-date apply to medical personnel in medical institutions, and penalties or liability will be incurred by the institution or personnel. This means that hospitals and doctors can lose their licenses to operate if they are found selling gametes or offering surrogacy.

News reports note that there are black market agencies that provide egg donors or surrogates operating in China. These may face criminal prosecution for operating without a business license as an illegal business. Currently, there is not a provision to criminalize donors and intended parents who work with these agencies, but those who pursue black market solutions may still face legal or other consequences. Legal advice to understand the lawful processes and how to comply with them is strongly recommended for any intended parents considering third party reproduction in China.

Availability of Donor Eggs, Sperm, and Embryos in China

Overall, the availability of legally obtained donor eggs is low in China, while the availability of donor sperm is higher but still not commonly used. There are no donor egg banks in China, while there were reportedly 27 sperm banks as of June 2021[1]. According to an analysis of ART by the Chinese Society of Reproductive Medicine over the period of 2013-2016, 1.3% of all births from ART were the result of the use of donor sperm, while 0.14% of births were the result of the use of donor eggs[8].

Currently, China’s National Health Commission forbids any kind of commercialized egg donation and supply. Only women undergoing IVF are allowed to legally donate ‘extra’ eggs, and a donor must retain at least 15 oocytes for her own treatment cycle [9]. Under this arrangement, a woman who is undergoing IVF retains some of her eggs to fertilize with her husband’s (or donor’s) sperm to produce embryos, and donates the rest of the eggs to another couple. The donated eggs cannot be used immediately, but are frozen and retained for at least six months as an infectious-disease quarantine period before they can be transferred. This means that only frozen eggs are available for donation; no so-called ‘fresh’ donation cycles are possible [10]. The donors are compensated with free or discounted fertility treatment. However, due to social norms, most couples going through IVF treatment are reluctant to share their eggs. As a result, the availability of donor eggs is reported to be low.

Commercial sperm donation is also prohibited. Sperm banks often have health criteria for donors, such as requiring men to be non-smokers, healthy and free from infectious diseases, and sometimes a certain height or even educational criteria. Some newer sperm banks include psychological assessments and an assessment of family history (for heritable diseases) for donors. According to Ministry of Health regulations, only five women can get pregnant from one donor [11].

Embryo donation is not allowed in China.

Egg Donor Compensation in China

Egg donation is not allowed to be commercialized. Under the egg donation model described above, a couple may have their fertility treatment cost partially or wholly subsidized in return for their donation. Commercial solicitation of egg donors in China is prohibited, but many news outlets report that illegal arrangements are not uncommon.

Sperm donation is not allowed to be commercialized. However, men who produce semen that meet the parameters to be considered high quality are often compensated through prizes and competitions. In some places, donors are reportedly awarded up to 7,500 yuan (approximately USD 1,050) upon a high-quality semen analysis and for completing multiple donations [12]. In addition, all donors (regardless of the quality of their donation) receive a nominal compensation for their time, reportedly around CNY 50 (approximately USD 7) [13].

Anonymous, Open, and Known Donation in China

All sperm donation through government-approved sperm banks is anonymous in China. Egg donation is also intended as anonymous, though there is no legislation on this.

Surrogacy in China

Surrogacy is understood to be prohibited in China because of Ministry of Health administrative regulations that prohibit medical institutions and medical staff from performing surrogacy. Violations are punished by fines to the institution, administrative sanctions for the individual, and possible criminal liability if a crime has been committed. This in essence eliminates the supply of surrogacy. There is no separate law that imposes criminal sanctions on intended parents.

In practice, it has been noted that surrogacy arrangements are common in Mainland China with an underground market for commercial surrogacy estimated to encompass between 400 and 500 agencies in 2012 [14]. These agencies operate illegally and can face penalties and liability for running illegal businesses. In addition, the legal parentage of the child can be in question.

Can LGBTQIA+ Couples Use IVF in China?

No. Assisted reproductive technologies (such as IVF with own or donor gametes) are only available to heterosexual married couples as a medical treatment for infertility [15]. Same-sex marriage is not legal in China, and the country does not recognize same-sex marriage certificates issued abroad [16].

Can Single Women Use IVF in China?

No. Assisted reproductive technologies (such as IVF with own or donor gametes) are only available to heterosexual married couples as a medical treatment for infertility. Clinics across China are prohibited from providing ART services for single women. You will need to present your marriage certificate at the hospital, and have a diagnosis of infertility. The consequence for breaching the rules includes warning, confiscation, fines, and revocation of license (for the clinic). The compliance is monitored and enforced by health authorities across China [17].

How to Choose an IVF Clinic in China

The approving body for IVF clinics in China is the National Health Commission (NHC), which in March 2018 replaced the National Health and Family Planning Commission. IVF clinics must obtain a license from the National Health Commission and adhere to their regulations, as well as any standards or regulations set by the province or municipality[18].

Look for clinics that are listed through the Chinese Society of Reproductive Medicine (CSRM) and doctors that are affiliated with the group. The CSRM also maintains its own ART reporting system, with clinics reporting data annually[8].

Average Costs of IVF in China

The cost of IVF in China may vary widely depending on the location of the IVF clinic and the technologies used. This is reported to be anywhere from approximately USD 4,500 to USD 14,000 per cycle, with add-ons such as preimplantation genetic testing increasing the total [19]. Egg and sperm donation is not allowed to be commercially compensated.