BEIJING • On a recent afternoon, a visitor from northern China took a smoke break outside the Beijing Perfect Family Hospital.
Cigarettes were one reason he had come to the capital: He reckons his nicotine habit played a part in damaging his fertility.
The 38-year-old construction businessman, who asked to be identified by his last name, Mr Zhang, worked hard to build a business with his wife, who is 35.
But when they were finally ready to have kids, it was a struggle. So the Zhangs became one more couple among millions of Chinese to turn to an assisted reproductive health market that has the potential to be worth about US$15 billion (S$20.7 billion).
A paradox has emerged in China: As the country finally relaxes its one-child policy, factors like lower sperm counts, later pregnancies and other health barriers are making it harder for many to get pregnant. As a result, businesses from China to Australia, and even California, are lining up to help - and profit from - the growing market of hopeful prospective parents.
Families in the world's most populous country are willing to pay top dollar for fertility therapies.
Mr Zhang said his package for IVF, or in-vitro fertilisation, was 100,000 yuan (S$20,300) for each round. "It's difficult for me and my wife to conceive naturally and we needed help," he said.
A paradox has emerged in China: As the country finally relaxes its one-child policy, factors like lower sperm counts, later pregnancies and other health barriers are making it harder for many to get pregnant.
For decades, couples in urban China were allowed to have only one child, but the country, which is trying to boost its shrinking workforce, moved to end that policy in 2015. China's market for IVF was worth US$670 million last year and is expected to surge to US$1.5 billion in 2022, according to BIS Research.
Assuming that 65 per cent of infertile couples choose to seek treatment, the total assisted reproductive health market could some day be worth about 107 billion yuan using an average cost of as much as 40,000 yuan, brokerage firm Hua Chuang Securities estimates.
Sperm counts (measured by the number of sperm per millilitre) dropped very significantly from 100 million in the early 1970s to as low as 20 million in 2012 in China, according to Dr Yanzhong Huang, senior fellow for global health at the Council on Foreign Relations. Higher stress levels accompanying economic development, pollution, late marriage and childbirth, smoking and alcohol use could be contributing factors, he said.
A study in central China showed only 18 per cent of those tested had healthy enough semen to be sperm donors in 2015. That number had been much higher, at 56 per cent, in 2001, according to the study published this year in the medical journal Fertility & Sterility.
Many Chinese women, meanwhile, are choosing to have children later as they pursue their careers.
Yet the desire to have biological children looms large, and that is driving demand for services like IVF.
Virtus Health, an Australian company that offers fertility treatments, receives regular approaches from Chinese firms looking for partnerships, but getting a local licence is difficult. So Virtus works with medical tourism agencies in China that help patients get to its Australian and Singapore clinics.
Thousands of miles away, Dr Mark Surrey, co-founder and medical director of the Southern California Reproductive Centre in Beverly Hills, said about 20 per cent of its patients came from China over the past year.
As of last year, China had 451 sperm banks and medical institutions licensed to provide reproductive care, the National Health and Family Planning Commission estimates. But that is outpaced by demand in a country of 1.4 billion people.