More and more Chinese women are having twins and triplets, according to the China Daily newspaper, which reported the number of cases jumped from a prior annual average of 20 sets to 90 sets in 2005 at one hospital in Nanjing.

It is believed that Chinese couples are using fertility drugs - sometimes bought without a prescription or on the black market - in a deliberate attempt to have more children.

The country, which reported a population of 1.2 billion in 1997, has an average birth rate of two children for every woman, according to the World Health Organization.

China's one-child policy, in place since 1970, is intended to keep the birth rate at a single child per couple.

But the policy has been widely criticized for contributing to increased numbers of abortions, sterilization and female infanticide. For the last three decades, the country has had an unequal male-to-female ratio among newborns because male heirs are preferred. Hence, countless female babies are aborted, killed, sold or abandoned each year.

Infertility Treatment In The West

In the Western world, one of seven married couples experiences infertility, according to statistics from a 1997 issue of the British medical journal The Lancet.

In the U.S., out of the approximately 62 million women of reproductive age in 2002, about 1.2 million (2 percent) had an infertility-related medical appointment within the previous year. In addition, 10 percent had had an infertility-related medical visit at some point in the past, according to the Centers for Disease Control and Prevention (CDC) in Atlanta.

Seven percent of married couples in which the woman was of reproductive age reported that they had not used contraception for the past 12 months and that the wife had not become pregnant.

Fertility treatment had become a booming industry in the U.S. Interestingly, multiple births are now the biggest challenge facing infertility specialists here. In the year 2000, of the 35,000 infants that were born after assisted reproductive technology procedures, 44 percent were twins and 9 percent were triplets or higher-order multiple gestations, according to the journal Pediatrics.

Before starting any fertility treatment, a couple should determine the cause of the infertility, said urologist Peter N. Kolettis, M.D., of the University of Alabama at Birmingham.

In about 40 percent of the cases, it's the male partner who causes the infertility, Kolettis added, and sometimes it's a medication that is affecting sperm production. He advises that males get tested before females, as the procedure is less expensive and less invasive.

A male infertility test is expected to receive U.S. Food and Drug Administration approval for over-the-counter sales soon, but Kolettis cautioned against using a store-bought test to determine fertility.

The in-home test might only give the user a sense of fertility potential because it only determines whether the sperm concentration surpasses a certain threshold, he said. There are other factors that need to be checked out by a doctor.

Whatever the cause turns out to be, fertility drugs and treatments can offer a welcome alternative when couples can't conceive on their own.