How to find the right sperm donor.

Making a baby can be the most horrendous shopping experience you'll ever have. In the bedroom, procreation is great fun. In the marketplace, it's awful.

For infertile couples, single women, and gays, the process of producing a child—anything from in vitro fertilization to donor insemination to surrogacy to adoption—is not simply psychologically agonizing. It is also commercially befuddling. As shoppers, we're accustomed to excellent information, government regulation, and consumer protection laws. But desperate baby-seekers are at the mercy of ignorance, conflicting medical advice, price gouging, recalcitrant insurance carriers, a complete absence of regulation, and ticking biological clocks.

The sperm business, one daunting subset of the baby industry, certainly has a history that inspires mistrust. A half-century ago, in the early years of artificial insemination, patients were denied any choice at all: They were impregnated with semen from whatever med student their doctor grabbed that day. In the '80s, several women were infected with HIV by semen from anonymous donors. The Repository for Germinal Choice, the "Nobel Prize Sperm Bank," also damaged sperm-banking's reputation in the '80s, suggesting the field was filled with loopy eugenicists. (A Slate series recently investigated what happened to the Nobel Prize bank's offspring. Click here for the introduction.) And it was only a decade ago that Virginia doctor Cecil Jacobson went to prison after fathering as many as 75 kids using his own sperm, while telling his patients he was supplying sperm from anonymous donors. Even today, no federal regulations and only a handful of state rules govern sperm banks: In many states, says University of Southern California professor Alexander Capron, "You could open Sam's Sperm Bank and Delicatessen."

Still, the sperm industry is prospering. In 1987, the last (and only) time the government tried to figure out the size of this cowboy industry, the feds guessed that 30,000 kids per year were born from anonymous sperm donations. The "lesbian baby boom" and the rise in single women having children have likely increased that number.

And yet, despite its anarchy and messy history, sperm banking has become the most organized, cheapest, and consumer-friendly niche of the fertility industry—once you know how to shop.

The first question you should ask yourself is: Do I need donated semen?

If male infertility is the problem, the answer may well be no. Doctors can now extract a minuscule number of sperm from the testicles and, using a new technique called ICSI, fertilize an egg by injecting a single sperm into it. Since very few men produce no sperm at all, this has made it possible for virtually everyone to father children. (Because ICSI is expensive and intrusive, and because the father can still pass genetic disease to his children, some straight couples still opt for donor semen.)

Lesbian couples and single women are increasingly driving the sperm business. Because exotica like ICSI isn't an option for them, sperm donation is the fertility method of choice. At the Sperm Bank of California—a bank with strong feminist roots—three-quarters of the clients now are lesbians. Even at California Cryobank, probably the most successful bank, 40 percent of customers are lesbians or single women. 

You decide that donor semen is the right fertility option. What are your basic choices?

1. A sperm bank that uses semen from anonymous donors, frozen at 200 degrees below zero in liquid nitrogen. Such banks are what most people think of when they discuss sperm donation. The banks store semen from donors who have been screened for genetic and infectious diseases. The United States has at least 120 sperm banks, located in almost 40 states. You can find a good directory here. Geography is not a barrier, because most leading sperm banks mail their specimens anywhere. Almost all banks require approval from your doctor—an OB-GYN or GP will do—before they will sell you sperm, and some will ship the samples only to the doctor.
   
   
   
   
2. A doctor's office that collects sperm from a few donors. Some physicians, especially those in more remote places, offer this kind of service to patients. They may use fresh rather than frozen semen. Bear in mind that any donation of "fresh" rather than frozen sperm is suspect because HIV can't be ruled out. Since major sperm banks ship nationwide, there is generally no compelling reason to use a local doctor's deposits.
   
   
   
   
3. An ad hoc private arrangement. At least one Internet bulletin board posts advertisements from women seeking donors and donors offering semen. Several men—such as this one—have Web pages volunteering themselves as donors.
   
   
   
   
4. A "known donor." Many lesbians and single women recruit male friends to provide semen. Some sperm banks will assist such arrangements, running the men through the same battery of medical tests that they use on anonymous donors. "Known donors" present legal obstacles. State laws clearly establish that anonymous donors surrender their parental rights, but known donors don't. A mother needs to draft a careful contract for the known donor to give up paternity rights. According to Marla Eby, vice president for marketing at California Cryobank, many women hope to use a known donor but reconsider when they realize how complicated it is.