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?
- 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.
- 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.
- 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.
Your first concern is probably safety. Relax. Sperm banks are amazingly careful with their product. Virtually all established banks rigorously test and screen anonymous donors. Applicants are subjected to a physical, complete blood count, and urinalysis, give a personal and family medical history, and get tested for genetic diseases such as cystic fibrosis, sickle-cell anemia, and Tay-Sachs and for infectious diseases such as HIV, hepatitis B, hepatitis C, chlamydia, and gonorrhea. Sperm must be quarantined for six months so that donors can be retested for HIV. Most banks require donors to have above-average sperm counts and very motile sperm. And most only accept donors under 45 or even under 35, on the grounds that older men's sperm harbors more genetic abnormalities. In other words, these guys are much healthier than the average husband. The California Cryobank accepts fewer than 5 percent of its applicants, and because it keeps adding new tests, says Eby, the bank is having a harder and harder time finding qualified donors. (What is it like to be a donor? Click
Nine of the biggest sperm banks have been accredited by the American Association of Tissue Banks, which means they obey especially strict rules about donor screening and handling of samples. AATB accreditation is a sure sign that a bank is careful. Still, it's worth remembering that many reliable banks are not accredited by AATB. Such banks often follow the same guidelines as accredited banks—requiring the same tests—but can't afford accreditation. You can see the list of all AATB accredited facilities here. (Note: Most of the AATB-accredited institutions on this list are not sperm banks, but facilities for other tissues such as skin and bone.)
Other kinds of sperm donations are not as safe as sperm banks. Donors at small doctor's offices are not likely to be so extensively tested, and there is certainly no guarantee about donors you find online.
What kind of donor do you want? Your choice is endless. Sperm banks used to tell customers almost nothing about donors—hair and eye color, and perhaps blood type and religion. But in the early '80s, the Sperm Bank of California and the Repository for Germinal Choice pioneered the idea that the buyer should know as much as possible. Sperm banks are now incredibly attuned to consumer choice. The banks have made finding a donor as information-rich as shopping for a car—a real live flesh market.
Most banks publish regular catalogs containing cursory donor information. (Click here to see one from Cryogenic Laboratories. Want a brown-haired, hazel-eyed, O-positive man of German origin interested in antiques? Try number 1,314!)
But that's just the start. Customers can also pay $10-$25 for stunningly detailed long profiles. California Cryobank's 26-pager, for example, includes SAT scores, an extensive medical history, three generations of family medical history, descriptions of the personalities of the donor's parents, aunts, uncles, and grandparents, the donor's favorite color, a brief essay on his ambitions, and much, much more. (All of this is in the donor's own handwriting, so you can read him that way, too.)
Several banks sell audio interviews and childhood photographs of donors. Some will do "photomatching," searching for a donor who looks like the husband. Fairfax Cryobank takes the information glut to the extreme. It runs donors through the Keirsey Temperament Sorter to judge their personality types. Fairfax collects data on favorite cars, songs, movies, even plays (who has a favorite play?). Fairfax provides chest, inseam, wrist, sleeve, shoe, and hat sizes (in case you need to buy him a suit?) and rates physical features down to the microscopic level: the thickness, arc, and "set" of eyebrows, and the size, width, length, bridge, nostril flare, and septum of the nose, for example. (Is this extra data reliable? The physical measurements and health results probably are, but banks don't fact-check information about family history, SAT scores, and the like.) This consumer focus is distinctly American. European sperm banks serve up little more than hair color, eye color, and blood type.
How many men can you shop for? The biggest banks offer stables of 100-200 donors, while some banks are successful with 20-40 donors. The vast majority of donors are white. No bank I have seen offers more than 10 African-American donors.
Banks also cater to customers with super-selectivity or special features. Many accept only men who are graduates of or enrolled in college. (California Cryobank's offices are in Los Angeles, Palo Alto, and Cambridge, Mass., in order to recruit from Harvard, MIT, Stanford, and UCLA.) Virginia's Fairfax Cryobank charges higher prices for its "doctorate" program, in which all donors have earned or are studying for an advanced degree. Many banks are biased against short men: The California Cryobank accepts almost no one under 5 feet 9 inches, because women don't choose shorter donors.
Perhaps the most remarkable innovation is the Sperm Bank of California's "identity-release" policy. Anonymous donors have traditionally been anonymous till death, with no way for kids to find them or for them to find their offspring. But some of the Sperm Bank of California's donors have agreed to be contacted by their "children" when they reach age 18. According to executive director Maura Riordan, 85 percent of the bank's clients now choose identity-release donors. (Single women and lesbians tend to pick them, because there is no father who would feel threatened by having his child meet another "father.") A couple of smaller California banks now offer ID release, too. The Sperm Bank of California's first group of identity-release kids turns 18 this year. If the family reunions go well, expect some large banks to adopt the idea as well.
Banks narrowcast in other ways. Most banks ship specimens only to doctors. But the Sperm Bank of California and a few other banks mail directly to customers, allowing women to inseminate themselves at home. ("It's not rocket science," says Riordan.) And Rainbow Flag Health Services, a tiny California facility, actively recruits gay men, who are barred from donation by most banks. (Its Web address: www.gayspermbank.com.)
How much will all this cost? Buying sperm is a bargain, as fertility treatments go. Sperm banks charge anywhere from $120 to $300 for a vial of sperm. (Why the variation in price? More established banks charge more. Some charge extra for sperm from more accomplished men. Most have higher fees for intrauterine samples than for intracervical ones.) Women need one or two vials per ovulation cycle and can require anywhere from one to a dozen cycles to get pregnant. Customers can also buy and store extra vials from a favored donor to ensure that sperm is available for a sibling. And most customers must pay to have the sperm shipped and to have a doctor perform the insemination. A successful sperm donation can cost anything from a few hundred dollars to several thousand—not nothing, but a fraction of the $5,000 per cycle that women can spend on more intrusive fertility treatments. (Private sperm deals arranged on the Web are cheaper, since most donors give their sperm for free as a public service.)
The sperm bank industry will soon be less chaotic. Within a year, the federal government should issue final regulations for reproductive tissue banks. Sperm banks will have to register with the feds and meet strict standards for donor screening and sample-handling. This will likely drive private physicians out of the sperm business and may cut down on Internet semen trafficking, too.
But one thing federal regulations cannot do is turn sperm shopping into regular shopping. Shopping for sperm looks like any other kind of commerce. There are products, marketing, competition. It's tempting to think that with enough knowledge, you will get exactly what you want, as you can buy exactly the car you want. But there is serendipity in DNA. Children have health problems. Donors lie or slip up, and pass on an unfortunate trait. People shop carefully for sperm in hopes of certainty. But there is no certainty in a baby. It does not come with a 10-year power-train warranty. In sperm shopping, there is a deposit, but there are no returns, no refunds, no exchanges.