Anonymity is such a passionate issue, says Dr Rothman, that when he recently brought up the idea of contacting a donor on one offspring’s behalf “three of my most trusted employees threatened to resign”. Dr Rothman’s quandary is exquisite: on the one hand there’s a donor who, for a nominal fee and the assurance he’ll remain anonymous, provides the semen that helps create a child. On the other there’s the child who says he has the right to know his genetic heritage, for reasons that range from the sentimental Does his donor like the same foods, play the same sport, enjoy the same music? – to the practical, such as whether his father’s genetics put him at increased risk of heart disease or prostate cancer.
“I’m trained as a urologist, an anthologist, a fertility specialist, but I have no training in this,” Dr Rothman sighs.
The ethical issues are ever more stark. The US Food and Drug Administration calculates that between 80,000 and 100,000 donor inseminations are performed each year (in the UK, the figure is over 25,000) leaving the annual birth rate at around 22,500. But those numbers are probably significantly underreported: neither the US Centre for Disease Control and Prevention nor the American Society for Reproductive Medicine, which both monitor success rates for a variety of reproductive procedures, includes “donor insemination” in its mandates.
“Typically, when a man becomes a sperm donor, no one is there to counsel him about the issues that may arise one day,” says Dorothy Greenfeld, director of psychological services at the Yale University Centre for Reproductive Medicine. “As a result, donors never consider that one day some of their offspring may look for them.”
And we’re not talking about just one offspring, or even 10. An individual donation of some 400 million spermatozoa, when frozen and stored for use, can yield up to four children. While the pregnancy rate from donor insemination is around 25% – similar to the incidence of pregnancy for a healthy couple in their twenties who try ‘the old-fashioned way’ – a frequent donor may well have 100 or more children.
John, 37, a pediatrician, donated twice a week for two-and-a-half years to supplement his income during his residency training at medical college in Houston. That was eight years ago. Until last year, when stories about offspring who searched for – and sometimes found – their donors started to appear on talk shows such as Oprah, he never once thought about what he estimates to be his some 150 biological children. “Watching those programmes, I said to myself, ‘God, I hope that’s not me someday,- he says.
Single, and still without kids of his own, John thinks that one day, maybe, he would welcome contact from an offspring or two. “But when I think about 100 or more kids getting in touch, the answer is no. No way.”
“Men have come to think about donorship only in terms of their testicles, as opposed to the more profound reality that they are sharing a deep part of who they are,” says Kyle Pruett, a professor of psychiatry at Yale University’s child study centre. “In countries like Australia and Sweden, donors don’t get paid, so you don’t have a lot of repeat donors like you do in the United States.” In the UK, donors are paid a maximum of £15 per donation (plus expenses).
Indeed, repeat donation is a crucial part of profitability for American sperm banks. A potential donor’s semen must now undergo rigorous and expensive tests for viability, disease and genetic defects. But once a donor clears those hurdles (at California Cryobank, for example, only about 3-5% do, says Dr Rothman), his sperm can become a highly profitable commodity. A man is typically paid $50 to $75 for his sample; that sample may yield up to four individual ampoules of sperm; and those ampules may sell for between $200 and $300 each.
To maximize profits, many US sperm banks make their “product” available internationally over the internet; today, a donor’s sperm may be as likely to help populate Europe as it is to populate Middle America.