The collection and transfer of human gametes for others' use is an important sector of the fertility industry. Debora Spar, author of The Baby Business, calculated that the United States gamete market produced over $112 million in revenue in 2004.1 Commercial sperm banks were foundational to the formation of the fertility industry.2 Sperm banks offer catalogued inventories of pre-collected, cryopreserved sperm. Eggs are mostly sold fresh and through a variety of retail venues. The major players are the egg donation centers, which offer catalogues of women who stand by, ready to provide fresh eggs on demand. Some businesses offer more individualized search and brokerage services. Some who seek eggs for their own use advertise directly to women who might be willing to provide the raw material of human conception. Recently, improved cryopreservation and thawing techniques have made the use of frozen eggs a bit more reliable. As a result, egg banks have formed to offer cryopreserved eggs for others' use.
The gamete market could not exist without "donors" and "recipients." "Donors" refers to those who provide ova and sperm for others' use. In fact, most "egg donors" and "sperm donors" receive payment. "Recipients" are those who acquire gametes for use with assisted reproductive technology (ART) such as assisted insemination and in vitro fertilization. Most "recipients" pay for the gametes they use.
Sperm banks and egg donation centers deploy overtly commercial means for both procurement and distribution. They advertise heavily for "donors" and to recipients, in print media, on billboards, and especially on the Internet. Sperm bank and egg donation center websites are designed to provide a window shopping-like experience to potential recipients. The websites proffer a package which includes medical and legal safety, confidentiality, and most of all, information about the "donors." While recipients make choices that are deeply personal, recipients choose from a set of offerings carefully tailored to construct and maintain the market for human gametes. Undoubtedly, both supply and demand-side interests shape the offerings, the preselected "donors" and the information about them.
Sperm banks and egg donation centers use screening criteria to develop their human inventory of "donors." Some companies tout their selectivity. Fairfax Cryobank "offers a large selection of high quality donors; only 1 in 200 applicants make it through our rigorous screening process to become donors."3 The California Cryobank describes a multi-step screening process, depicted in a "donor screening pyramid."4 Screening criteria express a mix of social and medical concerns. Many criteria, whether framed as medical or social, define "normal," "healthy," and "desirable" in extremely narrow terms. While infectious disease testing addresses near-term health risk to recipients, screening based on genetic testing and family medical history simultaneously selects out applicants at risk of transmitting genetic disease and establishes a narrow definition of "healthy and able."
What is a trait? Donor screening criteria and information offered about donors describe a wide range of descriptors as "traits." Thus, traits include height, ethnicity, education, and personality. Egg Donation, Inc. includes "donor" statements on personality and character, philosophy on life, favorite food, favorite color, favorite season, holiday and sport under the heading of "Traits & Characteristics."5 Traits, then, do not necessarily refer to heritable traits. But the use of "traits" in donor profiles leave room for interpretation. Donor profiles often mix descriptors that refer to heritable traits and those that do not. They allow potential recipients to imagine, as other potential parents imagine that a future child will share their love of sports or art, and just as many freely attribute character and personality quirks to genetic parentage. The phantom genes in these imaginings tap into widespread beliefs about the power of DNA and leave those beliefs intact.
Many who use third party gametes choose donors who resemble their mates. Thus websites that include search functions use hair color, eye color, and ethnic origin as their starting points. The genetic content of these choices serves social functions that most deem acceptable. For some couples, choices based on resemblance may mask the use of third party gametes. They may also "simplify everyday interactions and perhaps enhance feelings of affinity between the matched parent and child."6 At the same time, the offer of hair color, eye color, and ethnic origin as a set of independent menu choices echoes the Dell Computer sales model that allowed purchasers to customize their otherwise generic desktop PCs.
Perhaps not surprisingly, gamete marking is gendered. For example, both sperm banks and egg donation centers offer "donor" photographs. Sperm banks typically offer baby pictures of "donors," presumably to suggest what the recipient's resulting baby might look like. Egg centers, on the other hand, are much more likely to offer photos of the women willing to provide eggs. The Egg Donor Program, which calls the women "Donor Angels," uses professionally-photographed glamour shots. Some sites allow the women to choose and upload their own photos. Tips offered to the women advise avoiding, "racy, scantily clad images," "photos with alcoholic drinks," and "too many serious, non-smiling shots."7 Most sperm banks in the U.S. offer anonymity to "donors." The use of baby photos helps maintain that anonymity. Egg centers offer known and anonymous donation. Thus, for many, use of contemporary photos does not jeopardize anonymity. In addition, most egg "donors" are on physical and financial standby, until selected. Sperm banks offer genetic material that has already been separated from the man. Egg centers offer the woman as a means of obtaining the eggs. The photos-the glamour shots, the smiling, happy face and full-body pictures-allow potential recipients to visually inspect the woman with whom they must form either a paper-only or face-to-face relationship. The photos, then, may allow assessment of genetic as well as cooperative potential.
The swirling of genetic, social, and personality traits in donor profiles begs comparison to other matching services. The websites for both Cryos International and Cryos/New York use "staff impressions" that read like dating ads. "Ace is a very likeable guy who you can tell has a very positive outlook on life, living it to the fullest. When talking to Ace it is clear that he is a smart guy with a good heart and someone who has had great life experiences."8 This brief appears on the same page as information about race, ethnicity, eye color, height, weight, education/occupation, blood type, reported pregnancy, psychological profile, and CMV status. The page includes a link to an extended profile in question and answer format. The extended profile categorizes the Q&A's into physical description, academics, personality, and family information. The dating service comparison may not be inapt. Research has shown that women choosing sperm donors may rely on "the psychology used to choose a long-term mate when they assess attributes in a sperm donor."9 Another profile, "Alexandro P," includes family history, an account of his performance in equestrian competition, photographs, a personality assessment, and reported pregnancies achieved by use of his semen.10 Alexandro P is a riding stallion whose semen Yancey Farms offers for sale through its website. Both Ace's and Alexandro P's wares may be purchased by clicking a box and providing payment and delivery information.
For most, human sperm banks and egg centers offer a chance to form a family. At the same time, comparisons to Dell computers, dating services, and equine semen sales surface questions about the effects of offering pre-selected traits in a competitive, for-profit market. Why else would California Cryobank offer a search function that allows potential recipients "to produce a list of donors who resemble the listed celebrities"?11 It may be all in fun. But it also gleefully invites the expansion of consumerism in ART use. While ART use is about making babies, it is also about making money from genetic selection. So the question we face is: How should we counter narrow standards for "desirable," "healthy," and "able," set by commerce and guarded by emotion-laden narratives of family formation?
Lisa C. Ikemoto, JD, is a Professor at UC Davis School of Law.
1. Debora L. Spar, The Baby Business: How Money, Science, and Politics Drive the Commerce of Conception 3 (2006).
2. Id. at 35.
5. See, e.g., https://www.eggdonor.com/donor-profile/?pid=40095
6. Joanna E. Scheib, Maura Riordan & Phillip R. Shaver, Choosing Between Anonymous and Identity-Release Sperm Donors: Recipient and Donor Characteristics, 10 Reproductive Technologies (now Reproductive Biomedicine Online) 50-58 (2000).
8. http://ny.cryosinternational.com/private-customers/donor-search.aspx (spelling errors in original).
9. Joanna E. Scheib, Sperm Donor Selection and the Psychology of Female Mate Choice," 15 Ethology and Sociobiology 113-129 (1994).