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Whose Sperm Counts?

Whose Sperm Counts?

Recently, a Canadian fertility clinic made the news because it refused to allow a white client to be impregnated with sperm from a donor of color. The clinic director told the media, “I’m not sure that we should be creating rainbow families just because some single woman decides that that’s what she wants.”

When I first read this, I felt offended. Personally. My husband and I are different races, and our kids are bi-racial. I guess I had never proclaimed us a “rainbow family,” but ok. The clinic’s decision to avoid creating bi-racial children seemed like a judgment on my family. Like, my family’s not terrible or anything, but as a society we wouldn’t want to go making extra families like mine if we can stick to normal, uni-racial families. Am I a bad mother because I ignored race when I chose my spouse? Would it have been more responsible of me to have my kids with a white father?

The media and Canadian officials agreed with my gut feeling. Journalists have written highly critical stories. Through a spokesperson, Health Minister Rona Ambrose declared, “Our government believes that discrimination in any form is unacceptable.” Through my twitter feed came declarations of “old time racism” in Calgary.

So, case closed? If we chastise the backward clinic director and remove the race stipulation, everyone is happy, no one is second-class, and the infertility client can have a “rainbow family” just like mine?

Not so fast. Because, when you think about it, discrimination is inherent in the infertility clinic process. The client tried to choose a donor of a different race because he had “more ideal qualities” than the Caucasian donors on offer. These days, sperm banks generally offer a wealth of details about donors, including appearance, ethnic background, health history, education, hobbies, and religion. Sperm bank clients interviewed by medical anthropologist Linda Layne talked about how uncomfortable it could be to “shop” for sperm, like it was just another high-priced consumer good. Was it really ok to be tempted to choose the “best” donor by income, education, or looks, just because you could, and you had to make a choice of some sort anyway? Would it really be about “matching,” or maximizing?

51q5+5L2JiL._SY344_BO1,204,203,200_As historian and law scholar Kara Swanson explains in Banking on the Body: The Market in Blood, Milk, and Sperm in Modern America, these concerns about matching and maximizing have been a part of medically-supervised artificial insemination from the get-go. While the first inseminations-by-donor documented in the medical literature were performed in the nineteenth century, it was in the early decades of the twentieth century that physicians really began to discuss and debate the propriety of using donor sperm. The biggest concern at the time was that socially and legally, insemination-by-donor was commonly likened to adultery, and the resulting child was vulnerable to being stigmatized as illegitimate. Doctors who performed it therefore put a premium on producing children who would resemble the patient’s husband. They also took pains to choose healthy donors in order to protect the patient from infectious disease. Donors were often medical staff, particularly medical students, and physicians assumed that these donors had intellectual and moral qualities that would produce especially high-quality children. Some advocates of insemination-by-donor went so far as to propose that population quality would be improved if Nobel laureates and other outstanding men were solicited as donors. This explicitly eugenic approach fell out of favor after the Nazis used eugenic theories to inspire and justify the Holocaust. Still, physicians who performed inseminations continued to believe that it was their responsibility to recruit “quality” men as donors.

By the late 1980s, the choice of donor began to shift to patients rather than doctors. Previously, individual doctors chose the best option, according to their evaluation, from the handful of possibilities they had available. As in vitro fertilization entered the scene, and reproductive medicine became big business, patients, rather than doctors, became the “customers” for donated semen. By that time, freezing sperm was well-established as an effective and safer way to handle donations, and sperm banks could have a much larger stable of donors. Today, sperm banks have tens, even hundreds, of choices on hand. Patients generally deal directly with sperm banks, though as the Canadian woman found, they do need cooperation from a fertility doctor as well. Many sperm banks are happy to sell semen to lesbian couples and single women, so many more people can create the families they desire. And they are likely to look through an extensive catalog of donor profiles as the first step.

Photograph by Siri Stafford. Getty Images.
Photograph by Siri Stafford. Getty Images.

Still, even if you went shopping for the sperm and eggs to make a family like mine, you wouldn’t find them. I would never pass the health screening. I was approached once by a fertility clinic that must have liked my on-line resume, and wrote me a fawning letter about how much a particular couple desired my eggs. I wrote back that I was flattered, and that yes, my eggs had produced some pretty fantastic children. But since I have multiple sclerosis[1] (a condition that is somewhat heritable, yet rare enough to still be very rare in children of those with the condition), I assumed that my eggs were not good enough for this couple. I guess I was right — I never heard back. Sperm banks and fertility clinics screen out donations from people like me. We have conditions that seem scary, even though no one knowledgeable about MS would suggest that it was irresponsible for those with MS to have children. Facing this request from the fertility clinic, I felt strangely bad. The clients at that fertility clinic must have found someone more perfect than I. Harvard Ph.D.? Check. No obscure scary diseases? Check.

In the end, I still think a clinic director deserves criticism for telling clients that they can’t form mixed-race families. But this kerfuffle should not obscure the fact that the process of sperm donation as it is structured today inherently puts more value on some sperm than others. It implicitly ranks some kinds of parents, children and families above others. Putting all the decision-making in the hands of the clients, and making it a consumerist “free choice,” does not fix the problem. It simply shifts the moral burden.

[1] Don’t worry, I am fine! (Knock wood, of course.) I need extra sleep, and I take an unpleasant injection medication; that’s about it. I have been lucky. I seek no pity, I’m just sharing this medical history because it makes my point.

Lara Freidenfelds is a historian of health, reproduction, and parenting in America. She is the author of The Myth of the Perfect Pregnancy: a History of Miscarriage in America and The Modern Period: Menstruation in Twentieth-Century America. Sign up for her newsletter and find links to her op-eds and blog essays at www.larafreidenfelds.com.