It’s been so long since I’ve covered current events, but some days there are just stories that scream out for comment. Today’s is from the New York Times and is about sperm banks. Simply put, it’s a parade of horror stories in which sperm is lost, misused or passed over as something it is not.
On one level the problems here are obvious when you give even a little thought to how sperm banks generally operate. Men come in and give sperm. Some are paid to do so. (There’s a lot more complexity than this–you could discuss payment structures, etc. But I only need to do this in broad brush for now.) These men providing sperm that will be used by people they do not know (and sometimes will never know.) Other men are preserving their own sperm for subsequent use.
There are at least two different sorts of problems here. First, all the sample look alike–you cannot recognize your own–and so it’s easy to see how mix-ups could happen. It’s also easy to see that mix-ups are potentially disastrous. Sloppiness, carelessness, perhaps even greed, where a sperm bank short of samples appropriates samples it should not, lead to some of the difficulties discussed in the article.
And then there are the lying sperm providers. (I’ve said in the past–discussed at length–that I don’t like the terminology “donor.” Men providing sperm might lie, mislead or simply be uninformed for a number of reasons. If you’re set to provide sperm for money, for whatever reason–and it turns out you have some family history that could be problematic, why not just omit that little detail? And does the sperm bank really have that much interest in being diligent about following up? Clearly the answer here is “some do and some do not.”
All of this is to say that I am hardly surprised that the industry (and I do think it is an industry) has its share of abuses and abusers. The cases discussed in the article are, if true, indefensible. And not that surprising in a very lightly regulated industry.
And yet I support the use of third-party sperm. (Again, long story on terminology.) How can this be? I think it can be done well and safely and I think many many places do it well and safely. No doubt it my mind, in fact. There’s nothing inherent in the business that disturbs me–it’s the particular practices of unscrupulous individuals. And you get those everywhere–there are unscrupulous lawyers, unscrupulous doctors and so on.
What I am surprised about is that the American Society of Reproductive Medicine (ASRM) doesn’t see that better regulation is needed. And yet surely it is. The industry overall suffers from the presence of the the few unscrupulous practitioners, not to mention the individuals who are victimized. An actual regulatory regime—with enforcement–could make a world of difference. Yes, it would probably make it more expensive (and that hs it’s own complications), but safety is often worth paying for.
What would the regulations look like? How would they be enforced? I’m not there yet. But I don’t know what to do when faced with stories like the ones in the paper except to take some sort of action to minimize the likelihood of future repetition.
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To play the other side here….
There is no regulation on who you choose to have sex with, so why regulate clinics. I could choose someone and be sexually monogamous being open to any and all children or I could choose to just randomly hook up with strangers. When it is the conjugal act that opens itself to procreation, the government can’t tell me who I should or shouldn’t have sex with. I mean even if I was married, I could have an affair. There may be consequences in a divorce proceeding and social shame for passing off another man’s child as my husband’s, but no criminal charges.
According to the article two thirds are not heterosexual couples suffering from infertility, they just don’t the child’s father to be part of the children’s life. I can’t write off my children’s father existence as a matter of law, but customers of sperm banks demand us to exempt them from ever appearing on Paternity Court.
Anonymous sperm is akin to hooking up with a guy you just met, but because they made money….. they have expectations.
I see your point and there’s certainly some truth to it. The guy you’ve just met in the bar is a cipher. You could say that the sperm provider is the same. Part of the problem–for me–is that sperm banks DON’T say this. They make all sorts of representations about who the men are, what screening has been done, what sperm you’re being given. People rely on those representations. And I think when you make them, you undertake an obligation to honor them. I cannot imagine a sperm bank that said “just random chance here” would do very well in the marketplace.
And of course plenty (I’d guess most) sperm banks take those obligations quite seriously and do all that they can to honor them. Part of the problem is the unscrupulous practitioner, and while we can wait and weed them out via tort litigation, I’d much rather have a more active process. A clinic that cannot keep decent records should be closed. Ditto a clinic that has no means of tracking samples, or that is so sloppy that it amounts to the same thing.
the sperm banks could probably be doing a better job of covering their behinds by making some sort of disclaimer on a tiny printed document somewhere “this is based on the report of the sperm donor alone and we make no guarantees for its accuracy”. but of course this wouldnt make things safer for the public.
Would it help if it were in really big print? That would, in my view, help a bit. At least then people might appreciate the risk presented. As it is, I think most don’t think about it.
I wonder if there is some way you commercial sperm banks could do more than just rely on reporting. They could, of course, require some forms of documentation. This would reduce the number of donors and would increase the cost of sperm in all likelihood. Would it be worth it? Might well be. That could be a good conversation to have.
The problem with driving up the cost is when it pushes people into the completely unregulated Craig’s list sort of market. And that can have severe legal consequences, too.
“What would the regulations look like? How would they be enforced?” And how is it going to be funded? By taxpayers, through Obamacare (Affordable Care Act). That’s not going to go over very well with the public.
Absolutely critical questions, and I can only barely glimpse the answers. I just don’t know enough. But I wonder, for example–is there regulation of blood banks? Does someone go round to check that there is a system in place to ensure that the blood labelled “O Positive” is, in fact, O Positive? One could start by looking at that.
I don’t mean to duck your question, but there’s too much I really don’t know. Perhaps I should break off a piece of it: What would the regulations look like? I’ll think about that one.
As for cost, it seems to me costs should be borne by those who use the system–which means gametes would end up being more expensive. I see that this may trouble some, but I think that’s something I would have to live with.
“As for cost, it seems to me costs should be borne by those who use the system–which means gametes would end up being more expensive.”
Yes, that makes sense. The cost for oversight should be allocated to the industry and participants, BUT many of these costs are picked up by the Affordable Care Act which is funded by the public so that may be an issue. Thank you for taking the time to think this through Julie!
I wonder if that is a question about insurance, really? If insurance covers a procedure, then costs–which were originally imposed on the user–are spread over a much wider range of people. So for instance, I was in the hospital one night earlier this year the costs (according to bills) were substantial, but insurance covered it, so I didn’t personally owe the money. On the flip side, my insurance pays for many things I don’t use myself. I think there might be a difference between the questions of who bears the cost and then how the costs are paid (the latter being via insurance)? So maybe there is a separate question to think about–whether insurance should cover ART? But I’m not sure about this at all.
The Affordable Care Act is a tax – publicly funded. There is already controversy over abortion, but perhaps this will fall under the radar. This is for another topic.