Ma, Ma, Where's My Pa?

Should anonymous sperm or egg donation be a crime?

There are two crucial elements to any news story about infertility treatment in the United States. First, any IVF story must contain a breathless reference to the shockingly unregulated state of the American fertility clinic. Second, the fertility industry must always, always be under attack.

A Janunary 20 New York Times story obligingly defers to tradition. The angle this time around: Children of anonymous donors are demanding to know who their genetic parents are, which just might lead to a law stripping egg and sperm donors of the right to be forever anonymous. That, say fertility gurus, would surely stanch the flow of sperm, decimate the egg supply, and crush the industry. What they and the Times fail to mention is this: The industry already has a solution to the anonymity problem, and it hasn't come in the form of a federal mandate.

There is no doubt that the U.S.is unique in its laissez-faire approach to the egg trade. The vast majority of countries will not allow donors to be well compensated, and among countries that do, most have outlawed anonymous donation. The result? A worldwide shortage of willing donors. Foreigners hunting for eggs are now coming stateside to find them.

To anyone with an affinity for government regulation, the fertility industry is a monstrous organism evolving in the shadows of legislative neglect. Donor agencies largely set their own rules for the sale of genetic material: Some cater to same-sex couples, others strictly to heterosexual married ones. Many cap egg donor compensation at a paltry $3,000; others let donors set the prices, encouraging Olympic athletes and Ivy-leaguers to ask for many times that amount. Some agencies demand anonymity, others will fly donors across the country to meet hopeful parents. At its most individualized, egg donation is contractual agreement between donor and recipient, with the agency acting as broker.

This most intimate of physical connections—the transfer of a human egg from one woman's uterus to another's womb—is thus hammered out in that most impersonal of documents—a lawyerly contract. Can the extra eggs be donated to another couple or used for research purposes? If so, must the donor be notified? If the donor forgets to take her fertility meds and ruins the cycle, does she owe the intended parents the thousands of dollars they wasted on her injections? Under a flexible contractual arrangement, each of these questions is up for negotiation. The donor's compensation relates to her flexibility and willingness to accept financial risk.

Here is the industry solution to identity issues: Transparency comes at a price. Men and women who aren't worried about a knock on their door 18 years down the road can ask a premium for their openness; private types can choose anonymity. Clinics already keep donor medical histories and contact information on file for medical emergencies. Anti-anonymity advocates say the shroud of secrecy surrounding most donations allows agencies to escape oversight and accountability: How do parents really know, after all, that its Donor Number 15's eggs they're writing a check for? With a pay-for-transparency option, parents can verify that their new eggs match the high school yearbook–like catalogue blurb they've selected.

Most donations today are anonymous, and that won't change absent a legal mandate; the anti-anonymity crowd is actually a very tiny minority of an IVF-mad public. Although secrecy is often painted as a boon to the donor, it's often more important to the future parents. Imagine: You're a 40-something married woman who has repeatedly tried and failed to conceive. You peruse donor catalogues for a young woman whose features, interests, and intellectual ability roughly match your own, trying to preserve the illusion, in every way possible, that this is your baby. You find a match—Donor Number 7, say—you've got your eggs. Now, do you want to meet the hyper-fertile, attractive 21-year-old undergrad who is the genetic mother of your child-to-be? Do you want your husband to?

Donor agency representatives won't talk frankly about these issues because their awkward business comes shrouded in euphemism. They're not out to buy and sell life; they facilitate egg "donation." That $40,000 you're getting isn't for your Princeton-educated eggs, it's for your "time" (apparently worth far more than the time of donors without your pedigree). They're not peddling genetic material; they're helping create happy families. Talk of contracts and transactions hardens the soft patois of baby-making.

Even if the clinics work up the nerve to reveal their preferred solution, it's not one that will satisfy the grown children of anonymous donor agreements, who, according to the Times, suffer from something called "genetic bewilderment." But in this one aspect, perhaps, growing up the child of newfangled fertility advances isn't so different from growing up the old fashioned way. You don't get to choose the circumstances under which you're conceived. And if we want to declare a legal right to know one's genetic parentage, we'd better get cracking on a massive system of sexual surveillance—because children of sperm donors aren't the only people who don't know who fathered them.

None of this is to say that a booming infertility industry lacks complicated and troubling implications. Fertility clinics double as abortion clinics; their short history is pocked with scandal; they try to limit donor compensation in often unscrupulous ways. Infertility treatment is ripe with truly difficult issues. Anonymity just isn't one of them.