Match, Mate, Trait When gametes are bought and sold, supply and demand shape not just a transaction, but a human being LISA C. IKEMOTO 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 4 GeneWatch
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 nearterm 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. June-July 2011