Having a baby can be really, really hard. Not just the having of the baby, or the keeping of the baby, both of which are daunting enough.
We're talking about the process of becoming pregnant.
Many women experience fertility problems severe enough to require medical assistance; a solid 1% of babies in the United States are born using assistive reproductive technology, which includes elaborate procedures such as IVF.
These procedures are anything but cheap. In the past, we've discussed the costs of freezing your eggs (which can run up to about $20,000) and the price of IVF, which is about $12,000 per cycle if you use your own genetic material.
Those processes are admittedly complicated, but one step that might not seem so complicated is using donor sperm from a bank. Seems like a simple transaction, right?
Maybe not. Although obtaining donor sperm is about $500, the costs can run much deeper.
It's these hidden costs that intrigue us the most.
How Many Is Too Many?
The New York Times brings to light doctors' and parents' concern that sperm donations aren't appropriately regulated. According to the article, some donors were advised by sperm banks that no one knows for sure how many children can come from a single sperm donation, but that they should expect five--and, in rare cases, ten--children per donation.
In actuality, The New York Times says, some donors have fathered as many as 150 children.
The problem with that is that the wide distribution of the same genetic material might transmit genetic diseases at an artificially high rate. The article also pointed to the worry of accidental incest between half siblings birthed from the same sperm donor without their knowledge.
How These Issues Fall Through the Cracks of the System
Mothers of donor children are encouraged to report births, but it's not required, and at most only 40% of them do so. (Which is why, although an estimated 30,000-60,000 children are born per year from donor sperm, we can't get any more accurate than that.)
When it comes to distribution regulations, things in the United States get complicated. "In the American health care system, you're working under rules of patient privacy and autonomy," says John Rinehart, M.D., Ph.D., J.D., and Founding Partner and President of the Reproductive Medicine Institute. "If you're requiring mothers to report births of donor children, you run into an issue of whose privacy takes precedence: the patient or the donor?" The competing interests only make the possibility of disclosure laws more complicated.
The American Society for Reproductive Medicine has issued a recommendation that sperm donations be limited to 25 per 800,000 people in a population, but that is not a law, and it is not strictly enforced. In some cases, it's not even followed.
The hidden costs of these practices are large scale, and who gets hit with them can be a product of chance.
One mother profiled by a Utah news outlet gave birth to a donor child with Asperger's and a heart defect, both of which she claims were inherited from his unknowing father. When she searched out the father, she found that at least 36 children were conceived from his donations before he learned of his conditions, and that many had similar health problems. Even after becoming aware of his flawed genetic material, he neglected to inform any of the banks selling his sperm, which could have informed prospective mothers of the risk.
What Dr. Rinehart says: There are two ways to approach the medical risks. Legally, he told us, there is always risk. But medically speaking, artificial insemination is as safe as they can make it. "As we gather more genetic information, what does risk mean? If the sample has been collected and stored correctly, it's about as safe as it can get."
Because of its very nature, sperm donation is more commonly used in non-traditional family situations, such as for same-sex couples, single mothers or heterosexual couples who can't conceive naturally. And non-traditional can often mean more complicated.
What Dr. Rinehart says: "We say in this industry that people make people, but the legal system makes families." He explains that there are no parental rights associated with sperm donations, and that parenthood laws are established by individual states. But if your family or custody situation is particularly complicated, you'll have to bring your case to court. Physicians should be familiar with the laws concerning their states, (so if you're considering using sperm donation, ask your doctor first!) but these guidelines are also available by searching your state government's website or the American Society of Reproductive Medicine.
According to a 2010 study of 1,610 children who joined their families via donor, adoption or biological birth, donor children are more likely to have trouble with the law, substance abuse problems and depression.
Out of the sample, 21% of the donor children reported trouble with the law before age 25, as compared to 18% of adopted children and 11% of the biological children. (The exact nature of the trouble isn't disclosed.) A similar breakdown emerged when asked about substance abuse problems: 21% of donor, 17% of adopted and 11% of biological children admitted to them. Note that the researchers tried to avoid skewing the study to be about upbringing rather than circumstances of conception, because more children of sperm donors are born into less traditional families. So, they studied a representative population of the United States: 262 of the donor offspring had heterosexual, married parents; 113 had single mothers; 39 had lesbian parents.
What Dr. Rinehart says: Specialized doctors, especially the reproductive endocrinologists who specialize in fertility, don't usually have contact with a donor child beyond its conception. For that reason, it's hard to determine if donor children actually have more emotional problems than children from similarly non-traditional family situations.
What to Do if You're Considering Using a Sperm Donor
If using a sperm donor is an option you're considering, your first and most trustworthy source of information is your doctor. Make sure to get the answers to the following questions:
- Where is the safest place to get genetic material, based on your experience?
- What are the parenting laws in my state?
- What resources do you recommend for emotional support as my child grows up?
We bring you this article today because the issues around donor families, like those with many non-traditional families, deserve attention and increased awareness. Even though we're all about money, "cost" means much more than dollars and cents.
Artificial insemination is a viable, often-used option for those looking at alternate methods of conception. We aim to bring to these issues to light not to harp on the difficulties of the process, but to bring awareness to the factors that need to be considered so you and those you love can have the best chance at a safe and healthy family.