Sex Cells: The Medical Market for Eggs and Sperm (10 page)

In this first stage in the process of gamete donation, there are structural similarities in that both egg agencies and sperm banks expend funds on recruitment and employ a range of medical and social standards to garner “sellable” donors. But comparing how staff evaluates donors and their genetic material reveals how gendered stereotypes shape the definition of “high-quality” eggs and sperm. Both women and men are screened for infectious and genetic diseases, which suggests parallel concerns raised by the exchange of bodily tissue. However, “girls who just want to lay their eggs for some quick cash” are rejected, while men are expected to be interested in making money.

These gendered expectations correspond to traditional norms of women as selfless caregivers and men as emotionally distant breadwinners, a link between individual reproductive cells and cultural norms of motherhood and fatherhood that is made especially clear in the psychological evaluations, which are required of egg donors but not sperm donors. In addition to being evaluated for psychological stability, women are asked how they feel about “having their genetics out there.” Sperm banks do not require that men consider this question with a mental health professional, which suggests that women are perceived as more closely connected to their eggs than men are to their sperm.

The majority of women and men who apply to donation programs are not accepted. Both sperm banks reject more than 90% of applicants, most because they do not have the exceptionally high sperm counts that are required because freezing sperm in liquid nitrogen significantly reduces the number that are motile. Both egg agencies estimate that they reject over 80% of women who apply.
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In short, donor recruitment is time intensive, rigorous, and costly. As staff members sift through hundreds of applications, the framing of egg donation as an altruistic win-win situation and sperm donation as an easy job shapes subsequent staff/donor interactions, from constructing individualized donor profiles to the actual sale of sex cells.

CONSTRUCTING DONOR PROFILES

Once applicants pass the initial screening with program staff, they are invited to fill out a “donor profile.” These are lengthy documents with questions about the donor’s physical characteristics, family health history, and educational attainment; in some programs, standardized test scores, GPA, and IQ scores are requested. There are also open-ended questions about hobbies, likes and dislikes, and motivations for donating. Once approved by staff, egg donor profiles, along with current pictures, are posted on an agency’s password-protected website under the woman’s first name. The donor then waits to be selected by a recipient before undergoing medical, psychological, and genetic screening.

In contrast, sperm banks do not post profiles until donors pass the medical screening and produce enough samples to be listed for sale on the bank’s publicly accessible website. Western Sperm Bank’s donor manager explained,

From the moment the donor is signed on, it’s really nine months before we even see any profit from them. They have six months worth of quarantine [for HIV], and then another three months before we can really release enough inventory so that people aren’t upset at us. If we release five vials and twenty women call, only two women are going to be happy. The others are going to be really upset that that’s all we got on him this month.

Sperm banks are much more concerned about donor anonymity, so men’s profiles are assigned an identification number and do not include current photographs.
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Both banks do offer a “photo-matching service,” in which recipients pay staff to select donors with specified phenotypes.

Profiles serve as the primary marketing tool for both the program and the donor. For donation programs, posted profiles represent the full range of donors available and thus are used to recruit recipient clients. The founder of Creative Beginnings explained that she would prefer not to have profiles on the website because she thinks they are impersonal but that she needs them to be “competitive” with other programs.
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For donors, the profiles are the primary basis a recipient will use to select
them. Typically, recipients also consult with staff about which donors to choose; occasionally, egg recipients will ask to meet a donor, but under no circumstances are sperm recipients allowed to meet donors. If a donor’s profile is not appealing, recipients are not likely to express interest in purchasing that donor’s sex cells.

This explains why programs spend a great deal of energy encouraging applicants to complete the profiles and, in the case of egg donation, to send in attractive pictures. During an informational meeting for women interested in becoming egg donors, Creative Beginnings’ staff members offered explicit advice about how they should appeal to recipients.

Egg donors are encouraged by agency staff to construct properly feminine profiles for the recipients, who are continually referenced as an oblique “they” who will be reading the donors’ answers and making judgments about their motivations. Although it is important for the “girls” to let their “personalities” shine through, the recipients do not necessarily need to know about their flaws, such as wearing revealing clothing, drinking, or smoking.
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If a donor’s profile is deemed unacceptable by staff or if she sends in unattractive pictures, an agency will “delete” her from the database. Creative Beginnings’ office manager explained, “We have to provide what our client wants, and that’s a specific type of donor. Even though [the recipients] may not be the most beautiful people on the face of the earth, they want the best. So that’s what we have to provide to them.” In contrast, sperm recipients are not allowed to see photographs of donors, and thus men’s physical appearance is not held to similarly high standards.

Sperm bank staff members will take extra time with men who discuss only financial motivations in their profiles, but they are much less explicit about the need to appear altruistic. This dynamic was made clear as Western Sperm Bank’s donor manager explained how she came to understand the importance of profiles.

[Prior to this job,] when I worked on the infertility side, women [recipients] would come in with their little donor vials [of sperm]. Some of them would show me the [donor profile and say,] “Doesn’t he sound wonderful?” And of course this is all they’ve got. This is their person, this little sheet. So [Western Sperm Bank’s staff] will look at [the profile] and if someone’s sort of negative will really question the donor. “Do you really mean that money is the only thing for you?” And if it is, we are honest enough to just leave it that way. But a lot of times [donors] say, “Well, it’s not just the money, it’s also. . . .” [So the staff will say,] “Why don’t you rewrite this little portion to reflect that also?” The new [staff] became more conscious and willing to put in the effort to make more complete answers, because they did care about what was presented to the recipients, to give them a fuller image of what the person was like.

Although egg agencies specifically use the terms “help” and “altruism” in advising women who are writing their profiles, the sperm donor manager does not specify what other motivation the man is expected to have besides financial compensation. He is only supposed to revise his profile with the “also” in mind.

These gendered coaching strategies contribute to statistically significant differences in how women and men answer the profile question “Why do you want to be a donor?” Based on a content analysis of 826 donor profiles,
Figure 2
reveals that the majority of egg donors at OvaCorp, Creative Beginnings, and Gametes Inc. dutifully reported that they were interested in donation only because they wanted to help people. A small percentage of women reported being motivated both by altruism and financial considerations, but almost none said they were solely interested in the money. At the sperm banks, men are much less hesitant about stating their interest in the compensation, even though they are making much less money than women. And it is interesting to note that CryoCorp’s profiles do not even include this question, in keeping with a general lack of interest in men’s motivations.
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Although the distribution of profile responses among egg donors and among sperm donors is strikingly similar across programs, the reader is cautioned against seeing evidence of some “natural” difference between the sexes. As will be discussed more in
Chapter 4
, the majority of men
and
women are drawn to donation by the financial incentives, but these initial interests are whittled into gender-appropriate responses on the donor profiles.

Figure 2
. Percentage of women and men expressing altruistic and/or financial motivations on donor profiles, by program

Both egg agencies and sperm banks believe that donor profiles offer recipient clients “reassurance” in the form of extensive information about the donor. The founder of Creative Beginnings explained that infertility “is emotionally devastating, and [recipients] feel like they have no control. So those first appointments, sometimes people are really excited about the profiles, because they want to see what the people are like that we are going to be supplying to them. They’re really happy when they see the quality of the donor and the amount of information they get.” Similarly, the donor screener at Western Sperm Bank noted that “it’s hard on the recipient end to be taking this leap of faith, buying reproductive fluid from unseen, unknown strangers, so I understand the desire to know as much as you possibly can. So we try to glean stories about [the donors], and then it’s just nice reassurance for the recipients that these are real people.” In the same breath, staff members draw on both economic and social understandings to describe donors as “real people” who are “supplied” to recipients.

Egg agencies and sperm banks use donor profiles to recruit clients, and recipients who select particular women and men based on details about eye color, family health history, favorite movie, and SAT scores
begin to think of the donor as that profile. But donors are not producing unmediated texts that travel from keyboard to website display. Gendered cultural norms, formalized through organizational processes, result in expectations that women reflect altruistic sentiments beneath an attractive photograph, and sperm donors are vaguely encouraged to provide a “fuller image.” Although the recipient is actually buying eggs or sperm, these sex cells become personified through the donor profile, and it is this gendered, commodified personification of the donor that the recipient is purchasing.

MATCHMAKING

When a recipient chooses a specific donor, it is called a “match.” In egg agencies, the selected donor will then be medically and psychologically screened before she signs a legal contract with “her couple.” In sperm banks, there is a limited “inventory” of vials from each donor, and this supply is replenished as men continue to make regular deposits throughout their yearlong commitment to the bank.
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The vials are listed in the bank’s “catalog,” so a recipient who calls to place an order is advised to choose two or three different sperm donors to ensure that at least one will be available for purchase.