The Genius Factory (19 page)

She gave me the phone number for the chief lab technician and told me to call the next day to find out whether I had a high enough sperm count and whether my guys had survived freezing and thawing. “Now, of one hundred men who apply,” she said reassuringly, “we only interview twenty or thirty. And the vast majority of those—even men who have their own children already—end up being disqualified by sperm count. So
don’t feel bad
if you don’t make it.” She thanked me for coming in. She flashed me one more gleaming, sexy smile, closed the door, and locked it from the outside.

The next few minutes passed as you would expect and are none of your business.

When I was done, I walked my cup down the hall to the incubator. I tried to catch the eye of one of the technicians, to ask if I could take a sperm paperweight as a souvenir. None of them looked at me.

The next morning, I called the chief lab technician. “I was about to call you,” she said. “I have some good news. You passed the freezing and thawing. We want to make arrangements for your second trial specimen—that is, if you are still interested.”

I flushed. I couldn’t resist asking “So what were my numbers? What was the count?”

“Your count was about 105 million per milliliter. The usual is around fifty to sixty million. So you are well above average.”

I grinned—105 million! I considered breaking my promise to Hanna, and continuing as a donor. I was, after all, “well above average.” I started to make an appointment for my second deposit, then thought better of it. Hanna was right: Who knew what they were doing with my sperm? The longer I kept up the charade, the greater the possibility that my sperm would end up in the wrong hands (or wrong uterus). So I told the tech I needed to check my schedule and would call back. I didn’t call back. She phoned me again a few days later and left a vague message. I didn’t return it.

I was not much closer to wanting to be a donor than I had been before I started, but I was closer to understanding why someone else might want to do it. In the abstract, donating sperm had seemed fundamentally silly. But actually doing it was seductive. I had been accepted by the ultraexclusive Fairfax Cryobank! My sperm was “well above average”! My count was 105 million! What’s yours, George Clooney? Amanda, lovely Amanda, had asked for my help. The women of America—barren, desolate, desperate—needed
me.
They yearned for my B-positive, brown-eyed, six-foot-one-inch, HIV-negative, drug-free, heart-attack-prone, only slightly mentally ill sperm. And what kind of selfish monster was I to deny it to them?

From the vantage point of today’s fertility-crazed America, where people talk about their fertility specialists the way they used to talk about their plumbers, where every woman is either making a baby through in vitro fertilization, donating an egg so someone else can, carrying a surrogate baby for her daughter or mother or rich neighbor, or seeking to adopt her lesbian partner’s hormone-spawned sperm-bank triplets, where getting pregnant the old-fashioned way seems not merely old-fashioned but slightly foolish, it can be hard to remember that infertility used to be a badge of shame, that the only fertility choice women used to have was “Blue eyes for the donor or brown?” and that they were supposed to be grateful even for that. The most important thing—and arguably the best thing—Robert Graham’s genius sperm bank did was to transform how Americans thought about making babies.

Today, sperm banking is a business with “customers” instead of “patients,” marketing plans instead of doctor’s orders, professional donors instead of Johnny-on-the-spot medical students. None of this was true when Robert Graham started the Repository. Sperm banking—and American fertility in general—experienced a revolution, and Robert Graham was a most unlikely Thomas Jefferson.

To understand how sperm banks got the way they are today, you have to start with a very short article in the April 1909 issue of the journal
Medical World.
The article was titled “Artificial Impregnation.” The author was an obscure Minnesota doctor named Addison Davis Hard.

Hard wrote that twenty-five years earlier, he had witnessed a medical procedure so bizarre and so shocking that everyone who knew about it had taken an oath never to reveal what they saw. But the time had come, Hard said, for him to break the oath. In 1884, Hard continued, he had been a student of Dr. William Pancoast at Jefferson Medical College in Philadelphia. Pancoast was a professor of surgery, a former Civil War doctor who was just wrapping up a fine though unremarkable academic career. A wealthy Philadelphia businessman consulted Pancoast to learn why his wife wasn’t getting pregnant. Pancoast examined the wife thoroughly—it being the nineteenth-century (and twentieth-century, and twenty-first-century) assumption that if something was wrong it must be the woman’s fault—and found nothing amiss. The husband, too, showed no obvious “physical defect,” but Pancoast collected a semen sample just in case. He plugged it under the microscope: there were no sperm at all. Pancoast diagnosed the husband’s sterility as the result of a youthful bout of gonorrhea. Pancoast was confident he could treat the problem and restore the husband’s fertility. But when the businessman and his wife returned to Sansom Street Hospital two months later for the follow-up appointment, there was no change in the husband’s condition. Pancoast told his students that the merchant was a lost cause: his seminal ducts were permanently blocked.

But then, eureka! According to Hard’s account, “A joking remark by one of the class, ‘The only solution of this problem is to call in the hired man,’ was the probable incentive to the plan of action which followed.”

Pancoast, without telling the husband or wife what he was going to do, knocked the woman unconscious with chloroform. The six students decided who was the “best-looking” man in the class, and the winner obligingly provided a sperm sample. Pancoast placed the semen in a hard rubber syringe and squeezed it into the unconscious woman’s uterus. She woke up none the wiser. Later, Pancoast did deign to explain the insemination to the husband, who was “delighted with the idea,” Hard reported. The husband and Pancoast then conspired to keep the secret from the wife, who soon found herself happily pregnant. This was the first recorded use of a sperm donor and probably the first use of a sperm donor, period.

In due course, a son was born. Remarkably, Hard said, he looked very like “the willing but impossible father.” The boy, Hard added from the perspective of 1909, “is now a business man of the city of New York, and I have shaken hands with him within the past year.” (Why would Hard, a Minnesota doctor, have any reason to meet a young New York businessman? As A. T. Gregoire and Robert C. Mayer speculated sixty years later, Hard had no reason—unless of course
he
was that “best-looking member of the class,” and thus the boy’s father.)

Hard wrote that he was breaking his secrecy vow because Pancoast was dead and because he himself had concluded that donor insemination was a wonderful idea—a necessary eugenic remedy for a troubled nation. Too many men were secretly infected with gonorrhea, so babies needed protection from the “satanic germs” of their fathers. “Artificial impregnation” was the remedy. (“Go ask the blind children whose eyes were saturated with gonorrheal pus as they struggled thru the birth canal to emerge into this world of darkness to endure a living death; ask them” if they object to artificial impregnation, he wrote.)

It wouldn’t matter which man supplied the seed, Hard concluded with the certainty of true ignorance, because the child was shaped entirely by the mother. The father made no contribution at all: “It may at first shock the delicate sensibilities of the sentimental who consider that the source of the seed indicated the true father, but when the scientific fact becomes known that the origin of the spermatozoa which generates the ovum is of no more importance than the personality of the finger which pulls the trigger of a gun, then objections will lose their forcefulness, and artificial impregnation will become recognized as a race-uplifting procedure.”

I linger on the first donor insemination because it so perfectly prefigured the whole sorry history of sperm donation. From day one—from ejaculation one in Sansom Street Hospital in 1884—sperm donation has been characterized by its abundance of secrecy, embarrassment, deception, and ignorance. Hard’s article encapsulated the business to come, all themes struck: the authoritarian fertility doctor making it up as he went along and issuing awesome decisions casually (“Call in the hired man”) . . . the wife ignorant and unconscious, literally a mere vessel . . . the husband a coconspirator, lying to protect his own ego . . . the careless medical student, donating sperm without a thought to the consequences . . . the self-justifying scientific hoo-hah masquerading as empirical fact.

Artificial insemination is an elementary medical procedure—you can do it competently in your own home, after a few minutes’ training—so why wasn’t it practiced regularly until the twentieth century? One reason is that it took a long time for people to understand what sperm was or why it mattered, as Gina Maranto explains in
Quest for Perfection.
Until the seventeenth century, Maranto says, the male and female reproductive capacities were black boxes. Scientists knew about semen (obviously), but they couldn’t figure out what the milky fluid had to do with reproduction. Some hypothesized that male semen mixed with a “female semen” in the uterus to form a child. Others guessed that semen fertilized menstrual blood. Finally, in 1677, Antoni van Leeuwenhoek, the Dutch inventor of the microscope, spotted sperm cells swimming in seminal fluid.

At first, sperm only confused matters. Another Dutch microscopist, Nicolaus Hartsoeker, speculated that a perfectly formed human being was curled inside the head of each sperm cell. These tiny men were dubbed “homunculi,” and they became the foundation of a bizarre theory called “spermism.” Spermism was a variation of the already popular notion of “preformation,” which held that fully formed people already existed, microscopically, in their parents. Taken to its logical conclusion, preformation said that if your teeny son is housed in you, then your even teenier grandson is housed in him, and so on for
N
generations, till the end of time. We were God’s own Russian nesting dolls. Until Hartsoeker, most preformationists had been matriarchal; these “ovists” believed that God had deposited us in the maternal eggs. (Therefore, Eve had held
all
of mankind to come, like some gigantic warehouse.) The homunculus flipped the attention to men, contending that humans came from sperm, and women were merely pots to plant in. The spermists and the ovists bickered for 150 years until they were both proven wrong. In the late eighteenth century, the Italian Lazzaro Spallanzani, performing what may have been the first artificial inseminations, showed that frogs and dogs couldn’t get pregnant without contributions from both males and females. Then, in 1827, the mammalian egg was finally discovered. In the nineteenth century, European scientists ran experiments on animals, tinkering with sperm and eggs, eggs and sperm, and concluded, at long last, that each was useless without the other.

Meanwhile, doctors facing the practical problem of infertility wondered how to use sperm to help their patients. In the 1770s, the celebrated London physician John Hunter (my father is named after him, incidentally) arranged the first human artificial insemination. Hunter’s patient suffered a penis defect that made it impossible for him to impregnate his wife, but he was still able to ejaculate. Hunter gave the man a syringe, told him to masturbate into the syringe’s barrel, and then inject the semen into his wife’s vagina. It worked. In the mid-nineteenth century, famed New York gynecologist J. Marion Sims used Hunter’s method—along with some very painful surgery—to impregnate women suffering from “hyperesthetic” vaginas with their husbands’ sperm. (The women supposedly had vaginas formed in such a way that they couldn’t have intercourse with their husbands. “Hyperesthetic” is Greek for “Not tonight, dear.”) Sims called his technique “ethereal copulation.” The success rate was low—less than 5 percent of the women got pregnant, probably because menstrual cycles were poorly understood. Condemnation was emphatic. The Catholic Church denounced artificial insemination: be fruitful and multiply, yes, but not this way.

Hard’s 1909
Medical World
article was the first public hint that the new technique of artificial insemination could exclude the husband from reproduction. If artificial insemination using a husband’s sperm was morally questionable, artificial insemination by donor (AID, as it came to be known) was anathema. Doctors were outraged by the mere thought of it. Some, with a striking ignorance of human physiology, insisted that what Hard described occurring at Sansom Street Hospital was literally impossible: a woman simply could not get pregnant in this way—certainly not without her husband’s contribution. Others said that it was so immoral that it could not have happened. A doctor as noble as Pancoast would have been incapable of such a monstrous act.

But, immoral or not, AID was real, and it was useful, because it was the first effective fertility treatment. AID established the moral arc that all fertility treatments since—egg donation, in vitro fertilization, sex selection, surrogacy—have followed.

First, Denial: This is physically impossible.

Then Revulsion: This is an outrage against God and nature.

Then Silent Tolerance: You can do it, but please don’t talk about it.

Finally, Popular Embrace: Do it, talk about it, brag about it.
You are having test-tube triplets carried by a surrogate? So am I!

With AID, as with the subsequent fertility treatments, three potent forces combined to overwhelm the initial disapproval. First, the distress of the husbands and wives, who would risk anything to have a baby; second, the enthusiasm of doctors to try something new (and profit from it); and third, doctors’ constitutional belief that
they,
not a backward society, should decide how their patients were treated.

After Hard’s article, AID slowly progressed from the denial phase to revulsion. Then, in the 1930s, revulsion began to give way to silent tolerance. In 1934, Dr. Hermann Rohleder wrote
Test Tube Babies,
a history of artificial insemination and description of his AI techniques. He initially asserted that the only suitable purpose of artificial insemination was impregnating a wife with her husband’s sperm and that donor insemination was outrageous: “What husband or wife, no matter how intense their longing for an heir, will consent to an injection of strange semen? Thank God that most people still have that much tact, decency, and moral feeling.” Yet just a few pages later, writing as a doctor rather than a moralist, Rohleder conceded that he
would
impregnate a woman with a stranger’s semen, under the right circumstances—if the husband was so desperate that suicide or divorce was a possibility, if the donor was healthy and unmarried, if the wife consented.