The God of Sperm26 Sep 2007, Posted by Article Sampler in
LA Weekly, September 26, 2007
The world’s largest collections of stored genetic materials are found in Sussex, England; Spitsbergen, Norway; and Los Angeles, California. Sussex hosts the Millennium Seed Bank, which houses some 750 million species of plant seed. Spitsbergen, an island less than 600 miles from the North Pole, is the site of the Svalbard Global Seed Vault, which safeguards—inside a tunnel, inside a mountain—every variety of the Earth’s twenty-one major food crops. And Los Angeles is home to the California Cryobank, the largest sperm bank in the world, which stores enough human seed to repopulate the planet several times over. The first two of these projects are international efforts to preserve our genetic future; the last is a private enterprise run by a man known to many as “The King of Sperm.”
The King wears Buddy Holly glasses. He is of medium height and medium build, balding, sixty-nine years of age, with a penchant for flashy shirts and comfortable shoes. His name is Dr. Cappy Rothman and “Cappy” is not a nickname. It is the colorful moniker given to him by his colorful father—if by colorful one means mobbed up.
The King of Sperm began his career in casinos. His father, Norman “Roughneck” Rothman, ran the San Souci Club in Havana, so Dr. Rothman spent his teenage years in Cuba. One of his earliest jobs was ferrying money—in a briefcase handcuffed to his wrist—between Cuba and banks in the States. One of his later jobs was working as an organizer for Jimmy Hoffa — to raise extra cash for medical school at the University of Miami.
Medical school led Rothman to a residency at the University of California in San Francisco, where he studied under the legendary urologist Frank Hinman Jr. Hinman liked to assign his students yearlong research projects on medical mysteries. How sperm got from testicle to outside world was the puzzle Rothman was assigned to solve during his first year of medical school. In his second year, it was the mechanism of erection. Both are considered infertility problems. “I loved infertility immediately,” says Rothman. “There was so much we didn’t know. I felt like a pioneer.”
By 1975, that pioneer was board-certified in urology and took a job at the Tyler Clinic, becoming Los Angeles’ first male infertility specialist. A couple years later, after the Tyler clinic had folded, Rothman went out on his own, and the California Cryobank was born. In 1977, Rothman published the very first article on sperm banking in the Journal of Urology.
That was also the year a prominent U.S. senator’s son was killed in a car crash. The statesman contacted Rothman and asked if his boy’s sperm could be saved. In 1978, because of the work he’d done on the senator’s son, he published the first article on postmortem sperm retrieval, thereafter appearing on Oprah to explain the procedure.
Despite these accolades, what Rothman remembers most about starting up his business was a young couple who came to see him very early on. “The man was infertile and the woman was angry. In the middle of that discussion, she turned to her husband and said, ‘Because I married you, I’ll never be a mother.’ It was a statement I never wanted to hear again. Then and there, I decided to open a sperm bank.”
If you adjust for size, the distance sperm must swim from testicle to ovum is the equivalent to that of a human running from Los Angeles to Seattle. Because of serious concern about transmission of diseases like AIDS to unborn children, and the drastic rise of what is known as “single mothers by choice,” the human seed in the King of Sperm’s collection now travels much farther—serving women in all 50 states and some 28 countries.
This is no thin slice of the pie.
In the United States, the fertility industry is an annual $3.3 billion business, with sperm banking accounting for $75 million of that. Thirty percent of that business flows through the California Cryobank, but even these numbers do not truly capture Rothman’s influence. Frozen sperm and eggs—which the California Cryobank also stores—are the first step in assisted-reproduction, so wherever the sperm-and egg-bank business goes, so goes the rest. As Rothman himself points out, “When California Cryobank makes a decision, some six months later the rest of the industry tends to follow.”
Increasingly, these decisions are no small thing. For almost four decades, the sperm banking industry has operated almost completely without outside influence. Beyond a series of somewhat bizarre FDA rulings (more on these later), there is no top-down governance. The industry is, as it has always been, self-policing. Which means that California Cryobank and a few other key players wield enormous influence over the future of childbirth.
Right now, that future is uncertain. A growing pile of ethical, legal and biological issues now surround the industry: the problem of donor anonymity; rules involving genetic diseases occasionally passed on by sperm and egg banks; the prevention of accidental incest between half brothers and half sisters; and strange quandaries resulting from a government increasingly using science to play politics. Will the government step in is the question. Because, until they do, the people profiting most from the future of childbirth are actually the people shaping the future of childbirth.
California Cryobank’s headquarters sit in a two-story office building in West LA, specifically designed by Rothman to resemble a set from Star Wars. But it’s a little bit of overkill. Seriously, who needs sci-fi window dressing, when there’s actual sci-fi technology.
Outside the building, for example, stands a 6,000-gallon nitrogen tank and a backup generator capable of providing six months of emergency power. Inside, just past the receptionist, sits a large, rectangular room: the home to ten cryotanks, each containing 20,000 color-coded ampoules of sperm. Each ampoule holds up to 60 million sperm, with the color-coding determining the ethnicity of the donor. In other words, just off the lobby of the California Cryobank, is enough sperm to re-fertilize the Earth several times over.
Just down the hall from the cryotanks are the masturbatoriums—the little rooms where prospective donors jerk off. There are three masturbatoriums to choose from: erotic, less-erotic and not-so-erotic. Perhaps because Rothman is a bit old-fashioned, or perhaps because the masturbatoriums were designed by a woman from the marketing department, the photographs that wallpaper these rooms, especially when measured against today’s Internet porn standards, are downright tasteful.
“For some guys,” notes Rothman, “it doesn’t take much.”
It may not take much to finish one’s business in these rooms, but it takes quite a lot to get into them in the first place. To become a donor at California Cryobank, one must submit to what Rothman calls “the most rigorous prescreening process in the field.”
This process begins with a college education because, without one, California Cryobank doesn’t want your sperm. A long conversation follows, where donors are filled in on the obligations that come with the job—specifically its year-and-a-half-long commitment. During that commitment, donors are paid 75 bucks a pop, with two to three pops a week required, meaning a guy stands to earn anywhere from $11,000 to $17,000 for his services.
If those terms are acceptable, two separate semen samples are taken and analyzed. “We’re looking for very fertile men,” explains Rothman. Normal sperm count is 20 million to 150 million sperm per milliliter of semen. By “very fertile,” Rothman means over 200 million sperm per milliliter. Sixty percent of those sperm must be motile and must look as sperm are supposed to look.
If all of this is shipshape, a three-generation genetic history is taken. More semen is obtained and screened for diseases. Most sperm banks test for 23 variations of the mutation that causes cystic fibrosis, while California Cryobank, known for their rigor, looks for 97. Jewish donors are screened for Tay-Sachs; African-American donors for sickle-cell anemia. A complete physical is then taken, followed by a six-month quarantine to assure that slow-developing HIV is not lurking in the sperm—one of those ideas that originated at California Cryobank and has since spread to the rest of the industry.
After this waiting period, donors start producing. “We see them twice a week for semen, we see them once every three months for an updated battery of STD tests,” Rothman says. “We get to know them pretty well along the way.”
But the major problem facing the industry right now isn’t how well sperm banks get to know their donors—it’s how well prospective parents get to know their donors.
Here, in the Twenty-first century, we shop for kids via catalog—“donor catalog” to be exact. These catalogs are thick, usually including a description of donor eye color, ethnicity and education level, a psychological profile, personal essays, and even audio interviews. Occasionally, adult photos are included and California Cryobank has just added baby pictures as well. But the one thing prospective buyers are never permitted to know is the donor’s name.
Donor anonymity is the bedrock of the business and, as a result, as Jane Mattes, a New York psychotherapist and founder of “Single Mothers by Choice,” an organization that represents the fastest-growing group to utilize frozen sperm, says, “the most crucial issue facing the industry today.”
While the industry maintains continual contact with its donors during the sperm-collection phase, California Cryobank and others have no way to keep track of donors after their tour of duty is done. Illness is the problem. There are plenty of diseases that don’t manifest until later in life, yet most donors are college students who have yet to get sick. Furthermore, though most sperm banks are rigorous in their pre-donation screenings, many donors don’t know their own genetic history. Others lie to conceal it.
Add in the fact that nobody demands that cryobanks stay in contact with donors; that banks don’t have to tell new clients about health concerns among donor’s prior children or release any follow-up medical information about a donor; that, traditionally, sperm banks destroy donor records to preserve anonymity after the bank is done selling their sperm, and—as the saying goes—you have the makings of a quagmire.
This quagmire has led to problems, like those facing Brittany Johnson. In 1988, Diane and Ronald Johnson used California Cryobank sperm—from a man known only as “Donor 276”—to conceive their daughter Brittany. The problem with 276’s sperm was an exceptionally rare kidney disorder known as autosomal dominant polycystic kidney disease, a late-onset ailment that typically doesn’t appear until after age 40—but one that usually requires a kidney transplant by age 50. It is possible that Donor 276 didn’t know he was a carrier (though this seems unlikely, since his grandmother died from it and his mother and aunt also suffered from it). Either way, when Brittany got sick at age six, she became what the media dubbed “the test case for sperm gone wrong.”
It became a nasty fight. The Johnsons alleged that California Cryobank knew the truth about Donor 276—though Rothman strenuously denies this—and went out of its way to conceal it. And Brittany may not be the only sick child around. Between 1984 and 1988, Donor 276 made $11,200 for himself by donating over 300 specimens and court documents suggest the bank sold nearly 1,500 vials of Donor 276 sperm to an unknown number of women before being taken off the market 1991.
While the facts of this case remain murky (it was settled out of court in 2003 and some records remain sealed), the resulting hoopla brought similar problems to light. There is the widely reported story of Donor 1084 at Fairfax Cryobank in Virginia, the second largest cryobank in America, whose sperm carries a rare platelet disease and has resulted in a half-dozen sick children up and down the East Coast. Also at Fairfax, Donor 2148 carried a rare genetic immune disorder that has already infected one of 23 of Donor 2148’s known children. Then there’s Donor F827, from International Cryogenics in Michigan, who fathered somewhere between five and eleven children and all with a rare blood disease that leaves carriers at serious risk for leukemia.
And this list goes on and on.
The answer that many are pushing for is to ban donor anonymity. But this brings problems of its own. In 1984, Sweden outlawed anonymity, and so severe was the drop in potential donors that Swedish women began traveling to Denmark for sperm, giving rise to what is now known as “reproductive tourism.” And the same thing happened in New Zealand. In 2005, England outlawed anonymity—which saw donor numbers drop by 84 percent. On an island of 22 million men, fewer than 200 are now willing to bank their sperm. After the law’s passage, Clare Brown, chief executive of the Infertility Network UK, told reporters, “Clinics across the country are having to close because there is a shortage of donor sperm—and that constitutes a crisis.”
In the U.S., that crisis is following an even stranger path. In 2005, while England was banning donor anonymity, a donor-sperm-born teenager named Ryan Kramer decided he wanted to know his father. So he swabbed his cheek and sent the DNA sample to an online genealogy testing service and soon became the first person in history to use Internet DNA services to track down a lost parent.
There were two immediate reactions to Ryan Kramer’s quest—the first by the sperm-banking industry. “We removed a bunch of information from our donor profiles,” says Cappy Rothman, “making it a lot harder for people like Ryan to track down their fathers.” The second was the creation of a number of organizations dedicated to chipping away at donor anonymity and a number intent on washing it away completely.
In the chipping-away category is the “Donor-Sibling Registry,” founded in 2000 by Ryan Kramer’s mother, Wendy. “I started the Web site as a Yahoo message board,” she says, “to give these donor kids a place to go to try and find their half brothers and half sisters.” For the first two years, the registry totaled 37 members, then word started to spread. By 2003, the site’s popularity had grown so much that Wendy removed it from Yahoo and created a dedicated site (donorsiblingregistry.com), which now has 8,500 members.
In the washing-away category are projects like those started by Dr. Kirk Maxey, a former sperm donor and founder of the “Donor Semen Archive,” the “Donor-X Project” and the “Donor Y Project,” a series of endeavors that use genetic markers to track both donors and the resulting children, with hopes of forcing the industry’s hand.
“I think that gamete [egg and sperm] banking is by its very nature a nonprofit activity,” says Maxey. “It is only a misguided perversion that has allowed it to become an industry, and that industry is the only strong advocate for donor anonymity. The malfeasance perpetrated under the guise of donor anonymity is what we are slowly but steadily bringing to light through genetic testing.”
In an interview with ABC News, Maxey said he began donating his own sperm in the 1980s and guesstimates that over the course of 16 years he may have produced more than 200 children. While Maxey uses these figures to paint a disturbing picture of the industry he now opposes, there is no way to verify his claims.
Dr. Rothman defends the industry, saying, “We’ve been trying to create an industry-wide donor tracking system, but it’s expensive and we’re trying to get other sperm banks to buy in as well. Either way, we’re hoping to have something in place within a year or two.”
But there’s an important caveat in Rothman’s avowed support for a donor tracking system, which would put an end to the destruction of former donors’ records: Their names would remain anonymous to parents. Donor tracking would be used only internally to allow gamete banks to keep track of how often and where donors sell their sperm and eggs, and, as they age, to monitor donor health issues that aren’t currently tracked.
As such, this form of donor tracking would be the middle ground between current practices and an outright ban on anonymity. Many industry watchdogs feel this tracking system doesn’t go far enough, while others feel Rothman’s sentiments—despite the fact that he publicly applauded Wendy Kramer’s efforts and initiated talks to partner with her enterprise (as of yet inconclusive)—are mere lip service. Whatever the case, when it comes to donor tracking, California Cryobank may be sailing alone.
Recently, William Jaeger, vice president of Genetics and IVF Institute in Virginia, another of the nation’s biggest banks, told The New York Times that mandatory donor-identity disclosure “would devastate the industry.” Kramer has found similar attitudes elsewhere. “I’ve spoken to the directors of all the major sperm banks and they don’t all think like Cappy,” she says. “Even though my site is based on mutual consent, Northwest Andrology [one of the other major players] is very much against what I do.”
Kramer contends that Northwest Andrology—whose web site features a photo of a fat wad of $100 bills and touts the news that donors earn up to $16,000—is so opposed to unveiling the donor names that “they’ve threatened donors on my site, making them take down their information. They’re hell-bent on preserving anonymity.”
While anonymity is a major issue, industry watchdogs maintain that hidden beneath it is a far more insidious problem: incest. There is a growing concern that sooner or later two donor-siblings are going to meet and mate without realizing that they share the same father or, in the case of egg donations, mother. “No one on the sperm-bank side wants to talk about it,” says Kramer, “but there are over one million donor children in the world, and I know of several cases where unknowing siblings have ended up going to college together and having the same groups of friends. The industry says accidental incest is a statistical impossibility, but from what I’ve seen, it’s only a matter of time.”
This is no small issue. Simply put, incest is bad for the gene pool. Sleep with your brothers and sisters and mutations arise. If this pattern of intimate relations with intimate relations continues for more than a few generations, pregnancy becomes impossible. The line dies out. For this reason, in 1910, anthropologist James Frazer demonstrated that the incest taboo was universal, an idea extended by anthropologist Claude Levi Strauss, who felt that the incest taboo drove us to procreate with people outside of our own family and tribe—meaning this fear is actually the fundamental building block of society.
To protect this building block, some countries have laws limiting the number of women who can receive sperm from a single donor. Britain sets their legal limit at 10, Denmark at 25. In the U.S., there are guidelines. The American Association of Reproductive Medicine suggests that a single donor sire no more than 25 children within an urban area with a population of 800,000, but—as there’s nothing stopping a man from donating sperm at LA’s California Cryobank and then traveling a few miles down the freeway and making another donation at Pasadena’s Pacific Reproductive Services—these guidelines are hard to enforce.
Instead, the banks police their own limits internally. California Cryogenics, for example, draws its line at twenty kids per donor, but only 40 percent of the women who buy frozen sperm report back to the Cryobank with news of a live birth—yet they don’t cap sperm sales until those live births are reported. And, because certain—think blond-haired, blue-eyed—donors are extremely popular and not all pregnancies take, banks often sell the same sperm to more than the recommended number of buyers. Furthermore, because most families order sperm for their immediate needs and then pay a storage fee to hold more in reserve for future use, there’s no way to enforce the limits.
“No sperm bank knows how many children are born to specific donors,” says Kramer. “They don’t know who these kids are or where they are. There’s no accurate record keeping.”
More alarming is the charge that sperm banks have been intentionally underplaying how many kids have been sired by particular donors. The most egregious example of this is Dr. Cecil Jacobson, who ran a reproductive-genetics center in Tysons Corner, Virginia. Instead of using donor sperm, Jacobson substituted his own. When he was caught, investigators found seven children sired by the doctor and—because mothers refused to submit their kids for DNA testing—seventy-five other possibilities.
Talking about this problem, San Francisco’s Chloe Ohme, both a midwife and the first person in history to impregnate herself using Internet-found, mail-order sperm, says, “I’ve been at gatherings of single mothers and people suddenly realize their kids look a little too alike and begin comparing donor numbers and, sure enough, they match.” And that’s nothing compared to what Kramer noticed after she opened her donor-sibling registry for business. “Very quickly,” says Kramer, “we found donors on the Web site with 30 and 40 and 50 kids.”
Unfortunately, no one really knows the scope of the problem. One of the only times the issue of sibling incest and sperm banking has been studied was in 1984, by the Law Reform Commission of New South Wales, Australia. The Commission found no danger of incest among donor offspring in the U.S., but based this determination on annual, nationwide, assisted-reproduction birthrates of 10,000. These days, some 30,000 women a year use California Cryobank’s services—and that’s only one bank out of thousands.
Not surprisingly, it’s religious organizations who are most vocal about this issue. The Catholic Church feels that any form of assisted reproduction threatens the sacred covenant between man and woman, often citing the dangers of incest among its reasons. The Southern Baptist Church has also begun looking into the dangers of accidental incest. Dr. Richard Land, president of the Ethics and Religious Liberty Commission for the Southern Baptist Convention and head of the organization’s public-policy arm, says, “We don’t share the Catholic prohibition against AIH (artificial insemination by husband), but forget the religious implications. There are good medical reasons why all states have laws against incest. It produces very real medical dangers. In the past 20 years, we’ve learned enough about the tyranny of biology to know that, for the most part, the nature-versus-nurture argument is dead. Nature always wins. Which means incest is a real concern, and the more children who are the product of sperm banks, the more this concern becomes a problem for everyone.”
Rothman disagrees. “Incest isn’t an issue. Not only is it statistically improbable, but go back 300 years and just about all of us lived in tiny villages. There was no public transit. Everyone was related to everyone else because there was no one else around to marry. We’re all descendants of incest. Secondly, from a medical perspective, you’re talking about the danger of one generation of incest—even if that happens, the chances of something going wrong are minute.”
Still, even if incest isn’t an issue, it remains a fundamental taboo—so the problem doesn’t seem likely to go away.
The King of Sperm has a corner office, exotically decorated. Perched by the window is a small statue of a man with, as is appropriate, enormous testicles. His balls, literally, hang to the floor. Above the statue, hanging from the ceiling, is a sizable replica of the solar system—a Starship Enterprise model positioned dead center. This is also appropriate.
“I’m interested in the frontiers of technology and humanity,” Rothman says. “And I know there are dangers in sperm banking. I reread Brave New World once every three years. But I also know that infertility is the kind of problem that ruins lives. I only wish the government would recognize this fact as well.”
What Rothman means is that unless the industry finds a quick way to address donor anonymity and its downstream concerns (incest among them), it’s only a matter of time before the federal government gets further involved, and that’s exactly what the industry most fears. “The Food and Drug Administration has become the most onerous obstacle involved in reproduction right now,” says Rothman. “They’re unaware of the field and are currently taking orders from the Bush administration—which has time and again proved themselves irresponsible with science.”
Take the 2001 FDA ruling that banned the importation of European sperm on the grounds that it might be contaminated with mad cow disease. “The problem,” says Rothman, “is that Creutzfeldt-Jakob disease is a prion disease—it’s not sexually transmittable. The only way someone could get it is to eat the frozen sperm.”
Nor is this an isolated incident. In 2005, because of the dangers of HIV transmission via blood transfusions, the FDA created Donor Eligibility and Determination Labeling—a set of rules pertaining to the transference of biological material from one person to the next. Sperm banking and in vitro fertilization labs must adhere to these rules, yet there has never been a case of anyone getting HIV from the transfer of reproductive material. Concurrently, they also banned sperm banks from using the sperm of any man who has had “gay sex” in the past five years—even though, again, there is no instance of AIDS being passed via purchased sperm.
As Dr. Barry Behr, Stanford University associate professor of obstetrics and gynecology, and director of Stanford’s in vitro fertilization lab, says: “The government has put unreasonable and nonsensical demands on reproductive clinics.”
Among those nonsensical demands, Behr points to a California law stating that all couples considering assisted childbirth must be screened for diseases like HIV, HDLV, syphilis, hepatitis and rubella. Save HIV and HDLV, all of these results can be ignored or waived—meaning one partner can sign a form saying they understand the dangers and want to go ahead anyway—so infected material is occasionally stored at cryobanks. “The FDA demands that this material be held in a completely separate “biohazard” location in the cryotank,” says Behr. “This means we need more cryotanks, a separate labeling system and a ton more paperwork. All of it is unnecessary. What they don’t get is that every sample in the tank is still sharing the same liquid nitrogen. It’s like making people with a cough live on the same street, but using only one school bus to pick up the entire neighborhood.
“Every time the government passes another law,” says Rothman, “all they’re doing is restricting women’s reproductive freedom. I don’t think the government belongs in our bedrooms. I understand that if the industry doesn’t establish a donor registry, this is what’s coming. But I think the American public should rise up against it. By letting the FDA tell you whose sperm you can’t use, they’re in essence telling you whose sperm you have to use. And I don’t think we want the federal government deciding what kinds of kids the American public should be allowed to have.”
Unfortunately, since few in the industry share Rothman’s position on donor tracking and almost no one on the banking side wants to see donor anonymity revoked, without some sort of intervention, the dangers of accidental incest and hidden genetic disease will continue to grow. The truth of the matter is, as the famed physicist Freeman Dyson once pointed out, “If we had a reliable way to label our toys good and bad, it would be easy to regulate technology wisely. But we can rarely see far enough ahead to know which road leads to damnation. Whoever concerns himself with big technology, either to push it forward or to stop it, is gambling in human lives.”