Yale Sociology Professor, Rene Almeling, has just published a book entitled Sex Cells: The Medical Market for Eggs and Sperm. My thanks to the invaluable Marna Gatlin, CEO of Parents Via Egg Donation, for bringing this study to my attention. Here is an interview with Professor Almeling that appeared on The Huffington Post:

What really goes on behind the closed doors of sperm banks and other institutions that broker the exchange of reproductive materials for money?

That’s a difficult question to answer. A few weeks ago The New York Times reported that a single sperm donor was responsible for 150 children. How did that happen? What regulations, if any, exist for what has become a $3 billion industry?

To find out more about this industry and how it affects the lives of those who donate, Yale sociology professor Rene Almeling spent four years interviewing staff members at egg agencies and sperm banks in different parts of the country and talking with donors about their experiences. The result is new book called Sex Cells: The Medical Market for Eggs and Sperm.

Almeling learned that when it comes to donating genetic material, men and women are groomed very differently, and the way the process is marketed impacts everything from how individuals talk about their donation to their perceived relationship to the resulting offspring.

One of the biggest takeaways from your research was that sperm banks and egg agencies present sex cell donation to potential donors in very different ways. What was so different?

Both sperm banks and egg agencies call this a donation, even though the women are being paid and the men are being paid. The difference is that the egg agencies are framing the egg as a gift from one woman to another, and so they look for altruistic women who want to help infertile couple have families. They frame sperm donation as an easy job for men. There are a lot of jokes and cartoon drawings of sperm in advertisements that say “make some cash,” but they’re not talking about recipients; they’re not talking about families.

Did you discover a difference in how men and women feel about donating after they’ve done it? If so, how does the marketing play into that?

One big thing is that the egg agencies encourage recipients to send thank you notes and thank you gifts to the donors. And the result of that is women talk with a lot of pride about being egg donors, and having given this gift. They feel good about their donations and about the creation of a family. That was true of women who were older and younger, women who had kids and didn’t have kids.

With the men, no one is sending their sperm donor thank you notes or giving them gifts. The men used sort of alienated or objectified language. They described themselves as being resources and assets for the sperm bank. In that sense, sperm banks don’t spend a lot of time with donors talking about recipients or thanking them for what they’re doing.

How does the language around donation effect the ways that men and women talk about the financial aspect?

Women are being paid an average of $5,000. They would talk about that as “a gift” for the gift that they had given. Men would call the money they were paid “wages” or “income” or “paychecks.”

That’s interesting because the vast majority of donors were interested in being donors so that they could make money. They were in it to make money, they made the money, and yet the women had this script that they could draw on of helping other women and giving the gift of life.

You also found that sperm donors think of themselves as fathers but egg donors don’t think of themselves as mothers. Why is that?

Because there is so much emphasis on the recipients in egg donation, egg donors don’t think of themselves as mothers. They give this egg in the hopes of giving another woman the experience of motherhood, so they point to the recipients as the real mother.

Sperm donors — because there’s not a lot of talk about recipients — have it in their minds that they are fathers to all these children that are out there. Men and women are each providing half the genetic material for an embryo, but they think of their relationship to the offspring in very different ways.

This really [reflects] that for women, maternity can be broken out into different pieces now because of technology. One woman can provide the egg, another can provide the pregnancy and a third woman can raise the child. Paternity is not so easily broken apart.

Egg donor after egg donor, in different parts of the country, used this phrase: “Just an egg.” They’d say, “What I’m giving is just an egg.” They’re distancing themselves from the label of mother, because otherwise they would be the worst kind of mothers — they would be the kind of mother who sold their child for $5,000. They have a pretty vested interest in saying, “I’m not a mother. I’m not a mother. I’m not a mother.”

Many of us have read egg donation advertisements targeting college women who are presumably looking to pay off debt. How do the agencies go from stressing the compensation of donating an egg to emphasizing that the egg is a gift?

The ads are really interesting because they will highlight the fact that there is compensation. But at the larger agencies, they get hundreds of applicants a month: anyone who was blunt about wanting money wouldn’t make it through the first stages of their screening process. It’s certainly the case that egg donors in general want to make money, but if they are blunt about that, they’re violating this idea of egg donation as a gift from one woman to another.

Even if they’re not actually there for altruistic reasons, they have to voice altruistic reasons. It [speaks] to our deep societal discomfort with a market for body parts: people are not comfortable with people selling body parts. There’s a euphemistic language of donation that’s all over this market.

The funny thing is that sperm banks expect men to be motivated by the money. Men are supposed to be making money. We are more comfortable with men in the marketplace. Women are considered closer to children and closer to motherhood, so their earning money for their eggs is more uncomfortable than men earning money for their sperm.

Why do the sperm banks and egg agencies frame things so differently?

I think the answer can be found in our gendered cultural stereotypes of women as nurturing caregivers and men as productive breadwinners. There is a sort of 1950s-era gender stereotyping that plays out in the brave new world of assisted reproduction on a daily basis.

A lot of people will look at this market and say, “There are biological sex differences between men and women. Women have to take shots and undergo surgery.” They’ll think the differences in the market are due to biology, but biology doesn’t explain all the differences we see, and in fact, these cultural stereotypes of women and men are part of the explanation.

What were the biggest concerns your research prompted about the reproductive donation industry?

I think the major concern that comes out of my research — and other people’s — is a concern about the physical risks of egg donation. We know that for the short-term risks, around one or two percent of women will have serious complications. But there are still no good studies of the long-term side effects. To truly provide women with informed consent, those are studies that need to be done.

[Also], the vast majority of egg donors have to undergo psychological screening. They have to consider how they’re going to react to this [in consultation] with a mental health professional. That same psychological screening is not required of men. It’s doing sperm donors a disservice to emphasize the short-term financial gain rather than the long-term implications of donating genetic material.

I wish I had more time to reflect on this article, but I am sure I will have much more to share once I have read Professor Almeling’s book. So I apologize in advance for my stream of consciousness that follows.

My experiences over the past two decades track with what Professor Almeling states in her interview with The Huffington Post. Perhaps one of the reasons for the stark gender differences between the experiences of egg and sperm donors can be traced back to the origins of each industry. Because of the nature of frozen sperm storage, sperm banks were run and operated almost exclusively by physicians (and male doctors too boot) who released very limited information about their sperm donors. In many instances, it was the doctor who selected the sperm donor — not the patient.

Contrast that with egg donor programs which are largely run by non-physicians and thus not locked into the sperm donor model that has been around since the days of the Great Society. These egg programs, not constricted by decades-old policies, were free to focus on the psychological, emotional and personal desires of their recipient parents and egg donors. This has led to significant departures from the sperm donation model including open donation as well as providing the recipient parents with comprehensive personal, medical and psychological information on their donor that historically was only available to their physician.

I always have wondered what the field of egg donation would look like today if egg freezing was developed in 1983 — before fresh egg donor cycles. So while certainly I defer to Professor Almeling given her extensive research, I wonder if the gendered cultural stereotypes identified by her are the root cause for the dissimilarities between sperm and egg donation or is it grounded in the distinctly different origins of their respective markets? My own personal suspicion is that the distinctions identified by Professor Almeling would not exist as egg donation would have been within the exclusive domain of physicians who would have continued to apply the sperm donor model to egg donation. So while cultural and gender differences would have to yield some disparate experiences between sperm and egg donors, would these differences be so stark if egg programs had been operated like the original sperm banks?

Your thoughts?