on lists

I was in Quebec and Ontario and back again over the last two weeks, accumulating curiousities and perversities to write about as this week peters out and the last crusts of blackened snow melt.

I had dinner with the lesbian couple I mentioned a few posts ago; doctor S and I joined some other mutual friends in our old neighbourhood to get the low-down on lesbian procreation. Here are the details you’ve all been wondering about: no turkey baster and no known selfless friend, but a fertility clinic that operates on a competitive and early-riser-privileging first-come-first-served basis, using an anonymous American’s semen.

American? Yes…because Canada does not allow payment for reproductive products (including semen, ova and surrogacy), our men are not as keen to “donate” sperm as their American brothers. Since this regulation came into effect, basically all of Canada’s sperm banks have closed. When I was researching sickle cell disease and eugenics, I called around to find out if heterozygous carriers could donate sperm, and discovered there were only three banks in the country at that time. (And yes, men with SCD trait could donate).

Three sperm banks eh? Well, not only does the restriction on payment for semen in this country raise the commodity value of semen (transporting sperm from another country is probably more costly than boy-next-door production, given today’s fuel costs anyway), reduce the supply and the variety of the product available, it also causes a problem for patients in an area I’m new to but getting increasingly engaged in (more posts on that to follow): cancer. Young cancer patients, often diagnosed with reproductive cancers, could really use high-quality, easy access fertility clinics and banks for their reproductive products to improve fertility experiences after systemic and radiation therapies. If there were a commercial market to back up the infrastructure for these banks, it would not be such a struggle for young guys with testicular cancer to find a place to store their seed before they go in for treatment. At the very least, it wouldn’t be such an afterthought.

But back to lesbian conception. My pals sorted through an on-line catalogue, ruling out prominent and inheritable chronic diseases and donors with poor political preferences. Just kidding- but one mother being an epidemiologist, the reactive gleaning of health status from the list was pretty reasonable. They purchased a baby photo of the lad and listened to his voice on CD. Hearing him made them cry. Meanwhile at the head of the table, another former classmate of mine is doing her own modern catalogue browsing. About what she’d accept from an adoptee preschooler- FAS, mental and physical disabilities, boy, girl, etc. It’s lavalife for infant selection.

But cyber quipping aside, I am not adverse at all- quite the opposite. Not only because if couples are going to go through the enormous wait, expense and anxiety of assisted reproductive or public adoption, they should have as much say in the matter as possible. I was struck by the painful self-study (or couple study) the process is. The grotesque truth-telling, grotesque because it is so black and white and typed.

Most of the time we demonstrate our preference for partners (and genetic offspring) without chronic disease by spooning up against the evolutionarily-preferable healthy & strong. No one goes around judging our selfishness for the choosing of a non-smoking athlete with an IQ of at least 125. Except for some bitter jealous sniping, maybe.

But further and as Dr K pointed out, every big life-altering action is a crapshoot and the odds run proportional no matter how you approach the gamble. A pregnancy can result in trisome 21. An assisted pregnancy can result in trisome 21. An adoption can result in trisome 21. All can be terminated, at who knows what level of disappointment and further delay. But then again all could result in something not on the screening list, not knowable from genetic pasts or amniotic presents. And trisome 21 might be something you think you can handle anyway.

Lists (and science!) lacking all-inclusiveness, they’re more of a tool for some heavy self-reflection than a conclusive decision aid. And perhaps in the context of deciding whether a donor’s history of heart disease is more or less acceptable than one of juvenile diabetes, there will be some initiation into the thorny brush of sharing parenting.