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When the donor refused to come forward, the sperm bank joined him in fighting the subpoena. In 2000 the California Court of Appeal rejected the bank's argument and forced the donor to testify, ruling that he could do so anonymously. "There may be instances under which a child conceived by artificial insemination may need his or her family's genetic and medical history for important medical decisions," the court wrote.

By protecting the donor's privacy while demanding that he testify, the California court sought to help Brittany without shredding the guarantee of anonymity. That's what donors are promised in the contracts they sign. Identity protection also appears to be key to a thriving donor market. Despite the financial incentive—at California Cryobank, donors can make almost $8,000 for a year of twice weekly visits—sperm is now in short supply in Australia, the Netherlands, and the United Kingdom, where laws have been changed to give donor offspring the right to know who their fathers are. Faced with long waiting lists, some foreign banks have even resorted to importing sperm from abroad.

The fear of scaring away future donors complicates the question of sharing medical histories with donor children. Still, advocates argue that there is plenty of room for reform. Wendy Kramer wants the banks to take a first step by tracking live births. As it stands, California Cryobank admits that it doesn't hear back from many of its clients. Meanwhile the bank allows as many as 25 families, each of which may have multiple children, to purchase the sperm of any one donor; after that, he is retired. Without a complete record of births, it's nearly impossible for the banks to notify all the potentially affected families when evidence arises of a genetic risk like Brittany's kidney disease, or Dylan's, Joseph's, and David's autistic spectrum disorders. This is where Kramer hopes the DSR's new medical page will come in. The details of a family's history can prompt a mother to get a child tested, as Theresa and Elizabeth did—no small thing, because with autism, early intervention can matter. And then there are the decisions that parents make about their family's future. The Florida mother whose 5-year-old son has developed normally recently elected to use Donor X's sperm again. Pregnant with a second son and in a long-term lesbian relationship, she says, "I wanted my two boys to be related in every way possible. Since my partner and I can't reproduce without the assistance of a donor, we felt that choosing the same donor was the only logical way to go." But a second Donor X mother, Dixie (she did not want her last name printed), says that she will use the sperm of a different man if she has more children. Her daughter, Sydney, now 4, looks like Theresa's daughter, Anna, and has the donor's professed aptitude for music. Still, Dixie doesn't want to take her chances with autism, now that she knows about the risk. "Not that you wouldn't love the child, but why would you want to stack the odds against yourself like that?" she asks.

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