[Page 7]
Overall, then, the fertility trade is a wide and disparate market, defined by clusters of providers specializing in distinctive competencies. There are component suppliers in the trade: assembly operators and manufacturing centers, surgical experts and diagnosticians. There are clinics that cater to particular clienteles, along with a growing legion of consultants, marketers, and reproductive lawyers. All these segments operate under the same broad rubric that defines the baby trade. All of them are selling into a market where “whatever it takes” is often the going price. They are selling to clients joined by their desire to buy but divided sharply by their ability to pay. They are selling a product that is simultaneously hope and medicine. And they are selling in an environment constantly subject to ethical concerns and political oversight.
Each of the segments involved, however, experiences these factors in a different way. Each of them faces a slightly different aspect of the demand for children, a slightly different threat of regulation, and a different calculation of entry costs and the value of scale. To understand the modern fertility market, therefore, we need to probe beyond an abstract notion of supply. We need to break the market into its component parts, looking at how each operates and how together they meet and shape the ever-present demand.
Arrayed along the fertility trade’s bottommost rung are those that supply its most basic components: sperm, eggs, and hormones. These are among the industry’s oldest firms and its most profitable. They are also its most unapologetically commercial, seeing no contradiction between the products they sell and the profits they reap.
Commercial sperm banks, for example, have been a feature of the fertility landscape since 1970, when the first for-profit bank opened its doors in Minnesota. As in other segments of the baby business, many of these firms began life as nonprofit, in-house clinics—service centers, really, for the growing treatment of male infertility. Both technically and commercially, their function was simple. Men would produce sperm in a laboratory setting, and the labs would capture and preserve it for future use.
This content is authorized for use only in the HarvardX course "Bioethics: The Law, Medicine, and Ethics of Reproductive Technologies and Genetics," September/October 2016. Copyright 2016 by the President and Fellows of Harvard College. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means without the permission of Harvard Business School.