In the new film Delivery Man, Vince Vaughn plays David Wozniak, a man who discovers that he’s the biological father of 533 children—all conceived through his anonymous sperm donations. Now, almost two decades after his “donations” (from which he netted over $20,000), 142 of those children have filed a lawsuit against the sperm bank to reveal his identity. They want to know their biological father, gain access to their medical histories, and discover their roots.

The film is fictional—but it’s not far from reality. In 2011, the New York Times reported the story of one donor with 150 confirmed offspring. There have only been a handful of major studies following children who were conceived via anonymous gamete donation, yet certain key trends are emerging as they reach adulthood. Although these adult children have mixed opinions about the means in which they were conceived and the limits of such technologies, they’re almost all united in one belief: anonymity should be removed from the equation.

Readers of Public Discourse are already familiar with Alana S. Newman, founder of the Anonymous Us Project and, most recently, editor of Anonymous Us: A Story Collective on 3rd Party Reproduction. In this volume, Newman compiles over one hundred stories of donor-conceived individuals who, like the kids in Delivery Man, long to know their biological parents.

“While anonymity in reproduction hides the truth,” writes Newman, “anonymity in storytelling helps reveal it.” Accordingly, these stories offer a glimpse into the reality faced by many donor-conceived children. Some contributions are angry, others are conflicted. All, however, reveal a deep loss. Consider just a few of the sentiments shared within the volume:

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“Who are you to deny me half of my family tree—branches rich and strong with stories I may never be told? Who are you to give away my heritage, knowing it will be replaced with something false?”

“I am a human being, yet I was conceived with a technique that had its origins in animal husbandry. Worst of all, farmers kept better records of their cattle’s genealogy than assisted reproductive clinics … how could the doctors, sworn to ‘first do no harm’ create a system where I now face the pain and loss of my own identity and heritage.”

“As a donor-conceived person, I have a sense of being part of an underclass … Having a child is a privilege not a right.”

There’s also the story of a young donor-conceived adult who was raised by a single mother. After her mother’s early death, she’s since been desperately searching for her donor father and potential other siblings in hopes that she might have some remnants of a family to piece together. Another young woman tells of her own struggle with infertility when she and her husband were trying to conceive. After telling her mom of their difficulties, her mom casually suggests artificial insemination—informing her for the very first time in her life that this was the means in which she was brought into the world. Countless other stories capture the experience of donor-conceived children finding out their origins after their social father is diagnosed with a major medical condition—only to be told not to worry because it won’t affect them, since they’re not actually biologically related. The grief stemming from the medical difficulties is then compounded by an unexpected family identity crisis.

The entries included in the Anonymous Us collective aren’t just limited to the testimonials from donor-conceived children. Stories from medical providers, sperm and egg donors, and parents who chose to conceive via this method fill the pages of these raw and emotional testimonials. While some entries are an effort to justify past decisions, others speak with great candor about the regrettable outcomes of such a practice.

One Italian sperm donor reflects on the experience of his own family life and laments that the children whom he helped bring into this world won’t be able to have similar memories:

“I have only a sister, but many, many cousins … and every time I meet them and all the relatives, we love to talk about similarities in the features, the body, the way we talk and move, because this gives us a stronger sense of identity and it is beautiful to have such a ‘big family’ … I hope this little story can help people in learning from the mistakes of the past.”

In another entry, a former egg donor regrets the fact that she’ll never be able to meet her son or daughter, admitting that she only participated in the practice because of the lucrative financial incentives attached to selling her eggs: “I don’t even remember what I spent the money on,” she writes. “Debt, dresses, and dinners probably. I’d give you $10,000 this very second to meet my kid. Biggest oops of my life.”

In the United States, there’s an open and unregulated market for gamete donation. Unlike Canada and most European countries, which limit the number of times a man can sell his sperm and have mandatory database registries where donor children can access their biological parents’ medical histories, the United States enforces no such regulations. This lack of regulation is due, in large part, to legislators’ failure to listen to the voices of donor-conceived children. “How can we as a nation make wise decisions about family structure, third-party reproduction, and gamete donation,” asks Newman, “without the participation of and insights from those who have been most directly affected by these practices?”

Just how many donor-conceived children are born each year is anyone’s guess, due to negligible tracking and regulation. At a recent conference for fertility-industry attorneys, I listened to a prominent children’s psychologist (who favors the practice of third-party reproduction) speak about the potential psychological issues donor-conceived children might face. In a moment of candor, she admitted, “We never thought about the future families. We only set out to fix the infertility.”

And this is precisely the problem with donor conception: the desires of the parents always trump the needs of the children.

The stories in the Anonymous Us Project and Delivery Man demonstrate the real suffering and loss felt by donor-conceived children. Yet, in considering the problem of infertility, we also encounter countless couples who experience great distress and grief as a result of their inability to conceive. Infertility is a deeply painful and often isolating experience for millions of couples. The CDC estimates that 10 percent of women trying to conceive are infertile; hence the increasingly common decision to pursue assisted reproduction. This drive to have children is understandable; social science research reveals that the presence of children in a marriage leads to greater happiness, increased financial security, and a lower likelihood of divorce.

We must acknowledge the painful truth that, as infertile couples seek to remedy their suffering through third-party reproduction, they are unwittingly inflicting pain on their future children. Eventually, those children must wrestle with the circumstances surrounding their conception. In aiming to satisfy their very natural desire for offspring, infertile couples go to great lengths to create children who are destined to experience complex crises of identity and purpose.

This transgenerational suffering precipitated by the experience of infertility is one that must be met with compassion, to be sure. Yet we must also offer a corrective that acknowledges the limits of desire and love.

Rather than supporting an inward focus on one’s own pain and loss from infertility, we ought to encourage infertile couples to give deep consideration to the suffering that children conceived from these technologies may face. Moreover, rather than privileging one’s own desire for a child as the ultimate goal, we must encourage a preemptive compassion and empathy that should motivate infertile couples to refrain from pursuing such means.

In one of the most revealing entries of the Anonymous Us collective, a former sperm donor criticizes the industry he profited from: “I now realize I was wrong. This whole system is wrong. Please forgive me, but I am not your father, nor did I ever intend to be.” Similarly, in one of the scenes from Delivery Man, when one of the donor children discovers that Wozniak is his biological father, the son seeks to spend time with him. Annoyed by this prospect, Wozniak brushes the kid off, telling him that he has a real family to attend to.

Infertile parents who desperately seek a child might see anonymous egg or sperm donation as an imperfect, though still acceptable, solution to their fertility difficulties. But as the stories in the Anonymous Us collective reveal, for the children conceived through these technologies, the difficulties are just beginning.