Victoria Hill is among at least twenty-six children conceived when a former Yale fertility doctor inseminated unknowing patients with his own sperm—an injustice difficult to prosecute and impossible to process, particularly after his recent death.
Victoria Hill had been sick for months. She first fell ill in 2020 while on vacation in Iceland, but her symptoms persisted back home: migraines, vertigo, nerve damage. Her doctors found that she didn’t have a common virus—nor one they could identify. They could not conclusively diagnose her. Could it be genetic, she wondered? Neither of her parents had experienced anything similar, so she turned to commercial DNA testing. 23andMe, she heard, could connect genetic data to health risks.
Her test results prompted more questions than answers. She first noticed a few relatives listed as paternal “half-siblings.” This must be a mistake, she thought; DNA tests often confuse siblings with close cousins. Still, there were too many unfamiliar names, including members of a mysterious “Caldwell” family. In the middle of the night, she marched the results to the other side of her duplex in Wethersfield, Connecticut, where her mother lived. Her mother tried to avoid the late-night confrontation. But eventually, the two sat and faced one another. At the age of 35, married and mother to a child of her own, Hill learned she was donor-conceived.
Such discoveries are all too common in the world of sperm donation. Particularly for children of Hill’s generation, parents were advised by fertility doctors not to tell their children the truth about their conception. For some parents, that was just standard practice. For others, it was to shield their children from the shame, confusion, and emotional ambiguity that accompany sperm donation. Neither parents nor doctors predicted how popular the genotyping technology used by companies like 23andMe would become.
So when children unexpectedly discover the true origin of their conception later in life, that mix of emotions can come crashing down at once. Sometimes, it leads to truths about their lineage that they would prefer as fiction. Who was their father, really? Where were their half-siblings? As Hill would soon discover, the answers to these questions can be disappointing—and even revolting.
Yet in many states, such as Connecticut, few laws guarantee children’s rights to information about their donor parent. Those who have misgivings about their conception are often left stranded in the absence of legislation. For Hill, that means being unable to seek justice against her biological father.
. . . .
Maralee Hill had struggled to conceive with her husband. They discovered he had a low sperm count with slow motility, which reduced their chances of conception. Still, the couple wanted children. They decided to try fertility treatment, a practice that was only just gaining popularity in the 1970s. The couple drove to Yale New Haven Hospital and began visiting an endocrinologist, who recommended sperm donation. Doctor Burton Caldwell promised that the donor would be anonymous; he would select a healthy Yale medical intern who resembled Maralee’s husband. In 1977, they welcomed a baby boy. The doctor also recommended they keep quiet about their fertility treatment, as couples often did then. Their children would never find out they were donor-conceived. And even if they did, they would have no means to learn more about their biological father—that was common wisdom. So the Hills didn’t tell their first child about his biological father. In 1985, when they had their second child, Victoria, also by sperm donation, they decided not to tell her either. Even as genotyping technologies threatened to reveal their secret thirty-five years later, Maralee tried to keep her daughter’s conception under wraps.
When Hill told her mother she was interested in testing her DNA, Maralee discouraged her: “Don’t send your genetics to a corporation.” And when she learned that Hill had mailed her saliva sample to 23andMe anyway, she began to stalk their shared mailbox to steal and hide the results. Maralee didn’t realize that 23andMe returned results digitally.
The night Hill confronted Maralee with her DNA test, her mother was reluctant to talk. It would mean confirming the truth she had hidden from her daughter for so long. She feared Hill might resent her.
What Maralee could not have expected was that Hill had learned more about her supposedly anonymous father. After she received her 23andMe results, one of her half-siblings messaged her: “Do you want to know more about what you’re seeing?” Originally, Hill ignored the emails, thinking they were a scam. Then, she received a message she couldn’t ignore: “Did your mom or dad go to Yale for fertility help?”
Hill knew her mother had visited the Yale New Haven Hospital at some point during her pregnancy. But how did this stranger know? She responded to the mysterious inquirer and, after a brief exchange, they quickly connected the dots. They were half-siblings of the same father, who was not, as it turns out, a medical intern, but a Yale-affiliated endocrinologist—the same doctor her mother had been visiting for over a decade. Their biological father was Dr. Burton Caldwell.
Maralee was in disbelief—she had been promised an anonymous medical intern. In fact, she later confirmed that her son, Hill’s older brother, was conceived with an intern’s sperm as promised. But for some reason, after Maralee had had one stillbirth and two miscarriages, Caldwell decided to use his own sperm for her second pregnancy. Maralee couldn’t accept that. “She was in denial,” her daughter recalls.
Hill accepted the fact quickly. She spent her nights googling Caldwell and his family. Nothing was too trivial. “I even looked up what cars they drove,” she admits with a laugh. Her preoccupation with her new knowledge made focusing on her job as a high school social worker a challenge. “I was trying to meet patients where they were at, and I could not be present,” she remembers.
One day, almost a week after she found out about Caldwell, school ended early. “I can’t do this anymore,” she told herself, “I just got to go.” She drove to an address she had found online. She had only meant to survey the lay of the land.
Before she knew it, she was knocking on his door.
. . . .
The Caldwell home is a forty-minute drive from Yale. The address is difficult to find online—as if, Hill speculates, someone had wiped it. The house is an off-white suburban estate with three stories and two garages. It rests atop a hill, surrounded by the unmistakable geography of a wealthy suburb: wide, winding roads sandwiched by greens and houses. There are no sidewalks.
When Hill arrived at Caldwell’s house, his wife, Itie, answered the door. She seemed welcoming, albeit concerned for the young woman claiming to be her husband’s biological child. “She did one of those head tilts where she’s like, ‘Oh, you poor thing,’” Hill recalls. Itie Caldwell did not know that her husband might have biological children scattered throughout Connecticut. But Hill says that as soon as she walked in, her husband readily revealed that fact. “I didn’t think that she knew at all,” Hill says of Itie that day. “My heart kind of broke for her.”
But Burton Caldwell remained poised.
“He had that kind of callous, clinical feeling,” Hill recalls. She asked him how he felt about the children he fathered: “He told me he didn’t think about us.”
Caldwell was suffering from advanced Parkinson’s. When Hill met him, his body was deteriorating: he had spotty skin, thin lips, and translucent white hair. He looked nothing like Hill’s father.
Caldwell had been a tall and in-shape Irishman; her father, a German, was neither. Hill has Caldwell’s blue eyes, not her father’s brown eyes or her mother’s green ones. She always wondered why she looked so different from her father. Her answer was now standing before her.
Caldwell asked about Hill’s academic achievements and any grandchildren, but revealed little about his intentions in using his sperm to conceive her. No one—except perhaps the man himself—can know for certain why he used his sperm.
Perhaps he thought it was convenient, similar to how one New York gynecologist who inseminated his patients explained himself to The New York Times: “I admit I did it…it may have been less than perfect, but with luck, the women were able to conceive.” Or, as one activist suggested of doctors like Caldwell, he never reconciled the “disconnect between this being a medical procedure and the fact that they were creating and giving away their own children.” What is certain is that Caldwell never expressed sympathy for his newfound relationship with Hill. Later, she would learn Caldwell had lost a son at the age of 36 to an aortic aneurysm.
That son was the only child he conceived with his wife. She could not understand how he could not feel anything for her or any of the children who had suddenly appeared in his life at just about the same age. “There was no indication whatsoever that he was trying to look at me like he would look at a daughter,” Hill says, matter-of-factly. She
speaks of the moment as though she had relived it many times.
Caldwell’s lack of remorse disgusted Hill. It would still take time for her to confidently articulate what exactly she felt Caldwell did wrong, but she had an intuition that some deep misconduct had taken place.
“I view this as a form of sexual assault,” she would write about her mother’s insemination in testimony at a trial
four years later. “The line between medical touch and sexual touch [was] blurred.”
But when Hill first sought legal counsel in 2020, she was met with little more than sympathy. What Caldwell had done to her and her mother was known as fertility fraud. In the last several years, at least fifty fertility doctors in the United States have been accused of such fraud; advocates claim there are at least eighty. But like most states, Connecticut law does not consider fertility fraud a crime. There was nothing in the law, her lawyers said, that could give her recourse.
. . . .
Sperm donation is a strikingly low-tech process. Its most basic form only requires viable sperm, a healthy egg, and a syringe, making it possible for a doctor to produce sperm outside his patient’s room and use it immediately after to inseminate his patient.
In most cases, however, the process is more complicated. If a mother decides to visit a sperm bank, they choose a donor based on a myriad of traits: height, race, education, family, medical history, sometimes even a photograph. Once they decide on a favored combination, they are medically examined for an optimal date of insemination, upon which sperm is transported through a tiny catheter into their cervix. This process is known as artificial insemination, which, according to anwidely-cited 1988 study by the now-defunct Office of Technology Assessment, results in thirty thousand births in the US every year. There have been no studies of annual donor births since, but according
to a 2019 article published by the National Institute of Health, the number has likely increased.
Maralee did not visit a sperm bank, which was then a nascent business model. She did undergo artificial insemination at Caldwell’s hands. It’s unclear exactly how Caldwell’s insemination process in the 1980s might have differed from common practice today. Still, one element remains true today: American sperm donors are mostly anonymous.
That is not the case in Germany or the UK. And unlike in Sweden and Portugal, the US also has no federal laws guaranteeing a child’s right to their donor’s medical record. And there exists no national registry of donor-conceived children or their donors—data on cattle sperm are better catalogued. The American artificial insemination industry remains, in Hill’s words, the “Wild West.”
This anonymous system emerged partially out of a desire to incentivize sperm donations. Established fertility clinics are often highly selective of the sperm they accept: out of every hundred men who express interest in donating, only four pass the health screening, the lifestyle screening, and the sperm quality control. The more selective the screening, the more expensive the sperm: costs can range from the hundreds to the thousands. And, since nearly a third of interested men prefer to donate anonymously, eliminating anonymity would diminish the sperm market, increasing prices even more. Some particularly desperate prospective mothers have sought sperm donation black markets on Facebook and other social media platforms, where regulation is practically nonexistent.
Opponents of regulating donor anonymity, however, believe laws enforcing disclosure threaten the legitimacy of LGBTQ+ families. In February 2023, an Oklahoma judge removed parental rights from Kris Williams, a woman who had used sperm donation to conceive with her then-partner, also a woman, two years prior. Williams’ wife carried the child, and the couple split two years after the baby was born. During the divorce proceedings, a judge removed Williams from her son’s birth certificate, replacing her name with the male sperm donor, with whom her former spouse had since moved in.
Of those seeking sperm donations, 70 percent are lesbian couples and single parents. Disclosure laws may indirectly lead to the legal recognition of biological donors as “real” parents, undermining the legitimacy of same-sex couples’ parental rights.
In the absence of federal and state legislation,the American Society for Reproductive Medicine (ASRM), a nonprofit organization of medical practitioners, determines the guidelines that most American sperm banks and clinics follow. Most credible sperm banks are affiliated with the ASRM and follow their guidelines voluntarily. Among the ASRM’s recommendations is a limit on the number of children a donor can father. But outside this voluntary guide, there is no regulation. One man can donate for two children in the same family, twenty in the same neighborhood, even two hundred in the same state—and federal laws have nothing to say on the matter. The ASRM suggests 25 births per population of 800,000 to “avoid any significant risk of inadvertent consanguineous conception,” or, in common parlance, incest.
“But who’s counting?” asks Dr. Lubna Pal, a professor of reproductive sciences at the Yale School of Medicine. There are no committees, government or private, to effectively oversee guidelines like the birth cap. Outside the basic health guidelines that the FDA and CDC enforce, there are few government mandates on donation. “There are societies where all of this is legislated,” she says. “We’re not one of them.”
That changed in Colorado, which in January 2025 became the first and only state to forbid donor anonymity. The state passed legislation requiring banks and clinics to document and update donor information every three years, enshrining the ASRM’s 25 births guideline into law. But in February, the Colorado House of Representatives introduced a bill eliminating that new requirement: if passed, donor-conceived children could no longer contact their donors, and banks and clinics in Colorado would not have to follow the 25-births guideline. The ASRM backs the new bill. The original bill, they argued in a written letter, was “rushed” and set a “problematic precedent” of government interference in private matters. The new bill would not let “the state insert itself into reproductive and child-rearing decisions, decisions which should be the domain of individual families.”
For the banks and clinics in other states claiming to follow the ASRM’s guidelines, there is no guarantee that these guidelines are enforced.
This, combined with the lack of a shared or national registry of donors, makes determining
the number of donor-conceived children in any given area a herculean task—and makes it impossible to estimate how many children are products of fertility fraud. “There’s no real, unbiased information available,” says Guido Pennings, a professor of bioethics at Ghent University. “There are a lot, undoubtedly. But the percentage?” He shrugs.
There’s just no way to know.
. . . .
When Hill saw her old friends at a high school reunion in 2023, she had been searching for lawyers for three years. In the meantime, she kept track of advancements in fertility legislation: five states—there are thirteen today—had passed laws criminalizing fertility fraud. Still, there was no legislative development in Connecticut, and lawyers would not commit to her case without convincing evidence of damages. Hill’s high school boyfriend was also at the reunion—someone she once imagined a future with. That night, she told him about Caldwell. Then he shared his own revelation: he had also recently discovered he was donor-conceived, though he hadn’t tested his DNA. She suggested 23andMe. Weeks later, his text arrived with a screenshot of their connection: “You are my sister,” he wrote.
Caldwell had blurred the boundary between family and community. “At this point, I’m waiting for a client to be one of my siblings,” she says of her job as a social worker. At least four other half-siblings attended the same schools at the same time she did.
She now has twenty-five confirmed siblings, many in the area. “We had so many surprises that it was one more thing,” Hill remembers. “We’re kind of numb to what will come.” But the news incited legal momentum. Her high school boyfriend’s mother found a Connecticut lawyer willing to represent her, and Hill’s mother joined the case. In March 2024, the two women sued Caldwell and Yale New Haven Hospital. They presented a joint lawsuit arguing that their children’s inadvertent relationship was evidence of damages.
Caldwell’s affiliation with Yale when Maralee visited him for fertility help remains unclear. Yale insists that he was no longer working in Yale-owned buildings when Hill was conceived in 1984. According to Yale attorneys, Caldwell left Yale sometime in 1983 to establish an independent clinic. But the mothers contend that Caldwell convinced them to believe that his clinic was Yale-affiliated. They also insist that Caldwell remained a member of the medical staff and continued to teach at the School of Medicine, even after he left his position at Yale New Haven Hospital. Yale New Haven Hospital declined to comment.
Maralee argued that she had the right to know the extent to which Yale was involved in Caldwell’s practice, and in January 2025, a judge ordered the Yale Corporation to provide documents related to Caldwell’s affiliation with Yale New Haven Health.
It’s important that neither Hill nor her high school boyfriend are represented in the suit. The reason is strategic: Connecticut law is ill-equipped to defend children of artificial insemination. In principle, the court struggles to recognize a victim who, at the moment of the alleged crime, had not yet been born. If Hill joined the lawsuit, she would be suing a man for the very action that created her existence. Lawyers might interpret that as claiming she would prefer not to have been born at all.
The sentiment is ubiquitous. “He gave us life, and our moms wanted babies,” Hill recalls friends reminding her. “And that was the best gift he could have given them.” They might even add that the man who gave them life was a smart man—a Yale doctor.
Hill scoffs at the suggestion. She is not ungrateful for her life, but she believes the way she was conceived was wrong. Some things are at once blessed and tragic. Life is among those things. But that does not always translate well in court. Jody Madeira, co-director of the Center for Law, Society & Culture at Indiana University Bloomington, remembers cases where courts have removed children from their lawsuits against donor parents or hospitals. In January 2019, an Idaho judge dismissed a donor-conceived child from a lawsuit against a fertility doctor who used his sperm to inseminate her mother.
Her mother remained in the lawsuit on the question of “fraud and deception by a physician.” But this lawsuit was not, a judge declared, “a case about parentage or conception.” The doctor had no obligation to the child because she had not yet been born.
Similarly, in 2024, the State of Connecticut appealed to the Supreme Court of Connecticut against accusations of medical malpractice at a state hospital: a prospective mother had not been debriefed about potential inheritable diseases carried by her selected sperm donor.
The State attempted to dodge the charges by dismissing the mother and child’s lawsuit as a “wrongful life” case. According to Madeira, this was the court’s way of saying that the family was violating a basic premise of law: “That life in all forms is better than no life.” The Supreme Court disagreed with the State’s interpretation and upheld the mother and child’s award of 34 million dollars in damages.
But Maralee’s lawsuit aims for a narrow claim to damages. It focuses on characterizing Caldwell’s deception as “fraud,” defined in Connecticut law as “obtaining valuable thing[s] or service[s] by false pretenses.” Some scholars of family law, such as Temple University’s Dara Purvis, believe this characterization downplays the scale of the crime. Why isn’t inseminating a woman with one’s sperm in a non-consenting manner considered sexual assault? It probably could be. But as it stands, Purvis explains, artificial insemination—a medical procedure— struggles to match the statutory definition of sexual assault.
. . . .
In February 2025, Caldwell died. Hill saw the message on her half-siblings’ group chat. The same sibling who had first contacted Hill on 23andMe relayed the news from a Caldwell relative. Hill didn’t know how to feel. Her friends sent her ambivalent condolences. Messages like: “Sorry?” She wondered, “Huh…am I sad?” Learning that some of her half-siblings sent flowers to Caldwell’s house perplexed her even further.
Now, a sense of frustration wells within her. “The only thing that really bothers me is that he won’t get to live to see any consequences,” she says. Hill wanted to see Caldwell confronted with the questions he would not answer when she came to his house. Once, she attended a deposition where Caldwell, in his declining health, was also present. “I wanted to go because I could just sit there and just stare at him. Like, I just wanted to examine him, his facial features,
his hands, his mannerisms, how he spoke.”
But any chance at a satisfying explanation for his actions had died with Caldwell. It remains unclear how his death will impact the lawsuit. All lawyers related to the case either declined to comment or did not respond to a request for one.
It also irks Hill that Caldwell died before a court could confirm that he had committed a crime—or, as she says, could “prove that what he did was wrong.” Yet the state-wide legislation she pushed for in Connecticut has not gained traction. Even seemingly uncontroversial bills that would retroactively criminalize physicians who “knowingly use [their] own sperm to inseminate a patient without the patient’s consent” have failed to pass the Connecticut House. Those who oppose government regulation, like the medical professionals at ASRM, dissent against Hill’s efforts. The ASRM declined to comment.
But a federal fertility fraud bill has shown promise in the House of Representatives, where in 2023 the Protecting Families from Fertility Fraud Act was introduced. The Act would criminalize fertility fraud at a national level, though without a clause on retroactivity, meaning that it would not help Hill’s case against Caldwell. The bill has been stuck in the House Judiciary Committee for nearly two years.
Asked if she remained optimistic, she admits, “I was, and I’m not anymore. I’m really not anymore.” Yet Hill feels that she must keep trying. She remains both frustrated and motivated by organizations like the ASRM that inadvertently hamper the passing of fertility fraud legislation. Some of her more vocal opponents may even assert that fertility fraud “doesn’t happen anymore” as widespread commercial DNA testing makes it harder for doctors to hide behind anonymity.
But Hill insists this isn’t true. Two years ago, a 14-year-old’s DNA test revealed that their mother had been inseminated by her fertility doctor’s sperm in 2009 at a fertility center at the University of California, San Francisco. The doctor continued his practice at a University of Washington clinic, where he saw 2,600 patients. In an investigation, the Washington Medical Commission identified two hundred potential children.
Hill thinks of her two children, who she claims have more than forty confirmed first cousins near where they live. She wants her kids to know that their mom “didn’t just sit back and say, ‘That sucks.’”
Beyond legal recourse, regulating fertility fraud would offer clarity for children like Hill and her half-siblings, who are otherwise stranded in a nation with muddy social mores surrounding sperm donation. For now, they are still in the dark.
Ryne Hisada is a sophomore in Davenport College.