12/02/2013 11:55 am ET Updated Feb 01, 2014

Is the Movie Delivery Man Plausible?

In Delivery Man, Vince Vaughn stars in another one of his endearing, yet slightly slobbish, roles. This time, he has just found out that his decades-old anonymous contributions to a sperm bank have resulted in 533 children. And lots of those children want to find out who he is. In fact, more than 140 have filed a lawsuit against him, trying to force him to reveal his identity. Oh, and he also has a love interest who thinks he's not reliable.

This remake of the 2011 French Canadian film Starbuck (yes, that's the real title, presumably with all puns intended) falls nicely into the genre of romantic comedy. For many people, it might also seem to fall into the genre of science fiction: how could one man's sperm create more than 500 children?

But it's not science fiction. It's the potential reality that hundreds of thousands of people live with. Their parents used anonymous sperm donors, and did so within an industry that is very lightly regulated. The movie shows that we need to step back and look carefully at the reproductive medicine industry in the United States. To date, it has primarily focused on helping to achieve pregnancy and profiting from the sale of eggs and sperm, rather than on the consequences to the families that are formed from these donations.

There are no enforceable limits on how many times one person can donate sperm -- or eggs, although the fertility industry does have suggestions. There is little "definitive data" on the long-term health risks of egg donation. No one keeps track of how many children are born from one donor's contributions, and donors are typically anonymous. Bertold Wiesner, a biologist who started a fertility clinic in London in the 1940s, allegedly used his own sperm to produce more than 600 children. Another donor at the clinic created more than 100 children. Wiesner destroyed the clinic's medical records, so there's no way to know for sure, apart from genetic testing of the approximately 1,500 babies born through the clinic.

More recently, Kirk Maxey, an American physician who donated his sperm twice a week from 1980-1994, has done the math and believes he may have created 400 children.

Hearing these stories is, to say the least, unsettling. In the movie, Vaughn is shocked by the numbers, and he then tries to become a guardian angel for as many of his offspring as he can. The trailer (no need for a spoiler alert) shows pictures of happy, smiling group of half-siblings, connected by Vaughn.

Outside of Hollywood, what happens when large groups of donor siblings search and find one another? While incorporating the reality of one or two new family members into your life seems daunting, the possibility of encountering twenty, fifty, one hundred, or even more is probably downright frightening. Very large groups can present challenges for parents, children, and donors. Imagine the potential psychological and emotional concerns for donor offspring, who now have to cope with dozens of half-siblings. They also have to cope with fears that they might meet a half-sibling and fall in love, without knowing of their genetic connection. And, because the law requires donors to be tested for little other than sexually transmitted diseases, they need to worry about potentially serious medical issues. One Michigan donor transmitted a rare genetic disease, severe congenital neutropenia, to at least five children.

It doesn't have to be like this. Other countries keep track of donors, and they limit the number of children who can be born from one donor; in England, a man can donate sperm to no more than 10 families. And a number of countries, including Sweden, England, the Netherlands, Switzerland, and New Zealand ensure that offspring will be able to learn the identity of their donors. Some American cryobanks and agencies already provide donors who are willing to be known to their offspring. While changes to the existing system might make potential parents worried about donor supply, consider that the number of men donating sperm actually increased in England after it allowed for identity disclosure.

Ultimately, we need various reforms from both within and outside of the fertility industry to make the whole donor conception process more humane and more responsive to the needs of the families it has helped create. Only then will Delivery Man be science fiction.