The young wife sought fertility treatment from a gynecologist in downstate Illinois in 1973 in the hope of conceiving via intrauterine insemination.
Her husband had a vasectomy prior to their marriage in 1971. But the couple longed to have a child together.
Patient Paula Duvall recalled that Dr. Bradley D. Adams of Christie Clinic in Champaign agreed to perform the procedure, adding that he would use fresh sperm samples from an anonymous University of Illinois medical student whose physical features resembled those of her husband.
After the fourth artificial insemination procedure, the 23-year-old patient was overjoyed to find out she was pregnant. The physician delivered her baby girl in August 1974.
Her daughter, Erin Culver, said she was never told about the sperm donor and grew up believing the dad who raised her — the late Michael Duvall — was her biological father. The gynecologist continued to treat Paula Duvall until his death in 1989.
It wasn’t until almost a half-century after conception that the mother and daughter learned new information that shocked them both: A commercially available genetic test in 2022 revealed that Culver’s DNA matched with the DNA of a granddaughter of Adams, according to a lawsuit filed by Paula Duvall and Culver in Champaign County in February.
The complaint alleged that “instead of using a fresh sperm sample from an anonymous donor to inseminate Plaintiff Duvall, Dr. Adams used his own fresh sperm sample to inseminate her.”
The lawsuit accused Christie Clinic and the late Adams — through a personal administrator identified as his wife — of committing fertility fraud, medical malpractice, lack of informed consent, breach of contract and other offenses.
The case was believed to be the first filed under the Illinois Fertility Fraud Act, which went into effect in January. The law states that “the assisted reproductive treatment of a patient using the health care provider’s own human reproductive material without the patient’s informed written consent has caused significant harm and had a severe negative impact” on Illinois residents, including fertility patients and their children.
But a Champaign County judge in late June dismissed Christie Clinic from the lawsuit, in part because the law “does not allow health care facilities like Christie” to be named as defendants, according to court documents.
The legislation provides liability against “any health care provider, embryologist, or any other person involved in any stage of the treatment who knowingly or intentionally” used their own reproductive material without the patient’s informed written consent to treatment. The law defines a provider as a physician, nurse or other individual who handles reproductive material in a health care setting, but doesn’t include hospitals, clinics, healthcare facilities or corporations.
An official at Christie Clinic declined to comment on the lawsuit, stating that, “out of respect for individual privacy, the clinic does not comment on pending litigation.”
In mid-July, Paula Duvall and Culver said they decided not to appeal the decision or continue with the lawsuit against the doctor’s estate. Paula Duvall added that they didn’t want to “go after” his family “because they were innocent bystanders.”
During the course of the case, the two women and their attorneys learned that t Adams’ wife was also deceased. A woman identified during court proceedings as a daughter of the doctor declined to comment on the lawsuit, through her attorney.
Although they have dropped the lawsuit, Paula Duvall and Culver said they still stand by their claim that the gynecologist used his own sperm during the procedure.
“Looking back now I just think, how dare he? It was so unprofessional and so unethical,” said Paula Duvall, 74, who now lives in River Falls, Wisconsin, during a recent interview with the Tribune. “It’s just kind of dazing.”
Experts in fertility fraud say these kind of cases can be particularly challenging to pursue.
Alleged offenses often could have occurred decades ago when there were no specific laws against fertility fraud; many times, the statute of limitations on crimes that might have been applicable had already run out, said Jody Madeira, professor at Indiana University Maurer School of Law and an expert on fertility fraud.
It can also be difficult to design new fertility fraud laws that encompass every offense that emerges, because the circumstances can be so different and specific from case to case, Madeira added.
“These are efforts that are being informed by every new case that’s brought. It’s not a cause of action like prosecuting a theft or shoplifting, where it’s very cut and dried and we know what to do,” she said. “There’s very diverse permutations of these cases and there’s so many things that could come up legally across states that it’s very hard to write a quote-unquote model fertility fraud law that would catch everything.”
Challenges with fertility fraud law
The mother and daughter said they were encouraged by the recent passage of the Illinois fertility fraud law, one of 11 similar laws nationwide.
The legislation was largely spurred by the experience of Curt Richardson, a 46-year-old attorney from the Bloomington-Normal area, who was stunned to discover after taking a DNA test a few years ago that his biological father was Donald Cline, an Indiana fertility specialist who treated Richardson’s mom and dad in the 1970s but used his own sperm instead of a sample from Richardson’s dad, unbeknownst to them.
Cline, who was the subject of the 2022 Netflix documentary “Our Father,” is believed to have conceived more than 90 children from secretly inseminating patients with his own sperm.
Richardson said he found some healing in helping pass the Illinois Fertility Fraud Act, which includes retroactive provisions, since many of these cases don’t surface until years or decades after the offense; it also allows any child born as a result of fertility fraud the right to access the medical records and health history of the person who committed the fraud.
“While this was something that happened that was out of my control — that was out of my family’s control — I can take back a little of that control,” he said. “I can’t control what happened to me but I can control how I respond.”
Richardson said he had been following the lawsuit filed by Paula Duvall and Culver but couldn’t comment on the outcome, adding that he would leave it to them and their attorneys “to speak with regard to their case.”
With the advent of commercial genetic testing, the phenomenon of fertility fraud has proved to be “more common than anyone ever expected,” Madeira said.
She added that she has tracked more than 80 cases of fertility fraud in the United States and 20 to 30 in other countries.
“This appears to be a much more widespread practice than anyone believed,” she said.
Yet the law often struggles to keep pace with advancements in reproductive technology, which is part of the difficulty in attempting to hold individuals accountable for fertility fraud or deception, she said.
“At the most basic level, that’s the problem. We didn’t know that technology like direct-to-consumer genetic tests would come along and reveal these incidents of fraud that were committed decades earlier,” Madeira said. “Now that the law does know about it, it’s important to, I would say, either provide accountability or some mechanism where victims can get what they need. Whether it’s medical records, whether it’s damages, that kind of thing.”
As for the recent Illinois case, Paula Duvall and Culver said they were disappointed in the judge’s decision to dismiss Christie Clinic from the lawsuit.
“We felt like Christie Clinic should be held responsible because he was an employee of the clinic,” Paula Duvall told the Tribune.
“It was done on Christie Clinic grounds,” said Culver, a 49-year-old mother of four, during an interview with the newspaper. “You had to make an appointment at Christie Clinic in order to see him.”
The mother and daughter say they’re still grappling with emotional upheaval.
“Plaintiff Culver was traumatized and suffered severe and serious emotional injuries when she learned that Dr. Adams was not only her biological father, but that he had utilized his own fresh sperm sample when he performed an artificial intrauterine insemination procedure on her mother,” the complaint said.
Culver added that she’s also struggling to regain her sense of self.
“It totally messes with your identity. Who you thought you were,” she said, as she began to cry. “You are not that person anymore. To try to figure out who you are now is hard.”
‘Totally different context’
The gynecologist had generally seemed professional and appropriate during the course of treatment, according to the recollection of Paula Duvall, a nurse who lived in Champaign at the time of her fertility treatments.
“I didn’t feel like he was going to pull anything over on me,” she said. “Maybe I had my guard down, I don’t know.”
Yet the lawsuit described some behaviors by Adams that would be considered atypical of most health care providers.
The physician told Paula Duvall “she would need to pay him $20 to perform the procedure and that she was to personally hand him the money and not make payment at the front office,” according to the complaint.
At one point, she asked the physician if he would use a sperm sample from one of his colleagues; he responded that he would not because “most of us have already had vasectomies,” the lawsuit stated.
“Dr. Adams indicated that he would use University of Illinois medical students as donors and that they would be ‘very happy to have that $20 in their pocket,’” the complaint said.
Paula Duvall requested a donor with similar hair color, eye color and physical build of her husband, and the gynecologist agreed to find a donor with those characteristics, the lawsuit said. At three appointments, she handed $20 directly to Adams and he performed the procedure, the complaint said.
On Thanksgiving week in 1973, Duvall came to the clinic for her fourth and final intrauterine insemination procedure, according to court records.
While she waited for her appointment, she “observed Dr. Adams walk in a side door holding a specimen cup containing what appeared to be fresh sperm and he looked at her, clearly embarrassed,” the lawsuit said.
When Paula Duvall was called for the procedure, she apologized to Adams and said that she only had $15 with her and not the full $20, the complaint said.
The doctor accepted the money and told Paula Duvall that if the procedure worked “it will be worth it,” according to the lawsuit.
Back then, she had assumed Adams had meant it would be worth it to her if she became pregnant, she recalled.
“But I don’t know now what he meant by that,” she said. “It might have been a totally different context from what I took it as, at that point.”
After the birth of Culver, the gynecologist continued to treat Paula Duvall for another 15 years or so until his death, she said.
The mother said she rarely thought of him over the next few decades, except the lingering gratitude that he had helped her conceive her daughter.
Devastating revelations
In December 2019, Culver mentioned to her mother that she had asked her husband for a commercial DNA test kit for Christmas.
Culver’s dad, Michael Duvall, was part Irish. She had given her children Irish names.
“So I was curious how Irish I was,” Culver said.
After hearing about plans for a DNA test, her mom panicked.
That’s when Culver was told about the artificial insemination procedure. The revelation was devastating, she recalled.
“I still have a really hard time trying to process that my dad wasn’t my biological dad,” she said. “He was a great dad. He did everything a dad would do. I was the apple of his eye.”
Paula Duvall said she had thought there would be no purpose to telling Culver until then.
“My feeling was — until Erin started doing DNA testing — there was never any point in really sharing that information with her. Although I think she feels differently about that,” Paula Duvall said. “But I felt like it would just make her wonder, well if it’s not dad, who is it? And we wouldn’t know.”
Culver “submitted her DNA to Ancestry.com and 23andme.com, hoping to find out more information about the medical student who served as the anonymous donor for her mother’s intrauterine insemination procedure,” the lawsuit said.
This was in part to try to learn more about her family medical history: Culver said she has suffered from an autoimmune disease that surfaced in her 30s.
But when she received results, they didn’t initially show anyone who was related to her paternally; so she set up alerts on both platforms to be notified if someone emerged as a match, according to the complaint.
In August 2021, Michael Duvall became severely ill with COVID-19 and was hospitalized for roughly eight weeks.
About 10 days after he returned home, he called Culver and asked if she and her kids could come and help him get ready for bed; he was so weak he had to be carried and his wife couldn’t do so on her own, Culver recalled.
Two of Culver’s children helped their grandmother lay him on the bed while Culver waited in another room.
“We’ve got to sit you up, you’re a little bit crooked in the bed,” Paula Duvall told him.
“I can’t do it,” he replied to his wife and grandchildren. “You’re going to have to do it for me.”
These were his last words, Paula Duvall recalled. On Nov. 2, 2021, he died at age 83.
Michael Duvall was never told that Culver had learned about the fertility treatments or that she knew he wasn’t genetically related to her and her children.
“He died thinking that Erin thought he was still her dad, biologically,” Paula Duvall said. “It would have been crushing to him to know that Erin was aware. He always loved her more than he did life itself.”
Nature vs. nurture
In December 2022, Culver received a notification from Ancestry.com that a person with the last name Adams “matched with her on her biological father’s side,” according to the complaint.
“I’m looking for my biological father. I’m hoping you can help me,” Culver texted the person, according to court records. “I am a sperm donor baby. … Supposedly my biological father was a medical student at the University of Illinois at the time.”
The person responded that “the only person in her family who would match that description was her paternal grandfather, who was a gynecologist in Champaign, Illinois, during that time period,” the complaint said. Culver asked her mother for the name of the gynecologist who performed the procedure; the person who matched from Ancestry.com confirmed she was the paternal granddaughter of Adams, the lawsuit said.
“So that makes you my aunt,” the person said in a text message to Culver, according to court records.
“Upon learning that her paternal grandfather had provided his own sperm sample for the intrauterine insemination of his patient, (the person) abruptly cut off contact with (Culver) and removed any identifying information from Ancestry.com,” the lawsuit stated.
Culver described a wave of mixed emotions afterward.
“My reaction, to be honest, was I was kind of relieved to know who it was,” Culver said.
Yet she simultaneously felt horrified for her mother.
“Because she had trusted him,” Culver said.
When Culver looks in the mirror, she said she now sees so much resemblance to photos of Adams.
“Our smile is the same. Our nose is the same,” she said, her voice cracking a bit. “Everything but the eyes. I have my mom’s eyes.”
Then Culver began to worry that when her mother looks at her, “does she see him now?”
“I’ve never seen him in you,” Paula Duvall responded. “You have your dad’s personality. You have your dad’s temperament.”
The mother invoked the age-old nature versus nurture debate as to whether innate biology or environmental forces are more influential on human development.
“I would say nurture comes into play in 95% of her personality,” Paula Duvall said. “Because she is her dad’s child — not her biological father’s child, but the dad that raised her.”
‘Grieving a loss’
Various cases of fertility fraud have made headlines in the United States and around the world.
Dutch investigators about two years ago discovered that the late Dr. Jos Beek, a gynecologist in the Netherlands had fathered at least 21 offspring by impregnating fertility patients with his own sperm in the 1970s and 1980s, according to United Press International.
In 1992, Dr. Cecil Jacobson of Virginia was convicted of fraud and perjury; he had lied to patients about their pregnancy status and had also used his own sperm during fertility treatments while informing patients it came from anonymous donors, according to federal prosecutors.
In some instances, Jacobson falsely told patients they had conceived but then months and multiple payments later said they miscarried and the fetus was “reabsorbed” into their bodies, prosecutors had said. The women testified they were given hormones, “which apparently caused their bodies to simulate pregnancy,” the Tribune reported at the time.
“The women had come to Jacobson, often as a last resort, for help in getting pregnant,” said a Tribune story documenting his trial. “They said his betrayal took two forms — falsely diagnosing pregnancy and using his own sperm for artificial insemination while telling patients it came from anonymous donors.”
Perhaps the most notorious case was Cline’s, the Indiana fertility doctor who fathered Richardson, the attorney from Bloomington-Normal, as well as many other offspring without consent of their parents.
Cline was given a one-year suspended sentence in 2017 after pleading guilty to obstruction of justice charges. He retired from practicing medicine in 2009 and the Indiana Medical Licensing Board has barred him from reapplying for a license in the state.
But prosecutors had said they were restricted in what charges they could pursue because Indiana law at the time didn’t specifically cover a doctor using his own sperm in fertility treatments, according to The Associated Press.
Madeira, the law professor and fertility fraud expert, had testified in favor of a groundbreaking 2019 Indiana law that made fertility fraud or deception a felony, legislation that was championed by many of Cline’s victims.
Richardson said many of his newfound half-siblings were instrumental in helping to pass the Indiana legislation.
He learned Cline was his biological father after taking a commercial DNA test in late 2020 to learn more about his genealogy. Richardson had also hoped to explore his medical history because he has Still’s disease, a form of arthritis.
But in 2021, Richardson received an odd message from a stranger.
“Something to the effect of, ‘Sorry I keep bothering you, please let me know if you don’t want me to contact you anymore. You’ve probably seen we were matches and you’re probably seeing a lot of names that you don’t recognize. The same thing happened to me like a year ago. If you have any questions or want to talk here’s my cellphone number,’” Richardson recalled.
At first he thought the note was a scam. Then he received a half-dozen more similar messages and one told him to look up the name of the fertility doctor. He did so and then talked to his parents on the phone, asking if they knew anything about the physician and if they had received fertility treatments.
The response was long silence.
“It seemed like forever,” Richardson said. “Then my parents were just sobbing. It was that moment that they realized what had happened. And that I realized what had happened.”
His mom and dad said they had seen the fertility doctor one time and had believed that his dad’s sperm was used during the procedure.
Questions began swirling in Richardson’s head. Why would something like this happen? Why would somebody do this?
And, perhaps most importantly, Who am I?
“My world was just turned upside down. Having thought one thing your entire life — my parents having thought I was their child my entire life — it’s an identity crisis,” he said. “For the child that finds out something like that, when it was supposed to be your mother and father, it’s grieving a loss.”
His biological connection to Cline has also been difficult to accept.
“What I came to realize … is it doesn’t change who I am as a person,” he said. “I’m not saying it’s easy to accept that or to understand that. But I think it supports, at least from my perspective, that I may have genetics that are similar to the doctor’s and things like that, but that’s not who I am as a person. What defines me is how I was raised. My experiences in life. My values. My integrity and honesty and everything else.”
The Associated Press contributed.
eleventis@chicagotribune.com
