You poor sap. You just don't want to face the facts. But Debora Spar won't allow you to bury your head in the sand. "We are selling children," she says. "The Baby Business describes how."

Spar, who holds an endowed chair at the Harvard Business School, joins a crowded field of writers who are exploring reproductive technology and allied matters (adoption, for instance). Her angle is to think of children as we might think of any other commodity. She doesn't mean, of course, that a child is equivalent to a case of ketchup or a new car. But she argues that, whatever else they are, children are commodities in a thriving, largely unregulated market: "Eggs are being sold; sperm is being sold; wombs and genes and orphans are being sold; and many individuals are profiting handsomely in the process." In 2004, Spar reports, the U.S. market for fertility treatment—just one component of the "baby business"—approached $3 billion.

Spar's aim, she says, is neither to condemn nor to endorse this market, but rather to examine it dispassionately. She insists that our fastidious reluctance to acknowledge the trade in "children and their component parts" prevents us, as a society, from beginning to come to terms with a business that needs to be regulated for the common good—not banned, not given complete license, but prudently, democratically regulated. To that end she surveys the field, from in vitro fertilization to adoption, with occasional sections of historical background for context.

As a guide, Spar is intelligent, briskly readable, and deeply confused. Consider her treatment of adoption. While she concedes that "the U.S. adoption market" has its flaws, she nevertheless concludes that it could serve as a model for the baby ...