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India’s caste system, in which people are born into a certain group, is now asserting itself even before birth as more couples in rural areas turn to sperm donors as treatment for infertility.

In Patna, the capital of Bihar, one of the most populous states, Dr. Himanshu Roy runs a popular fertility clinic that also has a sperm bank for patients. In the huge hall that leads to his office, a poster of “Vicky Donor,” a recent Bollywood comedy about a sperm donor, greets the crowds of hopeful couples.

Dr. Roy said the demand in Bihar for sperm donations in recent years has outstripped supply as more rural couples shed their social inhibitions to visit clinics like his. “And, yes, the film ‘Vicky Donor’ too has played its part,” he said.

Naturally, couples using donated sperm want to know all they can about the donor. In many parts of the world, that would include where a donor went to school, his medical history or what kind of job he had. In Bihar, couples’ primary concern is caste, doctors said.

“Sometimes...