Artificial Insemination

History of Artificial Insemination

The first human experiments with AIH in the United States were reported by gynecologist J. Marion Sims in the 1860s. Although only one of the six women he reported inseminating due to cervical abnormalities achieved pregnancy, none achieved a live birth. Using AID for male infertility was first practiced in 1884 by Philadelphia doctor William Pancoast, who was said to have arranged for his patient, a wealthy woman married to an infertile male, to be anesthetized under pretext and inseminated with the sperm of a medical student. According to the report, which was not published until after the turn of the century, the woman was never told how she became pregnant. Relatively few cases of artificial insemination were reported prior to the 1930s, and most were not successful because of an inaccurate understanding of women's fertility. It was not until the 1940s that AID was cited in the popular press as responsible for a number of births. Infertile couples in the United States during the 1950s and 1960s increasingly sought help from physicians. Although the true number of children born using donor insemination is impossible to ascertain, popular articles in Time and Newsweek suggested that as few as 10,000 and as many as 50,000 children were born using AID in the 1950s and 1960s.

The use of AID for treating male infertility increased in the United States over the 20th century, typically under secrecy and under physician control. Donor insemination was initially offered to heterosexual married couples, in which the male was infertile or had reduced fertility. Physicians matched physical characteristics of the donor with the husband and purchased sperm from medical students, residents, and other physicians. Donors were typically anonymous, and married couples kept their use of AID a secret. Sometimes couples were encouraged to engage in sexual intercourse around the time of insemination so that paternity might remain uncertain. With physician-controlled donor insemination, unmarried heterosexual women and lesbians (with or without partners) were generally excluded.

The first successful efforts to freeze sperm (cryopreservation), based on similar practices in animal husbandry in the 1950s, were reported in 1953. Yet the use of frozen sperm and the commercial development of sperm banking did not develop until much later. More effective techniques for freezing sperm were developed in the 1970s. This technological advance, coupled with concerns about transmitting human immunodeficiency virus (HIV) infection through the use of fresh sperm in the 1980s and 1990s, led to the use of frozen sperm for donor insemination, typically stored in a sperm [Page 82]bank (cryobank). Although estimates are difficult to obtain because of the secrecy involved and lack of regulation, in the United States some 30,000 children a year are currently estimated to be born as a result of donor insemination.

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