Artificial insemination

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Artificial insemination in humans (AI) is a medical technique for achieving fertilization by injecting sperm with a syringe through the vagina into the uterus or cervix. The word insemination refers to the word semen, which means seed. Artificial insemination can mean both sperm and egg donation. It is done by people who give other people a child, by people who cannot have children themselves naturally or who want to have a boy or girl. In general, sperm or egg donation is not intended for minors, as it is everywhere 18+ (or 21+). That doesn't mean there weren't minors who ever donated their sperm or eggs. This is the case with illegal sperm or egg donation or, if legal, in children diagnosed with cancer[1].

History

Early history

Artificial insemination (called KI until the 1980s) was first successfully applied to mares by the Arabs in the year 1322. In 1425-1474, unofficial history claims that the first attempts to artificially inseminate a female were made by Henry IV, nicknamed "The Impotent". In 1784 the first artificial insemination in a dog was reported by the scientist Lazzaro Spallanzani (Italian physiologist, 1729-1799). This insemination resulted in the birth of three puppies 62 days later. In 1799 method of artificial conception was first tried on a human in the year 1799 by the English physician Dr. John Hunter.

18th century

John Hunter (1728-93) was a brilliant Scottish surgeon known for his pioneering research into venereal diseases, child development and the lymphatic system. Although he liked to experiment on himself - especially unhappy with his research on syphilis and gonorrhea - the official surgeon of England's King George III was also known to instill in his patients an equally zealous zeal for self-experimentation. When a young married man, desperate for a child with his wife, came to him in 1790 with a grim condition known as hypospadias, in which the urethra actually makes a wrong turn toward the underside of the penis, Hunter developed a plan. He provided his patient with a collection of large syringes and a prescription for frequent masturbation. He had to collect his semen and inject it into his wife's vagina. Tragically, the exact details of their bedroom antics are lost forever, but the man has reportedly followed the doctor's instructions over the course of two years. According to most stories, a single pregnancy and Dr. Hunter had proven the possibility of artificial insemination in humans. But it would be a while before a doctor would formally take up the case of assisted reproduction.

19th century

In 1866, the practice spread to the United States in 1866 when Dr. J. Marion Sims of North Carolina performed a series of fifty-five inseminations with varying degrees of success. In 1884, the earliest recorded AI in a medical facility was at Jefferson Medical College in Philadelphia by Dr. William Pancoast. It was so secret that even the woman being inseminated was not told that the sperm belonged to a donor, not her husband. In 1890-1910 AI gained acceptance and popularity in Europe and Russia. In 1897, Dr. Heape, an outstanding reproductive biologist from Cambridge, discusses the use of AI in rabbits, dogs and horses. And in 1899, the first attempts to develop practical methods of artificial insemination were described by Ilya Ivanovich Ivanoff (Russia, 1870-1932). Although Ivanoff studied artificial insemination in domesticated farm animals, dogs, rabbits and poultry, he was the first to develop methods as we know them in human medicine today.

20th century

In 1909, Dr. Hamilton that he practiced artificial insemination for 15 years, "without failing even once". In 1924, Rohleder in an investigation; of the world literature could find only 123 reported cases, while in 1928 Engleman in a further investigation could only increase this number to 185, of which sixty-five were successful. Hiihner, writing in 1937, claims to have begun extensive use of the practice in 1915. In 1941 in the United States alone, AI resulted in ten thousand successful pregnancies. In England, the first publication of a modern account of what was then called 'Donor Insemination' (DI) appeared in the British Medical Journal. The doctor behind the study, Mary Barton, was vilified in the press and condemned worldwide. dr. Mary Barton stated that over a period of five years, about 300 children had been conceived as a result of artificial insemination. That same year, it was reported that 9,489 women had been impregnated successfully and that 97 percent of the pregnancies had been terminated successfully. These figures were compiled from a questionnaire sent to 30,000 physicians, 7,643 of whom responded, and of these, 4,049 reported having performed successful impregnations. In the 1940s and 1950s, AI was performed discreetly by private physicians. It was decided it was best to remain unregulated (and remains so today). Parents were told never to tell anyone, not even the child. (This practice of secrecy has continued for decades and is still recommended even today by some "experts".) In 1951, further evidence for the extent of the practice in the United States was found in Ploscowe's statement that in 1951 the number of children born as a result of artificial insemination had risen to 20,000. In 1953, as a result of this research, the first successful human pregnancy with frozen spermatozoa was reported in 1953. In 1955, a 1955 NY Post article estimated that the number of children conceived through AI was estimated to be 50,000 and growing at 6,000 per year. In 1963, responsible estimates point to one thousand to twelve hundred births per year, although higher estimates are given.

Recent history

In the 1970s, the sperm banking business became popular and commercialized. In 1979, of the 711 physicians likely to perform artificial insemination by donors surveyed to determine their current practices, 471 responded, of whom 379 reported performing this procedure. In this way they accounted for about 3576 births in 1977. In addition to treating infertility, 26 percent of these doctors used the procedure to prevent transmission of a genetic disease, and 10 percent for single women. Sperm donors were mainly from universities, screened only superficially for genetic diseases, and then phenotypically matched to the recipient's spouse. Most recipients were inseminated twice per cycle. Only 17 percent of physicians used the same donor for a particular recipient, and 32 percent used multiple donors within a single cycle. Only 37 percent kept records on children and only 30 percent on donors. The identities of donors were usually carefully guarded to ensure privacy and avoid legal complications. In 1987, the Office of Technology Assessment went to visit 3 sperm banks and 10 in vitro fertilization clinics. A total of 1,558 questionnaires were completed and returned by the sampled physicians (a response rate of 61 percent), including 37 physicians in the cross-sectional sample and 385 physicians from the Fertility Association who regularly performed artificial insemination, i.e. saw four or more insemination patients per day. year. A modified survey form was also sent to 30 US commercial sperm banks identified by the American Association of Tissue Banks (MTB) and the American Fertility Society (AFS), and 15 of those forms were returned. The research estimates that 172,000 women underwent artificial insemination in 1986-87, at an average cost of $953, resulting in 35,000 births by artificial insemination by husband (AIH), and 30,000 births by donor artificial insemination (AID). These incomplete figures from 1986-1987 are still used by the media and industry experts. This has led many to come to the false conclusion that there is an entity that keeps records of the children born from egg and sperm donations. While SART insists they have accurate numbers on egg donor births, research shows that over 40% of parents have never been asked to report the birth of their child. The oft-cited figure of 30,000 births per year is based on an extrapolation of a very small number of voluntary survey responses. These numbers are further clouded by a sharp decline in practitioners at the time, due in part to increased quarantine requirements (including restrictions on fresh sperm) following the discovery around 1984 that sperm could transmit the HIV virus. Prior to the AIDS crisis, donor insemination was likely much more common in small clinics and doctor's offices in the absence of restrictions on fresh sperm. In the years since the OTA report, the prevalence of large sperm banks and the increasing adoption and popularity of the technology suggest the numbers have likely grown significantly. As a result, the OTA numbers certainly represent an underrepresentation of reality.

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