"Sperm bank" integration - accident or fiction?
Kleegman, S.J.
JAMA 219(10): 1350
1972
ISSN/ISBN: 0098-7484 PMID: 12306294 Document Number: 48669
Two reports provide comparisons between the levels of plasma hormones (follicle stimulating and luteinizing hormones, FSH and LH) during induced and natural cycles. When the FS preparation (human menopausal gonadotrophin) was administered plasma FSH was elevated in all patients although a subsequent decline occurred in some patients during the last few days of hormonal treatment. Injections of human chorionic gonadotrophin (HHG) for 2 or 3 consecutive days induced a rise in progesterone concentration and a high plasma LH peak that declined a day or so after treatment. Responses to treatment could be influenced by differences in the source of human gonadotrophin (i.e. pituitary or urinary) and by the ratio of FSH to LH in different preparations used to stimulate follicular growth. Enhanced responses were observed when the LH amount was raised and the FSH was maintained at a constant level. Hi gher amounts of urinary estrogen were found with preparations having FSH -LH ratio of approximatley 1:1 than with those of greater than 4:1. The source of gonadotrophin was unimportant. Modification of the treatment in which follicles would first receive initial stimulation followed by declining levels of exogenous hormonal support would induce ovulation. The low incidence of pregnancy indicated a need for further injections of hormones for several days to ensure full follicular enlargement and ovulation. A Washington newsletter recently reprinted from another publication the story of a white, previously childless, married woman who supposedly bore a black baby after being artifically inseminated with sperm from a "sperm bank." The woman reportedly committed suicide after the birth. I was not aware of the existence of such banks and would like information about their operation, and whether such an incident as reported could possibly have occurred. This question interests me enormously, for I was one of the pioneer investigators in therapeutic donor insemination. Our 1st such baby is now 41-years-old. I do not know of any "sperm bank" which furnishes sperm to doctors or patients. I know of only 1 doctor in the U.S. who started freezing of sperm to a temperature of -74 degrees C who will on occassion ship sperm to a colleague for insemination. I can assure you that in this instance there has never been any mixup in the source of the sperm. Even those physicians who have sources of sperm which they use for donor insemination, for example, Edward Tyler, MD, in Los Angeles, and S.J. Behrman, MD, in Ann Arbor, Michigan, to my knowledge use the specimens only for their own patients. I have personal knowledge of only 1 instance of error. In this case a doctor advised me that through an error of his office nurse, sperm from a black donor was inseminated into the doctor's private white patient. Fortunately, the physician called me within 24 hours of this occurrence and I immediately instructed him to put the patient on a regimen of high doses of estrogen at once. This prevented the possibility of a pregnancy from a bank. Again I will say that in my large experience of donor insemination I do now know of any functioning sperm bank which furnishes semen to a casual physician. The letter from the inquiring physician did not clearly elucidate the sequential relations between the artifical insemination, the birth of the black baby, and the suicide. I presume that the black baby was born 9 months after the insemination; and, then because of having given birth to a black baby, the white mother committed sucide. Referring to my experience mentioned above, if sucn an accident should happen because of the use of the wrong sperm, whether it be of black, white, or other origin, treatment with estrogen within 3-4 days of insem ination will prevent the ainsemination from being successful. In all lik elihood, if this particular story were investigated, you will find that the sperm sample probably was not from a sperm bank but was fresh sperm, with somebody's carelessness responsible for the mixup; and, of course, assuming the incident really occurred.