Artificial reproductive technologies (ART), a reproductive physician’s standpoint

Abstract

History.- Inseminations with donor sperm have represented the first medically assisted reproduction (MAR) technique. In France, sperm banks gathered rapidly and constituted the “Federation of CECOS”. Three fundamental principles were defined relating to sperm donation: volunteering, gratuity, and anonymity. The rapid development of in vitro fertilization and embryo cryopreservation encouraged the French government to publish in 1994 the first bioethical law, that was supposed to be revised every 5 years.

New modalities of MAR introduced by the law of 2 August 2021.- MAR that were initially reserved to heterosexual couples, are now open to female couples and unmarried women, thus clarifying a situation that already existed in practice. Literature indicates that there are no major difficulties in children raised by female couples, however there are more concerns about single women. From a practical point of view, this extension of MAR leads to a significant influx of requests, with longer waiting times. Lifting the anonymity of gamete donation raises some problems as destruction of old sperm straws and possible solicitation of former donors who wanted to remain anonymous. Finally, from a medical standpoint, it must be stressed that self-preservation of oocytes will not constitute a guarantee for women to have a child later.