History of artificial insemination with anonymous donor in Switzerland
Since 1974 and until the implementation of the new law in 2001, sperm donation was anonymous in Switzerland. Doctors advocated that the child born from an artificial insemination with an anonymous donor should never be informed of the situation.
Sperm banks in Switzerland
In 1980, there were 5 centres with the same characteristics:
- District Hospital « La Carita », Locarno
- University Hospital of Bern
- Cantonal Hospital of Liestal
- Cantonal Hospital of St-Gallen
- Cantonal Hospital of Basel
The common features were that the insemination centre was located in a public gynaecological clinic and that the procedure was performed only at the hospital where the sperm bank was located. The 5 centres were part of the Swiss Working Group for Artificial Insemination which was established in 1977. Its aim was to coordinate the activities of the centres, to standardise working methods and to carry out scientific programmes on a common basis.
The use of frozen or fresh semen varied between centres. St. Gallen used the highest percentage of frozen semen while Basel used only fresh semen.
At the CHUV in Lausanne, artificial inseminations, spermograms (sperm analysis) and the use of the sperm bank have been available since 1981. The Unit of Reproductive Medicine (URM) was created in 1984 by Dr. Marc Germond.
Selection criteria for donor selection
In 1979, the working group stated: "Until the legal problems of AID have been definitively clarified, we consider that genetic screening should be carried out, including karyotype determination for all potential donors, followed by amniocentesis in the pregnant woman".
There were differing opinions about karyotyping. There were questions about whether it was justifiable to have such an expensive test and how a woman with an 'abnormal' result would be able to make a decision about whether or not to terminate a pregnancy.
The fact that the identity of the donor should not be recorded on any file was unanimously supported by the working group.
Each AID centre selected gametes according to the blood type that should match the future legal father. Locarno and St. Gallen also selected on the basis of the physical criteria of the couple. This was not possible in Bern, which mixed sperm from 3 donors so that no identification of the donor was possible, either by a paternity test based on the blood group or by indications from the nursing staff. Donor selection in Bern, St. Gallen and Liestal was carried out by the gynaecologist performing the insemination. Translated with www.DeepL.com/Translator (free version)
All centres shared the following criteria for accepting potential donors:
- Social motivation for sperm donation
- Stable psychological state
- Good laboratory results, including a negative result for syphilis and gonorrhoea
- A good sperm count with normal motility and morphology
- Donor's age between 20 and 40 years
Locarno and Basel, which used geneticists for donor selection, used a standardised test designed by Dr Bühler. The additional criteria are as follows:
- Research for potential genetic diseases
- Age < 40 years old
- Exclusion of high-risk professions and drug users
- Karyotype to detect possible chromosomal abnormalities
- Chromatopsia (colour vision) test
- Blood pressure measurement
- Urine test
- Sweat test
- Prenatal examinations during pregnancy
An average of 2 or 4 inseminations were performed per cycle at intervals of 24 to 48 hours.
Number of children from the same donor
This issue was studied by the geneticist Dr. Moser. He concluded that the risk of offspring between individuals born with sperm from the same donor was extremely low if they were evenly distributed in the population; even if ten or more children were born as a result of his donation. The donation period was usually a maximum of one year and many of the couples seeking AID came from neighbouring countries.
Number of pregnancies after AID from 1974 to 1979
There was a total of 1301 pregnancies following artificial insemination with donors in the 5 Swiss centres.
The culture of secrecy
All centres put forward arguments in favour of secrecy on the identity of donors and even on the fact of having used medically assisted reproduction.
The main arguments used by the doctors included the fact that it was almost impossible to prove that insemination had taken place and that no one could dispute that the child was not the genetic child of the legal father. This would promote the bond between the child and the parents. It would also allow the infertility of the man or couple to be hidden and the couple to be a couple like any other in society. Translated with www.DeepL.com/Translator (free version)
A study carried out at the end of the 1970s at the Centre d'Études et de Conservation du Sperme in Lyon shows that the situation is different for couples who have undergone AID. Of the 72 couples questioned, 77% of them replied that they preferred to keep the insemination completely secret, as opposed to 23% who wanted to talk about it.
In fact, it seems that just under half of the couples who said they wanted to keep it absolutely secret would have nevertheless discussed AID with someone they knew (excluding the doctors). The study therefore concludes that only half of couples who want absolute secrecy manage to do so. The study ends with a recommendation that the couple's freedom of choice in matters of secrecy or disclosure should not be compromised.
Concrete example -how an AID was done in Bern in the 70's
The couple were both present at the first meeting with the doctor. Afterwards, the woman was seen 2 or 3 times until she became pregnant. The doctor drew attention to the possible psychological risks and analysed the couple's desire for a child. Then he took the time to explain the conditions for the procedure. The procedure was carried out with absolute discretion. There was no written documentation for the couple and no information about the identity of the donors. Donors were recruited at the University of Bern and were tested for health conditions, including hereditary diseases. The blood type and eye colour had to match that of one of the parents. The insemination involved a cocktail from 3 different donors so that no one could assign a specific donor. A nurse performed the insemination. After the insemination, the woman had to lie down for an hour, then put money on the bed and leave. There was neither correspondence nor invoices.
The legal framework was not defined. In order to avoid risks of non-recognition of paternity, AID was only performed for women who were in a stable relationship or married. To avoid the risk of a wrong paternity test, donors were selected according to the blood type of the future legal father and the mother. Indeed, the criteria for a paternity test at the time was the blood type of the father, mother and child.
The insemination was carried out with sperm from 3 different donors and there was no paper trail of them. There was practically no risk for the future legal father that another man could claim paternity.
- Results of Heterologous Insemination at the University of Bern Gynecology Clinic; U. Gigon/R. Haldemann
- Present Statuts of Aid and Sperm Banks in Switzerland; A.Campana, U. Gigon, F. Maire, G. Szalmaj, H. Wyss. Plenum Press, New York, 1980