In today’s fast life we see a number of cases of infertility. This is due to the increasing stress factor and the changing lifestyle. With the increase in marital age and late diagnosis of infertility, Artificial Insemination is a widely used method. Before advising this method the doctors should be aware of its medico legal aspects as it may be troublesome for them later. Also the doctors should give the patient a clear idea of the medico legal aspects as it could later cause problems.
Artificial Insemination may be defined as the deposition of semen in the vagina, the cervical canal or the uterus by instruments to bring about pregnancy which is not attained by sexual intercourse.
This method is to be advised under the following circumstances
1) When the husband is impotent but fertile.
2) When husband is sterile.
3) When there is Rh incompatibility between husband and wife.
4) When the husband is suffering from some hereditary disease so as to prevent mentally or physically handicapped child being born.
5) Incurable defects in husband’s semen rendering him incapable of procreation.
6) When a widow or unmarried women wants to have a child.
1. A.I.H or artificial insemination homologus-
When the husband’s semen is biologically normal but he either cannot pour the same in the wife’s vagina by the way of intercourse or due to some defect with the cervical opening of the wife or condition in the vagina, living sperms cannot enter inside the uterus, semen from the husband is collected by way of masturbation & pushed inside the uterus.
2. A.I.D or artificial insemination donor-
When the defect is in the seminal fluid of the husband then, semen from another healthy suitable male is used & introduced inside the vagina or the uterus of the wife.
3. A mixture of husband’s semen as well as that of donor is used in cases where motile spermatozoa count in husband’s semen is poor though present in semen.
Legal and Social Complications
1. Artificial insemination is not a ground for nullity of marriage, but it is for divorce if it was without the consent of the husband.
Even the doctor can get implicated in legal complexities.
2. Widow or unmarried women & in case of married woman when husband does not adapt the child.
3. It inherits a remote chance of incestual relationship between the offsprings of the donor from his wife’s side & the recipient’s side as the identity of donor being the father of the offspring of the recipient, remains secret.
4. Family problem including mental trauma of husband of recipient wife is possible, even though he gives consent for artificial insemination of his wife.
Guidelines for Artificial Insemination
1. Donor should be of age below 40yrs & should not have any physical or mental disease which may be transmitted to the child.
2. Consent of both recipient wife and her husband is necessary.
3. Consent of the donor & his wife is also needed.
4. The donor should have children of his own.
5. There should be parity of race, religion and as much as possible, the morphological appearance between the donor & the husband of the recipient.
6. The donor must not be a relative of either the recipient or her husband.
7. The donor should not know the identity of the recipient & the recipient also should not know the identity of the donor.
8. The donor should not know the outcome of artificial insemination.
9. The donor should give a written declaration that he will not prefer parenthood claim for any child on the ground of donation of semen.
10. A female attendant must be present during the process of insemination.
11. Maintenance of strict confidentiality of all records is a must.
12. In suitable cases the sterile husband’s semen & the fertile donor’s semen should be mixed before insemination. (eg. When the semen of husband contains insufficient amount of motile sperm).
13. Rh. Compatibility between the recipient & the donor should be tested.
The Delhi Artificial Insemination Act, 1995.
This act regulates the donation, sale and supply of human semen and ovum for the purpose of artificial insemination. It requires registration and yearly renewal by the person intending to carry on a semen bank. The semen bank should test the donor, before accepting the semen for the presence of HIV 1 and 2 and screen for surface antigen. The semen should be stored by cryo-preservation of liquid nitrogen freezing for minimum 3 months in order to exclude window period of HIV. Second ELISA test is performed on the donor after three months & if negative then the semen is used.