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Instrumental Insemination pp Cite as. In France, artificial insemination with donor semen AID has encountered difficulties in the past for religious and moral reasons. Consequently, the technique had to be practiced in a clandestine manner. AID was performed by only a few private gynecologists using fresh semen obtained from donors. This practice provided only a scant number of donors with limited guarantees regarding the quality of semen and the protection of anonymity.

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[Editorial: Sperm banks in France].

Sperm donation seems to be the only solution in cases of negative results with testicular sperm extraction TESE. However, it implies a genetic dissociation between husband and offspring that results in psychological stress, as well as ethical and existential dilemmas for the couple. A broad discussion within the scientific community on these issues should contribute towards a better approach of these cases. The male factor is a significant cause of human infertility, implicated in most of the cases attending IVF programmes Edwards and Brody,
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[Editorial: Sperm banks in France].

Sperm donations in France have decreased significantly in recent years and new figures from the National Agency for Biomedicine are likely to show a further drop. While men donated their sperm in , only chose to do so in and a mere in Louis Bujan, head of a donor clinic in Toulouse, expects to see a further reduction when figures are released for , following the recent debate over gay marriage and adoption in France. Discussions in the run-up to the law put the spotlight on issues such as artificial insemination for lesbian couples and some sperm donors subsequently expressed concern that their sperm might be used by such couples. The National Agency of Biomedicine also points to other possible reasons for the decrease in the number of sperm donors.
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Carlsen and coworkers reviewed 61 heterogeneous observational studies on semen quality published between and This review indicates that mean sperm density decreased significantly between and An extended meta-analysis with studies confirmed a decline in sperm density for the period from to This assessment has been questioned.
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