Once upon a time, in America's not too distant past, the prevailing societal and medical belief was that infertility could only be a female problem. Hysteria, a twisted womb, an evil spell and God's wrath were all cited in medical texts as reasons for a woman's inability to conceive. Surely it was not a male issue but rather a concern confined to the unfortunate circumstances of women. One of the first physicians to challenge the aforementioned ideas and suggest that it was indeed possible that there might be alternative explanations as to why a woman could not conceive was Dr. William Pancoas, a professor at Jefferson Medical College, now known as Sidney Kimmel Medical College. In 1884 he performed what would would be considered a wildly unethical medical experiment by today's standards and went down in history as one of the pioneers of reproductive medicine. This is not a hero's tale per se. Its simply a glimpse at how a daring and unauthorized experiment broke new ground in assisted reproductive technologies and changed society's understanding of a woman's womb.
In Philadelphia in 1884 Dr. Pancoast was treating a Quaker couple who were struggling with infertility. The husband was forty-one years of age, of sound body, had a good family history, and had never suffered from any serious illness in his life, save for a bout with gonorrhea while sowing his proverbial "wild oats" in his youth. His wife was 10 years younger than him and was the picture of health. After years of trying every technique in the book to get pregnant the couple came to Dr. Pancoast in a state of utter frustration wanting to know what could be done to make the young woman fertile and give them the blessed child they dreamed of.
Dr. Pancoast suspected that the source of the infertility was not the young wife at all but the husband, however it was blasphemy at that time to suggest that a man and not the woman was the source of the problem. Given the diagnostic tests of the day, what could one do to determine if the infertility truly lay with the husband or the wife? Well, you could see if the wife could get pregnant by someone else? However, Dr. Pancoast knew that the Quaker couple would never hear of such a thing.
Undaunted, Dr. Pancoast set out to test his hypothesis. First, he collected a sample of the husband's sperm and looked at it under the microscope. He could see no spermatozoa. Nothing was swimming, a fact he attributed this to the man's history of gonorrhea. Second, he needed to test the woman's ability to become pregnant, but to do that he needed to take his experiment to the next level. His theory was that if the wife could be impregnated with the sperm of another man then the infertility didn't rest with her. But how to do this?
Warning: Please do not simulate the practices about to be described at home unless you have all consenting adults. Dr. Pancoast gathered six of his most handsome medical students and collected a sperm sample from each of them. Then, with the young Quaker woman anesthetized with chloroform he used a large galvanized rubber syringe to introduce the sperm to her cervix. Once she awoke from her chloroform-induced haze he sent her home with her husband and told them to come calling if there was any change in her condition.
Lo and behold the young woman became pregnant and gave birth to a bouncing baby boy. The couple were ecstatic but Dr. Pancoast felt so guilty about what he had done that he eventually confessed to the husband. However, the husband did not seem to mind as he was happy to have a child and loved the boy so much that he felt no need to tell his wife. And the Quaker family lived happily ever after. It is not known if he ever told his medical students about the experiment or the child born. Thus the question remains: Under what pretenses did he convince six guys to ejaculate into an Erlenmeyer flask?
The only reason this story is known to us today is because 25 years after the events took place Dr. Pancoast decided to write a letter to the editor of The Medical World, which published the doctor's confession/case study in the April 1909 issue. The identities of the couple and the sperm donor remain unknown. However, Dr. Pancoast's name lives on in two contexts: first, as renegade physician who was one of the pioneers of the practice sperm donation and artificial insemination and second, as a case study in unethical practices in medicine. Can anyone say, "informed consent"? It should please most people reading this article to know that it is currently against ethical and legal medical protocols to inseminate a woman with the sperm of a man she doesn't know. Also it would likely be generally frowned upon if any professor at a medical school today asked any of his students to give him a sperm sample. What a difference a 130 years can make.
The moral of this story, if there is one, is that as stressful and existentially painful and the struggle with infertility is today society has come a long way in the last century from where it was for the previous thousand years. Today, a woman and a man can be treated for the underlying medical conditions that cause their infertility without invoking the name of God or suggesting that their situation is a form of diving retribution. And perhaps best of all... medical students don't have to be coerced into donating sperm to impregnate a Quaker woman in order to get a passing grade.