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donor insemination – that is to say, the children were, reportedly, fathered in amorous liaisons with the Duke of Albuquerque and with the nephew of a Church bishop.

The first authenticated case of artificial insemination was performed successfully about three hundred years later, around 1776. In this revolutionary year the renowned surgeon and human dissector John Hunter was approached by a ‘linen draper in the Strand’ of central London who came to consult him because of a deformity of his penis. The draper suffered from hypospadias, in which the opening of his urethra, from which a man would normally ejaculate semen, was in a position on his penis from which his sperm could not physically make it into his wife – the same condition that likely afflicted King Henry II (and his bride Catherine de Medici). Hunter armed his patient with a syringe, and advised him to use it to collect his semen after sex and inject its contents directly into his wife, while she would be most receptive. Presumably Hunter felt she would be more open to having a syringe inserted into her vagina around that time, but he may also have suspected that this moment would give the semen (and its sperm) a better chance of making its way well into the uterus. It was a simple but effective intervention. The wife became pregnant, and the baby was born healthy.

Such hit-or-miss attempts were always in demand, though they were not always scrupulous. We have records of a French doctor by the name of Girault, who in 1838 used a hollow tube to blow sperm into the vaginas of infertile men’s wives. Another French doctor was forced by public disapproval to cease similar attempts to impregnate women artificially. After the American Civil War, James Marion Sims – credited as the father of American gynaecology – reported his own attempts at artificial insemination, in which he injected sperm past the vagina, directly into the womb.

Sims had a reputation for medical miracles: he was also known for curing crossed eyes, clubbed feet, and a debilitating condition called vesico-vaginal fistulae (VVF), which affects women. VVF is a trauma commonly associated with a prolonged, obstructed labour, during which the baby’s head puts pressure on the tissue that normally forms a barrier between the mother’s vagina and her bladder. If the baby gets stuck and remains in this position too long, this tissue can be destroyed, and a hole opens between the vagina and the bladder. This often leads to constant, uncontrollable urinary incontinence – a debilitating situation, physically and emotionally. In Sims’s day, women with the condition were likely to become social outcasts. In his efforts to find a surgical solution to this problem, between 1845 and 1849 he carried out a series of operations on black slave women. In that day, any woman with VVF would probably have accepted the slimmest of chances to be rid of it, so the slaves he operated on may well have been consenting; however, anaesthesia had only recently been discovered, and some accounts say he performed what must have been incredibly painful procedures on the slaves without the anaesthetic that he later used with his white patients. The alleged practice has left his medical legacy in something of an ethical limbo.

Regardless, Sims published his definitive work on women’s reproduction and ‘uterine surgery’ in 1866. In it, he also logged the fifty-five artificial inseminations he had conducted on six different patients using sperm from their husbands. Bypassing the vagina to put seminal fluid directly into the womb was excruciating for the patient; Sims himself states that his earliest insemination experiments were ‘often more painful than any operation’. Half of his attempts he considered to be utter failures, and only once did he achieve a pregnancy. Sims’s poor results probably had less to do with his technique than with the era’s limited knowledge about menstruation, and about where in a woman’s body conception actually happened. It was truly a guessing game. Unfortunately, the only time Sims guessed right and managed a successful artificial insemination, the woman miscarried, having experienced a ‘fall and a fright’ when she was four months into her pregnancy. The twenty-eight-year-old patient had undergone Sims’s procedure ten times. After that twist of fate, the doctor wrote, he gave up the practice altogether.

Other doctors forged ahead, however. To test the limits of artificial insemination, they soon began to turn to donors, breaking from the tradition of exclusively using sperm from a woman’s husband. The world’s first case of such donor insemination was performed in 1884 by Professor William Pancoast, who was based at Philadelphia’s Jefferson Medical College. Pancoast used a hard rubber syringe to insert sperm donated by one of his medical students, whom he had judged to be the best-looking of the bunch. His patient, a woman who had been anaesthetized prior to the insemination, was unaware that Pancoast had even performed the procedure, and then, when her infertile husband was made aware of Pancoast’s procedure, the doctor instructed him never to tell her about the day’s events. Their son was never told the circumstances of his birth either. Only the medical archives have given the story to us.

At the time, the thought of using ‘alien’ semen shocked many people. In the nineteenth century, the idea of sperm banks had inflamed the imagination of doctors and the public alike; as early as 1870, there was speculation that soon there would be places where you could buy the semen of a ‘thirty-year-old blond with black eyes’ or a nineteen-year-old virgin. These were not considered to be happy developments. This attitude persisted for decades – at least until the 1940s in the US, and into the 1970s in Australia, and was only supplanted after the first professional sperm banks were launched in these countries. Indeed, in Pancoast’s day, there were still