[Is an evaluative approach to medically assisted reproduction feasible? The experience of CECOS (Centers for the Study and Storage of Human Sperm and Eggs)].

Initial attempts at intraconjugal artificial insemination in the early 19th century marked the ingress of medicine into the field of procreation, which had previously been a strictly personal matter. The practice was hotly criticized by many sections of society. Objections grew still further in the 20th century, when the very notion of filiation was challenged by the use of sperm donors. This new practice was rejected, particularly as the donors were remunerated However, increased awareness of the frequency of male infertility in the 1950s led to greater acceptance of sperm donors as a last-chance option for infertile couples. The aim of the founder of the first CECOS, established in 1973, was to make this practice morally acceptable for society. An experimental program was set up, based on unpaid, voluntary sperm donation by fertile couples, as a gesture of solidarity towards infertile couples, with strict technical procedures, including sperm storage by freezing The success of this early work led to the creation of a network of about 20 similar centers throughout France. More than 50,000 children have since been born, and the guiding principles have since been enshrined in the Bioethics laws of 1994 and 2004. This example illustrates the need to objectively evaluate all innovations in the field of assisted reproduction.