Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, February 6, 1992 TAG: 9202060288
SECTION: VIRGINIA PAGE: B1 EDITION: STATE
SOURCE: THE WASHINGTON POST
DATELINE: LENGTH: Long
EX-PATIENTS CALL FERTILITY DOCTOR SAINT, CON MAN
When Carole Franda learned that Cecil Jacobson, her former fertility doctor, had been accused of using his own semen to impregnate dozens of his patients, she sat her 12-year-old son down for a serious talk.The Fairfax County woman explained that even though she had had only one insemination and believed his father's sperm had been used, there was the slimmest chance that Jacobson was his true biological father.
"We talked about it several times. I asked my son what he thought, if he saw his father in himself, his father's traits. And he says he does," said Franda, adding that she has no intention of testing her son to be certain her husband's sperm was used.
"I would never subject my son to genetic mapping, and I don't really care whose sperm it was as long as my son is comfortable," said Franda, who is expected to testify on Jacobson's behalf when his trial begins Monday.
Franda, 51, is one of scores of Washington-area women who never had reason to question who fathered their children until November, when Jacobson - an infertility specialist frequently published in medical journals and who helped pioneer the use of the amniocentesis test for fetal abnormalities - was indicted in federal court on 53 counts of fraud and perjury.
Prosecutors have described the doctor as a con man who used hormone injections to fool patients into believing they were pregnant, and who lied when he said he used an anonymous sperm bank for inseminations. They allege that in the late 1970s and early 1980s, Jacobson impregnated more than 70 patients with his own sperm, including a woman who believed she was getting her husband's semen.
According to a federal indictment, Jacobson told couples he could match a husband's physical characteristics and even religion.
Jacobson, 55, who owned the now-closed Reproductive Genetics Clinic in Vienna, Va., has said that he occasionally used his own semen, but argued that he did it with his patients' best interests in mind. He said his fresh sperm was more effective than a bank's frozen semen and that, because he was loyal to his wife of more than 30 years, he was disease-free.
The chasm between the defense and prosecution's versions of events is mirrored by the attitudes of patients themselves. Some revile Jacobson, accusing him of a perverse violation of their trust, while others praise him in almost saintly terms for providing them with the healthy children they so desperately sought.
Seven couples who have children proven to be biologically fathered by Jacobson are identified in the indictment, although their real names are not used out of concern that the children would learn who their father is by hearing accounts of the criminal case.
"A woman going into this procedure is bargaining for sperm," said Michelle Oberman, an expert in medical law at Chicago's Loyola University. "That's all she wants. She doesn't want the man that goes with it."
Anonymity on both sides is essential to prevent future legal complications, she said, such a sperm donor's claim for visitation rights or a woman's claim for child support.
In fact, Jacobson and his lawyer, James Tate, have faulted prosecutors for telling the parents who the father might be.
"We begged them not to do it," Tate said. "They did it anyway, and we think it was a terrible thing."
Most of the mothers treated by Jacobson were from the Washington area. If the allegations are true, many of their children - now ranging in age from 4 to 14 - would be half-sisters and half-brothers, and possibly classmates.
Tate said the doctor occasionally mixed his sperm with defective donor sperm to increase the chances of pregnancy, but only with a couple's consent. In any event, Tate said, it is not illegal for a doctor to donate sperm for a patient and many people would see nothing wrong with it.
The AMA doesn't have guidelines on whether a doctor should use his own sperm for patients but only because the issue has never come up before.
Neither does the American Fertility Society. The society's director, Dr. Robert Visscher, said that's "because it's so outlandish that the practitioner would provide the sperm."
Jacobson also is accused of using hormones to trick other women into thinking they were pregnant when they weren't.
Prosecutors say Jacobson injected those patients with high doses of hormones to simulate pregnancy and produce false urine test results. He allegedly faked ultrasound exams, falsely identifying fetal arms and legs, thumbsucking and heartbeats. On occasion, he would refer to a nonexistent fetus as "junior," an indictment said.
Eventually, the women were told they had miscarried and that the fetal tissue had been "resorbed" by the body, according to the indictment. The patient would be advised to begin another cycle of treatment. Some paid $5,000 or more for several cycles.
The government accuses Jacobson of causing "severe emotional distress" on his patients, some of whom bought maternity clothes and cribs before being told they had miscarried. One had started a journal about being pregnant.
Paula McMahan, 42, of Prince George's County, Md., said she went to Jacobson because she decided to have a sixth child after her husband had a vasectomy, a procedure that prevents a man from passing sperm.
In 1982, after two unsuccessful insemination attempts by another fertility expert, McMahan scheduled an appointment with Jacobson to talk about his anonymous sperm donor program.
She said that before performing the insemination, Jacobson requested $20 cash for the donor, who he said was waiting in an adjacent room. The doctor explained that cash was necessary to prevent a paper trail that later could reveal the donor's identity, she said.
After the procedure, Jacobson instructed McMahan and her husband to return home and have intercourse. She said the doctor told her that having intercourse "will help move things along - plus that way you'd never know whether the child was yours or the donor's. Well, we reminded him that my husband had had a vasectomy. We would know it wasn't his."
A few weeks after the insemination, McMahan said Jacobson conducted a sonogram that indicated she was pregnant with twins. "I thought, `Great, two for one.' They looked like lima beans in the picture," she said.
But the joy was short-lived. During a subsequent visit, Jacobson informed McMahan that one of the twins had died and would be reabsorbed into her body. She said she was horrified.
Not long afterward, he told her the other fetus also had died and would slowly be reabsorbed, she said. "He told me not to see another doctor and that Mother Nature would take care of things," McMahan said. "I was crying continuously."
Ignoring Jacobson's advice, she went to her regular doctor, who told her there had been no babies and that she had developed nonmalignant tumors in her uterus.
Years later, McMahan filed a complaint with the Federal Trade Commission, which obtained a court order halting Jacobson from practicing deceptive fertility treatments. McMahan gave her account to a commission investigator and was paid several hundred dollars out of a fund set up by the agency to reimburse patients who alleged they had been wronged by Jacobson.
"I had grieved for two babies who never existed," McMahan said this week.
Tate rejected McMahan's conclusion. "If Dr. Jacobson said she was pregnant, then she was pregnant," he said.
Franda is open in her praise for the doctor.
She had gone to several obstetricians, spending hundreds of dollars only to be told that a childhood accident had left her sterile. But when she met Jacobson, who was doing genetic research at George Washington University in the mid-1970s, she found hope.
"Cecil always used to say, `Don't play God. You can't say it's never going to happen,' " she said. As he did with many patients, Jacobson started Franda on a series of hormone injections intended to regulate ovulation. For two years she had the injections, with no success. It was then that Jacobson suggested insemination, telling Franda that he would use her husband's semen.
She conceived on the first insemination. Now, she said, she's not sure what caused the pregnancy - the shots, the insemination or her regular sexual activity with her husband. She said her son resembles her husband but added that regardless of who the biological father is, the important thing is that she has a healthy teen-age boy.
"Even if it turned out that it was Cecil's sperm, we'd survive that," she said. "Cecil Jacobson was a brilliant man . . . and I have a child because he didn't let me give up."