It was 1978 and I was in middle school. I met my neighbor at the mailbox getting her newspaper and she told me the story of Louise Brown, the first IVF baby born. My neighbor was a reproductive endocrinologist, one of the first women doctors in this field, and at that time I had no inkling that I would one day follow in her footsteps. But I caught her excitement about these advances in medicine – and so did the world. However, there was still much controversy about the ethics of test tube babies.
Now, more than three decades later, 1 percent to 2 percent of all babies are born through in vitro fertilization. And so when I say it’s about time, I am referring to the fact that the Nobel Prize was recently awarded to British biologist Robert Edwards, PhD for his pioneering work developing IVF.
For years, the OB/GYN community urged the Nobel committee to award the Nobel Prize to the inventors of IVF, but to no avail. Dr. Steptoe, the partner and co-research of Dr. Edwards passed away without ever getting that recognition. But luckily, Dr Edwards – and all his prodigies and all the families that have been helped through IVF – get to celebrate worldwide acceptance of a technology that has been proven safe, effective, and miraculous!
For you history buffs, the first IVF procedure in humans actually resulted in an ectopic pregnancy. At that time, there were no injectable fertility medicines available and no way to prevent ovulation before egg retrieval. Surgeries were often done late at night, with little notice, and the eggs were extracted through a laparoscopic procedure through the belly button and a VERY long needle. The first IVF live birth outside of the US occurred in Australia in 1980 and then in 1981 the first U.S. IVF baby, Elizabeth Carr, was born.
When IVF first started 10 percent pregnancy rates were considered good. The medicines used to stimulate the ovaries required intramuscular shots and were not very purified. The laboratory culture media was not sophisticated enough to grow embryos well beyond the first several days of life. In the mid-1980’s vaginal ultrasound began to be used which made the egg retrievals less complicated and invasive. In 1990 Preimplantation genetic diagnosis was discovered and in 1991 ICSI (intracytoplasmic sperm injection) allowed men who had low sperm counts to finally have a biologic child. Freezing and thawing embryos and egg donation also became more successful.
While some people still look at IVF and advances in reproductive medicine with skepticism – fearing we are inappropriately playing God- I feel that the careful application of science to the field of fertility has allowed to appreciate the greatest phenomenon of all- life. There are still many things we have not yet discovered that will always keep the miracle in IVF. We are working hard at RSC to discover which sperm are the best (using the PICSI dish). And to find the single best embryo (elective single embryo transfer) so that we can prevent twinning and the risks that accompany high order multiple gestations. We have refined the cryopreservation process to yield nearly identical pregnancy rates as fresh when the best embryos are frozen. And new technology is allowing us to preserve eggs to help women who need to delay fertility. This field is ever-changing, and with the recognition that it recently received in the form of the Nobel Prize, hopefully more great minds will enter the field and make their mark.