I have been talking about hyper ovulation, embryos, blastocysts and science of human reproduction a whole lot this past week as one of my dearest friends is going through the IVF process. In one of our nightly chats she wondered aloud about the historic evolution of this technology and that inspired the thought in me that perhaps a post exploring this rather obscure historical topic was in order.
Between 1845 and 1849, physician J. Marion Sims started on the road to becoming arguably the most famous American surgeon of the 19th century and acknowledged as the founder of modern surgical gynecology by experimenting on enslaved African American women in Montgomery, Alabama. Sims artificially inseminated fifty-five infertile females slaves. He produced one pregnancy, though the woman eventually miscarried. Then along came Dr. William Pancoast, who in 1884 as a professor at Jefferson Medical College in Philadelphia consulted with a Quaker couple who were struggling with infertility. Believing the woman was capable of having a child and the man sterile he constructed an ethically questionable experiment where he inseminated the wife in the Quaker couple with the sperm of one of his medical students. The experiment resulted in the birth of a baby boy.
The next great stride in the field of assisted reproductive technology came in 1934 when Gregory Pincus, the man who would later gain fame for being the scientist who, funded by reproductive rights advocate Margaret Sanger and heiress Katherine McCormich, synthesized Enovid, the first oral contraceptive pill on the market. Pincus claimed that he had achieved in-vitro fertilization of rabbits in his Harvard laboratory. Pincus was instantly vilified in the national press for tampering with life and playing God. Due to the backlash Harvard did not grant Pincus tenure.
Starting in the 1950s, Dr. Robert Edwards, a physiologist at Cambridge University was working on isolating hormones in mice. One night in 1965 Edwards successfully created a human embryo by adding his own semen to a human ovum in a Petri dish. It was a Frankensteinesque moment. Edwards realized one of the greatest fears of those critical of scientific research into fertilization: a lone scientist, late at night, creating life in a lab. It is possible that Edwards feared the potential criticism, ostracism and religious condemnation he would receive if he went public with his finding so he destroyed the evidence and kept his research a secret until he found a research partner in one Dr. Patrick Steptoe who could help him take his work to the next level.
Patrick Steptoe was a gynecological surgeon practicing in a small hospital outside of Manchester, England in relative obscurity. Steptoe had access to something Edwards did not: human ova. The two joined forces and over the next decade the duo set about created the first human pregnancy through in-vitro fertilization. They needed a woman and her husband who suffered from infertility and would allow them to join sperm and egg in the lab and then insert the resulting embryo into uterus of the woman. Enter John and Leslie Brown.
John and Lesley Brown's story reads like the plot of an independent BBC-funded film highlighting the quiet desperation of the British working class. The couple had been trying to have a baby for the better part of a decade. John worked as a bartender in Bristol and found part time work on the railroad. Leslie weighed and packaged cheese in a factory. Their relationship was strained by their failed attempts to have a child. Lesley's fallopian tubes were blocked from uterine scarring. Lesley reportedly told John, "I've nothing to give our marriage now that I can't have a child." But John, who had a daughter from a previous marriage, stuck by her, and their physician referred them to Dr. Steptoe, who was doing something that seemed like science fiction to them.
When they met with Dr. Steptoe they were confused by his language and terms like fertilization and re-implantation. It may have all gone over their heads but they understood enough to know that Dr. Steptoe was offering them the possibility of a baby. Lesley reportedly told him that whatever he was offering she was willing to try. She said that at night she would pray, "Dear God, I wouldn't moan about being kept awake at night and washing dirty [diapers] if you'd let me have a child."
All parties went ahead with the procedure. A healthy egg was harvested from Leslie and a sperm sample was taken from John. Steptoe and Edwards introduced the two gametes in a Petri dish and then transferred the fertilized embryo into Lesley's uterus. The embryo implanted and Lesley was pregnant.
Dr. Patrick Steptoe performed a Cesarean on Lesley Brown on July 25th, 1978 and the world's first test tube baby, Louise Joy Brown, was born weighing in at 5 pounds, 12 ounces. News of the test tube baby had gotten out to the media during the last month of the pregnancy and reporters swarmed the tiny Oldham, England hospital. It was the dawn of a Brave New World where children could be created outside of the marriage bed.
It wasn't long before IVF technology crossed the pond. The first IVF baby born in the United States was Elizabeth Carr in 1981 and since that time fertility clinics and cryobanks across the country have been creating and storing embryos. Since the introduction of these reproductive techniques more than 200,000 babies have been born in the United States alone and the technologies have spawned massive fertility industries in countries around the world, such as in India which boasts over 3,000 IVF clinics and one of the world's top destinations for fertility tourism.
It's a pretty impressive technological evolution to take place in just over 170 years. Imagine where the science will be in another 170 years and what the sociological trends in human reproduction will be as IVF and associated technologies allow couples to have children at later ages and to screen for genetic disorders.