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History of IVF

25 July 1978 (11.47PM)

At 11.47pm on 25 July 1978, the world's first IVF baby, Louise Joy Brown, was born weighing 5lb 12oz at Oldham and District Hospital in Greater Manchester.

Louise-Brown-worlds-first-test-tube-baby-with-Mum-Lesley RG Edwards and Steptoe with Louis Brown

30 years later, more than 3,000,000 IVF babies are born worldwide.

In the 25 years since the birth of the first test tube baby of the world, more than a million children around the globe have been conceived with the help of this medical technology.

In vitro fertilization, or IVF, has helped millions of women all over the world enjoy the experience of pregnancy despite health conditions making it impossible for them to conceive. Despite its somewhat low success rate and high costs involved, for many couples, IVF is no less than a miracle. Surprisingly, the history of IVF began more than a century before it was successfully achieved in a human.

Like many other therapeutic innovations IVF became applicable to the human only after it had been demonstrated to work in another mammalian speciesin this instance, the rabbit. Furthermore, the preclinical research and early clinical efforts were international in scope.

In 1930, an American on leave from Harvard, Gregory Pincus, while working at the School of Agriculture in Cambridge, published a description of his first experiments on IVF in the rabbit. These experiments were unsuccessful, as none of the ova exposed to sperm and transplanted into Fallopian tubes produced any offspring. However, Pincus was intrigued by the problem and upon returning to Harvard teamed up with Enzmann and studied IVF again. These later results were published in 1934 (Pincus and Enzmann, 1934). They thought that they had, in fact, succeeded. However, in their experiments, oocytes and sperm were mixed together and then transferred into the Fallopian tubes, following which young were born having characteristics of the genetic mother as opposed to the surrogate rabbit. We now understand that these oocytes were transferred not having been fertilized in vitro, but probably fertilized in the fallopian tubes just as they are in the procedure currently known as GIFT procedure.

In 1932, Brave New World was published by Aldous Huxley (Huxley, 1932). In this science fiction novel, Huxley realistically described the technique of IVF as we know it. The principal difference was that in the novel the embryo was allowed to develop entirely in glass vessels by a process that Huxley labelled, exogenesis, which at the present time remains scientifically beyond our reach.

A large number of experiments involving in vitro fertilization started in 1878. Walter Heape successfully transferred embryos between rabbits in the 1890s, long before the applications to human fertility were even suggested. Bavister writes that the 1951 discovery of sperm capacitation, or the final step in sperm's maturation, was central to the development of IVF. In 1959, researchers showed that rabbit eggs fertilized in vitro, or outside the human body, could develop into normal rabbit babies. Similar studies in 1963 and 1964 proved the same for hamster gametes. Robert Edwards, a physiologist, and Patrick Steptoe, a gynecologist, pioneered IVF in humans in Britain in the 1970s. Throughout the 1960s, Edwards had experimented with bits of human ovaries removed in surgery and had achieved the first fertilization of a human egg outside the body in 1967. At the same time, Steptoe was working to develop the new surgical technique of laparoscopy, surgery involving a small incision and a camera to see inside the body. The two men began to collaborate in 1971. In early attempts, Edwards and Steptoe retrieved eggs from the ovaries of volunteers by laparoscopy and focused on improving the timing of egg retrieval and in vitro culture conditions. In 1976, they achieved pregnancy in a patient, but, unfortunately, it was an ectopic pregnancy (it developed in the Fallopian tube) and had to be terminated. Then, in 1977, Edwards and Steptoe successfully implanted a fertilized egg in Lesley Brown, and the world's first "test tube baby," Louise Brown, was born on July 25, 1978. Edwards and Steptoe used a method known as "natural IVF," meaning that the patients were not given any fertility medication. Instead, mothers were monitored closely to predict ovulation, and a laparoscopy was done whenever ovulation seemed imminent. As ovulation is an imprecise phenomenon, prediction was difficult, and they often failed to obtain a mature egg. In 1980, Australian doctors tried stimulating their patients' ovaries with medication to produce more than one egg, and they enjoyed a higher success rate using this method, known as "stimulated IVF." Eventually, Edwards and Steptoe adopted this approach, and most modern doctors also use it.

In the 1980s, researchers made improvements to IVF treatment, including better embryology culturing techniques, refinements in fertility drug protocols and the ability to retrieve eggs with a vaginal ultrasound probe instead of laparoscopy. Because of these improvements, IVF success rates increased, reaching 20 to 25 percent per attempt for women under 40 by 1990.

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Dates 2015

4 - 6
Dec

Annual Meeting of the Middle East Fertility Society

Location: Liege, Belgium
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