IVF: 35 yrs, 5 mn little ones later
Birth of Louise Brown in 1978 was start of a revolution in fertility treatment, and there’s more to come. Kate Brian writes for the Guardian News Service.world Updated: Jul 14, 2013 00:27 IST
There’s an old bell jar that sits on top of a cupboard at a Cambridgeshire fertility clinic where history was made; it was in a dish inside this jar that the world’s first IVF baby spent the hours after her conception. With the success of in vitro fertilisation (IVF), British scientist Robert Edwards and his gynaecologist colleague Patrick Steptoe had changed the future for infertile couples around the world.
Louise Brown, that first IVF baby, is 35 this month and what was then a revolutionary scientific advance has become a routine medical treatment. More than five million IVF babies have been born, and it’s easy to forget quite how controversial the idea of fertilising human eggs in a laboratory was at the time of Louise’s birth. “It was viewed with absolute suspicion,” says Professor Peter Braude, head of the Department of Women’s Heath at King’s College London. “If you talk to people on Saturday about human reproductive cloning, the feeling you get that it is playing God is just how it was in 1978 with IVF.”
Steptoe and Edwards started to work together in the 1960s. Scientists had been experimenting with fertilising animal eggs outside the body, but few believed it would ever be possible to create human embryos this way. Steptoe and Edwards thought that they could help couples with fertility problems if they could take eggs directly from the ovaries and return them to the womb once they had been fertilised. Many, even within the scientific community, felt that their research using human eggs and sperm was unethical and immoral. They were refused a grant by the Medical Research Council, but set up base in Oldham, UK, where they had no shortage of infertile women volunteering for the experimental treatment.
Across the world, other scientists were attempting to replicate the British achievement, and Australia’s first success came in 1980. A year later, the first IVF baby in the US was born, but the total number of children across the world conceived using the process still only stood at 15.
Facing state disinterest, Steptoe and Edwards eventually set up their own private clinic at Bourn, just outside Cambridge. Treatment was expensive with each cycle of IVF costing £3,000, at a time when the average annual income was around £6,000. Fertility treatment was restricted to those who could pay, and were willing to undergo this radical new technique.
The media fascination with IVF was intense, and the literature given to patients included advice about publicity; women were warned not to talk to the media, to “beware of telephone enquiries” and to avoid mentioning the names of any other women they’d met at the clinic. Many people, even within the medical profession, knew little about the treatment, as Ro Facer, who went on to have three children using IVF, discovered. She had been trying to conceive for some years when she heard Steptoe interviewed on the radio. “I’d never heard of IVF, I’d never heard of Louise Brown, and when I went to my doctor, she had never heard of IVF either so I had to do the research myself,” she explains. “Eventually I got a referral. We saw Patrick Steptoe and I felt in very safe and caring hands. It didn’t ever feel as if you were being taken advantage of or experimented on.”
With success rates in the early years averaging 12%, most women who went to Steptoe and Edwards did not end up with a baby, but that didn’t deter couples from around the world joining the waiting list. Lucy Daniel Raby had eight cycles of treatment in the 1980s before she finally got pregnant with her daughter Izzy. “It was all new and a bit sci-fi,” she says. “We were the early pioneers, and part of this exciting experimental process. I didn’t have a second thought about it once I knew it was the only way I could get pregnant. We were lucky that it was available.”
The embryos created during IVF are stored in small dishes rather than test tubes, but the term “test-tube baby” has stuck and still has negative connotations. There were wild rumours about what went on inside the clinic and the hostility and suspicion took a while to die down.
In the 35 years since Louise Brown’s birth, IVF has become a global money-making business producing very healthy profits, and there are hundreds of centres offering treatment around the world.
On Saturday, average success rates have risen to around 25%. Professor Braude worries that women may put too much faith in fertility treatment, believing that it can override the biological clock.
“There is a huge expectation, and people think that if they stave off motherhood for whatever reason then IVF will be their salvation, but that’s not true. If one is realistic, it isn’t that successful.”
So where will we be in another 35 years? Yacoub Khalaf, director of the IVF unit at Guy’s and St Thomas’s, suggests that ongoing stem cell research is the area to watch. “IVF has evolved significantly, but I think it is almost near the limits of biology now unless we find a way of creating eggs,” he explains.
“We do see patients who are struggling at 40 to 45, and the only thing which would change the face of treatment would be if we could make gametes from stem cells; if we could make sperm from men’s skin cells, or eggs from women’s hair cells.”
If that all sounds rather “brave new world”, it is worth remembering that’s just what many people thought about IVF itself 35 years ago. Whatever the future holds, it is clear that Steptoe and Edwards, who are now both dead, have left an extraordinary legacy. Mike Macnamee worked with them in the early days and is now chief executive at Bourn Hall.
“They inspired incredible loyalty, but what came through most from both of them was that they understood the pain of infertility,” he explains. “We forget that until Louise was born there was no hope for many couples.”
Louise Brown may have grown up in the media spotlight, but is keen to stress that on Saturday she leads an ordinary life.
She is married and has a son, Cameron, who was conceived naturally. She says she tries not to think too much about being the first IVF baby, which is to her “just a normal thing because I have never known anything else”.
However, she is clearly proud of what Steptoe and Edwards achieved. “They helped thousands of people, people they hadn’t even ever met, to have babies,” she says. “Without them, these children wouldn’t have been born.”