You can watch an emotional video on YouTube from the birth of Louise Brown, born on July 25, 1978 at Oldham Hospital. The first moments of her life were just like any newborn baby: the girl was washed, weighed and examined. Born by Caesarean section, however, Louise was a scientific sensation – the first child to be born via IVF.
- 40 years ago, the first IVF-conceived child was born
- In those days, in vitro fertilization was considered to be an extremely complicated method. The oocytes were then harvested by laparoscopy under general anesthesia. After the procedure, the woman had to stay in the hospital for a few days and be under the constant care of doctors
- According to specialists, in 20 years from 50 to 60 percent. children will be conceived thanks to the IVF method
It is now 40 years since Louise was conceived. It happened on November 10, 1977, after many years of research conducted by prof. Robert Edwards and Dr. Patrick Steptoe, pioneers of a technique that has given millions of couples around the world a chance for offspring.
The process of in vitro fertilization, in simple terms, consists in removing an egg from a woman’s fallopian tube, fertilizing her with sperm in the laboratory and implanting the fertilized egg – the embryo – back into the uterus for further development. Today, this infertility treatment method is not sensational and is widely used – thanks to it, more than five million children have been born in the last four decades. In the beginning, however, in vitro fertilization caused a lot of controversy.
Prof. Edwards and Dr. Steptoe to look for a method of fertilization of a human egg in the laboratory, outside the reproductive system of the woman, and to bring the embryo to the blastocyst stage. In 1968, when prof. Edwards achieved his goal – to win the Nobel Prize in 2010 – embryology was a fledgling field of science that did not raise much hope.
It wasn’t until nine years later that Louise’s mother, Lesley Brown, became the first woman in the world to become pregnant thanks to a method of in vitro fertilization developed by two British scientists. In 1980 – two years after Louise was born – prof. Edwards and Dr. Steptoe opened the Bourn Hall Clinic in the small town of Cambridgeshire, the world’s first fertility clinic. Thanks to her, thousands of test-tube babies were born.
The development of this field of science is, in a way, the fruit of the sexual revolution in Great Britain in the 60s – After the 60s, many women had a “memento” of fallopian tubes damaged by sexually transmitted diseases such as chlamydia – says Dr. Mike Macnamee, the current director of the clinic Bourn Hall, who worked there with Stepto and Edwards from the beginning of his career. – In those days, 80 percent. of our patients had fallopian tubes destroyed, for comparison today this problem is 20-30 percent. female patients.
Four decades ago, IVF was a serious and complicated medical procedure. The oocytes were collected using the laparoscopic method under general anesthesia – the woman was usually in the clinical ward for four or five days. During the entire stay in the hospital, the doctors monitored the level of the patient’s hormones, for this purpose, her urine was collected 24 hours a day. The clinic had 30 beds, which were always full – for a long time it was the only place in the world offering IVF treatment. The staff worked around the clock.
It was not until the late 80s that an ultrasound-guided sedation method was developed that allowed a woman to return home the same day. Initially, the birth rate at the Bourn Hall clinic was quite low, at just 15%. – for comparison, today the national average is about 30 percent.
– We were not only at the forefront of the world of science, but also pioneers in vitro from the ethical side. We have won the acceptance of this method, says Dr. Macnamee. – Bob and Patrick have shown incredible persistence in these difficult times. The great Nobel Prize winners accused them of infanticide, while the medical and scientific elite distanced themselves from them, which was especially hard for them.
The birth of Louise Brown raised the fear that scientists were creating “Frankenstein’s children.” Religious leaders warned against artificially interfering with the process of creating life. After their daughter was born, the Brown family was inundated with threatening letters. It was not until the beginning of the 90s that the public mood began to change.
“Our job at Bourn Hall was to educate and generate interest,” says Dr. Macnamee. – We have always been open and honest.
Unfortunately, with such a low success rate for many couples, the therapy ended in disappointment. But there were also those that stubbornly did not give up. One of the clinic’s patients had 17 attempts before giving birth to a son.
‘The desire to have a baby is so great, especially when you can’t get pregnant, that people are really ready to make a lot of sacrifices,’ Dr Macnamee notes. – It is our responsibility to clarify the expectations of couples before they start therapy.
Of course, it’s not always easy to do. “Couples are not being suggested that IVF will fail,” says Susan Seenan, director of Fertility Network UK. – But everyone has access to the statistics.
Not all are eligible for therapy. As per the 2013 recommendations of the National Institutes of Health and Care (NICE) in England and Wales, women under 40 are entitled to three IVF cycles at the expense of the National Health Service, provided they have tried unsuccessfully for two years, or 12 attempts at artificial insemination have failed. Women aged 40 to 42 are entitled to one reimbursed cycle. However, the final decision about who is entitled to free IVF in a given area is made by local medical service contracting commissions, which do not always offer as many cycles as recommended by NICE.
Therefore, for British couples applying for a child, qualification for the procedure is an address lottery. – It also happens that two couples living on the same street but assigned to different GPs have the right to a different number of free IVF cycles, because their doctors are subject to different committees – explains Seenan. – At the moment, seven committees do not reimburse in vitro procedures at all.
With one in six couples having trouble conceiving in the UK, the fertility treatment industry is booming. Experts estimate it is currently worth £ 600m (assuming one paid IVF cycle costs £ XNUMX to £ XNUMX).
“Many women fail to get pregnant after one IVF cycle,” says Seenan. – The second time around, the likelihood is higher, but some become pregnant after the fourth, fifth, or even sixth cycle. The younger the woman, the greater the chances of success.
Regardless of age – according to Seenan, it is a myth that the majority of patients are women who have postponed motherhood for too long and now, due to their advanced age, are unable to get pregnant naturally – IVF is a complicated process. First of all, it requires time and many visits to a specialist. The woman has to take various medications, incl. stabilizing the level of hormones.
“Drugs can bring you into a state that looks like menopause, and many women don’t take it well,” Seenan explains. Patients are also given drugs that stimulate the work of the ovaries – they are given in the form of injections. At this stage, the condition of the ovaries should be constantly monitored so that they are not over-stimulated.
During drug therapy, women feel tired, swollen and have mood swings. For some, however, the most difficult thing is the two-week wait for the implantation of the embryo and the diagnosis of pregnancy.
That is why scientists in research centers around the world are constantly trying to improve the method of in vitro fertilization. A new laboratory has recently been established in Bourn Hall to investigate why certain eggs do not mature properly, a common cause of miscarriage and infertility among older women. It is the first laboratory in Europe that has a modern microscope that allows live observation of the development of egg cells.
Dr. Macnamee predicts that in 20 years the birth rate will be between 50 and 60 percent. In his opinion, scientists will probably also be able to correct abnormalities in embryos. Public opinion will again have to come to terms with the progress of science.
‘There should already be a serious debate about how far we can go,’ adds Dr Macnamee.