by Marthe Fourcade and Eva von Schaper
Edwards and Steptoe, working in the face of opposition from church and government, created a procedure that led to the birth of the first test tube baby, Louise Brown, in 1978. Since then more than 4 million IVF babies have been born worldwide, and a multibillion-dollar market for infertility treatments has arisen.
Brown’s birth “was a paradigm shift and showed for the first time that it was possible to treat infertility,” Christer Hoog, a professor in molecular cell biology at Sweden’s Karolinska Institute, said at the Nobel news conference. “That single event is the most important part of Edwards’s achievement.”
As a young researcher, Edwards began work on mice reproduction. He studied fertilized eggs collected from female mice, which tend to ovulate at night, according to the citation when he won the Albert Lasker award for clinical medical research in 2001. After three years of midnight visits to the lab, he found a way to coax the animals to ovulate during daytime. He also developed a way to prod dormant eggs to mature outside the female’s body.
Slices of Ovaries
Edwards began working on humans by persuading gynecologists to give him slices of human ovaries from women who underwent surgery. In 1969, he published a paper in which he described having achieved fertilization outside a woman’s body. He joined forces with Steptoe, who collected ripened eggs directly from women’s ovaries.
Edwards worked on fertilizing them in the lab. In 1972, they started trying to place the eggs in the womb of infertile women. On July 25, 1978, Brown was born using the procedure developed by Edwards and Steptoe.
“Ethicists decried us, forecasting abnormal babies, misleading the infertile and misrepresenting our work,” Edwards said in an article accompanying his Lasker award acceptance speech. After Brown’s birth, Edwards said his work was halted for more than two years because he and Steptoe couldn’t gain government support.
Four Million Babies
“The work at Bourn Hall in those heady days was directed at making the treatment more widely available and the patients were well aware that they too were making history,” Macnamee, who joined Edwards’s research team in the early 1980s, said in an e-mailed statement today. More than 4 million babies have been born from in-vitro fertilization, he said.
Louise Brown’s parents first approached Edwards and Steptoe in 1976 about helping them conceive because Lesley Brown had no fallopian tubes. “Me and mum are so glad that one of the pioneers of IVF has been given the recognition he deserves,” Louise Brown said in an e-mailed statement today.
Edwards, who was born in Leeds, served in the British army in Jordan, Egypt and Iraq before earning an undergraduate degree in zoology and agriculture from the University of Bangor, Wales. He did postgraduate work at the University of Edinburgh’s Institute of Animal Genetics. He met his wife, Ruth Fowler, as they worked together as doctoral students in Edinburgh. The couple has five daughters and 11 grandchildren.
“Unfortunately Professor Edwards isn’t in good health right now, so I spoke to his wife,” said Goeran Hansson, a professor in experimental cardiovascular research at Karolinska and secretary of the Nobel Committee for Medicine. “She was delighted and she was sure he would also be delighted.”
Demand for fertility treatments is booming. A 2009 report by Marketdata Enterprises Inc. estimated that in the U.S., $4 billion is spent annually on fertility services and the number of IVF procedures has almost tripled to 142,000 since 1999. The global market for fertility drugs is more than $1 billion, the research firm found. Infertility affects more than 10 percent of all couples worldwide, the Nobel Assembly said.
In IVF, eggs are removed from a woman’s ovaries after treatment with fertility drugs to stimulate the development of follicles in the ovaries. They are fertilized outside the body - - in vitro comes from Latin for “within the glass” -- before being transferred into the patient’s uterus. Merck KGaA’s Serono unit pioneered fertility drugs in the 1960s with hormones extracted from the urine of postmenopausal nuns.
“In the days before IVF, the techniques we had were exceptionally limited,” said Alan Penzias, a reproductive endocrinologist at Boston IVF and member of the board of the American Fertility Association. “Those individuals were completely and hopelessly infertile.”
The major complication of IVF is the risk of multiple births, which can occur when several embryos are transferred into the womb. Leftover embryos that didn’t get implanted can be discarded, or donated to help other couples conceive or for use in embryonic stem cell research.
Edwards had discussed the theoretical applications of IVF technology from the beginning, and was one of the first to speak of the potential for embryonic stem cells, which can grow into any kind of tissue, said Basil Tarlatzis, a professor at the Aristotle University of Thessaloniki in Greece.
‘He Was Dreaming’
“We were always joking with him that he was dreaming, but he had the knowledge to understand this was a viable option,” Tarlatzis said.
The average cost of an IVF cycle using fresh embryos, and not including medications, is $8,158 in the U.S., according to Resolve, the National Infertility Association, based in McLean Virginia.
“The more I look back, the more I see how ahead of his time he was,” Martin Johnson, a professor of reproductive sciences at Cambridge and a former Edwards doctoral student, said in a telephone interview. “At the time, infertility was not seen as a problem and he was flying the flag for it.”
Last year’s Nobel prize in medicine went to Elizabeth Blackburn, a professor at the University of California in San Francisco, Carol Greider from Johns Hopkins University School of Medicine in Baltimore and Jack Szostak of Harvard Medical School in Boston, for research on cell division.
Annual prizes for achievements in physics, chemistry, medicine, peace and literature were established in the will of Alfred Nobel, the Swedish inventor of dynamite, who died in 1896.