Nowadays, there perhaps doesn't seem to be anything too remarkable about IVF (in vitro fertilization). With around 4 million babies so far born as a result of the technique, it has become a familiar and, for many, easily-accessible option to turn to when problems are encountered in conceiving a child. The idea of giving new life a boost by allowing sperm and egg to meet in the well-regulated surroundings of the laboratory is something we've come to rely on.
It wasn't always so. When, in the 1950s, Robert Edwards started contemplating his vision of helping childless couples to conceive by fertilizing the mothers' eggs outside the body and then replacing them in the womb, relatively little was known about human embryology. Although in vitro fertilization had already been demonstrated to work for other species under certain circumstances, the human reproductive cycle was discovered to be very different from that of other mammals. Before performing the feat of fertilization Edwards had therefore to determine the baseline conditions, such as when in their life cycle human eggs can be fertilized, what substances control their progress through that cycle and what conditions produce activated sperm that can actually fertilize an egg. In the process, he revealed much of what we know about human reproduction.
This groundwork seemed to come to fruition with Edwards' first demonstration of human in vitro fertilization in 1969, but these fertilized eggs never underwent more than a single cell division. Seeking an alternative source of human eggs, Edwards teamed-up with Patrick Steptoe, a gynaecologist, whose experimentation with the newly-introduced technique of laparoscopy allowed him to remove suitable eggs directly from women's ovaries. With this improvement, eggs fertilized in the laboratory fared better, dividing a number of times. However, barriers of a different sort now presented themselves. In 1971, in the midst of both societal and establishment resistance to the research, Edwards and Steptoe's funding organization, the UK's Medical Research Council, decided not to continue to support their work. The project was fortunately saved by private funding and in 1978, more than two decades after Edwards had his vision, Louise Brown, the world's first ‘test tube baby', was famously born in Oldham General Hospital in the UK.
Two years later Edwards and Steptoe founded the world's first centre for IVF treatment, the Bourn Hall Clinic near Cambridge, UK. Uptake of the technique spread widely and by 1986 there had been around 2000 births, half of them resulting from the work at Bourne Hall. Patrick Steptoe died in 1988, sadly too early to see the first generation of IVF babies grow into adulthood and witness the final confirmation, made apparent by their robust good health, of the overall safety of the procedure. Thirty-two years after that first IVF birth, the 4 million ‘IVF babies' worldwide now have a rather unusual boast: who else can say that the method of their conception was worthy of a Nobel Prize?