The Past and Future of In Vitro Fertilization

In vitro fertilization, better referred to as IVF is an assisted reproductive technology during which fertilization takes place within the lab rather than inside the body. Ever since the world’s first IVF baby was born in 1978, in vitro fertilization has given hope to many couples who couldn't conceive a toddler in the other way.

The Past and Future of In Vitro Fertilization


Overview

The literal meaning of the phrase in vitro is "within the glass.” it's a Latin term, which more generally refers to anything occurring during a laboratory setting. This is often the other of in vivo, which suggests within the body (or literally, "within the living").

Today, IVF may be a mainstream—albeit expensive—fertility treatment. But 5% of fertility patients requires IVF. An estimated 8 million IVF-conceived babies are born round the world. These so-called “test-tube babies” are as healthy and normal as typically conceived children.

It wasn’t that way back that IVF was a fresh technology, highly controversial, and even illegal.alert-info

History of IVF

The road to successful IVF treatment was long and trying. Because of the bravery and persistence of the first scientists and doctors, the technology of in vitro fertilization are available today.

In 1934, Dr. Pincus performs first fertilization of an animal's egg during a lab. (A rabbit, during this case.)

In the spring of 1944, Dr. Pincus and a lab technician Miriam Menkin create conditions that achieve for the primary time the fertilization of a person's egg within the lab.

In 1951, Dr. Landrum Shettles is in a position to duplicate Dr. Pincus' fertilization of an egg during a laboratory setting and manages to stay the embryo developing up until day six.

In November of 1977, Dr. Robert Edwards and Dr. Patrick Steptoe perform the primary successful IVF treatment in England. Eggs are retrieved from Lesley Brown and fertilized with John Brown's sperm sample.

The world's first "IVF baby" Louise Joy Brown is born on July 25th, 1978 in England.

The world's second IVF baby and first boy Alastair MacDonald is born on January 4th, 1978.

Australian's first IVF baby Candice Elizabeth Reed is born on June 23rd, 1980.

Dr. Georgeanna and Howard Jones perform the primary successful IVF procedure within the us on April 17th, 1981.

On December 28th, 1981, America's first IVF baby Elizabeth Jordan Carr is born.

How IVF Works

Here's a really short explanation of what happens during IVF:

The woman takes fertility drugs, which stimulate the event of additional oocytes (or eggs) within the ovaries. This takes place over variety of days. Then, the mature eggs are faraway from the ovaries (either from the intended mother or from an egg donor). This is often through with an ultrasound-guided needle.

In the lab, the retrieved eggs are combined with sperm (from either the intended father or from a sperm donor.) The egg and sperm are put together during a Petri dish, where hopefully a sperm will fertilize an ovum. A fertilized human ovum is named an embryo. The resulting embryo then develops for a couple of more days within the lab. This is often done under very carefully controlled conditions.

Next, one or two of the healthiest embryos are transferred to the intended mother’s (or a surrogate’s) uterus. Any extra embryos are frozen for future cycles. Hopefully, pregnancy will result. IVF success rates are good, but pregnancy isn't a guarantee.

What Is a “Test Tube Baby?”

"Test tube baby" may be a term sometimes employed by the media to ask children conceived with in vitro fertilization (IVF). Despite the name, "test tube babies" aren't developed during a tube. Test tubes aren't a part of the fashionable IVF process in the least . With IVF, the egg is fertilized during a Petri dish. (Not a tube.) When the embryo is between three and five days old, it's transferred to the uterus.

To be clear, the embryo doesn't become a fetus within the lab. That concept belongs to the realms of fantasy. The embryo transferred may be a collection of living and developing cells—not what anyone would consider as a “fetus."alert-info
The term tube baby was first utilized in the 1930s. Then, it had been wont to ask artificial insemination—not IVF. AI is when specially washed semen is directly transferred into a woman’s uterus via the cervix. it's an in vivo fertilization — within the body — and not in vitro, within the lab, like IVF.

An early regard to the phrase “test tube baby” is found during a book published in 1934 by Panurge Press, written by Dr. Hermann Rohleder.

The book, entitled tube Babies: A History of the synthetic Impregnation of citizenry, is described as, "including an in depth account of its technique, along side personal experiences clinical cases, a review of the literature, and medical and legal aspects involved." This book is about AI, not IVF. IVF had not yet been invented.

When the primary human egg was fertilized outside of the body in 1944, the term tube baby began to ask IVF babies. Louise Joy Brown, the world’s first IVF baby, remains frequently mentioned because the world’s “first test tube” baby. (More on her below.)

Most within the fertility world consider the term "test tube baby" offensive and inappropriate due to the negative, sci-fi imagery it conjures up.alert-info

IVF in Rabbits

In 1934, Dr. Pincus successfully fertilized rabbit eggs within the lab. He didn't use male rabbits within the process. Through a process referred to as parthenogenesis, he was ready to take eggs from female rabbits, force fertilization of the eggs through chemical means, then transfer the fertilized eggs back to the feminine reproductive tract of a rabbit.

His work caused great controversy and concern. The experiments and negative publicity led him to lose his tenure at Harvard University. But not everyone saw Dr. Pincus’ work as unethical. Some saw hope and promise.

IVF in Humans

In 1937, Dr. Rock sent an unsigned editorial to the New England Journal of drugs entitled “What a boon for the barren women with closed tubes,” praising the potential of in vitro fertilization in humans.

In 1938, Dr. Rock hired Dr. Pincus’ former technician — Miriam Menkin. Miriam Menkin and Dr. Pincus then spent subsequent six years attempting in vitro fertilization of human ova. During their research, they collected 800 human ova and tried to fertilize 138.

Finally, within the spring of 1944, Pincus and Menkin decided to elongate the quantity of your time the egg and sperm were together within the Petri dish. They were finally ready to successfully fertilize four eggs. They didn't plan to transfer those fertilized eggs into a woman’s uterus.

Controversy

In 1949, Pope Dius XII condemned fertilization outside of the body. But this didn't stop progress.

In 1951, Dr. Landrum Shettles attempted to duplicate Dr. Pincus’ fertilization of human eggs within the lab. He was successful. Dr. Shettles was also ready to keep the embryo alive and developing until day six. (Day six is when an embryo would typically implant itself into the uterine lining.)

He went on to publish Ovum Humanum, a book containing over 1,000 pictures of the human egg at various stages of development.

IVF Research

In the meantime, in England, Dr. Robert Edwards was attempting in vitro fertilization with mice eggs. He was successful and wanted to try to an equivalent with human eggs. He tried for years but had no luck.

In 1965, Dr. Edwards traveled to America, where he met with Doctors Howard and Georgeanna Jones at John Hopkins University. Dr. Howard Jones was a reproductive surgeon, treating infertility surgically. His wife, Dr. Georgeanna Jones, was a reproductive endocrinologist. She treated infertility with non-surgical methods.

Dr. Edwards told the Jones’ about his hope of discovering a way of in vitro fertilization for couples who couldn’t conceive otherwise. The Jones’ agreed to assist him, and together, they successfully fertilized a person's ovum.

Progress

After returning to England, Dr. Edwards wanted to undertake transferring a embryo back to a woman’s uterus. That’s when Dr. Edward met Dr. Patrick Steptoe.

Dr. Steptoe had invented a then-new surgery referred to as laparoscopy. This is often a surgical technique where alittle incision is formed within the abdomen, and a camera and tools are put through that incision. Through laparoscopy, a mature human egg might be retrieved from a woman’s ovaries. This is able to be far less invasive than the opposite surgical options at the time.

Dr. Jones told Dr. Steptoe of his dream of IVF treatment. They decided to figure together.

Back across the ocean, in America, the American Medical Association was speaking out against IVF. They insisted that research involving "human fetal tissue" must stop. The American Fertility Society thought differently. Then, headed by Dr. Georgeanna Jones, the AFS stated that research on in vitro fertilization must continue.

And it did. But with continued controversy and risk to the doctors involved.

The First Attempts

Dr. Shettles remained determined to bring into the planet the primary in vitro fertilized baby. Doris and Dr. John Del-zio volunteered to be the primary IVF parents with the assistance of Dr. Shettles.

Doris and Dr. John Del-zio suffered from infertility for five years. A ruptured cyst had led to blocked fallopian tubes in Doris. She had had three attempted surgical repairs of her tubes and three attempts at AI. None of the treatments were successful.

Dr. Shettles said IVF might be a possible answer and offered to assist. However, Dr. Shettles’ university wasn't aware about his plans. In fact, he was going against the direct instruction of his superiors. He also chose to ignore ethical guidelines on research in humans.

On September 12th, 1973, Dr. Shettles retrieved eggs from Doris, sperm from John, and put them together during a glass vial. Then, he placed the vial in an incubator, where he planned to stay it for a couple of days to permit fertilization and embryo development.

But before fertilization and embryo transfer could occur, one of Dr. Shettles’ colleagues reported his unapproved experiment. The vial was taken out of the incubator prematurely, and Dr. Shettles was confronted together with his attempted IVF experiment. The likelihood of a primary IVF baby was lost.

In the aftermath, Dr. Shettles was forced to resign from his position at Columbia-Presbyterian.

The First IVF Pregnancy

Back in England, in 1975, Dr. Edwards and Dr. Steptoe finally achieved the primary successful IVF pregnancy. But the pregnancy was ectopic — the embryo implanted into the Fallopian tube — and therefore the pregnancy led to miscarriage.

In the meantime, in America, more obstacles to IVF research were put into place. Federal grants were not allowed to be used for the needs of “fetal research” (which would come with IVF research) unless the study was first approved by the National Ethics Board.

But because the board wouldn't officially be created until June of 1978, progress came to a quick pause.

Do you have to Freeze Your Eggs to increase Your Fertility?

The First IVF Baby

Back in England, Dr. Edwards and Dr. Steptoe continued their attempts at IVF treatment. In November of 1976, Lesley and Brown met Dr. Steptoe. Lesley’s fallopian tubes were blocked. Dr. Steptoe told the Browns that in vitro fertilization could also be ready to help them. They agreed to the treatment.

On November 10th, 1977, Dr. Steptoe retrieved eggs from Lesley Brown’s ovaries via laparoscopic surgery. Using John Brown’s sperm, Dr. Edwards put the eggs and sperm together during a Petri dish, and fertilization successfully happened.

After two days, the resulting embryo was transferred back to Lesley’s uterus. Pregnancy occurred and was a hit.

On July 25th, 1978, Louise Joy Brown — the world’s very first IVF baby — was born via cesarean delivery . She was 5 pounds, 12 ounces. Healthy, happy, and normal.

IVF in America

That same year, in America, Dr. Georgeanna, and Howard Jones retired from John-Hopkins University. They decided to maneuver to Norfolk, Virginia to open a fertility clinic.

On the day of Louise Joy Brown’s birth, a reporter interviewed Dr. Howard Jones in Norfolk. The reporter asked if an IVF baby were possible in America. Dr. Jones replied that it had been completely possible, all they needed was money to form it happen.

Dr. Jones later received a call from a former fertility patient offering funds to open the primary IVF clinic in America. But longer would pass before an IVF baby would change state within the USA.

IVF round the World

Controversy continued to arise and obtain within the way of in vitro fertilization research and progress in America.

While this was happening, round the world, more IVF babies were arriving. On January 4th, 1978, Alastair MacDonald was born — the second IVF baby and first IVF boy. On June 23rd, 1980, the primary Australian IVF baby was born — Candice Elizabeth Reed.

On October 2nd, 1981, the primary IVF baby born to American parents arrived — but the treatment and birth occurred in England. Her name is Samantha Steel.alert-info
In America, the Jones’ continued to fight for the power to open and run their IVF clinic.

First IVF Baby Born in America

Finally, after clearing several political hurdles, the primary American IVF clinic opened on March 1st, 1980. Within the first year after opening, the Jones’ attempted 23 IVF embryo transfers in Norfolk, VA. They were unsuccessful.

In the meantime, in Massachusetts, Judy and Roger Carr were struggling to conceive. The Carr’s infertility story started with a pregnancy that came quickly but ended quickly also . Their first pregnancy was ectopic, and Judy lost one among her fallopian tubes. They tried to urge pregnant again, conceived quickly again, but had another extrauterine pregnancy . Judy lost her second Fallopian tube .

Natural conception was now completely impossible. While Judy was recovering from surgery, she received a pamphlet about the IVF clinic in Norfolk, VA. IVF wasn't only unavailable in Massachusetts at that point , but it had been also illegal. The Carrs contacted the Jones and were invited to return to their IVF clinic. They proceeded with IVF treatment.

On April 17th, 1981, Judy’s embryo was transferred into her uterus. It had been a hit . Finally, on December 28th, 1981, at 7:46 am, Elizabeth Jordan Carr was born via cesarean delivery . America’s first IVF baby.

IVF Then vs. Now

The procedure for IVF looks very different today than it did when it had been first invented. The primary IVF patients were required to stay hospitalized during most of their treatment cycle. so as to live hormone levels, that they had to gather all of their urine.

Now, IVF patients are ready to be reception and work. They not got to collect all their urine. Blood work is employed to guage hormone levels.

IVF patients still do got to inherit the fertility clinic frequently for blood work and ultrasounds. But the treatment is not any longer a round-the-clock endeavor.alert-info
During the first days of IVF, when their hormone levels indicated ovulation, the egg retrievals had to be scheduled exactly 26 hours later. This sometimes meant doing the procedure within the middle of the night.

Today, injectable fertility drugs are wont to control when ovulation occurs. This enables scheduling the egg retrievals at more normal hours of the day. It also allows doctors to possess more control of the whole ovulation process, increasing the chances for fulfillment .

In the beginning, egg retrieval required invasive surgery. Laparoscopy was required. This is often a surgical technique where alittle incision is formed within the abdomen, and a camera and tools are put through that incision.

Today, an ultrasound-guided needle is employed to retrieve the eggs. This is often significantly less invasive, less risky, and involves a shorter recovery time.alert-info

The GIFT Procedure

Some religions are ethically against the thought of fertilization outside the body. The GIFT procedure, invented by Dr. Shettles in 1979, allows for fertilization to occur inside the body. But the technique is invasive and doesn’t have great success rates.

The gamete intrafallopian transfer (GIFT) procedure may be a fertility treatment somewhat almost like IVF. In it, the lady usually takes fertility drugs to stimulate her ovaries. Her eggs are then retrieved from the ovaries via an ultrasound-guided needle.

But unlike IVF, fertilization of the egg doesn't happen within the lab. Instead, the egg and sperm are transferred to the fallopian tubes, where fertilization would normally happen. Due to the low success rates and invasiveness of the procedure, GIFT is never done today.

Potential Alternative Treatments

A fresh technology may make fertilization inside the body available to all or any IVF couples. A tool called AneVivo is currently being developed within the uk and in select fertility clinics in Europe. It received approval from the Human Fertilization and Embryology Authority (HFEA) in September of 2015, and in 2016, the primary baby conceived using the technology was born.

Researchers involved within the development of the new device believe embryo health are often further improved if the embryos spend less time within the lab and longer within the natural environment of the uterus.

The new technique involves putting egg and sperm cells inside the very small capsule. (The capsule is simply one centimeter long and one millimeter wide.) This capsule is then transferred into the uterus for twenty-four hours. During this point , hopefully, conception will happen . After the prescribed time, the capsule is removed and opened. Then, doctors select healthy embryos to transfer back to the uterus.

Not only would this new technology possibly solve religious concerns (for some), it's going to also provide a more natural environment for conception. It'll also allow women the experience of conception occurring inside their own bodies.

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