Brown Gives Birth to the First Test-Tube Baby

Date July 25, 1978

The science of assisted conception gained worldwide attention when Lesley Brown gave birth to the first “test-tube baby,” aided by the pioneering efforts of biologist Robert Geoffrey Edwards and obstetrician Patrick Christopher Steptoe.

Locale Oldham, Lancashire, England

Key Figures

• Lesley Brown (b. 1947), mother of the first “test-tube baby”
• Gilbert John Brown (1941-1999), father of the first “test-tube baby”
• Patrick Christopher Steptoe (1913-1988), English obstetrician who perfected the laparoscope used to obtain oocytes from the ovary and who delivered Louise Joy Brown
• Robert Geoffrey Edwards (b. 1925), biologist and professor of human reproduction at the University of Cambridge who designed methods for in vitro fertilization and early embryo development
• Jean M. Purdy (fl. late twentieth century), laboratory technician and former nurse who was vital to the monitoring of the eggs, sperm, and embryos in culture that led to Louise Brown’s birth

Summary of Event

As a medical student in the 1930’s, Patrick Christopher Steptoe was concerned about the plight of women coming to his clinic with blocked reproductive tubes that prevented fertilization and travel of an embryo to the uterus for development. After moving to a position at Oldham General Hospital in 1951, he developed the technique of laparoscopy to study the internal abdominal area. He used a flexible source of cool light and fiber optics to visualize, move, and even take samples from the ovaries and other organs through a small incision in the naval.

In the 1950’s, Robert Geoffrey Edwards was a student in zoology and, later, genetics, working on the immunology of reproduction and on embryos. Edwards and Steptoe met at a scientific meeting in 1968 in London. They spent the next several years working on perfecting the techniques of oocyte ripening and fertilization in the culture dish. In 1969, they published a paper in the journal Nature about the ripening of twenty-four of fifty-six human oocytes and subsequent fertilization of some of them in the culture. It was at this point that the researchers began to involve patients. Steptoe obtained by laparoscopy already ripe oocytes from the ovary follicles, areas of the ovary where oocytes matured. Edwards and lab technician Jean M. Purdy, who designed the apparatus to retrieve the oocytes, attempted to fertilize the oocyte using the husband’s spermatozoa. Within a short time, the researchers had routine fertilization and some development of the embryo in the culture dish, a process called “in vitro fertilization.”

In 1971, they moved their research to Kershaw’s Cottage Hospital in Royton, near Oldham, and in 1972, they started transplanting embryos into female patients. They were not successful until the summer of 1975. The elation of those early weeks was ended when the pregnancy developed problems and had to be terminated at seven weeks. The report of their results, however, made medical history after being published in the journal The Lancet on April 24, 1976. A few more pregnancies occurred and ended prematurely on their own before Edwards and Steptoe, revising the process, decided to use the natural reproductive cycle instead of hormone treatment.

Finally, true success occurred in late 1977. Lesley Brown was the second patient to go through the regime of urine collection every three hours to check natural hormones in order to decide when the oocyte would be ready to be ovulated. A ripe oocyte was collected on the first try and was fertilized without problems. The embryo was placed into her uterus just after 12:00 a.m. on November 13, 1977. In three weeks, Lesley Brown was informed that the hormone level screening from urine and blood tests was positive for pregnancy.

After a full-term pregnancy, a cesarean section was planned and carried out with health officials filming and the world almost literally watching. At 11:47 p.m. on July 25, 1978, Louise Joy Brown—the world’s first “test-tube baby”—was born; she weighed five pounds and twelve ounces. Months later, Steptoe and Edwards were greeted with a standing ovation at the Royal College of Obstetricians and Gynecologists as they presented a report on their work.

Significance

The controversies and acclaims over in vitro fertilization techniques began in 1966 and have not ended, although by the end of the twentieth century the technique was well established and widely used, leading to the births of tens of thousands of babies. Arguments in favor of the technique include an expected increase in the number of successful test-tube babies, the growth of cells that might be used to replace defective tissues or organs in humans, and the understanding of normal human development that may help doctors prevent defective births.

One of the major concerns of early critics was over “informed consent.” Edwards and Steptoe always stated how they explained that the methods, being experimental, “might” result in a pregnancy. Gena Corea, in her book The Mother Machine (1985), gave evidence that many of the women in the early experiments were treated more like research subjects than patients, and she doubted that Edwards and Steptoe understood this. She concluded that these women would have subjected themselves to anything to have a child. Corea cautioned that their consent resembled coercion caused by societal and family pressures to have a child.

Some critics argued that in vitro fertilization is unnatural and could lead to genetic screening for certain traits in the search for “perfect” offspring and the destruction of others for increasingly trivial reasons, including being the “wrong” sex. Such issues have become increasingly important to the ethics committees connected with hospitals and medical clinics.

Bibliography

Adler, Robert E. Medical Firsts: From Hippocrates to the Human Genome. Hoboken, N.J.: John Wiley & Sons, 2004. Clearly written volume on innovations in medicine includes a chapter on the beginnings of in vitro fertilization.

Brown, Lesley, and John Brown, with Sue Freeman. Our Miracle Called Louise: A Parents’ Story. New York: Paddington Press, 1979. Personal account of the sorrows, drama, and joy surrounding the birth of the Browns’ desperately wanted child. Revealing as to the literal pain and fears the couple endured. Presented in a warm, homey style. Includes photographs.

Corea, Gena. The Mother Machine: Reproductive Technologies from Artificial Insemination to Artificial Wombs. New York: Harper & Row, 1985. Presents a feminist perspective on many reproductive technologies that take control away from the woman, with very thoughtful and provocative opinions. Each chapter includes detailed notes and explanations of processes. Part 3 discusses in vitro research.

Edwards, Robert G., and Ruth E. Fowler. “Human Embryos in the Laboratory.” Scientific American 223 (December, 1970): 44-54. Discusses early in vitro work with oocyte maturation, fertilization, and embryo development in a clear, basic manner. Includes photographs and drawings of embryos and their chromosomes.

Edwards, Robert G., and Patrick Steptoe. A Matter of Life. New York: William Morrow, 1980. Brief volume by both of the men who were involved with the research and the clinical aspects of the first “test-tube baby.” Provides some biographical information on both as well as a detailed account of their work and the controversies surrounding it.

Franklin, Sarah. Embodied Progress: A Cultural Account of Assisted Conception. New York: Routledge, 1997. Ethnographic work addresses the sociocultural dilemmas raised by the use of medical technology to assist in conception. Includes bibliography and index.

Gold, Michael. “The Baby Makers.” Science 85 6 (April, 1985): 26-38. Presents an account of the groundbreaking and controversial work that took place at the first American fertility clinic in Norfolk, Virginia, with Howard and Georgeanna Jones. Written for a general audience.

Moore, Keith L., and T. V. N. Persaud. The Developing Human: Clinically Oriented Embryology. 7th ed. Philadelphia: W. B. Saunders, 2003. Medical textbook is technical in some aspects, but reads very well and has many diagrams and pictures that are helpful for basic understanding of the processes of human reproduction.