Test-tube babies

PLACE Oldham, England

The birth of a test-tube baby in Great Britain in 1978 following a successful in vitro fertilization (IVF) procedure transformed fertility treatment and provided hope to couples throughout the world.

Patrick Steptoe, an obstetrician at Oldham General Hospital in Oldham, England, and Robert Edwards, a Cambridge University physiologist, first met while attending the same scientific meeting in 1968. Steptoe had long been interested in problems of infertility and, in particular, had studied women who suffered from blockages of the Fallopian tubes. Edwards’s specialties included the roles played by hormones in maturation of the ovaries and oocytes.

The first attempt at IVF occurred in the early 1970s. In 1963, Doris and John Del Zio had a baby. The pregnancy, however, had left scarring in Doris’s Fallopian tubes, which resulted in an inability to produce further children. In September 1973, the Del Zios requested their physician, William Sweeney of New York Hospital, to attempt external fertilization. On September 12, Sweeney withdrew follicular fluid from Doris Del Zio that contained a viable egg; the fluid was carried by John Del Zio to Presbyterian Hospital, where Landrum Shettles attempted an external fertilization using sperm from the husband.

Shettles had not initially obtained permission from the chair of his department, and in any event, the sterility of the solution in which the fertilized egg was being incubated was in question. The experiment ended when the material was removed from the incubator the next day and eventually destroyed. The procedure itself was a failure, and the controversies resulting from the methodology threatened future research into the process.

A year later, Doris Del Zio filed a lawsuit against the hospital for “destruction of their property.” Ironically, the “test tube death trial” reached Federal District Court at the same time that a more successful attempt at IVF was nearing completion.

Success for the Brown Family

Like Doris Del Zio, Lesley Brown—a twenty-seven-year-old Bristol, England, resident—suffered from scarred Fallopian tubes. She and her husband, John, were referred to Steptoe in 1976 and discussed with him the possibility of another attempt at external fertilization. Following 1969, Steptoe and Edwards had collaborated in research into methods of obtaining viable oocytes and carrying out fertilization. Their only “success” out of some eighty attempts, however, was a single ectopic pregnancy in 1975, which had to be terminated.

By 1976, modifications in their procedures, including more rapid implantation of the fertilized egg, promised a greater chance of success. On November 10, 1977, Steptoe removed an egg from Lesley Brown and placed it in a sterile dish, and Edwards mixed sperm obtained from her husband with the egg to allow fertilization. Three days later an embryo in the eight-cell stage was implanted in Brown’s uterus; the procedure was successful.

Hounded by the press, Brown spent the initial months of her pregnancy living with the Steptoe family or shuttling from house to house. In part, the media frenzy was of their own volition. A London tabloid, the Daily Mail, paid the equivalent of nearly $500,000 for exclusive rights to the story. The paper assigned reporters to follow the Browns twenty-four hours a day, including several who moved in with the husband. As the pregnancy progressed, Brown developed toxemia and elevated blood pressure, forcing her admittance to Oldham General Hospital for the final two months of the pregnancy. Fortunately, the baby developed normally. On July 25, 1978, Louise Joy Brown was successfully delivered by cesarean section. Weighing five pounds, twelve ounces, the baby was normal and healthy.

Impact

The ability to carry out fertilization outside of a woman’s body provided immediate hope to couples who wished to produce a child biologically rather than adopt one. The procedure developed by Steptoe and Edwards was quickly adapted by other clinics. As news of the success became widespread, thousands of women expressed the desire to undergo a similar procedure.

Subsequent Events

Initially, most attempts at IVF were unsuccessful. Beginning in the 1980s, procedures for preparation and isolation of the eggs underwent modifications, as well as the fertilization and implantation methods themselves. Statistics have borne out the safety and success of the procedure. In the early twenty-first century, the success rate was approximately 30 percent, higher even than the fertilization rate of 20 percent that a healthy couple may achieve through intercourse in a normal month. Four years after Louise Brown’s birth, the family had a second baby named Natalie, who was also the result of IVF.

Bibliography

Bonnicksen, Andrea. In Vitro Fertilization. Columbia UP, 1989.

Edwards, Robert, and Patrick Steptoe. A Matter of Life. William Morrow, 1980.

Edwards, Robert, and Ruth Fowler. “Human Embryos in the Laboratory.” Scientific American, vol. 223, 1970, pp. 44–54.

Henig, Robin. Pandora’s Baby: How the First Test Tube Babies Sparked the Reproductive Revolution. Houghton Mifflin, 2004.

Lenharo, Mariana. "Is IVF at Risk in the US? Scientists Fear for the Fertility Treatment’s Future." Nature, 4 Apr. 2024, www.nature.com/articles/d41586-024-00830-1. Accessed 20 May 2024.

McMahon C. et al. "What Do Women Undergoing in vitro fertilization (IVF) Understand About Their Chance of IVF Success?" Human Reproduction, vole. 39, no. 1, Jan. 2024, pp. 130-38, doi.org/10.1093/humrep/dead239. Accessed 20 May 2024.

Orr, Tamra. Test Tube Babies: The Science of In Vitro Fertilization. Blackbirch Press, 2003.