Thank you Mr Steptoe and Dr Edwards

In 11 days time, Louise Brown will be 30. She has her own son, Cameron, who was conceived spontaneously just over two years ago. She comes across as a nice, thoughtful, sensible and articulate woman, very aware of the role she's played but in no way starry because of it.

We owe a lot to her parents, to Mr Steptoe and Dr Edwards, and I'm sure a lot of unsung nurses, embryologists, researchers and other doctors without whom the good gentlemen would not have been able to treat Mrs Brown, who had blocked fallopian tubes. It's hard with scientific progress to disentangle the multiple threads that come together into the tapestry which is an individual breakthrough, but these articles give you a sense of the long line of clinical and scientific progress without which IVF would not have been possible. I did not previously know that the first IVF pregnancy ended in an ectopic, for example, although I was aware that Mrs Brown's pregnancy resulted from harvesting a single egg, caught just after ovulation, since the drugs to produce controlled ovarian hyperstimulation and to control ovulation were not yet well developed (hyperstim was already in use, just not put together into the edwards/steptoe protocol).

If we think back to all those many pieces of work, the century (at least) of work on human fertility which led to Louise's birth, we can marvel all the more at what's been developed since. The drugs to help us to produce multiple eggs in one go. Agonists, antagonists and recombinant chorionic gonadotropin (hcg) to control when ovulation happens. ICSI. The understanding that many women need progesterone support after artificial induction of ovulation to support a pregnancy. The use of trans-vaginal needle aspiration rather than laparoscopy to retrieve eggs. Laser surgery for endometriosis. Hysteroscopies to remove fibroids. The ability to freeze embryos. The use of estrogen therapy to support frozen cycles. Progesterone suppositories to replace nasty intra-muscular injections. Automatic dispensing pens for FSH rather than having to mix powders. The understanding of the role of blood clotting in recurrent miscarriage. And so on.

It is extraordinarily difficult to deal with the fact that - and oh so much more so to experience - after all that progress there are still some of us for whom the technology doesn't work, and some of us whose infertility has no apparent cause. In the next 30 years I believe many of those situations will be treatable. Probably not all, but more than today. Roll on progress.

Until more of the causes of our infertility are treatable - and until women's fertility is no longer over at 42 or so - thank you for all that progress has already given us. Thank you to Mr Steptoe and Dr Edwards. Thank you to Mr and Mrs Brown. To Louise and to her sister Natalie - the first IVF-conceived woman to bear a child. Thank you to all those couples who participated in early work on IVF, who agreed to be guinea pigs. Thank you to those who agree to be experimented on today - trying new drug protocols, participating in randomised trials. Many of our children would not be here without you. Thank you.

Comments

[Geohde]

Great post. I remember being amazed when I realised that the first IVF pregnancy was from a single egg, the odds against it must have been huge given the early stage of the technology.

But in a minor aside...suppositories??? Maybe I'm alone here, but I've always used that term for things that go up the bottom and pessaries for where my progesterone goes ;)

J

[Jenn]

I wrote about the same thing once after watching a documentary on IVF. I imagine how frightening it must have been for Mrs. Brown to even try this scary new thing. It was scary for ME and it's been around since I was born (i'm a week older than Louise Brown).

[Jamie]

Beautiful post and very true. We owe so many people so much for all of their hard work.

[Bea]

Interesting fact: LB's mum didn't know she was being experimented on, or at least not the extent. She was under the impression that "hundreds" of babies had been born by IVF already. The standards of informed consent weren't then what they are now either... When I heard that, it made me wonder how things would have been different if they'd told her. On the other hand, having known infertility, I'm confident someone would have stepped up to the plate.

Bea

[Kay/H]

Hear hear! Wonderful post!

[Tinker]

Our kids are sure to wonder about the primitive trials we endured for them too. Yay progress!

[Heather]

Thank you, indeed!

[Portia P]

Hear hear.

I've a huge amount to be grateful for. ICSI's even younger - only 15 years or so. If it didn't exist my whole world would be very different.

[Betty M]

I agree - thank you.

I now can't wait for teh advocates of treatments on the edge of what is generally accepted to get those randomised controlled trials done so we can see if it is just extra expense and potential side effects or something we should all be having. I'm sure any ethical concerns can be overcome and as Bea says the patients will step up.

[silene]

Amen. Thanks to all those you mentioned and many others who remain anonymous...

I hope you enjoyed Pob's blessing ceremony!

[Kristi]

Awesome post. I'm planning one of my own on the 25th, and next week an article I wrote about IVF and the need for the U.S. to mandate insurance coverage for IVF is appearing in my city's newspaper. It's an important day in my life, for sure, as I'm sure it is for many women whom without IVF would never be mothers. Thanks for posting this.