Lesley underwent a laparoscopy whereby a single mature egg was aspirated from one of her ovaries. John's sperm was added to the egg in the laboratory under the direction of Robert G. Edwards. A few days later a developing embryo was placed into Lesley's uterus.

At 11:47 p.m. July 25, 1978, Louise Joy Brown was delivered by cesarean section. She weighed five pounds 12 ounces and had blonde hair and blue eyes.

Louise is about to celebrate her 30th birthday. The world will celebrate the 30th anniversary of a new era. The era of extra corporeal assisted reproduction. History will regard that moment 30 years ago with as much awe and importance as the first moon landing.

 

On December 20th, 2006, Louise gave birth to her own child, Cameron John Mullinder. She conceived without fertility treatment of any kind on the six month that she and her husband tried. The delivery was by cesarean section since the baby was breech.


Before Louise there was... the rabbits

In 1891, Walter Heape (1855-1929), a professor and physician at the University of Cambridge, England, who had been conducting research on reproduction in numerous animal species, reported the first known case of embryo transplantation. Working with two species of rabbits, he flushed embryos from the oviducts (rabbit fallopian tubes) of one breed (Angora) and placed them into the uterus of a recently mated Belgian hare. In the resulting litter, there were 4 Belgians and 2 Angoras. Heape proved that it was possible to take preimplantation embryos and transfer them to a gestational carrier without affecting their development.

As a result of this work, many scientists became interested in culturing eggs and embryos in the laboratory. Gregory Pincus and colleagues were the first to show how eggs of various animals would undergo maturation if released from their follicle and cultured in a laboratory. In 1939, he reported that human eggs would mature in the laboratory within 12 hours. It was not until 1959, however, that M.C. Chang reported, in the journal Nature, the first unequivocal case of a live birth following egg fertilization in the lab, true in vitro fertilization and subsequent embryo transfer, to the uterus.

Robert Edwards gets involved

Bob Edwards became interested in working with humans in 1958. His first challenge was that he found that human eggs did not mature in vitro (in the laboratory) when released from the follicle as Pincus had reported in 1939. Using ovarian slices provided by Dr. Molly Rose, his wife's obstetrician, Dr. Edwards worked for two years trying to induce human egg maturation without success. As it turned out, human maturation took twice as long as what had been reported by Pincus. This error wasted two years. Eventually, each stage of human egg maturation was timed and in vitro fertilization of human eggs was achieved.

Patrick Steptoe arrives

In 1968, Dr Edwards phoned Patrick Steptoe after reading of his groundbreaking work with laparoscopy. They agreed to team up to try to accomplish human in vitro fertilization. Dr. Steptoe would aspirate the egg from the follicle (egg retrieval) via laparoscopy and Dr. Edwards would fertilize it in vitro and culture the embryo. Dr. Steptoe would then transfer the embryo back to the uterus (embryo transfer). A clinic was set up in a small hospital outside of Cambridge. Amidst a flood on controversy from the press, religious authorities and even other physicians and scientists, the stage was set for the first human in vitro fertilization pregnancy.

Medication problems

Initially, patients were stimulated with fertility medications in order to help with obtaining eggs. However, several patients developed severe luteal phase deficiency. Luteal phase deficiency is a problem that occurs when there is inadequate progesterone support of the uterine lining after ovulation or egg retrieval. The decision was made to supplement the patients with additional progesterone. Initially, daily injections of progesterone in oil was chosen but due to the problems inherent with the use of intramuscular progesterone (which persist until this day), they switched to a synthetic progesterone that could be given every five days. Sadly, this decision resulted in failure over the course of the next two years due to the abortion inducing properties of the synthetic progesterone.

Diagnosing pregnancy was more difficult due to the lack at that time of sensitive pregnancy tests. Despite this limitation, a few embryo transfers resulted in a brief rise in a serum pregnancy test. These early pregnancies were designated as "biochemical pregnancies" since the blood test was the only proof of their existence.

IVF Pregnancy

Drs. Steptoe and Edwards published a report in 1976 in the medical journal Lancet. A human embryo at the late morulae /early blastocyst stage was transferred into the uterus and resulted in a clinical pregnancy. Unfortunately, the result was an ectopic pregnancy (tubal pregnancy) and had to be removed.

Finally, they decided to abandon the use of fertility medications and try aspirating a single egg in a natural menstrual cycle. In addition, they returned the embryo to the uterus earlier at the eight cell stage in the hopes that this would compensate for perhaps inadequate culture condition in vitro. On their second attempt, Louise Brown was conceived.

IVF Spreads around the world

In June 1980, an Australian team led by Alan Trounson, produced that country’s first (and the world’s third) IVF baby. In the United States, Howard and Georgianna Jones’ IVF program in Norfolk, VA produced this country’s first IVF baby, born December 28, 1981. This also marked the return of injectable fertility drug to help stimulate an IVF pregnancy. Since the introduction of IVF, it is estimated that there have been millions IVF babies born worldwide.  IVF babies now make up a measurable percentage of the total births n developed countries. Some of these children, now grown to adulthood, have begun to have their own children, IVF's second generation.

Milestones in the history of in-vitro fertilization

May 1981
First report of using ultrasound for percutaneous oocyte retrieval instead of laparoscopy
March 1983
First egg donation pregnancy
1984
First delivery of an infant from egg donation
January 1984
First surrogate embryo transfer baby born in California
January 1984
First donor embryo baby born in Melbourne
March 1984
First baby born from thaw of frozen embryos in Melbourne
June 1984
First report using transvaginal ultrasound guidance for egg retrieval
January 1986
First report using Lupron to prevent premature ovulation
October 1987
First report using ultrasound for embryo transfer
March 1988
Death of Patrick Steptoe
1990
First pregnancies reported after preimplantation genetic diagnosis - PGD by our laboratory. Also first reported case of sex selection (gender selection) in IVF
1991
First report using assisted hatching of the zona pellucida to improve pregnancy rates
July 1992
First report of pregnancies and deliveries using intracytoplasmic sperm injection (ICSI)
1999
Recombinant gonadotropins become available for clinical use


In 2007, over 100,000 IVF cycles were performed in the United States alone.