Nobel Prize For Medicine Goes To IVF Pioneer

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The Nobel Prize in Physiology or Medicine has been awarded to Robert G. Edwards for the development of human in vitro fertilization therapy. His work led to the first "test-tube baby" in England in 1978, and opened a new field of medicine devoted to the treatment of infertility.

MARY LOUISE KELLY, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Mary Louise Kelly.

ROBERT SIEGEL, host:

I'm Robert Siegel. And welcome, Mary Louise, for joining us the next couple of weeks.

KELLY: Thank you. My great pleasure to be here.

SIEGEL: Good to see you here.

It's been 30 years since Louise Joy Brown became the first test-tube baby. And today, one of the scientists who made Brown's existence possible won a Nobel Prize.

KELLY: That's Robert Edwards. He's a�physiologist at Cambridge University, and he received the prize in physiology and medicine for his work on in-vitro fertilization.

As NPR's Jon Hamilton reports, IVF caused a huge controversy at first, but has since produced more than four million babies.

JON HAMILTON: Louise Brown was conceived in a dish using an egg from her mother and sperm from her father. The fertilized egg was placed in her mother's uterus and Louise arrived by c-section in 1978 with a film crew in attendance.

Patrick Steptoe, the gynecologist who was Robert Edwards' main collaborator described her birth.

Dr. PATRICK STEPTOE (Gynecologist): We don't want her first breath to inhale any of this fluid.

(Soundbite of baby crying)

A good healthy cry.

HAMILTON: That cry was a scientific milestone - a baby born to a couple who would otherwise have been unable to have a child. And it was a cry that would echo around the world as people debated whether scientists were tinkering inappropriately with life itself.

Edwards and Steptoe knew their work would be disturbing to many people. Steptoe died in 1988, and Edwards, who is 85, isn't granting interviews anymore. But in 2001, after he won the Lascar Award, Edwards said he and Steptoe had decided not to let public opinion slow them down.

Dr. ROBERT EDWARDS (Physiologist, Cambridge University): We agreed before we touched a patient that we would stop if we thought any damage were being done to the mother, the father or the child, but would not accept religious objections that weren't defined or political objections that weren't defined or personal insults, which we got in plenty.

HAMILTON: The Catholic Church objected, saying science shouldn't separate sex from procreation. Some scientists worried that IVF babies would be abnormal or unhealthy. But that didn't happen.

Alan Penzias of Harvard Medical School and Boston IVF says these days IVF has wide support.

Dr. ALAN PENZIAS (Boston IVF): The voices that you hear, all the cheering in the background, not only are the four million babies born due to IVF and their eight million parents, but every reproductive medicine specialist who can sit across the desk, look at a patient in the eye and said, congratulations, you're pregnant today because of IVF.

HAMILTON: IVF now accounts for more than one percent of babies born in the U.S. and many other nations. And Penzias says the work of Edwards and Steptoe is why we're grappling with another promising but controversial technology.

Dr. PENZIAS: The understanding of how eggs and embryos grow in the dish also led to the stem cell lines that exist today.

HAMILTON: And IVF has led to a whole new set of treatments for infertility. Roger Lobo at Columbia University is president of the American Society for Reproductive Medicine. He says those new treatments include...

Dr. ROGER LOBO (American Society for Reproductive Medicine): The injection of sperm into the egg, which is called ICSI, which allows male infertility to be treated; genetic diagnosis, what we call PGD.

HAMILTON: And freezing embryos for later use. Dr. Randi Hutter Epstein recently published a history of childbirth called "Get Me Out." She says society's gradual acceptance of IVF has been pretty typical for a new reproductive technology, whether it's the tools used to deliver babies, hormone treatments or choosing one embryo over another.

Dr. RANDI HUTTER EPSTEIN (Author, "Get Me Out"): Everything we do is considered horrible and weird and scary. And then when it works, because so many couples are desperate to have a baby, we just go with it.

HAMILTON: And Hutter-Epstein says that won't stop with new ways to get pregnant.

Dr. EPSTEIN: We think, oh, it's terrible that we're going to pick a child because it's a boy or it has blue eyes. And if we can figure out how to do it, sure. I think we're going to go with whatever technology is available.

HAMILTON: Hutter-Epstein says the one limiting factor is cost. And she says for IVF that's typically tens of thousands of dollars.

Jon Hamilton, NPR News.

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Contentious Fertility Research Traveled Long Road To Nobel

Robert Edwards

British physiologist Robert Edwards at the 30th birthday party of the world's first test-tube baby, Louise Joy Brown, in 2008. Bourn Hall Clinic hide caption

itoggle caption Bourn Hall Clinic

In vitro fertilization is so common today that it's hard to remember how challenging and controversial the work that led to some 4 million births was at its start.

Today, Robert Edwards, an 85-year-old British physiologist who spent his career in the lab unraveling secrets of human reproduction, won the Nobel Prize for Physiology or Medicine.

Early on, Edwards' lab didn't even have hot running water. Still, Edwards was able to shed light on how human eggs mature, including the roles of different hormones, and when sperm have the best chance for fertilizing them.

After decades of basic research, he and his partner OB/GYN Patrick Steptoe were able to fertilize human eggs retrieved through keyhole surgery, or laparoscopy, in petri dishes in the lab.

But in 1971, the pair were denied major research funding from the Medical Research Council of the U.K., the rough equivalent of the U.S. National Institutes of Health.

How come? Well, at the time there was a lot more funding interest in contraception than fertility treatment. And a recent paper in the journal Human Reproduction says there were shortcomings in the pair's research plan that fanned the doubts of some reviewers, fearful of birth defects, who wanted to see more work in primates before human treatments were tried.

The researchers were also seen as outsiders to the establishment, and the keepers of scientific tradition didn't cotton to Edwards' talking up the work in the mainstream media of the day.

Edwards and Steptoe, who died in 1988, carried on with private funding. And in 1978, Louise Joy Brown, the first test-tube baby, was born.

Subsequent research has shown that children conceived through in vitro fertilization are about as healthy as kids created the old-fashioned way.

While helping millions of people become parents, IVF carries some risks, including a higher likelihood of multiple births, when several embryos are implanted. Multiple births are more likely to be premature.

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