Written by Thomas H. Maugh II and Originally Published in The Los Angeles Times on April 10, 2013
About 10% of married couples suffer from infertility – the inability to conceive a child naturally. Through the better part of the 20th century, physicians considered this a minor and perhaps irrelevant problem, one that contributed overall to society by keeping the birthrate down.
British biologist Robert Edwards thought differently. He was among the first to fully appreciate the frustration and depression the condition engendered in its victims and the benefits that could arise from reversing it.
Along the way, he met resistance from religious conservatives who insisted that life must begin only through intercourse, not artificially, and from fellow scientists who resented the fact that he spoke frequently with the media about both his research and the ethical implications.
On July 25, 1978, after two decades of intensive research, Edwards and his colleague, Dr. Patrick Steptoe, announced the birth of Louise Joy Brown, the first infant born from an egg fertilized outside the human body. That seminal event, the world's first "test-tube baby," triggered the age of in vitro fertilization (IVF), a process that has led to more than 5 million births worldwide and dramatically altered the reproductive landscape.
Today, about 350,000 IVF babies are born each year to infertile couples, single people and gay and lesbian couples. The technique also allows for preimplantation genetic diagnosis, in which potential birth defects are identified before the fertilized egg is implanted.
The feat won Edwards the 2010 Nobel Prize in Psychology or Medicine – Steptoe died in 1988 and was thus ineligible – and a 2011 knighthood "for services to human reproductive biology."
Edwards died in his sleep Wednesday at his home near Cambridge, England, following a long illness, according to officials at the University of Cambridge, where he worked in the department of physiology. He was 87.
To the layman, IVF might seem no more complicated than adding sperm to an egg in a petri dish and then implanting the resulting embryo in either the mother or a surrogate. But Edwards and his colleagues had to overcome a variety of scientific obstacles before their work bore fruit.
As early as 1935, researchers had shown that a fertilized rabbit egg could pass through the early stages of growth in vitro, and by 1959 it had been shown that such eggs could be implanted in a female rabbit and produce viable embryos. But human eggs proved much more difficult.
The first problem was obtaining eggs. Working with mice, Edwards' team showed that females could be induced to release many eggs simultaneously by the injection of certain hormones, a process known as super-ovulation. They then showed that the same phenomenon could occur in humans, overturning the previous belief that super-ovulation was impossible in human females.
Mammalian eggs must reach a certain stage of maturity before they can be fertilized by a sperm. Previous researchers had shown that this maturation could occur in vitro for eggs from mice and other small animals, but they failed to observe it with human eggs. Eventually, Edwards deduced that human eggs simply took two or three times as long as mouse eggs to mature in petri dishes.
Another problem lies with the sperm. Many researchers had shown that sperm has to be activated, or "capacitated," in the uterus before it can penetrate the egg. For a time, Edwards' team thought they might have to retrieve capacitated sperm from the uterus to achieve IVF, but he and graduate student Barry Bavister eventually demonstrated that the sperm could be activated by increasing the alkalinity of the growth medium in the laboratory.
The potential need to recover sperm from the uterus led Edwards to contact Steptoe, one of the pioneers in the then-emerging field of laparoscopic surgery. Such surgery uses thin tubes and small television cameras and tools to probe inside the human body with minimal incisions, manipulating organs and collecting tissue samples.
That proved to be the crucial technique for safely collecting eggs from women, replacing previous approaches which relied primarily on ovarian tissue taken from infertile women in biopsies.
By 1969, the team had published a paper in the scientific journal Nature showing that human eggs could be fertilized in vitro and that some – two of 56 – could begin to mature. But the nature of his work and Edwards' extensive interactions with the media offended the scientific establishment, and he was unable to obtain grants. Most of his work for the next decade was supported by private funding.
In 1971, Edwards and lawyer Dave Sharpe published a seminal paper in Nature outlining the ethical issues involved in IVF research and the pros and cons associated with various regulatory responses to it. He clearly foresaw many of the objections to the work that would arise, but chose to continue anyway.