HISTORY OF TEST TUBE BABY

HISTORY OF TEST TUBE BABY

Fertility Consultant

The story of the development of in vitro fertilization (IVF) is a fascinating one . It starts with an infertile couple , Lesley and John Brown who had failed to conceive over a nine-year period . Lesley was a case of  bilateral fallopian tube obstruction . But , she was lucky enough to be referred to Dr. Patrick Steptoe in 1976 . He suggested she was a perfect candidate to try a new procedure , still in its experimental stages , which would make her blocked fallopian tubes a non-issue.

A single egg was aspirated from one of Lesley's ovaries during laparoscopic surgery. Robert G. Edwards then oversaw the addition of John's sperm to the egg which took place in a laboratory. Just a few days later, the developing embryo was transferred to Lesley's uterus. The embryo blossomed into the first test tube baby : “ Louise Brown “ . Louise Joy Brown, born on July 25, 1978 at 11:47 P.M., was delivered by cesarean section. Her weight was five pounds, 12 ounces, and she was graced with blonde hair and blue eyes.

Normally, a birth of a baby girl in England would raise no excitement except to family and friends. But when this little girl was born, she was on the cover of Time and Newsweek, Life and the Saturday Evening Post, as well as every front page of every major newspaper in the world . Her birth was marked by marvel and disbelief .

Louise Brown was not conceived in an actual test tube . It was more like a Petri dish . But to the layperson , the test tube became the symbol of concoctions , living or otherwise , that men and women in white coats tamper with at all hours of the reproductive night . And whether it's IVF (in vitro fertilization) or IBF (in bed fertilization) , it's still a human being--her conscience and soul and life experiences being who she is , not where her genetic fusion occurred .

It’s true, Louise Joy Brown had a mother and father. But there was a third person necessary in her being born, Dr. Patrick Steptoe. His team was the group of physiologists and reproductive endocrinologists who orchestrated the very complex steps needed to make the whole thing work . Together they forged a legacy that thousands of people have celebrated in making their own births possible. Today there are many, many living and thinking persons interacting with IVF Consultants   because of this first success .

Baby Louise has just turned 33with a son , conceived naturally . Dr. Steptoe was able to see her grow up before he died in 1996.  Her birth, just over three decades ago, ushered in a new era for those who suffer the heartache of infertility, in the form of assisted reproduction. This moment can only be compared to the first moon landing in terms of the awe and respect the event inspires.

( Mr.Robert Edwards with Lousie Brown &  the child is Lousie brown's son - who she conceived naturally )

IVF Timeline

3^rd century AD :  Jewish thinkers discussing possibility of accidental  or unintentional human insemination by artificial means .

14^th century AD : arab peoples using artificial insemination on horses .

1977 : Italian priest began experiments with artificial insemination of reptiles .

1785 : John Hunter attemted human insemination – a baby was born the same year

1890 : Robert Dickinson experimented with donor semen , work was carried out in secret because of the condemnation of the Church .

1945 : Early reports of donor insemination published in the British Medical Journal(BMJ).

1955 : Four successful pregnancies using previously frozen sperm .

1960’s : Big increase in knowledge of ovarian stimulants , how eggs mature , ovulation, fertilization and the growth of the embryo in vitro , safer and better laparoscopy .

1969 : Human fertilization in vitro is achieved for the first time .

1973 : First IVF pregnancy in the world was reported by team in Melbourne , Australia, and resulted in early embryo death .

1977 : First IVF pregnancy – but an  ectopic .

1978 : First IVF birth in the world , resulting from Bob Edwards and Patrick Steptoe’s pioneering work in the UK . Birth of Louise Brown , the first “test tube baby “ born as a result of IVF .

Dr. Subhash Mukhopadhyay created history  ( though his work remained unknown to rest of the world till his death )when he became the first physician in India (and second in the world) to perform the In vitro fertilization resulting in a test tube baby "Durga" (alias Kanupriya Agarwal) on October 3, 1978, just 67 days after Marie Louise Brown.

1979 : First two sustained IVF pregnancies reported by Melbourne team in Australia .

1980 ; Two Australian teams succeed in IVF deliveries after drug-induced superovulation in the mother .

1983 : Freezing of human embryos by Alan Trounson and Linda Mohr , resulted in world’s first frozen embryo baby .

1984 : World’s First Donor Egg Baby .  the world’s first birth in woman without ovaries , using donor eggs , the creation of an artificial menstrual cycle, and a special hormone schedule for the first 10 weeks of pregnancy .

Women who had no eggs or unsuitable eggs causing the risk of chromosomal or genetic disease were also treated .

1985:

First IVF twins born from frozen embryos born in Australia.

1986:

The world's first pregnancy and birth from the sperm retrieval operation performed on a patient whose vasectomy reversal had failed. 

1988/89 :

Gamete IntraFallopian Transfer (GIFT) introduced and the first successful pregnancies achieved.

1990 :

Human Fertility and Embryology Act in the UK and the setting up of the Human Fertility and Embryology Authority.

1992 :

Rosanna della Corte gives birth to a son, Riccardo, at the age of 62 after IVF treatment by Severino Antinori.
First pregnancy as a result of IntraCytoplasmic Sperm Injection (ICSI).

1997:

The birth of Dolly the sheep, the first cloned mammal

2000 :

The culture of embryonic stem cells, some from 'spare' embryos donated by couples who have had successful IVF treatment, opens the way to 'made-to-order' tissue for transplant surgery.

2001 :

Teams in the US and Italy announce that they are working on producing the first human clone.

2002 :

Severino Antinori, best known for his work in enabling post-menopausal women to have babies, claims that three human cloned pregnancies are taking place, two in Russia and one in 'an Islamic country'.

2010 :

 Robert Edwards of Britain won the 2010 Nobel Prize in medicine for developing in vitro fertilization, a breakthrough that has helped millions of infertile couples have children.

Brief History of IVF in India :

Dr. Subhash Mukhopadhyay created history when he became the first physician in India (and second in the world) to perform the In vitro fertilization resulting in a test tube baby "Durga" (alias Kanupriya Agarwal) on October 3, 1978, just 67 days after Marie Louise Brown. In this research he was assisted by Sumit Mukherjee and S.K. Bhattacharya . As their efforts were concurrent, Dr. Mukhopadhyay definitely deserved the credit for the original success of IVF techniques together    with Dr. Robert G Edwards and Dr. Patrick Steptoe.

Dr.  Mukhopadhyay ’s effort was not initially accepted as an IVF procedure frivolously sighting lack of scientific documentation. In November 1978, an ‘expert committee’ was appointed by the Government of West Bengal under the medical association to decide over the fate of a convict named Dr. Subhas Mukhopahyay. His charges were, one, he claimed to be the architect of first human test tube baby named Durga (3 October 1978) . Secondly, he announced the report to the media before being cleared off by the Government bureaucrats . Thirdly, he made this impossible possible with few general apparatus and a refrigerator in his small southern avenue flat while others cannot even think of it , although , having all the expensive resources in their hand. Fourth and most important allegation, he never let his head down by the Government Bureaucrats and his straightforwardness always attracted jealousy out of his peers.

The expert committee was presided over by a Radio physicist and it was composed of a gynecologist, a psychologist, a physicist and a neurologist. None of them were having any knowledge about modern reproductive technology.

“Where did you keep these embryos?”

 Mukhopahdhyay said “…in sealed ampoules.”

 Then he asked again “How did you seal an ampoule?”

Speechless Mukhopadhyay could only utter “pardon?”

From here started a questioning and counter questioning session which need not to be mentioned was utterly meaningless. “Oh! Embryos do not die while sealing?” there were people who never saw embryos in the entire span of their lifetime.

The Committee put forward its final verdict, “Everything that Dr. Mukhopadhyay claims is bogus.” Thanks to his peers and Government bureaucrats he was ultimately handed with a punishment. He had been transferred to ophthalmic department which sealed his prospect to work on hormones.

According to Scientific records, Harsha Chawda, born 16 August 1986 at KEM Hospital, Mumbai, became the first human test tube baby of India. The credit for this achievement went to T.C Anand Kumar, Director of IRR (ICMR) supported By Dr. Indira Hinduja.

 A country's pride was eventually restored after 27 long years when the Indian and international scientist communities had began accepting Dr Subhas Mukhopadhyay's claim and recognising India for producing the world's second test-tube baby Kanupriya Agarwal alias Durga. Ironically this turn of event is attributable to TC Anand Kumar himself. Kumar took the crown off his own head after reviewing Subhash Mukhopadhyay's personal notes. In 1997, he went to Kolkata for participating in the Science Congress. It was there that all the research documents of Mukhopadhyay were handed over to him. After meticulously scrutinising and having discussions with Durga’s parents, he became certain that Mukhopadhyay was the architect of first human test tube baby in India.

In 2005, The Indian Council for Medical Research (ICMR) officially acknowledged that Dr Mukhopadhyay was indeed the creator of India's first test-tube baby. Dr. Kumar himself took initiative in setting up a research institute in reproductive biology in memory of Mukhopadhyay. And then, Dr. Mukhopadhyay’s name found a place in the ‘Dictionary of Medical Biography,’.

Indeed, our establishment created all barriers so that his scientific papers could not be published in reputed journals; he was also debarred from presenting his papers in a major seminar in Tokyo in November 1978. An insulting silence carried on with every passing day.  Frustrated and in failing health , he killed himself on June 19, 1981 . Dr Mukhopadhyay's story was immortalised in the 1991 film 'Ek Doctor Ki Maut' starring Pankaj Kapur and Shabana Azmi and directed by Tapan Sinha.

  REFERENCE :

-          Several editions of different fertility journals .

-          ICMR ART Guideline

-          Frontline National Magazine (Volume 27 - Issue 23 :: Nov. 06-19, 2010 )

-          Indian analysis blog

-          Internet based excerpts 

By Dr Aditya Das , DNB, DGO,FICMCH