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In Vitro Fertilization Pioneer, Robert Edwards, Awarded Nobel Prize

October 4, 2010 at 5:58 PM EDT
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This year's first Nobel Prize was awarded to Robert Edwards for his work developing the in-vitro fertilization method that led to the birth of the world's first "test-tube baby."

JUDY WOODRUFF: The Nobel Prize in Medicine was awarded today, the first of this year’s Nobels. It was given to a pioneer in the field of assisted human reproduction whose work changed medicine and captured the world’s attention more than three decades ago.

On July 25, 1978, the birth of Louise Brown in England gave hope to infertile couples around the world. Known as the world’s first test tube baby, the infant was the first child born through the then-revolutionary procedure known as in vitro fertilization, or IVF.

It was developed by scientist Robert Edwards and gynecologist Patrick Steptoe, who died 10 years later. During IVF, eggs are removed from a woman, fertilized with sperm in a petri dish, and then implanted in the womb.

Scientist Kay Elder worked with Edwards at the IVF clinic he and Steptoe established in Cambridge in 1980.

KAY ELDER, Bourn Hall Clinic: They had repeated failures. They had no funding. They had everyone in the world against them. And they continued with immense passion, enthusiasm, and through their work have managed to change the face of society and also many different aspects of medicine.

JUDY WOODRUFF: Today, the Nobel Academy recognized the medical breakthrough.

GORAN HANSSON, secretary, Nobel Medicine Prize Committee: The Nobel Assembly and Karolinska Institute have today decided to award the Nobel Prize in Physiology or Medicine 2010 to Robert Edwards for the development of in vitro fertilization.

JUDY WOODRUFF: In the last 32 years, approximately four million babies have been born using the technique, according to the Nobel Prize Committee.

IVF has not been hailed by all, however. The Catholic Church has long voiced its opposition to the process and the use of donor eggs. Today, Louise Brown is 32, alive and well, seen here celebrating a recent birthday with Robert Edwards. She conceived her own child naturally in 2007.

The 85-year-old Edwards is a professor emeritus at the University of Cambridge. He was too ill to comment this morning.

For more on Edwards, his work, and its impact, we’re joined by Dr. Robert Stillman. He’s medical director of the Shady Grove Fertility Center, which is based the Washington, D.C., area. Dr. Stillman, thanks for being with us.

DR. ROBERT STILLMAN, Shady Grove Fertility Center: It’s a pleasure, especially on this auspicious occasion.

JUDY WOODRUFF: Well, Dr. Edwards was working on this, as we heard, for two decade before there was success. What drove him? What was pushing him to do this?

DR. ROBERT STILLMAN: The idea Louise Brown would have a birth and have a child of her own 32 years later drove him and his partner, Dr. Steptoe.

JUDY WOODRUFF: But we heard — we heard the scientist who worked with him say that there were — there was lack of funding; there was opposition. What exactly were they dealing with back then?

DR. ROBERT STILLMAN: Well, there was a huge limitation on the fears that there would be poor health in outcome. There was great religious limitations and concerns. Those still exist today. So, they were again — there was no funding from the British government, which they had asked for, for many, many years, so that there were enormous hurdles.

And when I said it simplistically, they were hoping for Louise Brown and the birth of her child, really, what they were hoping for was to bring progress to the science, bring progress to and hope for millions of infertile couples, which has been borne out.

JUDY WOODRUFF: And you actually met him, worked with him, trained with him.

DR. ROBERT STILLMAN: Well, I was privileged enough to meet him. I was actually training at Hammersmith Hospital in 1979 with then — or now Sir Robert Winston. And 1978 was the first birth.

So the town, scientific town in particular, was abuzz at that time, and I had the opportunity to meet him. I didn’t have the privilege of working with him. But everyone certainly of my generation knows him quite well, and now hopefully many generations forth will know him.

JUDY WOODRUFF: Explain for us exactly how this procedure works.

DR. ROBERT STILLMAN: The — the process involves ovulation in the normal process, fertilization of an egg in the fallopian tube of the woman, and then the embryo is transferred itself into the uterus.

This is a bypass. This is a detour, a cheating, really, around blocked tubes, which was the original diagnosis that was — this is Louise Brown’s mom — had.

So, what we do is, we stimulate the ovary, take out numerous eggs, fertilize them in the petri dish — it’s not really a test tube, even though it’s called test tube baby — and then transfer an embryo, sometimes more, into the uterus.

So, again, it’s a detour around the street that might be blocked. Now there are many more indications for it than just blocked tubes.

JUDY WOODRUFF: Well, what about the success rate today, compared to 1978, when he — when they were first able to do it?

DR. ROBERT STILLMAN: Yes. The — Louise Brown was born after about 250 attempts and years and years of work, as you mentioned, in the laboratory, before utilizing and trying this on humans. Today, patients at her age with her diagnosis, 65, 70 percent success rate, in one cycle.

So, there’s been enormous progress. Again, standing on the shoulders of those before you is a privilege, and in some ways easy to do, when you look at what they went through.

JUDY WOODRUFF: And the success rate varies, of course, according to the appropriateness of the patient, right?

DR. ROBERT STILLMAN: Yes. There’s a spectrum. Age can play an adverse effect in the success rates, different types of diagnosis.

But, overall, the success rates have gone up enormously. In fact, we’re doing very much of the work now with just one embryo, rather than years ago, even just a few years ago, multiple embryos, and the risk of multiple pregnancy.

JUDY WOODRUFF: And, Dr. Stillman, this is still a pretty complicated process for the couple who decide to go through this.

DR. ROBERT STILLMAN: Oh, very much so. I mean, coming to a fertility clinic with this type of medical problem is a compromise to couples. That’s not how they envisioned their lives would be beginning, their lives and families would be built.

And utilizing in vitro fertilization is another level of compromise in many ways, because it’s very complex and it be can be expensive, since much of it is, unfortunately, not funded by insurance companies. And, therefore, getting into it is a daunting process.

And that relies on our being able to provide success, as well as support, to couples. It was something that Steptoe and Edwards couldn’t necessarily do with any degree of security. They could give their passion. They could give their ethical beliefs in what they were doing to Louise Brown and the 250 women who — moms who preceded her.

At least we can offer great success. We just have to continue the passion and the ethics.

JUDY WOODRUFF: Talk a little bit more about the opposition. As you pointed out, there was opposition in the beginning, religious opposition, other types of opposition. How much — has that grown over the years? Has it diminished at all? What’s — how would you contrast?

DR. ROBERT STILLMAN: Other than for the couples who are faced with the difficult dilemma, especially Catholics, for instance, in our setting, the religious objections I think in many ways have been marginalized.

I don’t mean to minimize them. But the success rates and the millions of births have — and a means by which to family-build couldn’t be any more obvious for couples having infertility. The difficulty is that in those who are religious and their religious beliefs are against in vitro fertilization, and then they wind up infertile, they are in a very difficult dilemma.

So, I look at this as a terrible situation where individual couples are faced with this great dichotomy. I think the field has moved on, beyond the religious objections, because even in the United States, in Norfolk, where Dr. Howard Jones, who is turning 100 years old in December, the pioneer of in vitro fertilization in this country, having worked with Steptoe and Edwards, those individual couples are faced with a great, terrible dilemma.

And I sympathize with them. But the field has moved on, I believe, regarding the objections.

JUDY WOODRUFF: So how would you sum up what Edwards did, the contribution he made?

DR. ROBERT STILLMAN: Monumental. Monumental for the four million children who were born. It was a great scientific achievement then. It’s a great clinical and human triumph now.

JUDY WOODRUFF: Well, Dr. Robert Stillman, we thank you for coming to talk about this.