The Clinical Times
The Front Page of Medicine

Reproductive Health · 1978

Birth of Louise Brown: First Baby Conceived by In Vitro Fertilization

Illustration of the in vitro fertilisation procedure
US Government Owned Photo / Public domain (Wikimedia Commons)

For most of the twentieth century, tubal-factor infertility was a diagnosis with no procedural answer. Lesley Brown had blocked fallopian tubes; her only path to pregnancy was if an egg could be fertilized outside her body and returned to her uterus. That idea had been pursued for years before Patrick Steptoe, a gynecologist at Oldham General Hospital, and Robert Edwards, a physiologist at Cambridge, came close enough to make it work.

Edwards had spent the 1960s working out how to mature human oocytes in culture and establishing the conditions under which fertilization could occur in vitro. Steptoe contributed the laparoscopic technique to retrieve eggs without open surgery. Together they attempted embryo transfers repeatedly through the early 1970s, producing pregnancies that ended in miscarriage or ectopic implantation. The breakthrough came when they shifted the timing of oocyte retrieval to capture eggs at the natural peak of the cycle rather than after hormonal stimulation.

Lesley Brown's egg was retrieved on November 10, 1977. The fertilized embryo was transferred two days later, and the pregnancy continued without complication. Louise Joy Brown was born by caesarean section on July 25, 1978, at Oldham District General Hospital, weighing 5 pounds 12 ounces. The birth was reported in the Lancet later that year, though the media coverage reached the public well before the scientific paper did.

Reception from the medical community was mixed. Some critics raised concerns about unknown risks to children conceived this way; others questioned the ethics of manipulating human embryos. Steptoe and Edwards had been denied Medical Research Council funding and worked largely with private support. Those objections faded as healthy children accumulated. Edwards received the Nobel Prize in Physiology or Medicine in 2010; Steptoe, who died in 1988, was not eligible for consideration.

The clinical infrastructure that now surrounds IVF, ovarian stimulation protocols, embryo cryopreservation, preimplantation genetic testing, intracytoplasmic sperm injection, did not exist in 1978 and developed over the following decades through iterative clinical work. By 2018, roughly 8 million children had been born worldwide through IVF. Infertility affecting ovulatory function, tubal anatomy, male-factor issues, or unexplained causes can now be addressed through pathways that trace directly back to the methods Steptoe and Edwards assembled in Oldham.

Key People

Read the original — PubMed

Lancet, 1978

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