"Children from a test tube": 40 years of the revolutionary method of IVF

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"Children from a test tube": 40 years of the revolutionary method of IVF

On November 10, 1977, a miracle happened in an inconspicuous laboratory in the English city of Oldham: the egg fertilized in a Petri dish was successfully transplanted into the uterus of a woman. After 38 weeks, Louise Joy Brown was born - the first test tube baby, as children who were conceived in this way were later called.

The second name Joy - translated from English "joy" - advised physiologist Robert Edwards to give the baby, thanks to ten years of work of which the mother of a newborn, Leslie Brown, was able to know the joy of motherhood.

Questions of extracorporeal (that is, "outside the body", in vitro) fertilization have occupied Edwards since the early 1960s. It was then that he began to carry out the first experiments with the eggs of animals, believing that one day he would be able to help childless families to produce their own child.

But only after meeting with the gynecologist and one of the pioneers of laparoscopy Patrick Steptow and several years of their joint searches, the new progressive IVF (IVF) method developed by him began to be implemented.

It consisted in the initial stimulation of the patient's ovaries, then removing the eggs from the ovaries, inseminating them in a test tube and returning an already fertilized embryo to the uterus, or even two or three, to increase the chances of pregnancy.

Despite the success of the new method and the birth of Louise Joy, her fellow scientists and society as a whole, not to mention the church circles, were sharply skeptical, if not negatively.

That is why, although there were enough women volunteers willing to try out any new technique to get pregnant, Edwards and Steptow had enough, the first years of experimentation, and later treatment, were almost in a semi-secret setting.

In secrecy and high cost

Grace MacDonald, the mother of her second child, conceived using IVF, learned about the experimental method of infertility treatment Edwards and Steptow accidentally learned in 1978 from the medical journal Lancet and flew to the laboratory on the wings of hope.

Subsequently, in an interview with the Guardian newspaper, she recalled that at that time women volunteers were asked to keep all procedures secret for their own safety, since the view of assistive methods of reproduction was similar to that which reigns today with respect to, say, cloning.

Grace became pregnant at the second IVF attempt and gave birth to a boy in February 1979.

Initially, Edwards and Steptow intended to offer this method to the British National Health Service (NHS) and do it for free, but official medicine avoided it in those years, and then the doctors opened a small clinic in a suburb of Cambridge.

The treatment cost 3,000 pounds at that time, while the average annual income in Britain was about 6,000 pounds, and the success rate was only 12%. But despite all these obstacles, there was no shortage of patients in the new clinic.

The IVF procedure itself was not funny: first, women had to be in the hospital and every three hours they passed urine for analysis - so the doctors could monitor the level of hormones and carry out the removal of the eggs just at the right moment of ovulation. This also meant that at times all these procedures had to be carried out by doctors and patients at night, since every hour is important for successful fertilization.

Moreover, after embryo grafting, women were literally recommended to move around on their knees and not take an upright position in order to increase the chances of pregnancy.

Despite the imperfection of this procedure, the rumors about happy mothers grew, and the Edwards and Steptow Clinic pulled both inspired by the chance for success of the woman and fellow doctors to see and adopt the technique.

Their achievements in medicine as a whole and in fruitless families, having obtained their most valuable present in life, were eventually recognized both by the medical community and by the state, albeit many years later, when Patrick Steptow was no longer alive: in 2010, Professor Edwards received the Nobel Prize in Medicine, and in 2011, the British title of Knight Bachelor.

Routine procedure

Today, their revolutionary method is no longer viewed - at least by the majority of the population - as unwanted human intervention in God's work, and the percentage of success is, according to the British NHS, about 30%.

It makes it possible to overcome even such seemingly impregnable obstacles to the emergence of your own child, such as obstruction of the fallopian tubes or exhaustion of ovarian function.

IVF has become a routine procedure available in the framework of free medicine (if there are a number of indications), in addition, the possibility of using donor eggs and sperm has appeared.

And the process of freezing embryos for storage (no more than 15 years), as well as the emergence of a method of microinjection of sperm cells directly into the cytoplasm of the egg (ICSI), helps to partially solve the problems of male infertility too.

Research does not stand still: a few years ago, doctors at the Belgian Institute for Reproductive Technology in Genk managed to perform IVF, replacing expensive carbon dioxide (necessary for growing embryos) using a CO incubator with a mixture of citric acid and soda, which could potentially reduce the cost of one IVF course up to about 170 pounds (about 220 dollars).

Belgian scientists reported that as a result, 12 healthy babies were obtained in this way, and the success rate was 30% - comparable to traditional IVF, but so far this method, much cheaper, is not widely used.

At the moment, according to the NHS, in England and Wales, women under 40 can undergo this procedure in the amount of three cycles, who have tried to conceive naturally in the last two years or have undergone 12 cycles of intrauterine insemination.

The average age of British women resorting to IVF is 35 years, and this figure remains unchanged for quite some time.

For women aged 40-42, only one free cycle is offered, but in any case, for each case of providing free IVF, the decision is made by the local - district commission of the Ministry of Health (CCG), which takes into account a number of factors, for example, does the woman have children (from previous marriages, relationships), does she smoke, does she suffer from obesity.

And although the National Institute for the Health and Improvement of Medical Care (NICE) recommends that all eligible women under the age of 43 have three free IVF cycles, often the district CCG approves only one, so everything depends on the specific region - in a more prosperous more money, a woman has more chances to complete all three courses for free through the NHS.

Russian experience

In Russia, according to the 2013 law, assisted reproductive technologies (ART), which include IVF, can be done free of charge under an OMS policy, and this can be received by both married couples and those living in a civil union, and even single women, like typically between the ages of 20 and 40.

On average, the cost of IVF varies from 90,000 to 230,000 rubles, and each year as a result of in vitro fertilization, about 8,000 children are born in Russia.

At least 15% of families in Russia are barren, and, according to the Russian Association of Human Reproduction, in 2015, about 74 thousand IVF cycles were performed.

At the same time, according to the Moscow Clinic of Reproductive Medicine, Russia is now in last place on the use of ART among European countries.

The success rate of IVF, of course, shows that it is not a panacea, and does not help all women. Moreover, in Western countries, the age when women begin to think about having a baby creeps upwards, which also does not help in the continuation of the race.

Nevertheless, experts believe that at this stage, IVF is the final stage in the treatment of infertility, unless the doctors find a way to grow healthy eggs from, say, a woman's hair cells. Fantasy?

But only 40 years ago, IVF was considered a fantasy.

Origin:  BBC Russian Broadcast