Historic perspective of ivf

invitro fertilisation

1. HISTORIC PERSPECTIVE OF IVF

2. OUTLINE Introduction Historical Background 1800 1900 2000 Conclusion

3. Introduction Infertility is a problem across virtually all cultures and affects an estimated 10-15% of couples. IVF and embryo transfer for the treatment of human infertility has now resulted in the birth of over 5 million babies.  The technique did not arise as a quantum event but was built on the efforts of many earlier workers in the field of reproductive endocrinology  One should remember the famous saying of Isaac Newton: ‘ If I have seen further than most, it is because I have stood on the shoulder’s of giants ’

4. Introduction -2 The early attribution of infertility to women persisted for centuries and was often considered a divine punishment The only solution to infertility was prayer – to Egyptian Isis, Phoenician Astarte, Greek Aphrodite, or Roman Venus First written documentation on infertility may be found in the Kahoun papyrus (oldest Egyptian medical text), dated to 2200-1950 BC

5. Introduction-3 Ethical and moral issues have always arisen when investigators study early human development Test tube/ Petri dish baby

6. HISTORICAL PERSPECTIVE The 1800’s Fertility treatment mostly consisted of gynecological surgery at that time . Dr. Sims at the Women’s Hospital in New York performed a fresh intrauterine insemination from the husband’s sperm. This resulted in a pregnancy that ended in miscarriage.

7. The 1800’s- contd In 1884 Dr. William Pancoast in Philadelphia performed the first donor insemination using sperm from the medical student voted “best looking” in his class.   It was anonymous, and both the husband and wife were not even informed that a donor was being used until years later.   Luckily , the husband was elated when informed later

8. Early 1900’s Early 1900’s much research was done on hormones and how they related to fertility . The first successful attempts to culture preimplantation mammalian embryos were made in 1913 by Albert Brachet , Director of the Brussels School of Embryology at the Warocqué Institute of Anatomy In 1926 first infertility clinic opened in Massachusetts. In 1934 Gregory Pincus performed IVF-like research on rabbits but was fired from Harvard due to his controversial research . In Sydney, 1951, it was discovered that freshly ejaculated spermatozoa could not immediately fertilize an egg since they require a period of so-called maturation in the female genital tract. The word ‘capacitation’ was coined to denote the phenomenon  in 1952

9. 1961 Palmer from France described the first retrieval of oocytes by laparoscopy .

10. 1965 In 1965, Robert Edwards together with Georgiana and Howard Jones at Johns Hopkins Hospital in the USA attempted to fertilize human oocytes in vitro

11.   Robert Edwards’ contributions Edwards and his colleagues published the following key papers that paved the way for the birth of the first ‘test-tube’ baby : Maturation  in vitro  of human ovarian oocytes’ in  The Lancet  (Edwards, 1965b). (2)‘Early stages of fertilization  in vitro  of human oocytes matured  in vitro ’ in  Nature  (Edwards et al., 1969). (3)‘Fertilization and cleavage  in vitro  of preovular human oocytes’ in  Nature  (Edwards et al., 1970). (4)‘Laparoscopic recovery of preovulatory human oocytes after priming of ovaries with gonadotrophins’ in  The Lancet  (Steptoe and Edwards, 1970).

12. 1972 Surgery took place in a hospital in Brooklyn at 8am.   Dr . William Sweeney retrieved five eggs from a female. The woman’s husband took the eggs in a taxi five miles across town to give them to Dr. Shettles at Columbia-Presbyterian Hospital.  The husband then went into a collection room and produced a fresh ejaculate to be used to fertilize the eggs. By 2 p.m. The hospital chairman learned about the experiment and forbid the embryos to be transferred back to the mother.  The husband was informed at 4 p.m. that evening and the wife was informed by 9 p.m. while she was still recovering from surgery.  This would have been the first case of IVF with embryo transfer but it was stopped prematurely.

13. 1973 The first IVF pregnancy was reported by the Monash research team of Professors Carl Wood and John Leeton in Melbourne, Australia. Unfortunately, this resulted in early miscarriage

14. 1975 Steptoe and Edwards published a report on an ectopic pregnancy following transfer of a human embryo at the late morulae /early blastocyst stage.

15. 1976 Y. Menezo developed the world's first B2 culture medium, known as ‘the French medium

16. 1978 By 1978, the first successful live birth from IVF was announced by Drs Edwards and Steptoe in England. Lesley Brown gave birth to her daughter, Louise Joy Brown. Lopata in Melboure described the first cycles stimulated with clomiphene citrate Pregnancy following intrauterine implantation of an embryo obtained by in vitro fertilization of a preovulatory egg

17. Image -1 1 st IVF baby Lesley brown- mother of 1 st IVF baby

18. Image - 2 Professor Sir Robert Edwards Patrick Steptoe

19. Second Baby In October 1978, it was reported that Subash Mukhopadyay, a relatively unknown physician from Kolkata, India was performing experiments and this resulted in a test tube baby, - " Durga " (alias Kanupriya Agarwal) who was born on 3 October 1978. However, state authorities prevented him from presenting his work at scientific conferences and, in the absence of scientific evidence, his work is not recognised by the international scientific community.

20. 1979-1980 Steptoe and Edwards were responsible for the world’s first confirmed boy conceived by IVF, Alastair MacDonald born on 14 January 1979 in Glasgow. Pez et al, began tracking the growth of follicles by ultrasound. The first published use of ultrasound to identify growing follicles. A team led by Ian Johnston and Alex Lopata were responsible for Australia's first baby conceived by IVF, Candice Reed , born on 23 June 1980 in Melbourne The introduction of culture medium

21. 1981 The U.S. announced the birth of IVF baby Elizabeth Carr in 1981. This first IVF birth in the USA was achieved with the use of hMG . Wood and his colleague introduced a foot-controlled fixed aspiration pressure control, Technique for collecting mature human oocytes for IVF. I ntroduction of Clomiphene Citrate and hMG in the IVF treatment protocol  T he Clamart group in France developed an LH assay (LH-SIR0 which could detect the initial LH rise in plasma allowing accurate prediction of the ideal time for the retrieval of oocytes.

22. 1982 The first French IVF birth occurred in Clamart, France by the group of Frydman and Testart .

23. 1982- contd The first IVF birth in Sweden by Hamberger L et al. Birth of first Austrian "Test tube baby" (Twin pregnancy ) The first demonstration that GnRH agonists can be used to eliminate premature luteinisation and control ovarian stimulation by Fleming et al. The first report of the need for a delay between oocyte collection and insemination to allow oocytes collected to complete maturation. Susan Lenz and Jurgen G Lauritsen demonstrated trans abdominal transvesical oocyte aspiration using an ultrasound-guided needle. Ian Craft in London reported a pregnancy from transfer of gametes to the uterus 

24. 1982 contd Bourn Hall worlds first IVF Conference Front row, from left to right: Bob Edwards, Jean Purdy, Patrick Steptoe, John Webster and Simon Fishel

25. 1983 Donor egg: The Monash IVF team achieved the first pregnancy in a woman without ovaries by using donor eggs. Monash IVF team reported on the birth of the first frozen embryo baby. First pregnancy after oocyte donation  First successful delivery following egg donation Casper and his colleagues were the first to described the use of low dose hCG for support of the luteal phase in ART cycles . Gleicher and his group reported the first vaginal egg retrieval using an abdominal ultrasound First report on the Canadian IVF baby by the group of Victor Gomel at the University of British Columbia World's first IVF triplets reported by Christopher Chen. The first report on human pregnancy following cryopreservation, thawing and transfer of an eight-cell embryo

26. 1984 The Government of Victoria established a review of IVF research and practice which led to the proclamation of the Infertility (Medical Procedures) Act 1984, the first legislation to regulate IVF and its associated human embryo research. First surrogacy embryo transfer baby born in California First report on pregnancy following trans laparoscopic GIFT procedure  The world's first IVF quadruplets were born on January 6, 1984, in Melbourne.

27. 1985 and 1986 Human pregnancy by in vitro fertilization (IVF) using sperm aspirated from the epididymis First Delivery Resulting From Gestational Surrogacy . Monash IVF report on the world’s first pregnancy and birth from the sperm retrieval operation performed on a patient who had a blocked sperm duct First report on pregnancy after translaparoscopic zygote intrafallopian transfer Delivery of twins from frozen human eggs 

28. 1987-1990 Fertilization of human oocytes by microinjection of a single sperm under the zona pellucida  First two babies born after epididymal sperm aspiration for men with congenital absence of the vas deferens and naming of the technique MESA The death of Dr. Patrick Steptoe -March 21 1988 First report on biopsy of human preimplantation embryos and sexing by DNA amplification The first report on polar body biopsy, transfer of the embryo and achieving pregnancy

29. moment Louise Brown, the worlds first IVF baby, met Elizabeth Carr, the first IVF baby born in the USA

30. 1990s- The following advancements were made: Fertility Drugs were improved. IVF egg retrievals began to be performed vaginally instead of by laparoscopy. Intracytoplasmic sperm injection (ICSI) allowed men with low sperm to become fathers by 1991. Embryo transfers slowly moved from day 1 to day 3 and are now performed on day 5 by all outstanding fertility centres, as embryology labs became capable of culturing embryos safely for longer periods of time. “live-cam” 24-hour footage became available to monitor cell division. Embryo biopsy techniques evolved to safer and a more accurate prediction of the genetic makeup of an embryo – attempting to improve pregnancy rates and lower the risk of multiple gestation and miscarriage. Comprehensive Chromosome Screening (CCS) of the whole embryo genome (24 Chromosomes).

31. 2000s Cryopreserved oocytes and frozen sperm: first ever birth. Ongoing twin pregnancy after ICSI of PESA-retrieved spermatozoa into in-vitro matured oocytes reported by the McGill group First report of fertility preservation for cancer patients using IVM and oocyte vitrifica­tion   Cryopreserved oocytes in cancer patients: first ever birth of healthy twins after oocyte cryopreservation and bilateral ovariectomy Nobel prize in 2010- Robert G Edwards.

32. conclusion The field of assisted reproductive technique has progressed at an astounding pace over the past three decades as we have developed new techniques, medications, testing, and strategies to treat infertile couples. Now, many previously sterile couples are able to conceive, carry, and deliver healthy children of their own.

33. References Anand Kumar, T.C. Architect of India’s first test tube baby: Dr Subhas Mukerji (16 January 1931 to 19 July 1981). Curr. Sci. 1997; 72:  526–531 Biggers , J.D. In vitro fertilization and embryo transfer in historical perspective. in: A. Trounson , C. Wood (Eds.) In Vitro Fertilization and Embryo Transfer. Churchill Livingstone, London; 1984:  3–14 John D. Biggers . IVF and embryo transfer: historical origin and development. RBMO August 2012 Volume 25, Issue 2, Pages  118–127 Bavister BD . Early history of in vitro fertilization. Reproduction. 2002 Aug;124(2):181-96 . Perone N. In vitro fertilization and embryo transfer. A historical perspective. J Reprod Med. 1994 Sep;39(9):695-700. Sjo ¨ gren A, Hillensjo ¨ T. Methods for aspiration of human oocytes by various techniques. Acta Med Rom 1982: 20,370 – 378 ). Kretzer D, Dennis P, Hudson B, Leeton J, Lopata A, Outch K, Talbot J, Wood C. Transfer of a human zygote. Lancet, 1973 29;2:728-9. Trounson AO, Leeton JF, Wood C, Webb J, Wood J. Pregnancies in humans by fertilization in vitro and embryo transfer in the controlled ovulatory cycle. Science 1981 8;212:681-2 Testart J, Frydman R, Feinstein MC, Thebault A, Roger M, Scholler R. Interpretation of plasma luteinizing hormone assay for the collection of mature oocytes from women: definition of a luteinizing hormone surge-initiating rise. Fertil Steril. 1981 Jul;36(1):50-4). Rao GD, Chian RC, Son WS, Gilbert L, Tan SL. Fertility preservation in women undergoing cancer treatment. Lancet. 2004;363(9423):1829-30).