Robert G. Edwards: The father of IVF

Unfortunately, for health reasons he was not able to attend the Award Ceremony and the Nobel Banquet in Stockholm. His wife Ruth Edwards accepted the Nobel Prize on his behalf and at the Nobel Prize Symposium in his honor she said that Edwards was absolutely thrilled when he heard the announcement. “He would have just loved to go to Stockholm and accept the award,” said one of his daughters in an interview with Swedish Television.

They had to be sure that in vitro fertilization (IVF) was a safe method and follow up the children. Clearly, after over four million IVF births, this is an established fact.

Some say Edwards might have just as well been given the Nobel Prize five years ago, at a time when he could have appreciated it more, but many also understand the Nobel Committee’s reasons for waiting.

“They had to be sure that in vitro fertilization (IVF) was a safe method and follow up the children. Clearly, after over four million IVF births, this is an established fact,” says Dr Mike Macnamee, Executive Director at Bourn Hall, a colleague and a dear friend of Edwards, to Nordic Life Science.

“I was with him in his home at the time of the Nobel Prize ceremony, and he was overjoyed about receiving the Nobel Prize. It was a great thing. Everybody at Bourn Hall is so happy and proud. We all find him engaging and we love him,” he adds.

Love in the lab 

Robert Edwards was born 1925 in Batley, United Kingdom. He comes from a working class family and is the second of three brothers. The family moved to Manchester and all three boys did very well in school, which meant a lot at that time as they could continue to study and “step out of the working class”.

After military service during the Second World War, Edwards continued to study zoology and agriculture at the University of Wales in Bangor. With a thesis on embryonal development in mice, he received his Ph.D. in 1955 from Edinburgh University in Scotland.

Dr Ruth Edwards has also been his long-term scientific companion.

He also met his wife to be in Edinburgh, where they worked together as doctoral students. Dr Ruth Edwards has also been his long-term scientific companion. In 1958 he became a staff scientist at the National Institute for Medical Research in London, where he initiated his research on the human fertilization process. In 1963 he moved to Cambridge University, where he still is professor emeritus.

Important principles for human fertilization

Throughout his entire research career Edwards worked systematically to realize his goal, and along the way he discovered important principles for human fertilization. In a series of experimental studies conducted together with several different co-workers, Edwards clarified how human eggs mature, how different hormones regulate their maturation, at which time -point eggs are receptive to the fertilizing sperm, as well as the conditions under which sperm is activated and has the capacity to fertilize the egg.

He actually predicted a lot of what is happening today within IVF, like the use of embryonic stem cells.

“As a scientist Edwards is brilliant,” says Macnamee. “He is passionate and intelligent, he actually predicted a lot of what is happening today within IVF, like the use of embryonic stem cells. He also had the ability to deal with ethical issues at that time and he started the first journal in reproductive medicine.”

Early on in his career Edwards investigated the possibilities to perform genetic diagnostics on early embryos before implantation. He first published this research in 1967 and this laid the foundation for further development of clinical so called pre-implantorial genetic diagnostics (PGD).

The last decade this technique has become an important tool to diagnose serious and even lethal inherited diseases so that early abortion can be avoided. The first application of PGD was reported in 1992. In 1969 Edwards and his colleagues succeeded; a human egg was fertilized in a test tube for the first time. But there was a problem. The fertilized egg did not develop beyond a single cell division. Edwards suspected that eggs that had matured in the ovaries before they were removed for IVF would function better and looked for possible ways to obtain such eggs in a safe way.

Patrick Steptoe – from experiment to practical medicine 

In order to solve the problem of the eggs not developing beyond a single cell division Edwards started collaborating with gynecologist Patrick Steptoe. Steptoe was one of the pioneers in laparoscopy, a technique which allows inspection of the ovaries through an optical instrument. Steptoe could use laparoscopy to remove eggs from the ovaries and Edwards put the eggs into cell culture and added sperm.

If Patrick Steptoe had been alive I am sure that he would have shared the Nobel Prize with Edwards.

They were able to show that the fertilized egg cells divided several times and formed early embryos, eight cells in size. They had taken the IVF technique from experiment to practical medicine.

“If Patrick Steptoe had been alive I am sure that he would have shared the Nobel Prize with Edwards. His work was extremely important,” emphasizes Macnamee.

The ethical debate 

At that time there was a lively ethical debate about Edwards’ and Steptoe’s work. Religious leaders, ethicists and scientists demanded that the project was stopped and the Catholic Church said it was unethical and immoral. The Medical Research Council actually decided not to fund a continuation of the project.

The Pope condemned the project and the Nobel Laureate who discovered the structure of DNA, James Watson slammed Edwards’ work at a US conference in 1971.

“The Pope condemned the project and the Nobel Laureate who discovered the structure of DNA, James Watson slammed Edwards’ work at a US conference in 1971,” says Macnamee. “But Edwards entered the debate and passionately defended IVF. His publications about reproduction ethics have been very important for legislation about human rights in reproduction.”

The first IVF baby 

After the progress of the formation of early embryos, the process of testing on patients started. By analyzing a patient’s hormone levels Edwards and Steptoe could determine the best point for fertilization.

After several attempts the world’s first “test tube baby” Louise Brown was born on July 25th 1978. Her mother and father came to the clinic after nine years of failed attempts at conception. When the fertilized egg had developed into an embryo with eight cells it was returned to the mother’s uterus where the egg attached to the mucosa, and the healthy baby was born by Caesarian section following a full-term pregnancy. The birth caused international headlines.

“When the delivery date drew near there were nervous tensions and at the press conference following the birth Edwards and Steptoe were both relieved and overjoyed,” recalls Macnamee.

On January 14th 1979 the first IVF boy, Alistair MacDonald, was born. During the years that followed Edwards and his colleagues continued to refine the IVF technology and shared it with colleagues around the world.

The first clinic 

Since Edwards and Steptoe found it difficult to find a clinic who would work with them they set up their own clinic and were quickly besieged by couples who had been told they had no chance of having a child. They then co-founded the Bourn Hall clinic in Cambridge, the world’s first IVF clinic. Steptoe was the Medical Director until his death in 1988 and Edwards was the Head of Research until his retirement.

They then co-founded the Bourn Hall clinic in Cambridge, the world’s first IVF clinic.

“I first met Edwards in 1983, two years after he and Steptoe had founded Bourn Hall,” says Macnamee. “He is an incredibly charming and generous person.”

Today [2010], the Bourn Hall clinic delivers 350-400 babies every year and in total more than 11 000 families have been helped by the clinic. 

A milestone in modern medicine 

Edwards’ achievements have made it possible to treat infertility, a medical condition afflicting more than 10% of all couples worldwide. Infertility causes disappointment and in some cases lifelong psychological trauma. IVF is used when sperm and egg cannot meet under normal conditions. Common causes include obstructed fallopian tubes, too few eggs or impaired production of sperm. So far [2010] over four million babies have been born following IVF. Many of them are now adults and have become parents themselves. IVF is a new field of medicine and a milestone in modern medicine. Before IVF only 30% of all couples suffering from infertility could be helped. Today that figure is 90%.

IVF is both safe and effective and 20-30% of fertilized eggs lead to the birth of a child. A very rare complication is premature birth and long-term follow-up studies have shown that IVF children are as healthy as other children.

His research has also has a principle importance for the development of research within embryonic stem cells which in the future might be used for treating so far non treatable diseases.

Edwards unique ability to combine basal and clinical research has been of outmost importance for infertility treatments and has dramatically increased our knowledge about the physiological processes which regulates human reproduction, for example endocrine control of follicle development, ovulation, implantation, early pregnancy and freeze storage of embryos. His research has also has a principle importance for the development of research within embryonic stem cells which in the future might be used for treating so far non treatable diseases.