The Oldham Notebooks: an analysis of the development of IVF 1969–1978. III. Variations in procedures

Abstract

A survey is presented of the various technical and scientific challenges that had to be met during the 10-year period before the first successful live birth after IVF and embryo transfer was achieved, and the approaches used to meet these challenges is discussed. Records dated from January 1969 to July 1978 indicate that a minimum of 282 women were involved in 495 cycles scheduled for laparoscopic oocyte recovery, of which 457 cycles (92%) proceeded to attempted egg collection. A total of 1361 eggs were recovered over 388 cycles, of which 1237 (91%) are recorded as having been inseminated in 331 (85%) of these cycles. Approximately 221 embryos were described in 165 (43%) of the 388 cycles. A total of 112 embryo transfers were attempted, which resulted in five clinical pregnancies with two live births. This paper discusses the ways in which hormonal stimulation of follicle growth to the pre-ovulatory stage was varied, and the endocrine monitoring of these variations in blood, urine and follicular fluid, as well as their influence on egg recovery and fertilization rates. Variations in media composition and preparation are also described. It is concluded that, whilst driven by scientific reasoning, the approach adopted in trying to achieve successful IVF was empirical rather than evidence-driven.

The Oldham Notebooks: an analysis of the development of IVF 1969–1978. II. The treatment cycles and their outcomes

“…The scientific, ethical and social issues raised by these various data are described and analysed in the accompanying papers (Elder and Johnson, 2015b, Johnson and Elder, 2015a, Johnson and Elder, 2015b, Johnson and Elder, 2015c). …”

The Oldham Notebooks: an analysis of the development of IVF 1969–1978. I. Introduction, materials and methods

“…Detailed comparisons are reported in Elder and Johnson (2015b). In addition, the names and addresses of 41 women/couples from around the world (23 from southern England, 4 from North America, 3 from Australasia, 2 each from Wales and Germany, and 1 each from India, Switzerland, Greece, Italy, France, Scotland and South Africa) are recorded under a page heading in pencil saying ‘Standard letter 2’.…”

Reflections on 40 years of IVF

“…The journey from bench to bedside was fraught with difficulties – both technical and social . It took almost 10 years from the proof of principle of IVF in Robert Edwards’ Cambridge laboratory to the first live birth 40 years ago in Oldham, UK, achieved by Edwards, Steptoe, and Purdy.…”

“…The journey from bench to bedside was fraught with difficultiesboth technical and social. 1 It took almost 10 years from the proof of principle of IVF in Robert Edwards' Cambridge laboratory to the first live birth 40 years ago in Oldham, UK, achieved by Edwards, Steptoe, and Purdy. To be an IVF parent then was considered too shameful to admit, to be an IVF child was to be considered a freak, and to be an IVF practitioner or to be conducting embryo research led to one being likened to Frankenstein or Dr Mengele.…”