40 years ago, on July 25, 1978, Louise Brown became the world's first "test tube baby". Newsweek presented the remarkable child on his cover the following week and published a long article on the increase in in vitro fertilization by longtime science editor Peter Gwynne. Brown is happily celebrating her 40th birthday. Here is our cover story of 1978 in its entirety.
She was born at 11:47. with a lustful cry, and it was a cry that was heard around the brave new world. Louise Brown, blond, blue-eyed, and nearly six pounds, was the first child in history to be received outside of her mother's body. Her birth last week in a dilapidated British factory was a novelty in its own right ̵
Steptoe and his medical associate, physiologist Robert Edwards, made their breakthrough with only a slight variation in the technique they had developed for 12 years, and the crucial element was apparently the timing: the fertilized egg, the lice in Louise's womb implanted earlier than before, survived almost the normal nine months to a cesarean section. But that was enough to give new hope to millions of childless women, hundreds of whom besieged Steptoe at once with requests to help them father children.
The birth announcement prompted at least one new attempt to implant and possibly implant another test tube baby: According to the London Daily Express three more women are already pregnant – including a countess. It triggered feverish speculation and ethical debates about future miracles: the possibilities of surrogate mothers, the creation of superpowers, and a vision of Aldous Huxley of embryos born into artificial wombs.
For the moment, Louise herself was miracle enough. Chubby and disheveled, wrapped in a white muslin cloth she lay in the plastic bed next to her mother's bed, she was the center of a classic Fleet Street Circus. London Daily Mail had long since purchased the rights to the story and the pictures for a sum of $ 570,000 and had first-person accounts from Gilbert John Brown, a 38-year-old truck driver, printed in Bristol and British Rail his wife Lesley, 31. In the competition, reporters for other newspapers and television besieged the hospital and nodded details to improve their headlines. SMALL ERRORS PERFECT, gushed the Evening News ; The whole world in their hands, said the Daily Express .
There was little enough to say anything about the Browns, who appeared extraordinary only in their determination to have a child; The neighbors introduced them as quiet working people who believed in themselves. But there was no doubt about her pleasure in Louise. "She's so small, so pretty, so perfect," said Lesley Brown of Mail . And John Brown cheered, "It was like a dream, I could not believe it."
For some it had the ring of a scifi nightmare. Roman Catholic theologians, who even considered artificial insemination for an unlawful manipulation of the will of God, raised serious concerns. Jewish and Protestant authorities agreed to the process in principle, as long as the sperm used came from the husband of the woman who would carry the baby.
Probabilities on a Miracle:
But there were widespread concerns about the next possible steps: surrogate mothers, you could borrow their wombs or custom-made babies whose genes might be altered in the test tube. "I'm afraid we could get away with treating the patient to handle the race," said Father William Smith of the New York Catholic Archdiocese. However, few doubted that Louise's birth represented a major advance in medical research, with promises of further breakthroughs in embryo research, understanding of birth defects and their prevention, treatment of infertility, and, paradoxically, development new contraceptive. For Steptoe, this irony would be familiar enough; Due to lack of funds for his controversial work, he financed his research partly with the proceeds of legal abortions.
And miracles or not, the odds against Louise were long from the beginning. Their parents could only pursue their task because they had won $ 1,500 in the football pools. Her imagination, when her father's sperm pervaded her mother's egg in a one-inch diameter, two-inch ampoule, was found in a drowsy clinic called the Dr. Kershaw's Cottage Hospital is held in Oldham near Manchester in northwest England. And their birth with all their sci-fi raids happened in the Oldham and District General Hospital, a collection of Victorian buildings that were originally a Dickensian Workhouse.
When they married in 1969, John and Lesley Brown hoped for a stepbrother or sister for Sharon, John's daughter from a previous marriage. But Lesley was unable to open her blocked fallopian tubes even after surgery. The couple tried to adopt a child but gave up on a waiting list after two years. Finally, a sympathetic nurse sent her to Steptoe and Edwards.
It was an unusual partnership. Steptoe, 65, is an extravagant and somewhat mysterious character: he refuses to talk about his origins (reported in Eastern Europe) or his childhood, but he served in the British Royal Navy during World War II, spent time as a prisoner in Italy and later gained an undisputed reputation in gynecology as the developer of the technique for peering in a woman's ovary through a small abdominal incision and selecting and removing a mature egg. Edwards, 52, a part-time farmer and cobbler in politics, is an expert on the delicate and complex chemical changes needed to support the development of the human embryo.
Both men have been controversial – Steptoe above all for his fame in the popular press, Edwards for the nature of his experiments. He had canceled research grants and had to stop his research until a panel of experts could examine its ethical and social implications. Her 12-year collaboration was not easy; Edwards estimates he has traveled more than 50,000 miles between his home in Cambridge and the Oldham Clinic, often in the company of a hare that served as a rice container for an egg to be examined. But they had succeeded in removing and fertilizing more than 8 human eggs in vitro – literally in glass laboratory vessels – and then implanting the fertilized eggs in the would-be mother babies. None of the embryos survived more than a few months in the womb. But by the time Lesley Brown was ready to conceive, the two men should try a new fold in their technique.
From Rabbit to People:
Steptoe and Edwards had few precedents to guide them in their development of test tube baby technique. The first report of an in-vitro fertilization came in 1936 by Dr. med. Gregory Pincus of Harvard University; He combined a rabbit egg and sperm. Eight years later, Dr. John Rock, also from Harvard, and how Pincus was a key figure in the development of contraceptive pills, had fertilized a human egg outside the body and watched as it divided into three cells. In 1961, Dr. Daniele Petrucci from the University of Bologna, claiming that he had fertilized 20 different human eggs in vitro. There were even rumors that Petrucci had replanted some of them. But so bizarre to most scientists and laymen was the notion of test tube babies that research was either ignored or greeted with indignant disbelief.
The scientific community was scarcely more receptive when Steptoe and Edwards began their historical collaboration, and in the early years the couple became cautious. Edwards took the lead in perfecting the fertilization of human eggs and improving the chemical solutions necessary to keep them alive and healthy outside the body. In the meantime, Steptoe was working on the mechanical technique of removing eggs from expectant mothers and returning the dividing, fertilized eggs to the uterus. His most important contribution – and perhaps the most important event in the chain that led to the birth of the last week – was the pioneering role in the use of the laparoscope. A foot-long tube with its own eyepiece and interior lighting can be inserted through a small slit in the belly of a woman and select a ripening egg that can pull a suction needle out of her ovaries.
The success came slowly. In 1970, the couple reported in the journal Nature that fertilized human egg cells had grown to the eight- and sixteen-cell stage, and several years later they began serious efforts to resume such test tube egg cells no larger than the period at the end of this sentence.
Designed in a hut:
In 1975, Steptoe and Edwards produced their first definite pregnancy, but the the embryo was reimplanted into the patient's diseased tubal puncture, not the uterus, and after 10 weeks the embryo was missing. However, the researchers were confident that they were on the right path and continued to make minor changes to the process.
Lesley Brown was an excellent subject. "She was in an age group that was very suitable," Steptoe said in a press conference last week, "not too old and highly fertile." Shortly after her visits began two years ago, Steptoe removed Mrs. Brown's diseased fallopian tubes. This operation destroyed any weak chance that she would normally conceive, but she offered the obstetrician an unobstructed view of his patient's ovaries as he took the first step in creating Louise in November. At this point, Ms. Brown was given hormone treatment to stimulate egg production before she made the crucial visit to Oldham for the actual conception of her child. It took place in Dr. Kershaw's Cottage Hospital, a lesser-used brick building originally donated to the city by an Eduardian eccentric.
Operation in the tiny, white-tiled operating room, Steptoe took an egg from his patient. Edwards put the egg in a small jar where it was mixed with John Brown's sperm and absorbed by special fluids. After fertilization, the egg was transferred to another nutrient solution. The researchers observed the egg as it divided into two, four, and finally, after more than 50 hours, eight cells.
Now came the crucial point of difference. In earlier experiments, Steptoe and Edwards had tried to simulate the natural development of the egg, which is normally fertilized in the fallopian tube and multiplies into 64 or more cells when it reaches the uterus. But new research with rhesus monkeys – although it included only the implantation of conventionally fertilized eggs – suggested that an embryo as small as two cells could survive in the uterus. Therefore, the researchers decided to re-implant Lesley Brown's oocyte at the eight-cell stage to reduce the complexity of maintaining their development outside their body. She had already received a second dose of hormones to chemically prepare her womb for the embryo.
The brown fetus, born on November 10th and implanted two and a half days later, survived and thrived. Seven weeks ago, Lesley Brown went to the maternity ward at Oldham Hospital, where she took the name Rita Ferguson so the doctors could monitor her around the clock. Other mothers told reporters that she was quiet and muted, spending her time with knitting, watching television and crossword puzzles. She chewed gum, developed a craving for mints, and could not resist contradicting Steptoe's orders by occasionally smoking a cigarette-and blowing the smoke out of a window to hide it.
Premature but beautiful:
Steptoe had expected the birth to take place sometime this week, but when Lesley developed a mild case of high blood pressure and impending complications at birth, he decided that Baby immediately discharged by Caesarean section. In a ten-minute conventional surgery, he left the mother with a horizontal "bikini cut" and brought out Louise, a few days early and only five pounds heavy. The baby's appearance has benefited from the operation: because they do not have to fight through the birth canal, babies who are treated by cesarean section look prettier than children who get normal births. "She has a wonderful complexion, not red and wrinkled," her dad boasted in the Daily Mail . Edwards, a godfather of Art, added a unique perspective: "The last time I saw the baby, there were only eight cells in a test tube, it was beautiful at the time and it's still beautiful."
Even more uniqueness remained to be recognized. Louise was so obviously healthy that her doctors left her from the hospital's preterm department only hours after she'd been taken there as a precautionary measure. Nestled in her cradle, like every baby, she squeezed the bottle she got while her mother's breasts were filled. "She has a number of lungs like a glassblower," said a staff member on the fourth floor of the hospital. "This girl is growing up to become a politician or pop singer."
John Brown himself almost missed the magic moment: he had left the hospital almost two hours before the operation, Mail reported that his wife had been unnaturally quiet during his visit. Only when he later recalled did he learn the reason for her silence. She had been sedated in readiness for delivery, and in the manner of hospitals everywhere no one had thought to tell him about it. Brown hurried back to the hospital and spent nervous minutes in a waiting room. "Then a sister came to me with a smile and said," Mr. Brown, you are the father of a wonderful little girl, "he told the newspaper." And almost before I knew it, I held my daughter in my arms.
Brown then ran up and down the corridors of the gloomy Victorian hospital, hugging everyone he met, repeating, "It's a girl, me & # 39; I have a little daughter. "Later he went out and stood in the pouring rain to calm down a little, as he explained." The man who deserves all the praise is Mr. Steptoe, "he said to the Mail "What a man who can do such a wonderful thing."
How big is the birth of the world's first test tube baby? Medical researchers are certainly impressed, but some suggest that the Media Hoopla is a bit overwrought "I doubt it will win a Nobel Prize," said Dr. Malcolm Potts, executive director of the North Carolina International Fertility Program, "It's a human and useful thing, but it's a cookbook thing." Indeed, Potts added "Fertilization outside the body," is something frogs do in a dirty stream. "Some of Steptoe and Edwards' scientific competitors were also somewhat dubious." What we do not know at this time, "said a member of T at London's St. Thomas Hospital, which implanted a fertilized egg within 12 hours of Louise Brown's birth. Steptoe was able to overcome the disease problems that we have found or whether Mr. and Mrs. Brown's baby needs to be brought to good luck. "
Shortcut to Success:
Lucky or not, Steptoe and Edwards have overcome at least one formidable barrier: The lack of substantial animal studies to guide them Usually, researchers begin by testing new medical procedures near the bottom of the evolution tree using rats and mice, and then progressively work with monkeys and monkeys, the closest human relatives, before they can But before Lesley Brown's case, only rats, mice, and rabbits had a successful test tube fertilization followed by reimplantation and birth Scientists were apparently so confident they simply skipped non-human primates. This led to a scientific comment by W. Richard Dukelow, a physiologist at Michigan State University: "The work of Steptoe and Edwards should do much to make us experiment with monkeys." Nonetheless, such animal experiments are still very valuable. On the one hand, it promises to complement and expand the performance of Steptoe and Edwards. Dukelow, for example, hopes to re-vaccinate fertilized squirrel monkey eggs that have been exposed to various drugs and environmental toxins to detect the influence of chemicals on birth defects. Groups at the Universities of Pennsylvania and Wisconsin begin experiments to monitor the in vitro fertilization of cow eggs by bull sperm. The scientists have two goals: By finding out what makes sperm effective, the studies can help to identify and treat causes of male infertility; and they could point the way to contraceptive chemicals that prevent fertilization.
However, some animal experiments reveal future ethical dilemmas. An example is the embryo transfer. After treatment with hormones, a genetically superior cow can be artificially fertilized. It produces up to 16 embryos. They are flushed out of the womb and reimplanted into low-quality cows, which compensates for the calves. The result is a much faster breed improvement than nature allows without help – but a human parallel would be an ethical nightmare.
Animal researchers are also slowly moving towards a true test tube baby. In the 1960s, American and Canadian scientists managed to preserve lambs that were retired prematurely from their mothers. The fetal lambs were bathed in plastic containers in a solution similar to the amniotic fluid and connected to a mechanical circulatory system similar to cardiosurgical cardiopulmonary bypass machines. They survived in the artificial environment and were then reborn – as Huxley called them in Brave New World . At Johns Hopkins University, Dr. Yu-Chih Hsu, keeping mouse embryos alive eight and a half days after fertilization in vitro – nearly half of their typical 19-day gestation period. The chances are that experts can produce artificial uterus, which bring the test tube people from conception to birth, are far away, but hardly possible.
Beautiful new medicine:
The limits of biomedicine and the manipulation of the mysteries of life – are expanding at astonishing speed. A group of scientists from Harvard, Yale and the Turkish University of Hacettepe reported last week that they had for the first time identified a single gene among the millions in a human cell. Their technique relies on controversial herbal tinkering known as recombinant DNA technology. Their findings promise the possibility of discovering hereditary diseases in fetuses still in the womb. But the same recombinant technology could eventually be used to alter the genes of human fetuses that have just been fertilized in the test tube. Further ahead is the prospect of cloning individuals with identical genes – a process that requires such a test tube technology as reimplantation. "The whole idea of constructing our descendants, making the next generation, making the reproduction synonymous with the production is almost in the picture," warns the Protestant theologian Paul Ramsey from Princeton.
What worries many philosophers and theologians is the fact that so many steps have actually been taken in the beautiful new biomedicine – with the best motives. "At least one good humanitarian reason can be found to justify every step," says Dr. Leon Kass, biochemist at the University of Chicago. "The first step serves as a precedent for the second, and the second for the third, not only technologically, but also in moral arguments: Perhaps a wise society would tell infertile couples," We understand your grief, but it may be better to go on and do that. "
But can the mind be forced back into the test tube – and should it? Science journalist Isaac Asimov thinks that new technology can be controlled "Scientists are developing a potential," he explains, "governments and people are deciding how to use these potentials." However, one problem with this rationalization is that new techniques tend to ratify. "Daniel Callahan, director of the Hastings Institute of Society, Ethics and Life Sciences, stated that the experiment on Lesley Brown was indeed unethical, as it benefited if it worked, but the unborn child was at risk of failure. Callahan added, however, that once the procedure was safely carried out, "it appears justified."
Louise Brown's arrival has raised other practical concerns. For starters, there is the certainty that thousands of infertile women now hope that they can actually give birth to children. But many will be disappointed because, with the exception of Steptoe and Edwards, only a few teams are able to quickly learn the skills of performing test tube concepts. "I do not think this should be done at a cross-over hospital," Dr. Griff Ross from the National Institutes of Health. The two British researchers made great efforts last week to emphasize that their work is still experimental. "We are at an early stage and still need to learn a lot," said Edwards.
What if the learning process leads to errors, in the form of tests? -tube babies born with mental or physical defects? Harvard lawyer William Curran looks forward to such children against the parents or doctors who created them. Another potential legal minefield concerns the status of fertilized eggs prior to their reimplantation. Should they be considered as living human entities with a well-defined right to life, or as nonhuman material that can be arbitrarily thrown into the abyss or even subjected to experimentation? Certainly, such external oocytes are different than the fetuses in the uterus, because their existence does not affect the physical well-being of the mother. Leon Kass argues that abortion laws can not be easily applied to these "emerging lives".
The disposal of such eggs is naturally parallel in nature. In practice, about 67 percent of fetuses conceived in the human body do not reach the uterus alive. Every year in the US, about 6 million fetuses spontaneously die or die in the uterus, most of them so early in pregnancy that the mother does not even realize she is pregnant. "If a man and a woman go to the bedroom and experiment, the experiment will fail two thirds of the time," says Donald Chalkley of the National Institutes of Health.
But for many people the deliberate destruction of a fertilized egg seems to be a completely different matter. In a New York federal court, John and Doris Del Zio sue the gynecologist at Columbia University. Raymond Vande Wiele, the Presbyterian Hospital in New York City and the University for $ 1.5 million. Their complaint: Vande Wiele caused them physical and mental damage when, in 1973, he opened the glass in a laboratory at the Presbyterian hospital containing a fertilized egg ready for reimplantation in Doris Del Zio. "I do not think it was stopped without my consent," she said. Vande Wiele admits that he did it – for medical reasons. He has no qualms about test tube babies. In fact, he welcomed the birth of Louise Brown as a "crowning event." But the experiment he had destroyed was scientifically unfounded at the time, and Drs. William Sweeney and Landrum Shettles, who had performed the surgery, did so without the permission of the hospital.
There is little chance that such an experiment will be repeated in the US in the near future. In 1975, funding for human in vitro fertilization research was halted by the federal government, and a resumption of funding awaits the next meeting of a new Ethics Advisory Board. The Board, which will meet in mid-September, will be asked to review proposals on a case-by-case basis. Currently, only one proposal is under consideration: Piers Soupart of Vanderbilt University wants to find out whether in vitro fertilization increases the risk of genetic abnormalities. This risk can be real: with normal fertilization, only strong sperm can gain the long run through the vagina, uterus and fallopian tubes to hit the descending egg. In a laboratory dish, strong and weak sperm have almost the same chance – and some experts fear that the result could be hard-to-identify genetic irregularities.
Fear of such test tube babies could be prone to defects that could hamper researchers' plans to repeat the process developed by Steptoe and Edwards. Although Louise Brown now looks quite normal, there is no guarantee that smaller genetic problems will not occur in later years. Since genetic detective work is still in a fairly rudimentary state, it will be impossible to link any defects – or special attributes – that may emerge in Louise Brown with the unusual circumstances of their conception.
Perhaps the biggest worry that Louise faces derive from her uniqueness. "The child will be watched the rest of his life and be considered unusually unusual," says Daniel Callahan. "People will take pictures of them all their lives, just as they did with the Dionne Fives, and I can not imagine that this will be of much help to them." It could even endanger the family ties. "Excessive publicity distorts normal relationships," says Dr. Nicholas Zill of the New York Foundation for Child Development. "Die Eltern könnten am Ende das Kind ärgern, weil sie eine ständige Freakshow ist."
Louise könnte ein gewisses Maß an Bekanntheit vermeiden, wenn sie Gesellschaft hätte; wie Steptoe letzte Woche sagte, "Die beste Wette ist, sicherzustellen, dass solche Babys alltäglich sind." In der Zwischenzeit schien ihr junges Leben alltäglich genug zu sein. Sie sollte diese Woche für einen privaten Urlaub mit ihren Eltern das Krankenhaus verlassen. Sie hatte angefangen zu stillen. Und sie hatte zwei Unzen gewonnen.
Diese Geschichte erschien ursprünglich in der 7. August 1978 Ausgabe von Newsweek mit der Schlagzeile "Über dieses Baby." Berichtet von Peter Gwynne, mit Tony Clifton in Oldham, Mary Hager in Washington und Sharon Begley und Barbara Gastel in New York.