The idea of so-called “test-tube babies” (technically called in vitro fertilization) is not new, but it has developed and matured incredibly rapidly — up to the point where in developed countries, it’s become a fairly routine procedure. The technique can help with fertility problems, enabling millions to conceive a child.

But the technique can be used for even more things than just conceiving. The method has been used to screen for embryos carrying hereditary genetic diseases, and even for features that are unrelated to diseases, such as sex selection — which has raised a number of ethical questions and concerns. 

IVF is the same process that was once employed in the late 1970s to give birth to the world’s first test-tube baby, and since then it has come a long way. 

When a couple is unable to conceive children naturally (whether it’s due to physiological or reproductive issues), doctors carry out the artificial fertilization of their sperm and egg under laboratory conditions. This external lab-based fertilization is called IVF and the baby born from using this method is colloquially referred to as a test-tube baby.

Until now, about eight million children have been born by IVF globally — but IVF is not just limited to childbirth. Entrepreneurs and many medical experts believe that IVF could also play a key role in human genetic engineering, genetic diagnosis, and numerous other advanced medical technologies in the future. For these reasons, the technology has garnered a fair share of critics.

History of IVF and the first test tube baby

In 1891, Cambridge University professor Walter Heape performed the first-ever mammal embryo transfer. More than 50 years later, American scientists John Rock and Miriam Menkin introduced the concept of biochemical pregnancy by extracting and fertilizing oocytes (immature eggs) and sperm cells in-vitro.

In 1958, a paper concerning in-vitro fertilization was published in Nature by researchers Anne Mclaren and John Bigger, this was the first study that proposed that fertilization outside of a woman’s body as possible. The following year, biologist M.C. Chang performed a successful experiment involving the birth of a live rabbit using in-vitro fertilization, this groundbreaking achievement led to a spree of in-vitro fertilization experiments across the globe. Things were moving quickly and already, researchers started to look forward to the world’s first “test-tube baby”. But the time was not ripe yet.

In-vitro fertilization using human gametocytes (the precursors of male and female reproductive cells) would not be performed until 1973, when a team of Australian embryologists (Alan Trounson, Carl Wood, John Leeton) created a biochemically conceived human embryo that survived for just a couple of days. The same year, American gynecologist Landrum Shettles also tried to perform a human IVF experiment but he had to cancel the same due to unknown reasons. Then, it finally happened.

In November 1977, Lesley Brown along with her husband Peter Brown decided to conceive a child through IVF. The couple had their gametocytes fertilized on a laboratory dish at Dr. Kershaw’s Hospice in Royton, England under the supervision of Dr. Patrick Steptoe, Dr. Robert Edwards, and embryologist Jean Purdy. About nine months later, Lesley gave birth to the world’s first test-tube baby, Louise Joy Brown on July 25, 1978.

Just two months after Louise’s birth, a second test-tube baby was born in Kolkata, India. The newborn girl was named Durga and Dr. Subhash Mukharjee and embryologist Sunit Kumar Mukharjee were responsible for her conception through IVF.

Both Louise and Durga (official name – Kanupriya Agarwal) are now 43 years old and mothers of naturally born children. Louise’s younger sister Natalie was also born through IVF and she was the first IVF-born person to give birth to children. 

For his exceptional work in the field of in-vitro fertilization, Robert Edwards was awarded the 2010’s Nobel Prize in Medicine. Steptoe and Purdy had passed by that time so they were not eligible for the award.

IVF Facts

IVF has enabled hundreds of thousands of families to have children of their own, the assisted reproductive technology (ART) has emerged as the most successful treatment for infertility. However, there are various shocking myths and facts associated with test-tube babies that make it a controversial subject as well:

• IVF has been a subject of debate among various religious communities. The Catholic Church and many Sunni Islamic scholars have not been in the favor of IVF because they believe that assisted reproductive techniques are immoral and interfere with the natural process of reproduction. Several religious groups are against the practice.
• Unmarried couples and people having certain types of contagious medical conditions are not allowed to undergo IVF in China. In India, IVF is allowed to conceive children but prenatal sex discernment (detecting the sex of fetus) through IVF is a punishable crime.
• In the US, pineapple (the fruit) has emerged as a symbol of hope among many couples facing infertility or undergoing IVF treatment. People tend to believe that by eating pineapple, the probability of them being pregnant increases. However, there is no scientific evidence or research that validates this belief. 
• Many people also happen to believe that there is no risk of ectopic pregnancy when a couple conceives a child through in-vitro fertilization. This is not true because research reveals that while the possibility of ectopic pregnancy in IVF is between 2 and 8.6%, it is only 1 to 2% in the case of natural conception.
• There is plenty of room for IVF to grow, and it likely will. In the US alone, infertility affects 10% of women, and approximately 1.9% of all infants born in the United States every year are conceived using assisted reproductive techniques.
• Plenty of factors affect IVF success rates, but the most important factor determining success rates is a woman’s age. However, while complications are not uncommon after the age of 40, women much older can give birth through IVF. Until recently, Adriana Iliescu from Romania held the record for as the oldest woman to give birth using IVF and a donor egg, when she gave birth in 2004 at the age of 66. In September 2019, a 74-year-old woman became the oldest-ever to give birth after she delivered twins at a hospital in Guntur, Andhra Pradesh.
• In the US, the average IVF. cycle can cost anywhere from $12,000 to $25,000. Prices may vary in other parts of the world, but this remains a relatively expensive technique.

Impact and future of the test-tube baby technique  

Apart from families coping with infertility, the test tube method has also allowed same-sex couples, single individuals, and overaged life partners to conceive children. IVF techniques have made parenthood accessible to more human beings than ever before.

According to a report, the IVF market is expected to value around $25.56 Billion by the year 2026. Increasing delayed pregnancy among the youth, rising birth success rate, and growing acceptance for IVF also indicate that the test tube baby technique (along with other ART methods such as artificial insemination, surrogacy, etc) is going to be more popular in the coming years.

The birth success rate of test-tube babies has also increased considerably over the years and now stands at 52% (for people below the age of 35 years). During IVF treatment, doctors are able to choose an embryo that is least likely to carry genetic disorders. Moreover, scientists are now trying to go one step further, they are looking for ways through which they can manipulate the genes of in-vitro embryos so that genetically superior individuals could be born. Needless to say, many other scientists (and important parts of civil society) are strongly against this idea.

Concerns still loom regarding the potential use of IVF and related techniques for eugenics — the improvement of the embryo by the selection of desired hereditary traits. If you could make your baby more likely to be tall, intelligent, and have blue eyes, would you? Millions likely would, but this opens up a can of worms that many researchers and philosophers fear could steer humanity towards a darker path that could spiral out of control and lead to discrimination and in the long term, increase the risk of our species going extinct due to less richness in the gene pool.

Ultimately, technology has had a significant and positive impact on humanity, and will likely continue to have a bigger and bigger impact as technology progresses. The debate around what’s acceptable for IVF is still not settled, and the discussion will likely continue for decades and centuries. It’s up to researchers and civil society to try to steer the technology into a continuously positive direction and stay clear of dystopian applications.