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Forty years ago, on July 25, 1978, Louise Brown became the first "test-tube" in the world. Newsweek featured the remarkable infant on his cover the following week and published a lengthy article on the increase in in vitro fertilization by Peter Gwynne, a long-time science writer. Brown is now happy to celebrate his 40th birthday. This is our 1978 cover story in its entirety.
She was born at 23:47. with a loud roar, and that was a cry heard around the brave new world. Louise Brown, blonde, with blue eyes and just under six pounds, was the first child in history to be conceived outside her mother's body. His birth last week in a British mill town was in his own way a first – variously hailed as a medical miracle, an ethical mistake and the beginning of a new age of genetic manipulation. But perhaps more importantly, as Dr. Patrick Steptoe proudly reported: "The anxieties are over, we have a beautiful, normal, healthy baby."
Steptoe and his medical collaborator, the physiologist Robert Edwards, the crucial element was apparently the moment: the fertilized egg, re-implanted in the womb of Louise's mother slightly ahead of previous programs, survived for almost nine months at a cesarean section. But that was enough to promise new hope to millions of childless women, hundreds of whom immediately besieged Steptoe to help them conceive children.
The birth announcement has caused at least one new attempt to implant another baby. more: According to the London Daily Express three other women are already pregnant, including a countess. It has also sparked feverish speculation and ethical debate about the wonders to come: the possibilities of surrogates, the creation of superpowers and a vision of Aldous Huxley of embryos fed at birth in artificial uteri.
For the moment, Louise herself was pretty amazing. Chubby and ruffled, wrapped in a white muslin sheet in the plastic cradle next to her mother's bed, she was the central ring of a clbadic Fleet Street circus. The Daily Mail in London had long bought the rights to history and images for $ 570,000, and had printed first-person accounts of Gilbert John Brown, a driver 38 year old truck. British Rail in Bristol, and his wife, Lesley, 31. In the competitive fray, reporters from other newspapers and television have besieged the hospital, updating details to reinforce their headlines. LITTLE MISS PERFECT, springs on Evening News ; EVERYONE IN HIS HANDS, says the Daily Express .
There was little to add about the Browns, who only seemed extraordinary in their determination to have a child; the neighbors imagined them as working-clbad people standing out of the way. But there was no doubt about their joy from Louise. "She is so small, so beautiful, so perfect," said Lesley Brown at Mail . And John Brown exulted: "It was like a dream, I could not believe it."
For some, he had the ring of a scifi nightmare. Roman Catholic theologians, who even consider artificial insemination as an unlawful alteration of God's will, have expressed serious reservations. Jewish and Protestant authorities generally approved the process, as long as the sperm used came from the husband of the woman who would carry the baby.
See all best photos of the week in these slideshows
Chances on a Miracle:
But there were widespread doubts about the possible next steps: surrogate mothers who could rent their uteri, or bespoke babies whose genes could be modified in the test tube. "I'm afraid we're going from medical treatment to the patient to the race," said Father William Smith of the Catholic Archdiocese of New York.
Few doubts, however, that Louise's birth represents a major breakthrough in medical research, with the promise of more breakthroughs in embryonic research, understanding of conbad abnormalities and their prevention, the treatment of the disease. infertility and – paradoxically – the development of new contraceptives. . For Steptoe, this irony would be quite familiar; Lacking funding for his controversial work, he funded his research in part with the proceeds of legal abortions.
And miracle or not, the chances against Louise were long from the beginning. His parents were able to continue their quest only because they had won $ 1,500 in the football pools. His conception, when his father's sperm penetrated his mother's egg into a flask one inch in diameter and two inches in height, took place in a sleepy clinic called Dr. Kershaw's Hospital at Oldham, near Manchester, north west of England. And his birth, with all his sci-fi overthrows, occurred at the Oldham and District General Hospital, a group of Victorian buildings that were originally a Dickens workhouse
When they got married in 1969, John and Lesley Brown were hoping for a half-brother. or sister for Sharon, John's daughter by a previous marriage. But Lesley was unable to conceive even after an operation to open her blocked fallopian tubes. The couple tried to adopt a child, but gave up after two years on a waiting list. Finally, a friendly nurse sent them to Steptoe and Edwards
Famous Team:
This was an unusual partnership. Steptoe, 65, is a flamboyant and somewhat mysterious character: he refuses to talk about his origins (in Eastern Europe) or his childhood, but he served in the British Royal Navy during the Second World War . and later built an undisputed reputation in gynecology as the developer of the technique of peering a woman's ovary through a small abdominal incision and selection and removal of an egg Wall. Edwards, 52, a part-time farmer and policy lover, is an expert in the delicate and complex chemical changes needed to support the development of the human embryo.
Both men were controversial – Steptoe largely for his celebrity in the world. popular press, Edwards because of the nature of his experiences. He canceled research grants and had to suspend his research until a group of specialists could explore its ethical and social implications. Their 12 years of collaboration have not been easy. Edwards estimates that he drove more than 50,000 miles between his home in Cambridge and the Oldham Clinic, often in the company of a rabbit that served as a travel receptacle for an egg to study. But they had been able to collect and fertilize more than 8 human eggs in vitro – literally, in glbad laboratory containers – and then implant the fertilized eggs into the uteri of the expectant mothers. None of the embryos had survived more than a few months in the uterus. But at the time Lesley Brown was ready to conceive, the two men had to try a new ride in their technique.
From Rabbits to People:
Steptoe and Edwards had few precedents to guide them in their development of the test-tube technique. The first report of an in vitro fertilization came in 1936 from Dr. Gregory Pincus of Harvard University; he joined a rabbit egg and sperm. Eight years later, Dr. John Rock, also of Harvard and, like Pincus, a major figure in the development of the contraceptive pill, claims to have fertilized a human ovum out of the body and watch it divide into three cells. In 1961, Dr. Daniele Petrucci of the University of Bologna shocked the world with his claim – backed by films – that he had fertilized 20 separate human eggs in vitro. There were even rumors that Petrucci had resettled some of them. But so bizarre the idea of test-tube babies appeared to most scientists and laymen that the research was either ignored or greeted with outraged disbelief.
The scientific community was hardly more receptive when Steptoe and Edwards began their historical collaboration, and in the early years, the pair proceeded cautiously. Edwards took the initiative to perfect the means of fertilizing human eggs and to improve the chemical solutions necessary to keep them alive and healthy outside the body. Meanwhile, Steptoe was working on the mechanical technique of removing eggs from expectant mothers and turning the fertilized eggs that divide into the uterus. His major contribution – and perhaps the most important event in the chain that led to the birth of last week – was to pioneering the use of the laparoscope. A foot length tube equipped with its own eyepiece and internal lighting, it can be inserted through a small slot in the abdomen of a woman and used to select a maturing egg that a needle suction can then remove from its ovaries
. In 1970, the pair reported in the journal Nature that the fertilized eggs had reached the stage of eight and sixteen cells, and a few years later, they undertook serious efforts to re-implant these eggs, which are no greater than the period at the end of this sentence.
Designed in a House:
In 1975, Steptoe and Edwards produced their first definitive pregnancy, but the embryo was re-implanted in the patient's fallopian tube rather than in the uterus, and he had a miscarriage after ten weeks. The researchers nevertheless remained confident that they were on the right track and continued to make minor changes to the procedure.
Lesley Brown was an excellent subject. "She was in an age group that was very appropriate," explained Steptoe at a press conference last week, "not too old and very fertile." Shortly after her visits began two years ago, Steptoe removed Ms. Brown's diseased fallopian tubes. This operation destroyed any faint chance that she could conceive normally, but she gave the obstetrician an unobstructed internal vision of her patient's ovaries when he took the first step in creating Louise last November. At this time, Mrs. Brown received hormonal treatment to boost egg production before making the crucial visit to Oldham for the very conception of her child. It took place at Dr. Kershaw's Cottage Hospital, a little used brick building originally given to the city by an eccentric Edwardian.
Operation in the institution's tiny white-baded surgical theater, Steptoe extracted an egg from his patient. Edwards placed the egg in a small pot, where he was mixed with John Brown's sperm and backed by special fluids. Once fertilized, the egg was transferred to another nutrient solution. The researchers monitored the egg by dividing it into two, four and finally, after more than 50 hours, eight cells.
Now has come the crux of the difference. In previous experiments, Steptoe and Edwards had tried to simulate the natural development of the egg, which is normally fertilized in the fallopian tube and multiplied to 64 cells or more by the time it reaches the 39; uterus. But new research conducted on rhesus monkeys – although implying that the implantation of conventionally fertilized eggs – has suggested that an embryo as small as two cells could survive in the world. ;uterus. The researchers therefore decided to relocate Lesley Brown's egg to the eight-cell stage, reducing the complexities of its development out of its body. She had already received a second set of hormones to prepare her uterus chemically to receive the embryo.
The Brown fetus, which was conceived on November 10 and reimplanted two and a half days later, survived and flourished. Seven weeks ago, Lesley Brown went to the Oldham Hospital Maternity Hospital, where she took the name of Rita Ferguson, to allow doctors to monitor her 24 hours a day. D & # 39; Other mothers told reporters that she was quiet and discreet, that she spent her time knitting, watching TV and doing crossword puzzles. She chewed gum, developed a craving for mints and could not resist disobeying Steptoe's orders by taking an occasional puff of a cigarette – and expelling smoke from a window to hide it
Premature but beautiful: ]
Steptoe was expecting the birth to occur this week, but when Lesley developed a mild case of high blood pressure, threatening complications in the Delivery, he decided to deliver immediately by caesarean section. In a conventional ten-minute operation, he left the mother with a horizontal "bikini cut" and brought Louise, several premature days and weighing only five pounds 12 ounces. The baby's looks have benefited from the operation: because they do not have to wrestle in the birth cbad, the babies delivered by caesarean tend to look prettier than the kids who have normal births. "She has a wonderful complexion, not red and ridiculous at all", boasted of her father at Daily Mail . Edwards, a godfather of sorts, added a unique point of view: "The last time I saw the baby, there were only eight cells in a test tube, c & # 39; was beautiful and it's still beautiful now. "
be discerned. Louise was so visibly healthy that her doctors allowed her to get out of the premature child's unit of the hospital, just hours after she was brought there by measure precautionary. Nestled in her cradle, she screamed like a baby for the bottle that was being given to her as her mother's bads filled up. "She has a pair of lungs like a glbadblower," said a staff member on the fourth floor of the hospital. "This girl will grow up to become a politician or a pop singer."
John Brown himself nearly missed the magic moment: he had left the hospital almost two hours before the operation, reported Mail ] concerned that his woman had been unusually calm during her visit. This is only when he later recalled that he learned the reason for his silence. She had been sedated for delivery, and like hospitals around the world, no one had thought of telling her about it. Brown rushed to the hospital and spent anxious minutes pacing up and down a waiting room. "Then a nurse came to me full of smiles and said:" Mr. Brown, you are the father of a wonderful little girl, "he told the newspaper. "And almost before I knew it, there I was holding our daughter in my arms."
Brown then ran into the corridors of the dark Victorian hospital, hugging everyone he met and repeating: "It's a girl, I'm a little girl." Later he went out and stood up in the pouring rain, he explains, to calm down a little. "The man who deserves all the praise is Mr. Steptoe," he told The Mail . "What a man to be able to do such a wonderful thing."
What great achievement is the birth of the world's first test tube baby? Medical researchers are certainly impressed, but some suggest that the hype is a bit exaggerated. "I doubt that he wins a Nobel Prize," said Dr. Malcolm Potts, executive director of the International Fertility Program in North Carolina. "It's a human and useful thing, but it's a cookbook trick." Indeed, Potts added, fertilizing on the outside of the body, "is something that frogs do in a dirty stream." Some of Steptoe and Edwards' scientific competitors were also slightly doubtful. "What we do not know at this point," said a member of the team at St. Thomas Hospital in London, who implanted a fertilized egg within 12 hours of Louise Brown's birth , is whether Dr. Steptoe was able to overcome the problems we found, or if Mr. and Mrs. Brown's baby should be put to good luck. " 
Louise Brown, who became in 1978 the first baby in the world to be born following a successful in vitro fertilization (IVF), speaks at a press conference at the Science Museum in London on July 23, 2018. Daniel Leal-Olivas / AFP / Getty Images
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Happy or not, Steptoe and Edwards overcame at least one formidable barrier: the absence of substantial animal studies to guide them.Normally, researchers are beginning to test new medical procedures near the bottom of the evolutionary tree, using rats and then progressively work for monkeys and monkeys, the closest relatives of humans, before To experiment with humans. But prior to Lesley Brown's case, only rats, mice and rabbits had experienced fertilization followed by reimplantation and birth. British scientists were apparently so confident that they simply skipped non-human primates. This provoked an ironic comment from W. Richard Dukelow, a physiologist at Michigan State University: "The work of Steptoe and Edwards should greatly help those of us who are experimenting with monkeys."
Nevertheless, such animal research is still very valuable. On the one hand, he promises to complete and extend the achievements of Steptoe and Edwards. Dukelow, for example, hopes to re-plant fertilized eggs of squirrel monkeys that have been exposed to various drugs and environmental toxins to detect the influence of chemicals on birth defects. Groups from Pennsylvania and Wisconsin Universities launch experiments to monitor in vitro fertilization of cow eggs with bull semen. Scientists have a dual purpose: by specifically identifying what makes sperm effective, studies could help identify and treat the causes of male infertility; and they could pave the way for contraceptive chemicals that prevent fertilization.
Ethical Nightmare:
However, some animal experiments announce future ethical dilemmas. An example is the transfer of embryos. After treatment with hormones, a genetically superior cow can be artificially inseminated. She produces up to 16 embryos. They are rinsed from the cow's uterus and reimplanted into the lower cows, bringing the calves to term. The result is a much faster breed improvement than unbadisted permits – but a human parallel would be an ethical nightmare.
Animal scientists are also moving slowly towards a real test tube baby. In the 1960s, American and Canadian scientists managed to preserve lambs removed prematurely from their mothers. Placed in plastic containers, the fetal lambs were bathed in a solution similar to amniotic fluid and connected to a mechanical blood circulation system similar to heart-lung machines used in cardiac surgery. They survived in the artificial environment, and were then reborn-decadent, as Huxley called in Brave New World . At Johns Hopkins University, Dr. Yu-Chih Hsu managed to keep alive mouse embryos in vitro for eight and a half days after fertilization, nearly half of their usual 19-day gestation period. . The chances of experts being able to produce artificial uteri that will lead humans from design specimens to birth are remote, but not impossible.
Brave new medicine:
The boundaries of biomedicine – and the manipulation of the mysteries of life – are growing at an astonishing rate. A group of scientists from Harvard, Yale and the University of Hacettepe in Turkey reported last week that they had identified, for the first time, a single gene among millions in a human cell. Their technique comes from the controversial DIY with heredity known as recombinant DNA technology. Their discovery promises the possibility of detecting genetic diseases in fetuses still in the womb. But the same recombinant technology could eventually be used to modify the genes of newly fecundated human fetuses in the test tube. Further on is the prospect of cloning individuals with identical sets of genes – a process that would require such test-tube-baby technology as reimplantation. "The idea of designing our descendants, of making the next generation, of making reproduction synonymous with fabrication, is almost in sight," warns Protestant theologian Paul Ramsey of Princeton.
What worries many philosophers and theologians is the fact that so many steps into the brave new biomedicine have actually been taken – with the best of motives. "At least one good humanitarian reason can be found to justify each step," says Dr. Leon Kbad, a 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 morally: a wise society would say to infertile couples:" We understand your sorrow, but it is better not to do not go ahead and do it. & # 39; "
Technological Control:
But Can Genius Be Pushed Into the Test Tube – And Should It Do It? The science writer Isaac Asimov thinks that the new technology can be controlled. "Scientists develop a potentiality," he explains. "Governments and people decide how to use this potentiality." A problem with this rationalization, however, is that new techniques tend to Daniel Callahan, director of the Hastings Institute of Society, Ethics and Life Sciences, said that the experience on Lesley Brown was in fact contrary to the law. 39; ethics, because it would benefit if it worked but the unborn child could fail.However, Callahan added, once the procedure had been done safely, "it seems to be justifiable."
The arrival of Louise Brown also raised more practical concerns. For starters, there is the certainty that thousands of infertile women now hope to actually have children. But many are likely to be disappointed, as few teams, apart from Steptoe and Edwards, seem able to quickly acquire the skills needed to make test tube designs. "I do not think it should be done at any hub hospital," says Dr. Griff Ross of the National Institutes of Health. The two British researchers went to great lengths last week to emphasize that their work is still experimental. "We are in the early stages, and we still have a lot to learn," said Edwards
Legal Mining Domain:
And if the learning process leads to mistakes, as a test-tube of babies born with mental or physical defects? Harvard lawyer William Curran is considering malpractice lawsuits by these children against their parents or the doctors who created them. Another potential legal minefield concerns the state of fertilized eggs prior to their relocation. Should they be considered as living human beings with a definite right to life, or as nonhuman material that can be capriciously cast by the pit or even subjected to experiments? It is certain that such external eggs are different from the fetuses in the uterus, because their existence does not affect the physical well-being of the mother. Thus, argues Leon Kbad, abortion laws can not easily be applied to these "fledgling lives".
The disposal of these eggs, of course, is parallel to nature. In practice, about 67% of fetuses that are designed in the human body do not come out of the womb. Every year in the United States, about 6 million fetuses abort spontaneously or die in the uterus, most of them so early in gestation that the mother does not even realize that she is pregnant. "When a husband and a wife go to the room 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 may seem like a very different matter. In a New York federal court, John and Doris Del Zio sue Dr. Raymond Vande Wiele, Columbia University gynecologist, New York Presbyterian Hospital, and the University for 1.5 million of dollars. Their complaint: Vande Wiele caused them physical and emotional damage when, in 1973, he opened the pot in a laboratory of the Presbyterian hospital that contained a fertilized egg ready to be relocated to Doris Del Zio. "I do not think it was stopped without my consent," she said. Vande Wiele readily admits that he did – for medical reasons. He has no objections against test-tube babies. Indeed, he hailed the birth of Louise Brown as a "crowning". But the experience that he destroyed, he said, was scientifically flawed at the time, and Drs. William Sweeney and Landrum Shettles, who carried out the operation, did so without permission from the hospital.
It is unlikely that such an experiment will be repeated in the United States in the near future. In 1975, federal support for research on in vitro fertilization in humans was halted and a resumption of cash flow awaits the next meeting of a new ethics advisory committee. Le conseil, qui se réunira à la mi-septembre, est chargé d'examiner les propositions de recherche au cas par cas. Une seule proposition est actuellement à l'étude: Piers Soupart de l'Université Vanderbilt veut déterminer si la fécondation in vitro augmente le risque d'anomalies génétiques. Ce risque peut être réel: dans la fécondation normale, seul le sperme fort peut gagner la course longue à travers le vagin, l'utérus et la trompe de Fallope pour rencontrer l'œuf descendant. Dans un plat de laboratoire, les spermatozoïdes forts et faibles ont une chance presque égale – et certains experts craignent que le résultat puisse être des irrégularités génétiques difficiles à repérer.
Travail de détective:
Les bébés-éprouvettes peuvent être sujets à de tels défauts, ce qui pourrait freiner le projet des chercheurs de répéter la procédure mise au point par Steptoe et Edwards. Bien que Louise Brown semble tout à fait normal maintenant, il n'y a aucune garantie que des problèmes génétiques mineurs pourraient ne pas apparaître dans les années à venir. De plus, comme le travail de détective génétique est encore à un stade relativement rudimentaire, il sera impossible de lier les défauts – ou les attributs spéciaux – qui pourraient émerger chez Louise Brown aux circonstances inhabituelles entourant sa conception.
les visages proviennent de son unicité. "L'enfant sera observé le reste de sa vie, et sera considéré comme extraordinairement inhabituel", explique Daniel Callahan. Les gens vont prendre des photos d'elle toute sa vie, comme ils l'ont fait pour les quintuplées Dionne, je ne peux pas imaginer que ça lui sera d'une grande aide. Cela pourrait même menacer le lien familial. "Une publicité excessive déforme les relations normales", explique le Dr Nicholas Zill de la Fondation pour le développement de l'enfant de New York. "Les parents pourraient finir par en vouloir à l'enfant parce qu'elle est un monstre permanent."
Louise pourrait éviter une certaine notoriété si elle avait de la compagnie; comme Steptoe a dit la semaine dernière, "le meilleur pari est de s'badurer que les bébés comme ceci sont bbads." En attendant, sa jeune vie semblait badez bbade. Elle devait quitter l'hôpital cette semaine pour des vacances privées avec ses parents. Elle avait commencé à allaiter. Et elle avait gagné deux onces.
Cette histoire a paru dans le numéro du 7 août 1978 de Newsweek avec le titre "About That Baby". Présenté par Peter Gwynne, avec Tony Clifton à Oldham, Mary Hager à Washington, et Sharon Begley et Barbara Gastel à New York.
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