Howard Wilber Jones Jr. and his wife, Georgeanna Seegar Jones, developed a method of in vitro fertilization and helped create the first baby in the US using that method. Though the first in vitro baby was born in England in 1978, Jones and his wife's contribution allowed for the birth of Elizabeth Carr on 28 December 1981. Jones, a gynecologist and an obstetrician, researched human reproduction for most of his life.
Transvaginal ultrasound-guided oocyte retrieval, also known as egg retrieval, is a surgical technique used by medical professionals to extract mature eggs directly from the women’s ovaries under the guidance of ultrasound imaging. In 1982, physicians Suzan Lenz and Jorgen Lauritsen at the University of Copenhagen in Copenhagen, Denmark, proposed the technology to improve the egg collection aspect of in vitro fertilization, or IVF. During IVF, a healthcare practitioner must remove mature eggs from a woman’s ovaries to fertilize them with sperm outside of the body. Transvaginal ultrasound-guided egg retrieval is a surgery that can be completed in a medical office setting in twenty minutes. Transvaginal ultrasound-guided egg retrieval increased mature egg collection and rates of successful fertilization, becoming the new standard for egg collection in IVF.
Edwin Carlyle Wood, also known as Carl Wood, was a physician who helped develop in vitro fertilization, or IVF, treatments. From 1964 to 1992, Wood worked as a professor of obstetrics and gynecology at Monash University in Melbourne, Australia, where he was one of the first in the world to lead a team of physicians to establish IVF as a proven treatment for infertility. IVF refers to a medical procedure in which scientists inseminate an egg cell with a sperm cell outside of the body, such as in a glass dish in a clinical setting. Wood helped establish some of the first successful IVF pregnancies and births, and his findings throughout his years of practice helped to standardize the procedure. Wood also advocated for the right for women to have an abortion, and co-founded the Family Planning Association of Victoria in Australia at a time when there were not many abortion clinics in operation. Through his early contributions to IVF, Wood provided new options for people to have offspring, which as of 2021, has up to a 21.3 percent chance of producing a live birth.
On 29 September 1973, researchers David De Kretzer, Peter Dennis, Bryan Hudson, John Leeton, Alexander Lopata, Ken Outch, James Talbot, and Carl Wood published “Transfer of a Human Zygote,” in The Lancet. In the article, the authors describe an experiment that resulted in one of the first pregnancies established via in vitro fertilization, or IVF. Prior to the article’s publication in 1973, there was no published evidence demonstrating whether IVF treatment would work in humans, although evidence existed showing that IVF worked in other mammals for breeding purposes. At the end of the article, the authors state that the embryo failed to implant into the wall of the patient’s uterus, leading to a miscarriage less than a week after the authors found evidence of pregnancy in the patient. The authors of “Transfer of a Human Zygote” were some of the first researchers to perform IVF, although unsuccessfully, which contributed to the overall understanding of IVF as an emerging technology.
In June 2015, the Ethics Committee of the American Society for Reproductive Medicine, or ASRM, published “Use of reproductive technology for sex selection for nonmedical reasons” in Fertility and Sterility. In the report, the Committee presents arguments for and against the use of reproductive technology for sex selection for any reason besides avoiding sex-linked disorders, or genetic disorders that only affect a particular sex. When couples have no family history of a sex-linked disease, the use of reproductive technology for sex selection raises ethical questions about the application of sex selection technology to fulfill parental desires. “Use of reproductive technology for sex selection for nonmedical purposes” examines the ethical debate surrounding sex selection for nonmedical purposes and is an educational and ethical reference for physicians who are considering offering those services in their practices.
In the early 2000s, Richard S. Legro, Mark V. Sauer, Gilbert L. Mottla, Kevin S. Richter, William C. Dodson, and Duanping Liao studied the relationship between air pollution and reproductive complications. In the United States, Legro’s team tracked thousands of women undergoing in vitro fertilization, or IVF, along with the air quality of both the IVF clinics and patients’ home locations. IVF is a reproductive technology during which a physician obtains mature eggs from a patient’s ovaries and fertilizes them with sperm in a lab setting outside of the body, after which the physician transfers the fertilized eggs into the patient’s uterus. As stated in Legro’s publication, Legro suspected that poor air quality would adversely affect live birth rates during IVF, so he compiled and analyzed the various types of pollutants that IVF patients were naturally exposed to in their homes and clinics. Legro’s experiment led to an increased awareness among patients about the dangers of conceiving via IVF in highly polluted areas.
Jeffrey Keenan is the Director of the Southeastern Center for Fertility and Reproductive Medicine and the main developer behind the National Embryo Donation Center (NEDC) in Knoxville, Tennessee. This non-profit organization focuses on embryo donation and embryo adoption.
Established under the Assisted Human Reproduction (AHR) Act of 2004, Assisted Human Reproduction Canada (AHRC), also known as the Assisted Human Reproduction Agency of Canada, was created in 2006 to oversee research related to reproductive technologies and to protect the reproductive rights and interests of Canadian citizens. AHRC serves as a regulatory body for the development and use of such research and technology while enforcing the guidelines and restrictions laid out by the AHR Act.
Assisted reproductive technologies (ART) are a collection of different techniques designed to help those who are infertile achieve a successful pregnancy. The most popular technology currently in use is in vitro fertilization (IVF), but others include gamete intrafallopian transfer (GIFT), zygote intrafallopian transfer (ZIFT), intrauterine insemination (IUI), and intracytoplasmic sperm injection (ICSI). Although not encompassed under the umbrella term of ART, there are also various hormonal medications that can induce ovulation such as clomiphene citrate that can either be used alone to help women conceive, or used in conjunction with the above techniques. Infertility is a problem that has affected people throughout history, but it was only in the last half of the twentieth century that medical research developed technologies to help those who are infertile become pregnant.
Ovarian hyperstimulation syndrome, abbreviated OHSS, is an atypical reaction that women may experience in response to excessive hormones, and often occurs during fertility treatments. OHSS is typically triggered by hormonal medications designed to mature eggs in the ovaries, which can cause blood vessels within the ovaries to leak fluid. Sometimes that can lead to painful tenderness or swelling. In severe cases of OHSS, that fluid can leak into the abdominal cavity in large amounts, causing vomiting, blood clots, and severe pain. As many as one out of three women undergoing fertility treatment will experience some form of OHSS, although more severe presentations are rare. While the exact cause of OHSS is not fully understood as of 2020, researchers continue to discover various risk factors, prevention techniques, and treatments that may lead to decreased risks associated with OHSS and better fertility outcomes.