When Louise Brown was born in 1978, the event caused outrage among religious fundamentalists and the media. 5 million test-tube babies later, one of medicine’s greatest breakthroughs has revolutionised the very concept of human fertility.

While it is an established practice now, the idea of in vitro fertilisation was seen as fanciful as early as 1960

25 July 2018 will mark the 40th birthday of Louise Brown, the first of the more than five million human beings conceived through in-vitro fertilisation (IVF) worldwide. While some sources claim that IVF research dates back as far as the 1800s, the generally recognised commencement point of human IVF starts with British developmental biologist, Dr Robert Edwards of Cambridge University.

Dr Edwards started exploring human IVF as a way to treat infertility in 1960. In 1965, after successfully overcoming the problem of making mammalian oocytes mature in vitro, he started experimenting with fertilising matured eggs in vitro. Four years later, he and his team managed to fertilise a human egg in vitro, widely considered one of the greatest achievements in modern medical history.

Later, he started collaborating with gynaecologist and surgeon Dr Patrick Christopher Steptoe to study sperm capacitation. While Edwards and Steptoe conducted experiments to fertilise human oocytes in vitro with spermatozoa retrieved from fallopian tubes, Dr Edwards’ PhD student, Barry Bavister developed a culture medium that allowed him to accomplish in vitro fertilisation of hamster eggs.

Impressed by Bavister’s results, Dr Edwards tried the medium in his human invitro fertilisation studies. Using Bavister’s medium, he cultured ova obtained from twelve women for about 40 hours, letting the ova mature in vitro, before inseminating the culture with washed spermatozoa. Thirteen hours after insemination, Dr Edwards found that of the 34 human eggs that matured in vitro, 18 displayed significant signs of fertilisation.

In 1969 Edwards, Steptoe and Bavister published the results of their study in the journal, Nature. Their paper entitled Early Stages of Fertilization in vitro of Human Oocytes Matured in vitro received mixed reaction. While the science community hailed their work as groundbreaking, they were condemned by religious institutions who accused them of ‘playing God’ and being ‘morally wrong’.

The media also roundly condemned the researchers. The Times published an article suggesting that a ‘test tube time-bomb might explode into new forms of eugenics, human cloning, and many other social and ethical catastrophes’.

While the ethics of their work was being dissected, Edwards and Steptoe focused on yet another scientific and medical problem that emerged from their research. Although oocytes matured in vitro could be fertilised, they found that the resulting embryos had a tendency to behave abnormally and die during early cleavage.

They realised that for IVF to be clinically useful, it would be necessary to retrieve mature eggs from women directly, without letting the ova go through maturation in vitro. They devised a strategy to retrieve mature eggs from humans and fertilise them in vitro, moving from their research phase to testing their strategies in clinical settings with patients struggling with infertility.

They succeeded and their work culminated in the birth of Louise Brown by caesarean section shortly before midnight on 25 July 1978 at Oldham General Hospital in England. Her birth caused a media frenzy worldwide.

In an interview with The Telegraph newspaper last year, Louise recounted how her parents, Lesley and John, were targeted by members of the public and religious leaders who launched a bitter hate campaign against the young family. Some even referred to her and her sister, Natalie, also conceived through IVF, as ‘Frankenbabies’.

In her autobiography she revealed that her family received post-bags full of mail, including one package containing letters covered in red liquid, a broken glass test tube and a plastic foetus, accompanied by menacing notes. But as time went by, she added, many of these hateful and condemning notes were replaced by fan mail from women around the world who couldn’t conceive and for whom she represented renewed hope.

In another interview, Louise, now a mother of two conceived naturally, said it had taken her decades to feel entirely comfortable in her role of being famous by birth. “When I was younger it played on my mind that everyone knew my name. But now, I like raising awareness and really enjoy meeting people who have been helped, indirectly, by Drs Edwards and Steptoe.”