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      The Oldham Notebooks: an analysis of the development of IVF 1969–1978. V. The role of Jean Purdy reassessed

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          Abstract

          The role of Jean Purdy in the work leading to the birth of Louise Brown is assessed. We report that Purdy: (i) recorded and organized most of the data systematically; (ii) probably spent longer working in Oldham than did Edwards; (iii) whilst there, was primarily responsible for organizing laboratory supplies, including media preparation and testing; (iv) was involved in patient care; and (v) was a major source of support to Edwards. We find that Purdy, despite her nursing qualification, was not involved in laparoscopic egg retrieval and clinical aspects, but was focused on basic research activities. The evidence on who was present at embryo transfers is less clear, but suggests that Edwards was present for all, whereas Purdy may have been absent for some. Overall, we conclude that Purdy’s role was a highly significant and under-appreciated element in the achievement of IVF in Oldham.

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          Establishing full-term human pregnancies using cleaving embryos grown in vitro.

          The establishment of human pregnancies by the use of fertilization in vitro and placing cleaving embryos into the uterus is described. Preovulatory oocytes were aspirated at laparoscopy from the ovaries of patients soon after the beginning of the mid-cycle surge of luteinizing hormone (LH) during the natural cycle. The LH surge was identified by assaying 3-hourly samples of urine, and measurements of oestrogens in 24-hour samples were used to assess follicular growth. The surge of LH was identified in 68 patients and it showed a diurnal rhythm. Preovulatory oocytes were aspirated from most of the patients. Fertilization and cleavage occurred in 34 instances, and 32 embryos were put into the mother via the cervical canal. Four patients became pregnant. There were indications that a diurnal rhythm played a role in establishing cleaving embryos, each of the four pregnancies occurring when the embryos were placed in late evening. Each of the pregnancies resulted from oocytes which were aspirated from their follicles 24 hours or longer after the LH surge began. Details are given of three abortive pregnancies in patients given gonadotrophins to stimulate the maturation of of oocytes used for fertilization in vitro.
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            Follicular fluid.

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              Robert Edwards: the path to IVF☆

              The early influences on Robert Edwards’ approach to the scientific research that led to human IVF are described. His interest as a graduate student in the genetics of early mammalian development stimulated him later to investigate whether the origins of human genetic diseases such as Down, Klinefelter and Turner syndromes might be explained by events during egg maturation. This clinical problem provided the most powerful stimulus to achieve both oocyte maturation and fertilization in vitro in humans. Indeed, preimplantation genetic diagnosis was his main goal until he met Patrick Steptoe in 1968. A re-evaluation of his meeting with Steptoe suggests that initially Steptoe’s laparoscopic skill was of interest for its potential to solve the sperm capacitation problem. Steptoe’s impact on Edwards was twofold. First, Steptoe’s long-held interest in infertility raised this application of IVF higher in Edwards’ priorities. Second, Steptoe offered a long-term partnership, in which oocyte collection without in-vitro maturation was a possibility. The professional criticism generated by their work together encouraged Edwards to pursue a deliberate programme of public education about the issues raised and to challenge and develop professional bioethical thought and discourse about reproduction. The early life and career of Robert Edwards are described and re-evaluated in the light of documentary evidence. His early interest in the genetics of development provided the major motivation behind his goal of achieving IVF in humans. Through this work, he aimed to understand and hopefully to reduce the transmission of genetic disease in humans. His meeting with Patrick Steptoe, the details of which are re-examined, increased the significance for Edwards of infertility as an outcome of IVF. It also led to a creative long-term research partnership, initiated a long-term programme of public education in the UK about reproductive science and stimulated the development of bioethical thinking.
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                Author and article information

                Contributors
                Journal
                Reprod Biomed Soc Online
                Reprod Biomed Soc Online
                Reproductive Biomedicine & Society Online
                Elsevier Ltd
                2405-6618
                1 June 2015
                June 2015
                : 1
                : 1
                : 46-57
                Affiliations
                [a ]Anatomy School and Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, Downing Street, Cambridge CB2 3DY, UK
                [b ]Bourn Hall Clinic, Bourn, Cambridge CB23 2TN
                Author notes
                [* ]Corresponding author. mhj21@ 123456cam.ac.uk
                Article
                S2405-6618(15)00006-4
                10.1016/j.rbms.2015.04.005
                5341260
                dbc1ba1a-a54c-4088-8e25-5fe366b2c386
                © 2015 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 8 April 2015
                : 23 April 2015
                Categories
                Symposium: The History of the First Ivf Births

                edwards and steptoe,ivf,louise brown, oldham,purdy
                edwards and steptoe, ivf, louise brown, oldham, purdy

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