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Some "Firsts" in the history of fertility treatments

Assisted reproductive technology goes a long way back, in fact all the way to Biblical times in the story of Sarah and Abraham. Modern fertility treatments however are slowly gaining momentum as new sophisticated techniques and procedures get introduced more frequently. With the undue stigmas associated with infertility, it's also important to realize that new strides are being made also helped by the fact that the conversation has now become more mainstream. What had historically been a somewhat taboo topic is now being finally recognized as a health problem and not just a "women's issue". However, we're still not quite there yet as fertility treatments still lack insurance coverage making them a hefty treatment option.



Most fertility treatments actually date back decades ago which makes one think why we're still rallying for them to be acknowledged as a legitimate health issue and not a luxury.


The First Sperm Donation

The first successful artificial insemination of a woman was recorded in 1790. John Hunter, a brilliant Scottish surgeon known for pioneering research into venereal diseases, child development and the lymphatic system, among many other things. reported that he had successfully inseminated the wife of a linen draper, using her husband's sperm. The first artificial insemination in a medical institution however, took place roughly a hundred years later at the Jefferson Medical College in Philadelphia by Dr. William Pancoast. Even then the practice was believed to be so scandalous that even the woman being inseminated wasn't told about the procedure. The sperm was donated by a medical student of Pancoast's, voted with consensus as the most "good-looking" of the entire class.

The First Egg Donation

The first pregnancy resulting from an egg donation was reported in Australia in 1983. That same year, the first successful egg donation transfer was also completed in the US in Southern California resulting in a successful live birth. Egg donation was meant to be an alternative to sperm donation and also for women who were scared of passing down certain genetic disorders to their offspring. It also proved to be a boon for same sex couples who had little options for family building prior to this breakthrough. They now had a chance at having their own biological kids.


The Gestational Surrogacy

The first recorded case of gestational surrogacy took place in 1986 where a woman acted as the surrogate mother for the intended mother whose fallopian tubes had been damaged due to disease. As such, the surrogate mother was genetically unrelated to the baby paving the way for a future promising endless possibilities for infertile couples. However, a year later, in 1986, the infamous case of "Baby M" temporarily set gestational surrogacy back when a surrogate mother refused to give up the baby after birth as her own egg was used for the procedure. The surrogate and the intended parents got embroiled in a lengthy custody battle however, eventually the father who was the biological parent of the child was awarded legal custody. It is because of this incident that more and more surrogacy consultancies and professionals started moving exclusively toward gestational surrogacies to avoid these legal complications.



The First IVF

The recipient of the 2010 Nobel Prize in Medicine, Sir Robert Edwards was the pioneering physiologist behind the medical miracle known as in vitro fertilization. Today IVF is the single most important and frequently used fertility treatment. It all started in the July of 1978 when Leslie Brown gave birth to daughter Louise Joy Brown via IVF. Dr. Robert Edwards and Dr. Patrick Steptoe announced the first successful IVF pregnancy. This was the first live recorded birth after over 102 IVF attempts.


The First PGD

Preimplantation Genetic Testing is a set of techniques used to identify genetic mutations or defects in embryos created via IVF before the pregnancy. Preimplantation Genetic Diagnosis or PGD refers specifically to when one or both parents have a known genetic abnormality and testing is performed on the embryo to check if it is carrying on the genetic abnormality. Preimplantation Genetic Screening or PGS however, refers to when preimplantation genetic testing is carried out on the embryos of parents with no apparent genetic abnormality and screened for aneuploidy. PGD was pioneered by American embryologist and geneticist Alan Handyside in 1989 who used the technique to check the presence of gene defects causing Cystic Fibrosis. She conducted biopsies on IVF embryos, removing 1-2 cells from each, three days after fertilization. One of the women volunteering for the trial had the normal, cystic fibrosis free embryo transferred to her and went on to have an uneventful, healthy pregnancy. Her daughter was born perfectly normal and free of cystic fibrosis even though her mother was a carrier. This breakthrough trial proved that single gene diseases can be thus identified and prevented prior to implantation, an incredibly significant milestone for families struggling with genetic pre-conditions.



References

  1. https://www.britannica.com/science/preimplantation-genetic-diagnosis

  2. https://livio.se/en/research/history-ivf-brief/

  3. https://en.wikipedia.org/wiki/Robert_Edwards_(physiologist)

  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6262674/#:~:text=1985%20%E2%80%93%20A%20woman%20carried%20the,she%20made%20the%20surrogacy%20agreement.

  5. https://embryo.asu.edu/pages/intrauterine-insemination#:~:text=IUI%20has%20a%20long%20history,used%20it%20to%20breed%20stallions.&text=In%20London%20in%201793%2C%20John,successful%20human%20pregnancy%20using%20IUI.


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