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Facts of life: Celebrating Manchester’s role in the birth of 8 million IVF babies

25th July 2018

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Forty years after the birth of the first ever baby to be born through In Vitro Fertilisation (IVF), Greater Manchester remains at the forefront of fertility research and training.

Conceived in a petri dish at Dr Kershaw’s Cottage Hospital in Royton, near Oldham, Louise Brown became celebrated by the media as the miracle “test tube” baby, giving hope to millions of childless couples around the world.

Louise was born in Oldham General Hospital, Greater Manchester, at 11.47pm on July 25, 1978, the culmination of 12 years of pioneering collaborative research by Dr Patrick Steptoe, Dr Robert Edwards and Jean Purdy, who was initially employed as a laboratory assistant.

Dr Edwards, a Cambridge-based reproductive physiologist and experimental embryologist, had turned his research in animal reproductive physiology towards tackling infertility in women.

A barrier to progress was that IVF embryos could not progress beyond the two-cell stage, and so Edwards proposed retrieving them from the ovary just before ovulation.

Patrick Steptoe was busy developing the new technique of laparoscopy – procedures performed using a thin medical instrument known as a laparoscope.

The two scientists joined forces in 1966, then perfected a technique for removing an egg from a woman’s ovaries, fertilising it with sperm in a laboratory, and then returning the fertilised egg – the embryo – to the womb to develop.

In November 1977, Purdy became the first person to witness the successful cell division of the embryo in a petri dish that would become Louise Brown nine months later.

It is now estimated that more than eight million babies have been born through In Vitro Fertilisation and other advanced fertility treatments.

Following Louise Brown’s birth, the world’s first IVF clinic – Bourn Hall – was opened in Cambridge in 1970. Professor Edwards received the Nobel Prize in Physiology and Medicine in 2010. The same honour was not bestowed on Dr Steptoe because he had passed away and the Nobel Prize is not awarded posthumously.

But Greater Manchester remains a hugely significant centre for research and training in the fields of embryology, fertility and andrology, which relates to the health of the sperm.

Since, 2013, every new reproductive scientist trained in the UK to help start pregnancy through IVF treatment has been taught at Manchester Metropolitan University, an official NHS partner and the only centre for teaching clinical cellular scientists, who learn on the job while studying for an NHS-accredited master’s degree.

All reproductive scientists are trained through the official cellular scientists’ programme and the trainees must pass the three-year Scientist Training Programme (STP) to earn their final MSc. This means that the next generation of IVF-nurtured babies – 1 in 50 births in the country – will have been facilitated by a University-trained clinical embryologist.

Dr Michael Carroll, Senior Lecturer in Reproductive Science at the University, leads the programme and works closely with St Mary’s Hospital Department of Reproductive Medicine, part of Manchester University Foundation Trust.

“There is a massive requirement for these trainees to fulfil the workloads at clinics around the country,” Dr Carroll says. “The number of IVF cycles needed increases every year, with around 70,000 cycles currently taking place.

“You can go from an entry-level job in the NHS right up to consultant grade through Manchester Metropolitan training. We are the only place that delivers science training for the whole reproductive science pathway.

“The delivery of the MSc is helped by scientists from all over the country as guest lecturers, which exposes the trainees to a wide variety of speakers and potential employers.”

The programme recently expanded to include andrology – male fertility science – as well as embryology, an important, yet underdeveloped, area for focus with male sperm counts across the world dropping 50% over the last 40 years.

Dr Carroll adds: “How does Greater Manchester have an impact nationally and internationally in IVF? We’re the leaders in the UK and the world in IVF clinical embryology training. There is a very strict and stringent training programme through the NHS, partnered with the University.

“The region is a pioneer in IVF: Dr Patrick Steptoe, Sir Robert Edwards and Jean Purdy led the way, here in Greater Manchester.

“They were the first IVF scientists, the first clinic was set up in Cambridge and the IVF work carried out in Oldham.

“Now, the first national training scheme has been set up and the masters degree part of it is delivered from Greater Manchester – where Louise Brown was born 40 years ago.”

Professor Daniel Brison, clinical lead for the MSc and Scientific Director in the Department of Reproductive Medicine at St Mary’s Hospital in Manchester, says that IVF has changed the world, thanks to Greater Manchester’s contribution.

 “The first NHS-funded IVF service was also established in 1983 at St Mary’s Hospital here in Manchester. It is acknowledged as one of the best places to receive IVF.

“People working here are conscious that they are part of that long tradition of IVF research in the region,” Dr Brison adds.

Fertility treatment and embryology research has led to other advances in Greater Manchester.

Scientists in Greater Manchester have been licensed to conduct embryo research since the 1990s, enabling them to better understand the way that embryos develop and supporting the long-term health of IVF babies.

That research has supported increasing success rates for IVF, which now stands at around 30 per cent.

The goal for ongoing research is to ensure that IVF treatments achieve higher levels of success and become less invasive.

Potential advances being explored in Manchester include the use of nanotechnologies to better direct sperm – tiny metal collars could one day soon enable clinicians to use magnetic forces and joy sticks to “drive” them towards target eggs.

The North West Embryonic Stem Cell Centre at The University of Manchester is conducting pioneering research into wound healing and tissue regeneration.

Embryonic stem cells not suitable for IVF procedures are being used to grow stem cell lines that could be used to treat osteoporosis and blindness, or repair the spinal cord, for instance.

Professor John Aplin, from the University of Manchester, said: “Greater Manchester has played a hugely important role in the history of IVF, going back to Walter Heape, who first carried out embryo transfer in rabbits at his home in Prestwich in 1890.

“But IVF has also given birth to the field of human embryonic stem cell biology and has led to major advances in reproductive biology.  Ground breaking research in Manchester on human embryo development and implantation has continued to contribute to the advancement of IVF science.”

The anniversary of Brown’s birth is being marked with a two-day symposium hosted by the Society for Reproduction and Fertility at the Manchester Royal Infirmary and the Manchester Conference Centre.

On the evening of 24th July, Professor Roger Gosden, one of the pre-eminent scientists in the field, delivered an open lecture entitled Let There Be Life: An intimate portrait of the birth of IVF in Manchester.

On the 25th July, Manchester Conference Centre is hosting a scientific symposium entitled ‘Edwards, Steptoe… and Dr Kershaw: an SRF symposium to mark the 40th anniversary of IVF’.

Topics range from basic science at the edge of application, through clinical techniques to ethics and future regulation of this complex and exciting field.

Reflecting the diverse and complex nature of the programme, the event is hosted the Society of Reproduction and Fertility, with the support of the British Fertility Society, Association of Clinical Embryologists, Association of Biomedical Andrologists.

Interviewed about the anniversary by The Independent, Brown said: “Sadly, the pioneers – my mum and dad, Patrick Steptoe, Robert Edwards and let’s not forget their amazing assistant Jean Purdy, who stayed up all night to watch the cells that became me divide in a petri dish – have all passed away.

“Certainly, my mum would never have imagined what my birth would lead to.

“Forty years on, other scientists are pushing the boundaries, embryologists are inventing new techniques and moral questions are still being raised.

“I’ve seen IVF grow from just me in a small room in Oldham with my mum and dad, to a world-changing procedure.”

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