By Timur Abimanyu, SH.

MH

Robert Edward wins 2010 Nobel prize in

medicine for in-vitro fertizilation

By Rob Stein, Washington Post Staff Writer, Monday, October 4, 2010; 11:08 PM

Robert G. Edwards's breakthrough development of in vitro fertilization, which led to the

birth of the first "test-tube baby," Louise Brown, in 1978, gave humanity the power to do
what previously was considered the province of God: create and manipulate human life.

In the ensuing decades, the pioneering techniques that won the British biologist a Nobel
Prize on Monday have played a part in controversial scientific advances such as cloning and
the creation of human embryonic stem cells while redefining fundamental social roles such
as what it means to be a parent or a family.

"The impact on society has been profound," said Lori B. Andrews of the Chicago-Kent
College of Law, who studies reproductive technologies. "The creation of a child outside the
body for the first time has had scientific and personal implications far, far beyond the 4
million children who have been born through in vitro fertilization."

IVF has been crucial for human embryonic stem cell research because the cells are obtained
from embryos left over at infertility clinics. At the same time, the techniques helped lay the
groundwork for the 1996 cloning of Dolly the sheep, a procedure that could eventually be
tried in humans.
"In exploring the fundamental mechanisms of how human reproduction actually works,
Edwards unleashed a social, ethical and cultural tsunami that he could not have predicted
and I don't think anyone at the time could have anticipated," said Arthur Caplan, a
University of Pennsylvania bioethicist. "It opened so many doors that I'm not sure we even
fully appreciate it today."

Edwards, who began his work in the 1950s and persevered with gynecologist Patrick
Steptoe despite fears it would produce monstrously deformed babies and other problems,
was motivated primarily by the desire to help infertile couples. Although the procedure
remains controversial and is opposed by the Roman Catholic Church and others, it has
become widely accepted.

"His achievements have made it possible to treat infertility, a medical condition affecting a
large proportion of humanity," the Nobel Assembly at the Karolinska Institute in Sweden
said in announcing the $1.5 million prize. "Today, IVF is an established therapy throughout
the world."

The procedure involves taking an egg from a woman's ovaries, fertilizing it in a petri dish in
the laboratory with sperm and placing the fertilized egg into a woman's womb to develop
naturally. It is used to treat a host of fertility problems, including cases in which a woman's
fallopian tubes are blocked, preventing the egg from being fertilized normally.

Edwards, now 85 and a professor emeritus at the University of Cambridge, was too ill to
give interviews about the award. In a statement released by Bourn Hall, the infertility clinic
he founded, Edwards's wife, Ruth, said: "The family are thrilled and delighted. . . . The
success of this research has touched the lives of millions of people worldwide. His
dedication and single minded determination despite opposition from many quarters . . . has
led to successful application of his pioneering research."

But IVF has forced society to reconsider many assumptions. Using IVF, a child today can
have one "mother" who donated her genes, another who donated her womb and another who
raised him or her, for example. Family members have supplied eggs, sperm and wombs to
relatives, scrambling traditional relationships. The procedure has also helped fuel the debate
over gay rights by enabling same-sex couples to have genetically related children.
"The implications are just staggering," Caplan said. "Even some of the arguments about gay
marriage spin out from the fact that IVF lets gay people have children."

The procedure also furthered the trend that started with the birth control pill by giving
women greater control over their reproductive lives, leading more to delay childbearing to
pursue education and careers.

"In the 20th century, you could argue the two developments that shaped human behavior
were the birth control pill and IVF," Caplan said.

At the same time, because women are paid to donate their eggs or offer their wombs to
become surrogate mothers, worries have arisen that the pricey procedure has turned
reproduction into a commodity.

"It has led to some concerns about the commercialization - making childbearing into a
business," Andrews said. "You have couples creating embryos in the U.S. and implanting
them in women in the Third World, for example."

The law has also had difficulty keeping up with the technology, resulting, for instance, in
legal battles over the custody of embryos.

"This has led to reconsideration of men's role in reproduction," Andrews said. "Prior to this,
all the choices had to do with women. But now that the embryo is outside of her body, you
have to rethink what reproductive liberty means. Courts are moving toward giving men
more rights."

Because infertility clinics are largely unregulated in the United States, critics say many often
push ethical boundaries. For example, some enable couples to choose the sex of their
children.

"I would argue that IVF technology opened a door to a kind of control over human lives.
Upon reflection now three decades later, I think we're seeing the very dark consequences of
this," said the Rev. Thomas Berg, director of the Westchester Institute for Ethics and the
Human Person, a Catholic bioethics think tank. "I think we're seeing the very questionable
moral directions that this technology is taking us."
Another widely used procedure, known as pre-implantation genetic diagnosis, enables
doctors to test embryos for specific genes. The process is used primarily to spot devastating
genetic disorders, increasing the chances that couples will give birth to healthy babies. But
combined with the constant flow of discoveries of new genes, the procedure has led to
concern about "designer babies," in which couples might try to choose a host of traits,
including eye color, hair color, height and intelligence.

"In the 20th century, I would argue the biggest debate in America in terms of reproduction
has been abortion," Caplan said. "I believe in the 21st century, Edwards's discoveries will
make the issue of designing our descendants - that is, trying to create children who are
stronger, faster, live longer, that sort of thing - that's going to become the biggest issue in the
first half of the 21st century."

For her part, Brown, now 32, a mother of a son she conceived naturally, welcomed
Edwards's victory. "It's fantastic news," she said in a statement released by Bourn Hall. "Me
and mum are so glad that one of the pioneers of IVF has been given the recognition he
deserves."

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