John Rock was the first to extract an intact fertilised egg. The first pregnancy achieved through in vitro human fertilisation of a human oocyte was reported in The Lancet from the Monash team in 1973, although it lasted only a few days and would today be called a biochemical pregnancy. In 1977, Patrick Steptoe and Robert Edwards successfully carried out a pioneering conception which resulted in the birth of the world’s first baby to be conceived by IVF, Louise Brown on 25 July 1978, in Oldham General Hospital, Greater Manchester, England followed by Courtney Cross on 16 October 1978 and Alastair MacDonald on 14 January 1979. This was then followed by the birth of Candice Reed in Melbourne in 1980. It was the subsequent use of stimulated cycles with clomiphene citrate and the use of human chorionic gonadotrophin (hCG) to control and time oocyte maturation, thus controlling the time of collection, that converted IVF from a research tool to a clinical treatment.

This was followed by a total of 14 pregnancies resulting in nine births in 1981 with the Monash university team. The Jones team at the Eastern Virginia Medical School in Norfolk, Virginia, further improved stimulated cycles by incorporating the use of a follicle-stimulating hormone (uHMG). This then became known as controlled ovarian hyperstimulation (COH). Another step forward was the use of gonadotrophin-releasing hormone agonists (GnRHA), thus decreasing the need for monitoring by preventing premature ovulation, and more recently gonadotrophin-releasing hormone antagonists (GnRH Ant), which have a similar function. The additional use of the oral contraceptive pill has allowed the scheduling of IVF cycles, which has made the treatment far more convenient for both staff and patients.

The ability to freeze and subsequently thaw and transfer embryos has significantly improved the feasibility of IVF use. The other very significant milestone in IVF was the development of the intracytoplasmic sperm injection (ICSI) of single sperms by Andre van Steirtegham in Brussels, 1992. This has enabled men with minimal sperm production to achieve pregnancies. ICSI is sometimes used in conjunction with sperm recovery, using a testicular fine needle or open testicular biopsy. Using this method, some men with Klinefelter’s syndrome, and so would be otherwise infertile, have occasionally been able to achieve pregnancy. Thus, IVF has become the final solution for most fertility problems, moving from tubal disease to male factor, idiopathic subfertility, endometriosis, advanced maternal age, and anovulation not responding to ovulation induction.

Carl Wood was dubbed “the father of IVF (in vitro fertilisation)” for having pioneered the use of frozen embryos.

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