On 25th July, 1978 Louise Brown, the first in vitro fertilization baby was born thanks to privately funded research carried out by the Cambridge (UK) physiologist Robert Edwards and the Oldham (UK) gynecologist Patrick Steptoe. The whole thing was privately funded because the Medical Research Council (MRC), UK turned down a request for long-term financial support in 1971.

Today, an interesting article published in the European peer-reviewed medical journal Human Reproduction reveals for the first time why the MRC refused to help; a much-criticized decision.

The research team, led by Martin Johnson, Professor of Reproductive Sciences at the University of Cambridge, England and funded by the Wellcome Trust, write:

The failure of Edwards’ and Steptoe’s application for long-term support was not simply due to widespread establishment hostility to IVF. It failed, we argue for more complex reasons.

The reasons included:

  • Edward and Steptoe made a strategic error when they turned down an invitation from the MRC to join a new, directly funded Clinical Research Centre at Northwick Park Hospital, Harrow. They chose instead to apply for long-term grant support at the University of Cambridge. However, this meant competing for funding along with other projects who were bidding for MRC support at the time. Cambridge did not have an academic Department of Obstetrics and Gynecology at that time, which made things more difficult for them.
  • The majority of the MRC referees who were consulted on the proposal considered, in line with government policy, that limiting British fertility and growth mattered more than treating infertility, which was seen as experimental research, rather as a kind of therapy.
  • The referees were concerned about the risk of producing babies with severe abnormalities – they felt studies should have been conducted first on primates. There was also concern for patient safety.
  • Edwards’ and Steptoe’s high profile in the media irritated the referees; they disapproved of this method of public discussion of the science and ethics of treating infertility.

Edwards and Steptoe were not regarded by the MRC as being part of the medical establishment, which did not help.

Prof. Johnson and team write:

Steptoe came from a minor northern hospital, while Edwards, though from Cambridge, was neither medically qualified nor yet a professor.

Edwards had a PhD in developmental genetics from the Institute of Animal Genetics at the University of Edinburgh, then the leading UK centre in the field.

Prof Johnson wrote:

The MRC’s negative decision on funding of IVF, and their public defence of this decision, had major consequences for Edwards and Steptoe and set MRC policy on IVF research funding for the next eight years. This decision was only reversed after the birth of two healthy babies from seven IVF pregnancies. In its 1978/79 Annual Report, the MRC announced a change of policy and from that time on became a strong and major supporter of research on human IVF and human embryos, although curiously not research follow-up of IVF pregnancies.

An estimated 4.3 million babies have been born globally thanks to fertility treatment developed since Louise Brown was born.

Prof Johnson and colleagues, Sarah Franklin, Matthew Cottingham and Nick Hopwood, spent three years studying the MRC records at the National Archives at Kew in Surrey, and also documents from the Royal College of Obstetricians and Gynaecologists, Addenbrooke’s Hospital, Cambridgeshire County Council and Cambridge University Library. Bob Edwards’ wife, Ruth, gave them access to his private papers, and the researchers also interviewed many of the key players involved in the MRC’s decision in 1971 not to fund the research.

Professor John Biggers, Harvard Medical School (USA), in an accompanying Editorial, wrote:

By taking us back 40 years, the authors have demonstrated the importance of understanding a decision in light of the culture and circumstances at the time the decision was made. Although the grant was rejected, Edwards’ and Steptoe’s visions and persistence have benefited an enormous number of infertile people, both male and female.

Prof Johnson said:

The story of the MRC’s non-funding of IVF belies the cliché that science ‘races ahead’ of society. Similarly, the standard view, that ethical consideration of bioscience and biomedicine can only ever be reactive, is contradicted by the evidence of extensive ethical debate surrounding the prehistory of clinical IVF – most of it actively stimulated by Edwards himself. Although attitudes to medical scientists in the media have changed significantly since the 1970s, scientists and clinicians engaged in high-profile work still face a dilemma. If they encourage public discussion of their work – which they may see as both necessary to securing support and desirable to ensure full ethical debate – must they inevitably weaken their standing among their peers?

Finally, our case study questions the myth of two courageous mavericks pitted against a conservative establishment. This myth does capture important elements of truth: Edwards and Steptoe were outsiders and did pioneer – against prevailing wisdom – new ideas, therapies, values, public discourses and ethical thinking. But the process of decision-making was more complex than the myth allows. Our research provides a fuller understanding of what happened at the birth of the IVF revolution.

The decision-making processes involved in awarding funding projects are more open and transparent these days, Prof. Johnson believes. Discussions in the wider community as well as the media are actively welcomed now, as was the case with the two Human Fertilisation and Embryology Acts in 1990 and 2008. Prof. Johnson added:

A continuing problem, however, is more to do with the fact that there are some very fashionable topics that can create a buzz and attract huge research interest and funding, sometimes in disproportionate amounts; then it was fertility limitation, more recently genome sequencing would be an example. This can leave other Cinderella topics languishing in the ashes, with little financial support, even though they might well play an equally, if not more, important role in patient welfare.

“Why the Medical Research Council refused Robert Edwards and Patrick Steptoe support for research on human conception in 1971”
Martin H. Johnson, Sarah B. Franklin, Matthew Cottingham and Nick Hopwood
Human Reproduction, doi:10.1093/humrep/deq155

Written by Christian Nordqvist