Louise Brown—nursery-school aide, occasional pub crawler, and the world’s first test-tube baby—turns 25 on the 25th of July. To the outside world, it will be a day like any other, capping the string of equally uneventful anniversaries that have preceded it—but in many ways that’s the point. For science writer Robin Marantz Henig, the very ordinariness of Louise’s progression toward the quarter-century mark is noteworthy, because it illustrates the unqualified success of in vitro fertilization, or I.V.F.—the artificial process by which Louise was conceived.
In her book, Pandora’s Baby: How the First Test Tube Babies Sparked the Reproductive Revolution, set to be released by Houghton Mifflin this winter, Henig relates how I.V.F., once considered to “threaten the very fabric of civilization,” gradually became such a routine procedure that many medical insurance plans now cover it. This surprising historical trajectory sets the stage for the book's provocative central query: Might our current misgivings about cloning and other cutting-edge medical technologies dissipate as completely as our aversion to I.V.F. did?
Henig spins some fascinating yarns as she contrasts I.V.F.’s bumpy beginnings with the runaway medical triumph it eventually became. The first test-tube baby might have been born in 1974—a full four years before Louise Brown—had it not been for an untimely intervention. Renowned New York gynecologist Landrum Shettles combined egg and sperm extracted from an infertile Florida couple, convinced that an implantable embryo would develop, but the chairman of Shettles’s department found out about the dubious milk-chocolate-colored mixture in his test tube and ordered that the experiment be stopped. Later, when British doctors Robert Edwards and Patrick Steptoe produced the seemingly healthy Louise, naysayers predicted that she and her future test-tube counterparts would turn out to be genetic defectives and chromosomally damaged beasts. By all accounts, Louise has developed into a perfectly normal young adult, as do most babies produced by I.V.F.
Where does I.V.F. stand 25 years after the egg and sperm that became Louise Brown first met each other in a petri dish? For all the initial protests, introspection about the procedure now lags noticeably behind innovation. I.V.F. has become so specialized and refined that clinicians can reel off variations like ice-cream flavors. Among the options currently available to infertile couples are GIFT (gamete intrafallopian transfer), in which the egg and sperm are inserted into the mother’s fallopian tube so that actual fertilization can take place in the body, and ZIFT (zygote intrafallopian transfer), in which the egg is fertilized outside the body and then transferred to the fallopian tube. With traditional I.V.F., by contrast, an externally fertilized egg is implanted directly into the mother’s uterus. Although all of these procedures have drawbacks—I.V.F. babies in general are twice as likely as naturally conceived children to have multiple major birth defects, for example—their use continues to grow. The number of I.V.F. clinics in the United States has increased by 36 percent in the last seven years.
Henig draws a parallel between society’s initial disgusted reaction to I.V.F. and its current aversion to cloning technologies, implying that our eventual love affair with I.V.F. may prefigure changes in our attitudes about cloning. The analogy is valid but only to a point. Although it is simple to envision the public gravitating toward certain relatively uncontroversial applications of cloning, such as using cloned embryos to grow stem cells that would replace diseased organs, the prospect of cloned children will undoubtedly conjure up Brave New World specters for a long time to come.
Her efforts to convince us that cloning will follow I.V.F.’s lead occasionally fall short, but Henig does a fine job recalling some of the startling early controversies that preceded this quiet 25-year anniversary. As observers of the I.V.F. drama can attest, what is deemed “ethically and morally repugnant” is never a stable quantity.