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Johnson M.H.,Anatomy School and Center for Trophoblast Research | Elder K.,Bourn Hall Clinic
Reproductive Biomedicine and Society Online | Year: 2015

Three major sources of financial support for the research undertaken by Edwards, Steptoe and Purdy between 1969 and 1978 are identified: the Ford Foundation, Oldham and District General Hospital (ODGH) Management Committee, and Miss Lillian Lincoln Howell via the American Friends of Cambridge University. Significant possible financial support from the World Health Organization was also identified. In addition, evidence of support in kind from GD Searle and Co. plus staff at ODGH was found. Expenditure on salaries of staff at Oldham was negligible, as most volunteered their time outside of their official paid duties. Work in Cambridge was evidently funded largely from Ford Foundation grants, as was Edwards' salary and probably that of Purdy. Clinical costs seem to have been largely borne by ODGH. The funds from Lillian Lincoln Howell supported travel and accommodation costs plus office costs. Overall, Edwards, Steptoe and Purdy achieved reasonable support for the programme of research, despite the initial rejection of funding by the Medical Research Council. However, this was at the expense of considerable inconvenience to Purdy and Edwards, and depended upon the good will of staff led by Muriel Harris in Oldham, who donated their time and expertise. As a result of our research, we conclude that, to Edwards, Steptoe and Purdy, should be added the names of two other hitherto neglected people who were essential to the success of this pioneering research: namely Muriel Harris and Lillian Lincoln Howell. © 2015. Source


Johnson M.H.,Anatomy School and Center for Trophoblast Research | Elder K.,Bourn Hall Clinic
Reproductive Biomedicine and Society Online | Year: 2015

Six evidential sources are examined to investigate how Edwards and Steptoe applied ethical standards to their research leading to the birth of Louise Brown: (i) Their own contemporary writings from 1970 onwards. (ii) Archival evidence from the British Medical Association (BMA), the British Association for the Advancement of Science (BAAS), and correspondence between Edwards and the Ford Foundation. (iii) Minutes of Oldham General Hospital (OGH) Ethics Committee. (iv) Letters by Edwards to prospective patients. (v) oral evidence from interviews with a patient and colleagues. (vi) Evidence from their clinical case management of patients. Taken together these sources suggest that Edwards and Steptoe demonstrated a strong awareness of the ethical issues involved, and offer evidence of honesty to patients about the realistic prospects of success and ethical practice. Nonetheless, decisive evidence that ethical aspirations were put into practice is not available. © 2015. Source


Elder K.,Bourn Hall Clinic | Johnson M.H.,Anatomy School and Center for Trophoblast Research
Reproductive Biomedicine and Society Online | Year: 2015

A survey is presented of the various technical and scientific challenges that had to be met during the 10-year period before the first successful live birth after IVF and embryo transfer was achieved, and the approaches used to meet these challenges is discussed. Records dated from January 1969 to July 1978 indicate that a minimum of 282 women were involved in 495. cycles scheduled for laparoscopic oocyte recovery, of which 457. cycles (92%) proceeded to attempted egg collection. A total of 1361 eggs were recovered over 388. cycles, of which 1237 (91%) are recorded as having been inseminated in 331 (85%) of these cycles. Approximately 221 embryos were described in 165 (43%) of the 388. cycles. A total of 112 embryo transfers were attempted, which resulted in five clinical pregnancies with two live births. This paper discusses the ways in which hormonal stimulation of follicle growth to the pre-ovulatory stage was varied, and the endocrine monitoring of these variations in blood, urine and follicular fluid, as well as their influence on egg recovery and fertilization rates. Variations in media composition and preparation are also described. It is concluded that, whilst driven by scientific reasoning, the approach adopted in trying to achieve successful IVF was empirical rather than evidence-driven. © 2015. Source


Johnson M.H.,Anatomy School and Center for Trophoblast Research | Elder K.,Bourn Hall Clinic
Reproductive Biomedicine and Society Online | Year: 2015

The role of Jean Purdy in the work leading to the birth of Louise Brown is assessed. We report that Purdy: (i) recorded and organized most of the data systematically; (ii) probably spent longer working in Oldham than did Edwards; (iii) whilst there, was primarily responsible for organizing laboratory supplies, including media preparation and testing; (iv) was involved in patient care; and (v) was a major source of support to Edwards. We find that Purdy, despite her nursing qualification, was not involved in laparoscopic egg retrieval and clinical aspects, but was focused on basic research activities. The evidence on who was present at embryo transfers is less clear, but suggests that Edwards was present for all, whereas Purdy may have been absent for some. Overall, we conclude that Purdy's role was a highly significant and under-appreciated element in the achievement of IVF in Oldham. © 2015 The Authors. Source


Elder K.,Bourn Hall Clinic | Johnson M.H.,Anatomy School and Center for Trophoblast Research
Reproductive Biomedicine and Society Online | Year: 2015

This paper reports on the numbers of treatment cycles involved in the development of IVF (1969-1978) and their outcomes. We show that between 1969 and 1978: (i) a minimum of 282 women were involved in 495. cycles of potential laparoscopic oocyte retrieval (LOR); (ii) of these cycles, 457/495 proceeded to LOR to attempt egg collection; (iii) of which an outcome was recorded in 436/457; (iv) eggs were recovered in 388/436 of these; (v) inseminations were recorded in 331/388; (vi) embryos were recorded in at least 167; (vii) a total of 112 embryo transfers were attempted; and (viii) a maximum of 11 possible biochemical/preclinical pregnancies plus five clinical pregnancies were observed; (ix) from which two healthy live births resulted. © 2015 The Authors. Source

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