As early as the 1950s, Dr. Edwards had the idea that fertilization outside the body could represent a possible treatment for infertility. Other scientists had shown that egg cells from rabbits could be fertilized with sperm in test tubes, producing offspring. Dr. Edwards decided to investigate whether similar methods could be used to fertilize human egg cells.
In a series of studies conducted with co-workers, Dr. Edwards made a number of fundamental discoveries.
He clarified how human eggs mature, how hormones regulate their maturation and at which point the eggs can be fertilized. He also determined the conditions under which sperm is activated and can fertilize the egg.
By analyzing the conditions necessary for an egg and sperm to survive outside the womb, Dr. Edwards developed a medium — which he called “a magic culture fluid” — in which to achieve fertilization.
In 1969, his efforts met with success when, for the first time, a human egg was fertilized in a test tube. But the fertilized egg did not develop beyond a single cell division. Dr. Edwards suspected that eggs that had matured in the ovaries before they were removed for in vitro fertilization would function better. He looked for possible ways to safely obtain such eggs.
Dr. Edwards contacted Patrick Steptoe, a British gynecologist at the Oldham and District General Hospital near Manchester, England. Steptoe was one of the pioneers in laparoscopy, which allows examination of the ovaries through an optical instrument.
Steptoe used the laparoscope to remove eggs from the ovaries, and Dr. Edwards put the eggs in cell culture and added sperm. The fertilized egg cells divided several times and formed early embryos composed of eight cells, known as a blastocyst.
“I’ll never forget the day I looked down the microscope and saw something funny in the cultures. . . . What I saw was a human blastocyst gazing up at me,” Dr. Edwards recalled in 2008. “I thought, ‘We’ve done it.’ ”
The research became the topic of intense ethical debate. Religious leaders, ethicists and scientists demanded that the project be stopped.
Steptoe “faced immense clinical criticism over his laparoscopy, even being isolated at clinical meetings in London,” Dr. Edwards wrote in the biomedical research journal Nature Medicine in 2001 after receiving the prestigious Albert Lasker Award for Clinical Medical Research. “Ethicists decried us, forecasting abnormal babies, misleading the infertile and misrepresenting our work as really acquiring human embryos for research.”
Despite the intense criticism and trouble obtaining funding, Dr. Edwards and Steptoe persevered. By analyzing patients’ hormone levels, they could determine the best time for fertilization and maximize the chances for success. In 1971, they performed their first attempt to implant a fertilized egg in a patient. They were not successful, however, until 1978.
Lesley and John Brown sought treatment at the Oldham General Hospital after nine years of failed attempts to have a child. In vitro fertilization was carried out, and when the fertilized egg had developed into a blastocyst, it was transferred into Mrs. Brown’s body. On July 25, 1978, a healthy girl, Louise Brown, was born at the hospital through Caesarean section after a full-term pregnancy.
“Louise’s birth signified so much,” Dr. Edwards said at her 25th birthday celebration in 2003. “We had to fight a lot of opposition, but we had concepts that we thought would work, and they worked.”
Together with Steptoe, Dr. Edwards established Bourn Hall, which trained gynecologists and cell biologists from around the world and refined the techniques.
Dr. Edwards served as the clinic’s scientific director from 1988 to 1991. Steptoe was its medical director until his death in 1988, and Dr. Edwards was its head of research until his retirement.
By 1986, 1,000 children had been born using IVF at Bourn Hall, representing approximately half of all children born after IVF in the world at that time.
“His achievements have made it possible to treat infertility, a medical condition afflicting a large proportion of humanity, including more than 10 percent of all couples worldwide,” the Nobel committee at Sweden’s Karolinska Institute said in announcing the prize.
Steptoe would presumably have shared the Nobel Prize, but the award is not granted posthumously.
Robert Geoffrey Edwards was born Sept. 27, 1925, in the West Yorkshire town of Batley and at age 5 moved with his family to Manchester. After army service during World War II, he studied biology at the University of Wales and at the University of Edinburgh in Scotland, where he received a doctorate in 1955 with a thesis on embryonal development in mice.
At the National Institute for Medical Research in London, his early knowledge of animal reproductive physiology awakened his research into infertility in women. He joined the University of Cambridge faculty in 1963 and remained there until retiring in 1989.
Survivors include his wife, the former Ruth Fowler; five children; and 12 grandchildren.
In vitro fertilization has undergone several important improvements over the years. For example, a single sperm can be injected directly into the egg cell in the culture dish, improving the treatment of male infertility by IVF.
Also, mature eggs suitable for IVF can be identified by ultrasound and removed with a fine syringe rather than through the laparoscope. Approximately 4 million babies have been born using IVF.
Dr. Edwards’s Nobel Prize was condemned by a Vatican official. “Without Edwards, there wouldn’t be a market of eggs,” said Monsignor Ignacio Carrasco de Paula, the head of the Pontifical Academy for Life. “Without Edwards, there wouldn’t be freezers full of embryos waiting to be transferred in utero or, more likely, be used for research or to die, abandoned and forgotten by all.”
Other experts observed that Dr. Edwards’s work was far-reaching.
“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 forced society to reconsider many assumptions. Using IVF, a child today can have one “mother” who donated her genes, another who offered 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.
“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.”
The procedure also furthered the trend that started with the birth-control pill: of giving women greater control over their reproductive lives, leading more of them to delay childbearing to pursue education and careers.
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 costly procedure has turned reproduction into a commodity. Because infertility clinics are largely unregulated in the United States, critics say many push ethical boundaries. For example, some enable couples to choose the sex of the child.
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 so that the chances couples will give birth to healthy babies are increased. But combined with the constant flow of discoveries of new genes, the procedure has led to concern about “designer babies.”
“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.”
Stein is a former Washington Post science editor and is now a correspondent and senior editor on NPR’s science desk.