It was the sort of phone call that doctors routinely receive from patients who have had a pregnancy test.
"It's positive," the caller calmly told office manager Linda Lynch.
As it turned out, the May 8 phone call was not routine at all. It meant that America had its first "test-tube" pregnancy. And it meant that a tiny, virtually unknown medical school in this conservative Southern city had accomplished somehing coveted by established bastions of scientific research.
The young caller, who like one in 500 women is unable to conceive through normal means, had become pregnant through an intricate process by which an egg is extracted from her ovary, fertilized by her husband's sperm in a glass laboratory dish and then reimplanted in her womb to develop as a fetus.
The young woman, whose identity is being closely guarded, is about three weeks pregnant. She is said to be between 25 and 30 years of age.
Three years ago, the process, known as "in vitro" fertilization, sparked an international sensation and gave new hope to the world's infertile women when the first so-called "test-tube" baby, Luise Brown, was born in Oldham, England. Other test-tube babies have since been born in Australia and Britain, but none until now has even been conceived in the United States.
America's first test-tube baby clinic opened 14 months ago at the fledgling Eastern Virginia Medical School, under the leadership of Drs. Howard W. and Georgeanna S. Jones, an internationally known husband and wife team of fertility specialists recruited from Johns Hopkins University. Howard Jones, 70, is an obstetrician-gynecologist and Georgeanna Jones, 68, is an endocrinologist.
Having reached retirement age at Hopkins, the Joneses were lured to the 8-year-old school after officials promised them carte blanche to pursue whatever research they chose. They arrive in Norfolk on July 25, 1978 -- the day of Louise Brown's internationally heralded birth.
The couple set up the clinic in a closet-sized room in a corner of the maternity ward of Norfolk General Hosital, using laboratory support provided by a school eager to build its reputation on the work of the respected team. The initial financing of $25,000 came from private contributors, including a wealthy Norfolk woman who had become pregnant after treatment by Georgeanna Jones at Hopkins.
Ironically, Georgeanna Jones says she and her husband probably wouldn't have had the opportunity to run a test-tube program at more established medical institutions, where researchers rarely enjoy the sort of freedom and institutional backing lavished upon the couple by the small Tidewater school. Deans at some of the nation's leading medical schools agreed that they do not usually allow faculty members the kind of free rein Eastern Virginai gave the Joneses.
"The [Norfolk] school was willing to let them place a disproportionate emphasis on that. It's sort of like when somebody decides to do cardiac transplants," said Dr. Frederick Naftolin, chairman of Yale's obstetrics and gynecology department, where researchers several times tried and failed to create a test-tube pregnancy. "We were just not prepared to kick in that much of our staff resources without major research funding," he said, calling Norfolk achievement "a giant, colossal big deal."
Although the Norfolk clinic is now the only one of its kind in the country, several major universities -- Harvard among them -- are considering similar projects, a sign that the field once shunned by the scientific establishment is gaining credibility.
The Norfolk method resembles that pioneered by British fertility specialists Drs. Patrick Steptoe and Robert Edwards, which led to the birth of Louise Brown. In addition to the British techniques, the Joneses used a program of injections of natural female hormones, increasing their control over the delicate chemistry and timing of ovulation.This, they say, probably helped achieve the pregnancy, which followed 14 months of failed attempts.
The Joneses and other doctors in the field describe in vitro fertilization as a strikingly simply medical procedure that relies more on precise timing than on elaborate equipment. Women undergo extensive laboratory tests, including the removal of blood samples every four hours for two days, to determine the best time for extracting the egg. When the time is right, often in the middle of the night, the woman is wheeled into an operating room and placed under general anesthesia. A device called a laparoscope is then inserted through a small incision in her abdomen, enabling doctors to peer into her ovary and extract a mature egg with a suction needle. The procedure usually takes about 30 minutes.
Lab technicians then race to the clinic, a tiny room adjacent to the operating room, and place the egg in a petri dish that contains a special mixture of sperm from the woman's husband and fluids that aid conception. Several days later, when researchers determine that the fertilized egg has subdivided, the embroyo is inserted into the uterus in hopes that it will attach itself to the uterine wall and develop normally.
The Joneses admit into the program only women whose Fallopian tubes are blocked or have been surgically removed, making it impossible for them to conceive without artificial assistance. Women who have the best chance of success, based on the screenings, are selected for the treatment. The clinic also requires that all participants be married and under 35.
More than 6,000 women from as far away as South America have applied for the Norflok program, a reflection of the desperation of infertile women around the world. About 60 have undergone treatment, which is generally repeated three times and costs a total of $4,000.
Originally the Joneses announed that patients would pay only basic laboratory and hospital costs, because doctors would not charge for professional services. When they later began charging d$300 in fees for the laparoscopy performed during the inital screening, there were no public complains.
"Many of these couples would be willing to spend any amount of money," said one scientist associated with the program. "You have to see these families to realize some of the pressures put on them to produce children. The husband's parents will blame the wife and the wife's would blame the husband."
During the screenings and treatment, most women stay at Norfolk's Omni International Hotel, where they pay $25 a night rather thant the standard $75 -- a reduced rate the hotel initiated for conventions and extends to hospital patients. They also take a free shuttle to and from the clinic.
The Joneses were attending a meeting in Paris when news of the first successful pregnancy reached their Norfolk office, where it was greeted by cheers from the eight-member staff. The work leaked to some of the Joneses' other patients, who quickly began calling one another.
Lynch telephone the Joneses minutes after the call from the patient."I got Dr. Howard on the phone and told him, and he didn't say anything for about two minutes. I said, 'Are you still there, Dr. Howard?" I'd never heard him speechless in my whole life," she said.
"I cried; why certainly I cried," recalled a beaming Georgeanna Jones, on whose office wall hangs a green-and-pink needlepoint message: "Sometimes the smallest things in life can bring the greatest pressure."
Despite their excitement, the Joneses and their medical school colleagues shrouded the event in utmost secrecy, frustrating a public that clamored for details.
At a press conference called by the couple last Monday, reporters who peppered Joneses with questions ran into a wall of "no comments." The doctors said only that the woman's Fallopian tubes were removed by surgery after two problem pregnancies. They said they feared that disclosure of any details of the pregnancy could lead to discovery of the woman's identity and cause her enough stress to trigger a miscarriage.
"It is important not to count our chicken before it is hatched," Howard Jones said in a statement.
The Joneses' public silence about their work is nothing new to Tidewater residents who have sought information about an experiment that for many conjures up Orwellian images.
"In the world of academic medicine, you make your results public to the scientific community," said Vern Jones, the medical school's public relations chief, who declined dozens of interview requests on behalf of the couple after the press conference. "They're very uncomfortable with the publicity. They don't want any part of the public media," said Vern Jones, who is unrelated to the doctors.
Nonetheless, the morning after the press conference, the two doctors appeared on ABC's nationally televised show, "Good Morning, America."
The Joneses' general inaccessibility provided a stark contrast to the effusive reaction of civic boosters in this city of 280,000, Virginia's largest, located 200 miles south of Washington. Eager to erase Norfolk's image as the sleepy home of the world's largest naval base, they heralded the pregnancy as a milestone in their quest for enhanced respectability as an outpost of the New South.
"One of the things it says about Norfolk is that this isn't an ultraconservative Southern town," proclaimed Ken Wheeler, the city's director of communications and marketing. "'New' is kind of a watchword in Norfolk. It's a right important thing here."
At the Chamber of Commerce, a Greek-style building that stands out from the sea of concrete and vacant lots that is Norfolk's downtown, staffer Elaine Lois said: "It's a hometown baby, like a birth in your own family,"
Not everyone in Tidewater was so delighted. At the fundamentalist Christian Broadcasting Network, headquartered in nearby Virginia Beach, founder Pat Robertson said he feared "the violation of the sancity of life and what may be the beginning of scientific tampering with babies who are conceived in petri dishes." Norfolk's vocal antiabortion contingent had much the same reaction.
But the pregnancy brought longsought recognition to Norfolk's one-building medical school, which struggles in the shadow of the state-supported University of Virginia in Charlottesville and the Medical College of Virginia in Richmond.
Desks were adorend with a red, white and black sticker that reads: "Norfolkians do it in a dish," a parody of the state Department of Tourism's ubiquitous "Virginia is for lovers" bumper sticker.
"It'll help my degree," said graduate medical student Ernest Goins. "People used to say, 'Eastern Virginia what?' Now they'll say, 'Oh yeah, we read about it.'"
Dr. Mason Andrews, Norfolk's genteel vice mayor who also chairs the obstetrics and gynecology department, went so far as to link the pregnancy to the city's place in American history. In 1609, the first Pilgrims attempted to land in Norfolk, rather than Jamestown, Andrews said, adding that it is therefore logical that his city has produced another first.
A prominent obstetrician who wears a large silver tie clasp in the shape of a hound dog, Andrews ran for office on the slogan "Mason Delivers." He is widely considered responsible for the creation of Eastern Virginia Medical School and for luring the Joneses, whom he met more than 40 years ago at Hopkins.
Andrews, the soft-spoken scion of one of Norfolk's most patrician families, contributd more than $30,000 of his own money and spent more than 15 years persuading Tidewater residents to donate money to found the school. He lobbied the Virginia General Assembly and a reluctant governor, Linwood Holton, for the necessary approval.
The reception area outside Andrews' office abounded with signs that the pregnancy is being hailed most of all by infertile women. Flowers and congratulatory notes from other women in the program lay atop metal file cabinets. One note, addressed to the Joneses from a couple, said: "Bravo! We are absolutely thrilled for you."
"I think it's super," said 32-year-old Carmen Pittman of Houston, who dropped out of the program a year ago and adopted a baby boy after failing to become pregnant. "We understood all along that our chances were very slim. If you want a baby badly enough, you'll try just about anything. Even if it's a one-in-a-million chance, it's better than no chance at all." CAPTION: Picture, 1, Drs. Howard and Georgeanna Jones, of Eastern Virginia Medical College, worked 14 months on the new fertilization techniques. AP; Picture 2, Dr. Howard Jones and his wife and partner Georgeanna started the clinic in a closet-sized room with $25,000 financing. UPI