The George Washington University Medical Center's in-vitro fertilization program, still in its own infancy, has produced the first test-tube pregnancy in the Washington-Baltimore area.
The mother, a 30-year-old suburban Virginia resident, has had her approximately 6-week-old pregnancy confirmed by ultrasound examination. She is the fourth patient accepted into the new GW program, which has been doing in-vitro procedures only since late June.
The procedure involves removal of the potential mother's own egg from an ovary, its subsequent fertilization by the husband's sperm in a laboratory dish, and, a day or so later, its transfer into the mother's uterus. In this case, the embryo was successfully implanted on the first attempt at the procedure.
Dr. Joseph D. Schulman, GW professor of obstetrics, gynecology and genetics, said that "in a good program, you average three attempts per patient to have a 50-50 hance of achieving a successful pregnancy."
Schulman, who studied with in-vitro fertilization pioneers Drs. Patrick Steptoe and Robert Edwards at their Cambridge University clinic, and Dr. Robert Stillman, an associate professor of obstetrics/gynecology and reproductive endocrinology, head a team of seven physicians and several nurses, lab technicians, geneticists and ultrasound technicians at the GW center.
Sounding almost like expectant fathers themselves, Schulman and Stillman said yesterday that the parents, both professionals, do not wish to be identified. The couple has no other children--a criterion for admittance into the program.
The cause of infertility in the patient was an obstruction of her only remaining fallopian tube--the other having been removed earlier. "This is," said Schulman, "the classic situation in which an in-vitro procedure is indicated."
Other area in-vitro programs--one getting under way at Columbia Hospital for Women in the District, another at a private Bethesda center called Medically Assisted Pregnancy, a program at Union Memorial Hospital in Baltimore, and another about to open at Johns Hopkins in Baltimore--have produced no successful pregnancies yet.
Dr. John Young, of the Bethesda center, said he and his colleagues have transferred some 20 embryos grown from successfully fertilized ova, but they have failed to achieve any pregnancies.
"It is at that step--transferring the embryo back into the uterus--that the majority of pregnancies are lost," said Schulman. "One thing that makes a difference is to be quick and gentle in handling of eggs and embryos, but we really do not know why only a few implant . . ."
Since the first baby conceived outside the mother's womb was born in England in 1978, IVF clinics have sprung up all over the world. It is hard to know at any moment how many test-tube babies have been born, because the figure is an ever-changing one. Schulman estimates that the total must be "hovering around 200," most of them in England and Australia where the success rate has been high. The number includes several sets of twins.
The first--and most successful--center in this country is that at Eastern Virginia Medical College in Norfolk, which has "now hit 31 births," Schulman said. There have also been successful births at IVF programs at Yale University, the University of Southern California and the University of Texas in Houston, among a few others.
One regret he has, said Schulman, is that "at the moment, these procedures are basically reserved for affluent couples." Costs for each attempt range from $4,000 to $5,000, so that a patient could pay $15,000 to $20,000 or more to achieve a single pregnancy.
"We are trying very hard," Schulman said, "to convince insurance carriers that [the procedure] is no longer experimental. Their policies will change, but how rapidly depends on the extent that the public is aware of the need for change."