Nobel Prize for Good Work in Health Care

Robert Evans, PhD received the Nobel Prize in Medicine on Monday for his work as the health care pioneer who led the development of in vitro fertilization (IVF). His “test tube baby” procedures have provided a route to pregnancy for the 10% of couples worldwide that struggle with infertility. The award honored the 85 year-old Cambridge-based biologist for his efforts in the lab and clinic but also celebrated Dr. Evans’ persistence away from the test tubes and Petri dishes. He fought for funding, argued with ethicists, and faced libelous critics. This struggle for success was cataloged in his 2001 paper published in the journal, “Nature Medicine.”

Dr. Evans’ development of IVF began with mice. As a PhD student in the 1950s he developed methods to stimulate ovulation in mice, fertilize the eggs produced, and implant the fertilized eggs in mature animals. Some of the implanted eggs developed into fetuses and later into healthy infant mice. The success of these experiments led Dr. Evans and his colleagues to believe that a similar process could facilitate pregnancy in humans, yet they would wait over 20 years to realize turn this theory into health care reality.

As he shifted to understand the process of oogenesis (egg production) in humans, Dr. Evans faced a number of significant barriers. Not only did he wonder about how to harvest a potential mother’s eggs without harm, and the proper mix of hormones to stimulate embryo growth, he also faced public outcry. Religious leaders and ethics experts spoke out against his procedures and “forecast abnormal babies.” These doubters failed to deter his progress and, along with his colleague Dr. Patrick Steptoe, Evans forged ahead with human trials.

Evans faced challenges even after the July 26, 1978 birth of Louise Brown - the world’s first test tube baby. For the subsequent two years a halt on government funding stopped his work. Nevertheless, he managed to continue by scoring venture capital funding and opened an IVF clinic.

This pioneering work in IVF treatment not only helped treat infertility in women but also brought other health care breakthroughs. Evans’ research facilitated treatment for male infertility, for miscarriage, and early childhood growth. Today IVF is a common treatment option offered by health care providers throughout the world with test tube babies growing to be normal adults. The Nobel Prize validates Dr. Evans’ work, but even more powerful are the thousands of infertile families are indebted to Dr. Evans’ pursuit of IVF therapy. The story of his struggle to overcome critics now raises the question, which treatments that inspire controversy today will become commonplace health care offerings tomorrow?

For more on the Nobel Prize, see the Nobel Assembly’s homepage at nobelprize(dot)org

Dr. Evan’s paper in Nature Medicine is titled, “The bumpy road to human in vitro fertilization.”

Photo credit: kaibara