Danielle: Good evening, Jacksonville and happy Saturday. I am Danielle and welcome to the conversation with Dr. Ali Kasraeian. As always, you too can join the conversation. Give us a call. 340-1045. How are you doing today, Dr. Ali?
Dr. Ali: I’m doing well. Actually today, my wife and I who are on a tangential project about nature called Noctopia in Hendrix in the south bank of downtown. So we had a grand opening event so I’ve been there all day.
Danielle: Did it go well?
Dr. Ali: Went well.
Dr. Ali: Every day I kind of wonder how on earth we started opening a dog daycare as a secondary project. We don’t have enough to do. But [inaudible] has been an incredible amount of fun and hopefully we add something positive to our community and neighborhood and a wonderful place for the dogs in our life.
Danielle: I love it. I’m all about a doggy daycare.
Dr. Ali: So that’s what I did today. But today I’m even more excited about having my dear friend Dr. Sam Brown guest to the conversation. Many a time to offer his insight as an infertility specialist at Brown Fertility on a very momentous year. 2018 marks the 40th anniversary of the beginning of the amazing world of artificial reproduction. In fact, with the fact that the first test tube baby was born shortly before midnight on July 25th in 1978, Louise Joy Brown, and it was in the United Kingdom.
Drs. Robert Edwards and Patrick Steptoe were the innovative minds of making this dream of creating a miracle for people who could not see hope and the possibility of having children, making this a reality in a time of incredible controversy on both sides of the fence for that happening and weighing 2.5 kilograms. The world’s first test tube baby, and interestingly her parents had a second baby with the same technique who is the 40th test tube baby at that time.
So an amazing, amazing accomplishment, and it’s interesting. Initially, in vitro techniques, less than five percent of the time resulted in a live baby. Now conservatively saying so, those techniques are better than 50 percent positive. Dr. Brown’s data exceeds that in an impressive manner. And the data’s out there. It’s a little bit variable, but between six to eight million babies have been brought into this world using this technology.
So something that really for you, you talk about the fact that you guys produce and create miracles. That’s really, really true where people who see no possibility, we’ve opened the door of creating beautiful babies for people who really vastly, that’s one of the things that is a shining light of accomplishment for them when hope was not too long ago not present.
Dr. Sam Brown: Thanks for having me on the show, Dr. Kazrine. It really to me, it’s close to my heart and too many hearts, probably eight million or more hearts. But it is amazing. I met Louise Brown, the first baby. I met her last year at a national convention at the American Society for Reproductive Medicine. And gosh, I’m probably related to her down the line somewhere. But you know, the fact that [crosstalk]
Probably tied back to her some way. But I met her, and it brings up a few points. It is amazing. This is a very young science. It’s only 40 years or so. A lot of our surgical sciences and things have been developed over hundreds of years. And so it’s a relatively new science and it’s had dramatic impact.
And back to Dr. Steptoe and Edwards, they would extract one egg from a woman that she was gonna ovulate that month and try to fertilize it, then madly get it back into the uterus and hope it would take. It took them hundreds if not, well, hundreds of patients to finally have success with Louise Brown and it was earth shattering. It was huge.
And initially the world reacted nervously. They’re like, “Oh, my gosh. What are we doing? Is this science okay? Is this natural?” And then it came to this side, to the United States and we made it better. Modern IVF is really in my mind an invention of the United States. And it happened in Norfolk, Virginia at the Jones Institute and Howard and Georgeanna Jones were sort of the pioneers who came up with the next step.
Dr. Georgeanna is the mastermind that doesn’t really get credit for this and she said, “Hey, why don’t we give them a little bit of hormone to get instead of one egg a month like Dr. Steptoe and Edwards did, let’s maybe get 10 eggs and then try to fertilize them all. Wouldn’t that be better?”
And on the other side of the pond, they were like, “Well, we don’t know if that’ll work. It didn’t work in the [inaudible] model.” But she persevered and she was a pioneer on this side of the pond and made it happen and it made success rates much better, much easier to do. And we now just elaborated on that a little further today, that now there are eight million babies from this process.
But they really were the pioneers. They were the heroes. It’s amazing. I was fortunate to train there in Norfolk under them, these dinosaurs who invented this stuff.
Dr. Ali: What was that like?
Dr. Sam Brown: No, it was incredible. I mean, walking down the halls with these people who invented this stuff and hearing the stories of how they just applied basic science … let’s compare a thousand patients with this versus a thousand patients with that and just simple science and advancing this was simple and elegant. I hear in the pitfalls of this and that and things they were thinking at the time. It was awesome.
But you know, they went under a lot of adversity. We really are standing on their shoulders. They are our heroes. They got this rolling where they took, there’s death threats. They have mass demonstrations in the streets against IVF. They thought this was Frankenstein.
Dr. Ali: As much as we’d like to think those controversies and the stones that have been thrown at this technology are very, very distant and archaic, they’re really not.
Dr. Sam Brown: They really aren’t. It wasn’t that long ago. I mean 20, 30, 40 years really isn’t that long ago.
Dr. Ali: Obviously one thing that we can easily say that everyone’s like “Oh, now you’re playing God.” But what are some of the controversies that plagued assisted reproduction on the whole and what are the truths and myths to that?
Dr. Sam Brown: It’s a great question. That’s a great way to put it. To me, God gives us these tools. Let’s use them. And we have. And it’s been good. It’s not been bad.
The controversy was should we, if we can get an egg and get a sperm and it’s a natural egg and a natural sperm and help foster this to become a natural embryo and put it into a natural uterus, is that really playing God? I don’t think so. I think it’s God given sperm, it’s God given egg, it’s God given uterus, and we’re just crafty enough to be able to work with that and be kind of a middleman with that.
Dr. Ali: And that’s really what the process of this is. One thing, you’ve gotta put this in frame and frame of mind of the 61 million or so women who are between 15 and 44 which is thought to be a reproductive age and there’s data from 2011 and 2013. Almost seven million, which is 11 percent at some time in their life receives a test, medical advice, medical treatment or something to help them become pregnant other than what we routinely imagine quote unquote natural manners of conception are.
That’s a large number of women where if such technologies were not around, the joys of being able to have children may not be available to them.
Dr. Sam Brown: Your final, and back in the 70s and 80s when we didn’t have many tools available, infertility was kind of a hush hush thing. “Oh, but that’s my neighbor. She couldn’t have a child.” And they just kind of kept it quiet. And that’s really not where we are today. These tools and things are so available and become so affordable and so many people are using them, really the stigma is gone. So it’s nice, it’s beautiful to see an open approach to people going after these assistants to help have a family. It’s awesome.
Dr. Ali: If you think about this stuff, you know, fertility issues are so, so variable. It’s not a one size fits all in terms of the evaluation and you guys as infertility specialists go through an incredible amount of work up to find out what the why is and to try to fine tune yourself to the why. And if nothing else seems to work, the ability to ensure fertilization on the outside if it’s been not possible in other ways and then making sure that you safely set up a scenario to get the embryo the best chance of making it to life. That’s really what IVF is.
Dr. Sam Brown: It really is. And just getting that egg and sperm together, that natural egg, that natural sperm together, getting it into the uterus and the science helping us figure out how to make sure the hormones are just right and make the uterus hospitable and watching the natural process take over in the uterus and the pregnancy planned and it’s pretty awesome.
And in just 40 years we’ve learned all this. It’s wonderful. There’s eight million babies from this process just in a few decades.
Dr. Ali: That’s interesting. So one thing I want to talk about later on in the show is the idea of a uterus transplant, which is a little bit related but unrelated, as a means of helping the same process. But some of the scientists said we’re part of that process and positions, one of their lead researchers called the moment when the first baby-