ABSTRACT

Assisted fertilization (or in vitro fertilization) refers to a process when the oocyte is fertilized by a sperm “outside” of the body (i.e., in vitro) (1-3). The two techniques that are applied today are “conventional” IVF (2) and intracytoplasmic sperm injection (ICSI) (4). Robert Edwards, scientist (and rst “Clinical Embryologist”), together with Patrick Steptoe, clinician, achieved the rst successful live birth in 1978, which become a landmark in our eld of assisted reproduction (2). Louise Brown, the rst “test tube baby,” was born following a natural IVF cycle. Professor Edwards has been awarded numerous honors, the most prestigious one, the Nobel Prize (in Physiology or Medicine), was given to him in 2010. This breakthrough was the result of decades of research to better understand reproductive physiology both in humans and in animals. Spallanzani’s description in the late 1700s may be regarded as the rst report on in vitro fertilization, when he demonstrated the fertilization of frog oocytes mixed with semen. Antoni van Leeuwenhoek (1632-1723) deserves credit of developing the microscope, amongst his many other discoveries, which has been an essential tool for observing gametes and the process of fertilization. Prevost and Dumas, in the early nineteenth century, were able to demonstrate that spermatozoa are produced by the testes and that motile sperms were required for fertilizing frog eggs. In 1826, Baer discovered the mammalian ovum. Edouard van Beneden was the rst to observe fertilization in mammals in 1875. The beginning of the “modern era” may be regarded as starting when sperm capacitation was described simultaneously by Austin and Chang, in the middle of the twentieth century. Fertilization of rabbit ova was reported in 1959 by Chang (5). In 1965, Robert Edwards together with Georgeanna and Howard Jones (in the U.S.A,) attempted to fertilize human oocytes in vitro, followed by the report on pronuclear formation after insemination of human oocytes by Edwards in 1969 (6). A year later Edwards reported embryonic development to the 16 cell stage (7). Following the rst successful IVF in humans in 1978 from the United Kingdom, soon other countries also reported pregnancies after IVF, including Australia, the United States, and France (8-10). Births after IVF have increased exponentially over the years; it is estimated that in 1990, a little more than a decade after the rst IVF birth, about 95,000 babies were born. By 2000, it was thought that nearly 1 million babies were born, and in 2015, it had climbed to about ve million.