Nobel Laureate Robert G. Edwards, PhD: A Personal Appreciation
by Joseph D. Schulman, MD
Bob Edwards was the world's pre-eminent reproductive scientist. At last, after long delay, he has received the Nobel Prize in Physiology or Medicine which he so fully deserves. Louise Brown, the very first IVF baby, was conceived through Bob's scientific achievements in 1977. Since then, several million healthy IVF babies have been born around the world.
Bob was a friend to me, and a consistent source of enlightenment and encouragement. The Institute which I founded in 1984, one the first IVF centers in the United States, was directly inspired by his example. Bob on three separate occasions crossed the Atlantic specifically to participate as keynote speaker in the Institute's conferences for medical and research professionals. He was enthusiastic about MicroSort, a method of human preconceptual gender selection which we developed, and told me he considered it one of the most important breakthroughs ever achieved in the field of human reproduction. Bob encouraged articles about MicroSort in his journals, and strongly advocated its utilization in Great Britain. In 2008, Bob, I, and other scientists were organizing a major international conference on reproductive bioethics in Washington, DC, but this effort was halted after he tragically became incapacitated by a rapidly progressive dementia.
Given the hugely important benefits that IVF has made possible for so many patients, benefits that were apparent to many in the field of medical science by the mid-1980s, why was the award of the Nobel Prize so long withheld that Bob Edwards' principal IVF collaborator, surgeon Patrick Steptoe, was dead and Bob so ill that his wife, Ruth, had to take the call from Stockholm because he was unable to do so?
The fundamental reason the Nobel Prize award was delayed for decades was because Bob was a consistent fighter for reproductive innovation of many types. Indeed, it is not an exaggeration to call him the world's most important leader in this effort. In the course of these activities, which ended only with his current illness, he faced much opposition and made powerful enemies. Bob led the fight against those who would restrict medical progress and inhibit personal reproductive freedoms. The original IVF research with human embryos which Bob pioneered in the 1970s was bitterly attacked by numerous scientists, religious leaders, politicians, bureaucrats, and members of the press. Cambridge Professor Martin Johnson, one of the first graduate students of Bob's in the 1970s, described in 2009 how he was intimidated from any participation in IVF research: "We didn’t want to get too involved in it. The reasons for that were sheer level of hostility to the work........People were saying he really shouldn't be doing this kind of thing.......We were in this sort of little ghetto at the top of [the] Physiology [laboratory], which was ringed with prejudice and hostility and antagonism." Opponents of Bob's IVF work were influential enough to block support for his research from Britain's Medical Research Council. Scientific opposition was widespread, and included at least one Nobel Laureate. Foundation funding for Bob's IVF research dried up. The antagonism and dearth of financial support nearly stopped the IVF work before it became successful. After the birth of Louise Brown, the nationalized British health care system refused to make IVF available to patients, and Bob was forced to find investors and open Bourn Hall with private funding. Only those who lived through these early years of IVF research can fully appreciate the immense determination - the sheer toughness - of Bob and Patrick, helped by their few allies including Bob's department head at Cambridge, Professor C.R. ("Bunny") Austin, and the dedicated nurse and laboratory technician, Jean Purdy. It all very nearly failed. As the Duke of Wellington was reported to have said after winning the Battle of Waterloo, "It was the nearest-run thing you ever saw in your life." Without exaggeration, that statement could be accurately applied to the attainment of success with IVF.
The label of "controversial" has continued to surround Bob Edwards for the rest of his life. In his later years he passionately advocated the value of stem cell research, including research using embryonic cells. He strongly supported MicroSort in England, organized a conference at the Royal Society which included it, and was delighted that a Parliamentary committee reported favorably on it. His tragically delayed Nobel award is one of the prices he paid for such determined and publicly visible efforts.
The struggle to bring reproductive innovation to patients, and to advance reproductive science, still continues. To this day - over 30 years after the birth of Louise Brown - our own government still prohibits the National Institutes of Health from funding any research on human IVF, and all advances in the IVF field in the United States have been accomplished entirely without government support. The Vatican is still an opponent of IVF, and officially expressed its dismay at the awarding of the Nobel Prize to Dr. Edwards. Despite millions of IVF births, laboratories performing IVF have in the last few years been shut down in Italy. Despite Bob's strong support of MicroSort and the many normal births already achieved by this method of preconceptual gender selection, MicroSort is not today available to patients in England. And whether or not it will become widely available for patients in the United States will be influenced by the pending decisions of federal regulators.
Continued progress in the science and medicine of human reproduction is, in the long run, absolutely certain. And history has shown, as with IVF, that initially controversial medical advances ultimately become both widely adopted and wisely utilized. However, delaying such advances through restriction of research funding or denial of clinical access harms some patients irreversibly. Individuals, particularly females, have a time-limited window in which to exercise their reproductive choices. Time matters to all patients who seek reproductive assistance. That Robert G. Edwards was denied the Nobel Prize for several decades is a vivid proof of the legal truism, attributed first to William Gladstone, that "justice delayed is justice denied." With equal justice it may be said that "medical innovation delayed is medical innovation denied." As someone who has participated actively in medical progress for over forty years, I hope that the future will bring more innovation and less denial than in the past. The combined efforts of physicians, scientists, and men and women of goodwill both inside and outside of government are required for this to happen.
Joseph D. Schulman, M.D.
Genetics & IVF Institute
The author, a former professor and head of the Inter-Institute Medical Genetics Program at the National Institutes of Health, worked with Professor Edwards and Mr. Steptoe in England for an entire year in the 1970s on development of the first successful human IVF methods. He is the only American scientist or physician to have had the privilege of such participation.