In part two of our three-part series on fertility, we'll explore the revolutionary development of IVF (in vitro fertilisation).
We'll look at its impact, accessibility, and how it is changing the way in which people think about having babies.
[00:00:05] Hello, hello hello, and welcome to English Learning for Curious Minds, by Leonardo English.
[00:00:12] The show where you can listen to fascinating stories, and learn weird and wonderful things about the world at the same time as improving your English.
[00:00:21] I'm Alastair Budge, and today is part two of our three-part mini-series on fertility in the 21st century.
[00:00:30] In case you missed it, part one was on the world’s shrinking population, where we looked at some of the reasons behind this and its potential consequences.
[00:00:39] Next up, in part three, we are going to talk about the future of fertility, and look at some unusual theories about how babies might be born in 50 or 100 years from now.
[00:00:53] And in part two, in this episode, we are going to look at one of the most important developments in the history of fertility, in vitro fertilisation, otherwise known as IVF.
[00:01:06] So, let’s not waste a minute, and get right into it.
[00:01:11] On July 25th, 1978, at the Royal Oldham Hospital in Britain, a young couple waited expectantly to meet their new baby.
[00:01:23] The mother, Lesley Brown, was scheduled to go in for a caesarian section.
[00:01:30] On the face of it, it was a routine procedure, but nothing about this birth would be routine.
[00:01:39] Thousands of reporters had set up camp outside the hospital, there was even a camera crew that was allowed into the operating room to capture the operation, recording the most intimate moments and details of the birth.
[00:01:56] See, Lesley Brown and her husband had tried to conceive a child for 9 years, without any luck.
[00:02:05] It turned out that Lesley had blocked fallopian tubes, which meant that she was unable to naturally conceive a child.
[00:02:16] 9 months beforehand, she had undergone a then untested procedure called “IVF”, where a mature egg was removed from one of her ovaries, put in a laboratory dish and combined with her husband’s sperm.
[00:02:34] It showed early promise, and the fertilised egg was then put back into her womb.
[00:02:43] It looked like a foetus was growing well, and all the frequent tests she underwent seemed to suggest that there was a perfectly normal baby growing inside her.
[00:02:56] Of course, there was only one way to find out.
[00:03:00] And so it was, on July 25th, 1978, with the attention of the world’s media concentrated in that small operating theatre in Oldham, the doctors were finally going to see for themselves.
[00:03:18] As they removed the baby from her mother’s womb, they discovered a beautiful little baby girl.
[00:03:25] She had 10 fingers and 10 toes, two arms, two legs, two eyes, two ears, one nose, she cried out like every other little baby born that day.
[00:03:36] The doctors did over a hundred tests on the newborn child, and each one came back saying that she was perfectly normal.
[00:03:47] Her parents were, like any new parents, overcome with joy.
[00:03:53] They named the girl Louise.
[00:03:56] When she was four years old, just before she went to school, her parents told her that there was something a bit different about how she was born, and the young girl soon realised that photographers and journalists seemed to be very interested in her.
[00:04:13] They would turn up at birthday parties, they would interview her, and follow her life’s journey.
[00:04:21] And what they saw was, with absolutely no offence intended to Louise Brown, a very normal woman living a very normal life.
[00:04:32] She went to school, she got married, and she had two children of her own.
[00:04:38] Although she had no choice in the matter, she was a pioneer; she was the first baby to be born using a completely untested and unknown technology called in vitro fertilisation, or IVF for short.
[00:04:54] Since then, more than 12 million people have been born using the same technology, with an average of more than one IVF baby born a minute.
[00:05:05] I have many friends who are IVF babies, I have friends who have IVF babies, I imagine you know plenty of IVF babies too, perhaps you are an IVF baby or you have an IVF baby of your own.
[00:05:21] The point is, it is now incredibly widespread in many countries, with Denmark leading the world with 9% of all new babies born through IVF.
[00:05:32] So, in this episode we are going to look at this revolutionary medical development.
[00:05:38] First, some biology.
[00:05:42] As you will no doubt remember from school biology lessons, and perhaps pictures in textbooks that some of your classmates would snigger over, babies are conceived by sperm fertilising an egg, which then implants itself in the uterus, where it can grow and develop into a foetus, and as if by magic, 40 weeks or so later a fully functioning human emerges.
[00:06:09] Of course, it is rarely that simple. Things go wrong. Men can have a low sperm count, women can have blocked fallopian tubes, there may be issues with the production of or quality of the eggs produced.
[00:06:25] All manner of things can go wrong, and it is a biological miracle that I am here talking to you and you are listening.
[00:06:35] What’s more, time is not on our side. The females of almost all mammals can continue to have babies until old age, but not humans.
[00:06:48] We humans are not so lucky, or to be precise, female humans are not so lucky.
[00:06:55] As you’ll know, with every year after the age of 30 or so, a woman’s fertility rate drops, so the longer someone waits to try to conceive, statistically the harder it is.
[00:07:10] And, as we talked about in part one of this mini-series, statistically women are having babies later and later. In England and Wales the average age for a woman to have her first child is 29, up from 24 fifty years ago.
[00:07:29] In Italy and Spain it's almost 32, and in Spain 10% of all births are to mothers who are over the age of 40.
[00:07:40] Parents all around the world are getting older, meaning that on average it is harder and takes longer for people to conceive than ever before.
[00:07:51] But, of course, enter stage right, IVF.
[00:07:57] As a reminder of how IVF works, the basic steps include removing eggs from the woman, combining them with the sperm of the father in a petri dish so that the sperm fertilises the egg to create an embryo, then several days later, implanting the egg back into the uterus, and hoping that it grows to be a full-size baby.
[00:08:22] Of course, this is a simplification, and there are other variations on how it works, but the IVF process in 2024 is broadly the same as the process that resulted in Louise Brown back in 1978.
[00:08:40] One area that has improved significantly, however, is how effective it is.
[00:08:47] According to a recent Economist report, around 25-30% of each round of embryos transferred to a woman now lead to a live birth, which is 4x improvement from what it was in the 1990s.
[00:09:05] And as anyone who has gone through IVF themself will know, this is crucially important, because the procedure of taking the eggs and then implanting them back into the uterus is invasive and painful. And that’s not to mention the emotional pain and heartache of getting your hopes up with every round of IVF, only to have them dashed if you hear the fateful words from your doctor of, “I’m sorry, it hasn’t worked this time”.
[00:09:37] So, IVF is getting more effective, but it is still far from perfect.
[00:09:45] Many couples go through years of IVF only to find that they are not able to conceive. It seems unfair, as couples who are more likely to conceive will do so more quickly, and those who are unlikely to conceive will go through many cycles of IVF and not have anything to see from it.
[00:10:08] And another element of IVF that is deeply unfair is the cost of it.
[00:10:14] In some countries, such as Denmark and Israel, the cost is heavily subsidised by the government, meaning that it is free in most cases.
[00:10:25] The right to have a child is seen as the fundamental right of any woman, so IVF is considered in the same category as any other healthcare procedure.
[00:10:37] But these are anomalies, most countries do not do this.
[00:10:43] IVF is a complicated procedure, it requires skilled medical professionals and a top-quality laboratory.
[00:10:52] As a result, it’s expensive. It is expensive in Denmark and Israel, it just so happens that the state pays, not the individual.
[00:11:03] Elsewhere, hopeful couples aren’t so lucky.
[00:11:07] The cost of a standard IVF cycle varies, but it can reach $20,000 per cycle in the United States.
[00:11:17] And when you factor in that many IVF patients, especially those aged 40 and older, can have to undergo multiple cycles, often 6 or more, and even then there are no guarantees of success, it can get very expensive.
[00:11:35] It probably comes as no surprise that a sort of IVF tourism market has popped up, with countries advertising their low cost and high quality IVF clinics.
[00:11:47] Hotspots in Europe include the Czech Republic and Poland, where a cycle can be under €3,000, and hopeful parents from more expensive countries fly in, crossing their fingers that they will become one of the clinic’s success stories, plastered on the wall with a beaming smile and a little baby 9 months later.
[00:12:11] Elsewhere in the world, especially in lower income countries, this simply isn’t an option.
[00:12:18] €3,000 might be an amount of money that an average European couple could scrape together if needs be, but for many people in lower income countries this is more than a lifetime of savings.
[00:12:34] Again from that same Economist article I mentioned earlier, one study suggested that in lower income countries a single cycle of IVF costs between 50% and 200% of people’s average annual income.
[00:12:52] And to make matters worse, one of the most common reasons for fertility problems is blocked fallopian tubes, which are often caused by infections suffered more frequently by women in poorer countries.
[00:13:07] In other words, women in poorer countries are more likely to have fertility problems, and if they do, they are less likely to have the financial resources to do anything about it.
[00:13:21] But in the countries where IVF is either heavily subsidised by the government or relatively affordable privately, it has been a boon for tens of millions of parents.
[00:13:35] Couples who would, in all probability, not have been able to have children, have been able to become parents.
[00:13:43] And if there was something of a taboo in the early days, that is long gone; IVF, and often the pain and anguish that comes along with it, is something that people are willing to talk about publicly.
[00:13:58] From celebrities like Michelle Obama and Celine Dion through to my friends and perhaps yours, in many developed countries it has become something that people are happy to talk about in the same way as they might talk about any other health issue.
[00:14:14] It is a wonderful development, but IVF is not a miracle cure, and it doesn’t work for everyone.
[00:14:23] The biggest barrier facing IVF, apart from the cost, that is, is the clock; the older the egg, the lower the chance of success.
[00:14:35] The statistics show that IVF is much less likely to succeed for a woman in her 40s than her 30s, but that is not because of the age of the woman but because of the age of the egg.
[00:14:50] However, as you may know, there is a solution to this: freezing your eggs.
[00:14:57] If a woman decides to freeze some of her eggs when she is, let’s say, in her late 20s, then these can be used for a round of IVF in her 30s or even 40s, and the probability of success is similar to that of a woman in her late 20s, not in her 40s.
[00:15:17] Now, freezing eggs is not cheap, but as more women are deciding to put off starting a family until later in life, egg freezing has boomed, with the number of British women freezing their eggs increasing by 64% from 2019 to 2021.
[00:15:38] Yes, the process of collecting eggs to freeze them is invasive and unpleasant, but it is considerably less so than it was in the 1980s.
[00:15:50] If this becomes increasingly more widespread and accepted, if the procedure becomes even less invasive and cheaper, and if it becomes a very normal thing for women to freeze their eggs just in case, then this could lead to an even greater shift upwards in the average age at birth.
[00:16:13] After all, if people want it and IVF allows it, there is nothing to stop it.
[00:16:21] And if this is the case, it would lead to a large increase in the number of people opting for IVF.
[00:16:29] Globally around 1% of babies are born to IVF, but if Denmark and Israel are anything to go by, it could easily go 10%, a 10x increase.
[00:16:42] And although it is now almost universally accepted and acknowledged as an important fertility procedure, there are still some critics who argue that it is teetering towards playing God.
[00:16:57] If it becomes a standard thing to freeze your eggs when you are 25 because you know that you can have a baby at 45, so the critics say, how would this affect society?
[00:17:09] If a woman can have 10 eggs removed, and the process becomes so efficient and advanced that a parent can have 10 embryos growing outside the body, potentially choosing which one to keep based on certain criteria, then this really would be moving into “creator-like territory”.
[00:17:29] And that, my dear friends, is what we will talk about in our next episode, the future of fertility.
[00:17:37] OK then, that is it for part two of this mini-series on fertility in the 21st century, where we looked at IVF.
[00:17:46] As always, I would love to know what you thought about this episode.
[00:17:50] Do you remember the news of the first IVF baby in your country? Do you have experience with IVF that you would be happy to share? It is clearly a sensitive topic, but I would love to hear your thoughts and experience.
[00:18:03] You can head right into our community forum, which is at community.leonardoenglish.com and get chatting away to other curious minds.
[00:18:12] You've been listening to English Learning for Curious Minds, by Leonardo English.
[00:18:17] I'm Alastair Budge, you stay safe, and I'll catch you in the next episode.
[END OF EPISODE]
[00:00:05] Hello, hello hello, and welcome to English Learning for Curious Minds, by Leonardo English.
[00:00:12] The show where you can listen to fascinating stories, and learn weird and wonderful things about the world at the same time as improving your English.
[00:00:21] I'm Alastair Budge, and today is part two of our three-part mini-series on fertility in the 21st century.
[00:00:30] In case you missed it, part one was on the world’s shrinking population, where we looked at some of the reasons behind this and its potential consequences.
[00:00:39] Next up, in part three, we are going to talk about the future of fertility, and look at some unusual theories about how babies might be born in 50 or 100 years from now.
[00:00:53] And in part two, in this episode, we are going to look at one of the most important developments in the history of fertility, in vitro fertilisation, otherwise known as IVF.
[00:01:06] So, let’s not waste a minute, and get right into it.
[00:01:11] On July 25th, 1978, at the Royal Oldham Hospital in Britain, a young couple waited expectantly to meet their new baby.
[00:01:23] The mother, Lesley Brown, was scheduled to go in for a caesarian section.
[00:01:30] On the face of it, it was a routine procedure, but nothing about this birth would be routine.
[00:01:39] Thousands of reporters had set up camp outside the hospital, there was even a camera crew that was allowed into the operating room to capture the operation, recording the most intimate moments and details of the birth.
[00:01:56] See, Lesley Brown and her husband had tried to conceive a child for 9 years, without any luck.
[00:02:05] It turned out that Lesley had blocked fallopian tubes, which meant that she was unable to naturally conceive a child.
[00:02:16] 9 months beforehand, she had undergone a then untested procedure called “IVF”, where a mature egg was removed from one of her ovaries, put in a laboratory dish and combined with her husband’s sperm.
[00:02:34] It showed early promise, and the fertilised egg was then put back into her womb.
[00:02:43] It looked like a foetus was growing well, and all the frequent tests she underwent seemed to suggest that there was a perfectly normal baby growing inside her.
[00:02:56] Of course, there was only one way to find out.
[00:03:00] And so it was, on July 25th, 1978, with the attention of the world’s media concentrated in that small operating theatre in Oldham, the doctors were finally going to see for themselves.
[00:03:18] As they removed the baby from her mother’s womb, they discovered a beautiful little baby girl.
[00:03:25] She had 10 fingers and 10 toes, two arms, two legs, two eyes, two ears, one nose, she cried out like every other little baby born that day.
[00:03:36] The doctors did over a hundred tests on the newborn child, and each one came back saying that she was perfectly normal.
[00:03:47] Her parents were, like any new parents, overcome with joy.
[00:03:53] They named the girl Louise.
[00:03:56] When she was four years old, just before she went to school, her parents told her that there was something a bit different about how she was born, and the young girl soon realised that photographers and journalists seemed to be very interested in her.
[00:04:13] They would turn up at birthday parties, they would interview her, and follow her life’s journey.
[00:04:21] And what they saw was, with absolutely no offence intended to Louise Brown, a very normal woman living a very normal life.
[00:04:32] She went to school, she got married, and she had two children of her own.
[00:04:38] Although she had no choice in the matter, she was a pioneer; she was the first baby to be born using a completely untested and unknown technology called in vitro fertilisation, or IVF for short.
[00:04:54] Since then, more than 12 million people have been born using the same technology, with an average of more than one IVF baby born a minute.
[00:05:05] I have many friends who are IVF babies, I have friends who have IVF babies, I imagine you know plenty of IVF babies too, perhaps you are an IVF baby or you have an IVF baby of your own.
[00:05:21] The point is, it is now incredibly widespread in many countries, with Denmark leading the world with 9% of all new babies born through IVF.
[00:05:32] So, in this episode we are going to look at this revolutionary medical development.
[00:05:38] First, some biology.
[00:05:42] As you will no doubt remember from school biology lessons, and perhaps pictures in textbooks that some of your classmates would snigger over, babies are conceived by sperm fertilising an egg, which then implants itself in the uterus, where it can grow and develop into a foetus, and as if by magic, 40 weeks or so later a fully functioning human emerges.
[00:06:09] Of course, it is rarely that simple. Things go wrong. Men can have a low sperm count, women can have blocked fallopian tubes, there may be issues with the production of or quality of the eggs produced.
[00:06:25] All manner of things can go wrong, and it is a biological miracle that I am here talking to you and you are listening.
[00:06:35] What’s more, time is not on our side. The females of almost all mammals can continue to have babies until old age, but not humans.
[00:06:48] We humans are not so lucky, or to be precise, female humans are not so lucky.
[00:06:55] As you’ll know, with every year after the age of 30 or so, a woman’s fertility rate drops, so the longer someone waits to try to conceive, statistically the harder it is.
[00:07:10] And, as we talked about in part one of this mini-series, statistically women are having babies later and later. In England and Wales the average age for a woman to have her first child is 29, up from 24 fifty years ago.
[00:07:29] In Italy and Spain it's almost 32, and in Spain 10% of all births are to mothers who are over the age of 40.
[00:07:40] Parents all around the world are getting older, meaning that on average it is harder and takes longer for people to conceive than ever before.
[00:07:51] But, of course, enter stage right, IVF.
[00:07:57] As a reminder of how IVF works, the basic steps include removing eggs from the woman, combining them with the sperm of the father in a petri dish so that the sperm fertilises the egg to create an embryo, then several days later, implanting the egg back into the uterus, and hoping that it grows to be a full-size baby.
[00:08:22] Of course, this is a simplification, and there are other variations on how it works, but the IVF process in 2024 is broadly the same as the process that resulted in Louise Brown back in 1978.
[00:08:40] One area that has improved significantly, however, is how effective it is.
[00:08:47] According to a recent Economist report, around 25-30% of each round of embryos transferred to a woman now lead to a live birth, which is 4x improvement from what it was in the 1990s.
[00:09:05] And as anyone who has gone through IVF themself will know, this is crucially important, because the procedure of taking the eggs and then implanting them back into the uterus is invasive and painful. And that’s not to mention the emotional pain and heartache of getting your hopes up with every round of IVF, only to have them dashed if you hear the fateful words from your doctor of, “I’m sorry, it hasn’t worked this time”.
[00:09:37] So, IVF is getting more effective, but it is still far from perfect.
[00:09:45] Many couples go through years of IVF only to find that they are not able to conceive. It seems unfair, as couples who are more likely to conceive will do so more quickly, and those who are unlikely to conceive will go through many cycles of IVF and not have anything to see from it.
[00:10:08] And another element of IVF that is deeply unfair is the cost of it.
[00:10:14] In some countries, such as Denmark and Israel, the cost is heavily subsidised by the government, meaning that it is free in most cases.
[00:10:25] The right to have a child is seen as the fundamental right of any woman, so IVF is considered in the same category as any other healthcare procedure.
[00:10:37] But these are anomalies, most countries do not do this.
[00:10:43] IVF is a complicated procedure, it requires skilled medical professionals and a top-quality laboratory.
[00:10:52] As a result, it’s expensive. It is expensive in Denmark and Israel, it just so happens that the state pays, not the individual.
[00:11:03] Elsewhere, hopeful couples aren’t so lucky.
[00:11:07] The cost of a standard IVF cycle varies, but it can reach $20,000 per cycle in the United States.
[00:11:17] And when you factor in that many IVF patients, especially those aged 40 and older, can have to undergo multiple cycles, often 6 or more, and even then there are no guarantees of success, it can get very expensive.
[00:11:35] It probably comes as no surprise that a sort of IVF tourism market has popped up, with countries advertising their low cost and high quality IVF clinics.
[00:11:47] Hotspots in Europe include the Czech Republic and Poland, where a cycle can be under €3,000, and hopeful parents from more expensive countries fly in, crossing their fingers that they will become one of the clinic’s success stories, plastered on the wall with a beaming smile and a little baby 9 months later.
[00:12:11] Elsewhere in the world, especially in lower income countries, this simply isn’t an option.
[00:12:18] €3,000 might be an amount of money that an average European couple could scrape together if needs be, but for many people in lower income countries this is more than a lifetime of savings.
[00:12:34] Again from that same Economist article I mentioned earlier, one study suggested that in lower income countries a single cycle of IVF costs between 50% and 200% of people’s average annual income.
[00:12:52] And to make matters worse, one of the most common reasons for fertility problems is blocked fallopian tubes, which are often caused by infections suffered more frequently by women in poorer countries.
[00:13:07] In other words, women in poorer countries are more likely to have fertility problems, and if they do, they are less likely to have the financial resources to do anything about it.
[00:13:21] But in the countries where IVF is either heavily subsidised by the government or relatively affordable privately, it has been a boon for tens of millions of parents.
[00:13:35] Couples who would, in all probability, not have been able to have children, have been able to become parents.
[00:13:43] And if there was something of a taboo in the early days, that is long gone; IVF, and often the pain and anguish that comes along with it, is something that people are willing to talk about publicly.
[00:13:58] From celebrities like Michelle Obama and Celine Dion through to my friends and perhaps yours, in many developed countries it has become something that people are happy to talk about in the same way as they might talk about any other health issue.
[00:14:14] It is a wonderful development, but IVF is not a miracle cure, and it doesn’t work for everyone.
[00:14:23] The biggest barrier facing IVF, apart from the cost, that is, is the clock; the older the egg, the lower the chance of success.
[00:14:35] The statistics show that IVF is much less likely to succeed for a woman in her 40s than her 30s, but that is not because of the age of the woman but because of the age of the egg.
[00:14:50] However, as you may know, there is a solution to this: freezing your eggs.
[00:14:57] If a woman decides to freeze some of her eggs when she is, let’s say, in her late 20s, then these can be used for a round of IVF in her 30s or even 40s, and the probability of success is similar to that of a woman in her late 20s, not in her 40s.
[00:15:17] Now, freezing eggs is not cheap, but as more women are deciding to put off starting a family until later in life, egg freezing has boomed, with the number of British women freezing their eggs increasing by 64% from 2019 to 2021.
[00:15:38] Yes, the process of collecting eggs to freeze them is invasive and unpleasant, but it is considerably less so than it was in the 1980s.
[00:15:50] If this becomes increasingly more widespread and accepted, if the procedure becomes even less invasive and cheaper, and if it becomes a very normal thing for women to freeze their eggs just in case, then this could lead to an even greater shift upwards in the average age at birth.
[00:16:13] After all, if people want it and IVF allows it, there is nothing to stop it.
[00:16:21] And if this is the case, it would lead to a large increase in the number of people opting for IVF.
[00:16:29] Globally around 1% of babies are born to IVF, but if Denmark and Israel are anything to go by, it could easily go 10%, a 10x increase.
[00:16:42] And although it is now almost universally accepted and acknowledged as an important fertility procedure, there are still some critics who argue that it is teetering towards playing God.
[00:16:57] If it becomes a standard thing to freeze your eggs when you are 25 because you know that you can have a baby at 45, so the critics say, how would this affect society?
[00:17:09] If a woman can have 10 eggs removed, and the process becomes so efficient and advanced that a parent can have 10 embryos growing outside the body, potentially choosing which one to keep based on certain criteria, then this really would be moving into “creator-like territory”.
[00:17:29] And that, my dear friends, is what we will talk about in our next episode, the future of fertility.
[00:17:37] OK then, that is it for part two of this mini-series on fertility in the 21st century, where we looked at IVF.
[00:17:46] As always, I would love to know what you thought about this episode.
[00:17:50] Do you remember the news of the first IVF baby in your country? Do you have experience with IVF that you would be happy to share? It is clearly a sensitive topic, but I would love to hear your thoughts and experience.
[00:18:03] You can head right into our community forum, which is at community.leonardoenglish.com and get chatting away to other curious minds.
[00:18:12] You've been listening to English Learning for Curious Minds, by Leonardo English.
[00:18:17] I'm Alastair Budge, you stay safe, and I'll catch you in the next episode.
[END OF EPISODE]
[00:00:05] Hello, hello hello, and welcome to English Learning for Curious Minds, by Leonardo English.
[00:00:12] The show where you can listen to fascinating stories, and learn weird and wonderful things about the world at the same time as improving your English.
[00:00:21] I'm Alastair Budge, and today is part two of our three-part mini-series on fertility in the 21st century.
[00:00:30] In case you missed it, part one was on the world’s shrinking population, where we looked at some of the reasons behind this and its potential consequences.
[00:00:39] Next up, in part three, we are going to talk about the future of fertility, and look at some unusual theories about how babies might be born in 50 or 100 years from now.
[00:00:53] And in part two, in this episode, we are going to look at one of the most important developments in the history of fertility, in vitro fertilisation, otherwise known as IVF.
[00:01:06] So, let’s not waste a minute, and get right into it.
[00:01:11] On July 25th, 1978, at the Royal Oldham Hospital in Britain, a young couple waited expectantly to meet their new baby.
[00:01:23] The mother, Lesley Brown, was scheduled to go in for a caesarian section.
[00:01:30] On the face of it, it was a routine procedure, but nothing about this birth would be routine.
[00:01:39] Thousands of reporters had set up camp outside the hospital, there was even a camera crew that was allowed into the operating room to capture the operation, recording the most intimate moments and details of the birth.
[00:01:56] See, Lesley Brown and her husband had tried to conceive a child for 9 years, without any luck.
[00:02:05] It turned out that Lesley had blocked fallopian tubes, which meant that she was unable to naturally conceive a child.
[00:02:16] 9 months beforehand, she had undergone a then untested procedure called “IVF”, where a mature egg was removed from one of her ovaries, put in a laboratory dish and combined with her husband’s sperm.
[00:02:34] It showed early promise, and the fertilised egg was then put back into her womb.
[00:02:43] It looked like a foetus was growing well, and all the frequent tests she underwent seemed to suggest that there was a perfectly normal baby growing inside her.
[00:02:56] Of course, there was only one way to find out.
[00:03:00] And so it was, on July 25th, 1978, with the attention of the world’s media concentrated in that small operating theatre in Oldham, the doctors were finally going to see for themselves.
[00:03:18] As they removed the baby from her mother’s womb, they discovered a beautiful little baby girl.
[00:03:25] She had 10 fingers and 10 toes, two arms, two legs, two eyes, two ears, one nose, she cried out like every other little baby born that day.
[00:03:36] The doctors did over a hundred tests on the newborn child, and each one came back saying that she was perfectly normal.
[00:03:47] Her parents were, like any new parents, overcome with joy.
[00:03:53] They named the girl Louise.
[00:03:56] When she was four years old, just before she went to school, her parents told her that there was something a bit different about how she was born, and the young girl soon realised that photographers and journalists seemed to be very interested in her.
[00:04:13] They would turn up at birthday parties, they would interview her, and follow her life’s journey.
[00:04:21] And what they saw was, with absolutely no offence intended to Louise Brown, a very normal woman living a very normal life.
[00:04:32] She went to school, she got married, and she had two children of her own.
[00:04:38] Although she had no choice in the matter, she was a pioneer; she was the first baby to be born using a completely untested and unknown technology called in vitro fertilisation, or IVF for short.
[00:04:54] Since then, more than 12 million people have been born using the same technology, with an average of more than one IVF baby born a minute.
[00:05:05] I have many friends who are IVF babies, I have friends who have IVF babies, I imagine you know plenty of IVF babies too, perhaps you are an IVF baby or you have an IVF baby of your own.
[00:05:21] The point is, it is now incredibly widespread in many countries, with Denmark leading the world with 9% of all new babies born through IVF.
[00:05:32] So, in this episode we are going to look at this revolutionary medical development.
[00:05:38] First, some biology.
[00:05:42] As you will no doubt remember from school biology lessons, and perhaps pictures in textbooks that some of your classmates would snigger over, babies are conceived by sperm fertilising an egg, which then implants itself in the uterus, where it can grow and develop into a foetus, and as if by magic, 40 weeks or so later a fully functioning human emerges.
[00:06:09] Of course, it is rarely that simple. Things go wrong. Men can have a low sperm count, women can have blocked fallopian tubes, there may be issues with the production of or quality of the eggs produced.
[00:06:25] All manner of things can go wrong, and it is a biological miracle that I am here talking to you and you are listening.
[00:06:35] What’s more, time is not on our side. The females of almost all mammals can continue to have babies until old age, but not humans.
[00:06:48] We humans are not so lucky, or to be precise, female humans are not so lucky.
[00:06:55] As you’ll know, with every year after the age of 30 or so, a woman’s fertility rate drops, so the longer someone waits to try to conceive, statistically the harder it is.
[00:07:10] And, as we talked about in part one of this mini-series, statistically women are having babies later and later. In England and Wales the average age for a woman to have her first child is 29, up from 24 fifty years ago.
[00:07:29] In Italy and Spain it's almost 32, and in Spain 10% of all births are to mothers who are over the age of 40.
[00:07:40] Parents all around the world are getting older, meaning that on average it is harder and takes longer for people to conceive than ever before.
[00:07:51] But, of course, enter stage right, IVF.
[00:07:57] As a reminder of how IVF works, the basic steps include removing eggs from the woman, combining them with the sperm of the father in a petri dish so that the sperm fertilises the egg to create an embryo, then several days later, implanting the egg back into the uterus, and hoping that it grows to be a full-size baby.
[00:08:22] Of course, this is a simplification, and there are other variations on how it works, but the IVF process in 2024 is broadly the same as the process that resulted in Louise Brown back in 1978.
[00:08:40] One area that has improved significantly, however, is how effective it is.
[00:08:47] According to a recent Economist report, around 25-30% of each round of embryos transferred to a woman now lead to a live birth, which is 4x improvement from what it was in the 1990s.
[00:09:05] And as anyone who has gone through IVF themself will know, this is crucially important, because the procedure of taking the eggs and then implanting them back into the uterus is invasive and painful. And that’s not to mention the emotional pain and heartache of getting your hopes up with every round of IVF, only to have them dashed if you hear the fateful words from your doctor of, “I’m sorry, it hasn’t worked this time”.
[00:09:37] So, IVF is getting more effective, but it is still far from perfect.
[00:09:45] Many couples go through years of IVF only to find that they are not able to conceive. It seems unfair, as couples who are more likely to conceive will do so more quickly, and those who are unlikely to conceive will go through many cycles of IVF and not have anything to see from it.
[00:10:08] And another element of IVF that is deeply unfair is the cost of it.
[00:10:14] In some countries, such as Denmark and Israel, the cost is heavily subsidised by the government, meaning that it is free in most cases.
[00:10:25] The right to have a child is seen as the fundamental right of any woman, so IVF is considered in the same category as any other healthcare procedure.
[00:10:37] But these are anomalies, most countries do not do this.
[00:10:43] IVF is a complicated procedure, it requires skilled medical professionals and a top-quality laboratory.
[00:10:52] As a result, it’s expensive. It is expensive in Denmark and Israel, it just so happens that the state pays, not the individual.
[00:11:03] Elsewhere, hopeful couples aren’t so lucky.
[00:11:07] The cost of a standard IVF cycle varies, but it can reach $20,000 per cycle in the United States.
[00:11:17] And when you factor in that many IVF patients, especially those aged 40 and older, can have to undergo multiple cycles, often 6 or more, and even then there are no guarantees of success, it can get very expensive.
[00:11:35] It probably comes as no surprise that a sort of IVF tourism market has popped up, with countries advertising their low cost and high quality IVF clinics.
[00:11:47] Hotspots in Europe include the Czech Republic and Poland, where a cycle can be under €3,000, and hopeful parents from more expensive countries fly in, crossing their fingers that they will become one of the clinic’s success stories, plastered on the wall with a beaming smile and a little baby 9 months later.
[00:12:11] Elsewhere in the world, especially in lower income countries, this simply isn’t an option.
[00:12:18] €3,000 might be an amount of money that an average European couple could scrape together if needs be, but for many people in lower income countries this is more than a lifetime of savings.
[00:12:34] Again from that same Economist article I mentioned earlier, one study suggested that in lower income countries a single cycle of IVF costs between 50% and 200% of people’s average annual income.
[00:12:52] And to make matters worse, one of the most common reasons for fertility problems is blocked fallopian tubes, which are often caused by infections suffered more frequently by women in poorer countries.
[00:13:07] In other words, women in poorer countries are more likely to have fertility problems, and if they do, they are less likely to have the financial resources to do anything about it.
[00:13:21] But in the countries where IVF is either heavily subsidised by the government or relatively affordable privately, it has been a boon for tens of millions of parents.
[00:13:35] Couples who would, in all probability, not have been able to have children, have been able to become parents.
[00:13:43] And if there was something of a taboo in the early days, that is long gone; IVF, and often the pain and anguish that comes along with it, is something that people are willing to talk about publicly.
[00:13:58] From celebrities like Michelle Obama and Celine Dion through to my friends and perhaps yours, in many developed countries it has become something that people are happy to talk about in the same way as they might talk about any other health issue.
[00:14:14] It is a wonderful development, but IVF is not a miracle cure, and it doesn’t work for everyone.
[00:14:23] The biggest barrier facing IVF, apart from the cost, that is, is the clock; the older the egg, the lower the chance of success.
[00:14:35] The statistics show that IVF is much less likely to succeed for a woman in her 40s than her 30s, but that is not because of the age of the woman but because of the age of the egg.
[00:14:50] However, as you may know, there is a solution to this: freezing your eggs.
[00:14:57] If a woman decides to freeze some of her eggs when she is, let’s say, in her late 20s, then these can be used for a round of IVF in her 30s or even 40s, and the probability of success is similar to that of a woman in her late 20s, not in her 40s.
[00:15:17] Now, freezing eggs is not cheap, but as more women are deciding to put off starting a family until later in life, egg freezing has boomed, with the number of British women freezing their eggs increasing by 64% from 2019 to 2021.
[00:15:38] Yes, the process of collecting eggs to freeze them is invasive and unpleasant, but it is considerably less so than it was in the 1980s.
[00:15:50] If this becomes increasingly more widespread and accepted, if the procedure becomes even less invasive and cheaper, and if it becomes a very normal thing for women to freeze their eggs just in case, then this could lead to an even greater shift upwards in the average age at birth.
[00:16:13] After all, if people want it and IVF allows it, there is nothing to stop it.
[00:16:21] And if this is the case, it would lead to a large increase in the number of people opting for IVF.
[00:16:29] Globally around 1% of babies are born to IVF, but if Denmark and Israel are anything to go by, it could easily go 10%, a 10x increase.
[00:16:42] And although it is now almost universally accepted and acknowledged as an important fertility procedure, there are still some critics who argue that it is teetering towards playing God.
[00:16:57] If it becomes a standard thing to freeze your eggs when you are 25 because you know that you can have a baby at 45, so the critics say, how would this affect society?
[00:17:09] If a woman can have 10 eggs removed, and the process becomes so efficient and advanced that a parent can have 10 embryos growing outside the body, potentially choosing which one to keep based on certain criteria, then this really would be moving into “creator-like territory”.
[00:17:29] And that, my dear friends, is what we will talk about in our next episode, the future of fertility.
[00:17:37] OK then, that is it for part two of this mini-series on fertility in the 21st century, where we looked at IVF.
[00:17:46] As always, I would love to know what you thought about this episode.
[00:17:50] Do you remember the news of the first IVF baby in your country? Do you have experience with IVF that you would be happy to share? It is clearly a sensitive topic, but I would love to hear your thoughts and experience.
[00:18:03] You can head right into our community forum, which is at community.leonardoenglish.com and get chatting away to other curious minds.
[00:18:12] You've been listening to English Learning for Curious Minds, by Leonardo English.
[00:18:17] I'm Alastair Budge, you stay safe, and I'll catch you in the next episode.
[END OF EPISODE]
