2010年10月4日 星期一

Robert Edwards

Press Release

2010-10-04

The Nobel Assembly at Karolinska Institutet has today decided to award

The Nobel Prize in Physiology or Medicine 2010

to

Robert G. Edwards

for the development of in vitro fertilization

Summary

Robert Edwards is awarded the 2010 Nobel Prize for the development of human in vitro fertilization (IVF) therapy. His achievements have made it possible to treat infertility, a medical condition afflicting a large proportion of humanity including more than 10% of all couples worldwide.

As early as the 1950s, Edwards had the vision that IVF could be useful as a treatment for infertility. He worked systematically to realize his goal, discovered important principles for human fertilization, and succeeded in accomplishing fertilization of human egg cells in test tubes (or more precisely, cell culture dishes). His efforts were finally crowned by success on 25 July, 1978, when the world's first "test tube baby" was born. During the following years, Edwards and his co-workers refined IVF technology and shared it with colleagues around the world.

Approximately four million individuals have so far been born following IVF. Many of them are now adult and some have already become parents. A new field of medicine has emerged, with Robert Edwards leading the process all the way from the fundamental discoveries to the current, successful IVF therapy. His contributions represent a milestone in the development of modern medicine.

Infertility – a medical and psychological problem

More than 10% of all couples worldwide are infertile. For many of them, this is a great disappointment and for some causes lifelong psychological trauma. Medicine has had limited opportunities to help these individuals in the past. Today, the situation is entirely different. In vitro fertilization (IVF) is an established therapy when sperm and egg cannot meet inside the body.

Basic research bears fruit

The British scientist Robert Edwards began his fundamental research on the biology of fertilization in the 1950s. He soon realized that fertilization outside the body could represent a possible treatment of infertility. Other scientists had shown that egg cells from rabbits could be fertilized in test tubes when sperm was added, giving rise to offspring. Edwards decided to investigate if similar methods could be used to fertilize human egg cells.

It turned out that human eggs have an entirely different life cycle than those of rabbits. In a series of experimental studies conducted together with several different co-workers, Edwards made a number of fundamental discoveries. He clarified how human eggs mature, how different hormones regulate their maturation, and at which time point the eggs are susceptible to the fertilizing sperm. He also determined the conditions under which sperm is activated and has the capacity to fertilize the egg. In 1969, his efforts met with success when, for the first time, a human egg was fertilized in a test tube.

In spite of this success, a major problem remained. The fertilized egg did not develop beyond a single cell division. Edwards suspected that eggs that had matured in the ovaries before they were removed for IVF would function better, and looked for possible ways to obtain such eggs in a safe way.

From experiment to clinical medicine

Edwards contacted the gynecologist Patrick Steptoe. He became the clinician who, together with Edwards, developed IVF from experiment to practical medicine. Steptoe was one of the pioneers in laparoscopy, a technique that was new and controversial at the time. It allows inspection of the ovaries through an optical instrument. Steptoe used the laparoscope to remove eggs from the ovaries and Edwards put the eggs in cell culture and added sperm. The fertilized egg cells now divided several times and formed early embryos, 8 cells in size (see figure).

These early studies were promising but the Medical Research Council decided not to fund a continuation of the project. However, a private donation allowed the work to continue. The research also became the topic of a lively ethical debate that was initiated by Edwards himself. Several religious leaders, ethicists, and scientists demanded that the project be stopped, while others gave it their support.

The birth of Louise Brown - an historic event

Edwards and Steptoe could continue their research thanks to the new donation. By analyzing the patients' hormone levels, they could determine the best time point for fertilization and maximize the chances for success. In 1978, Lesley and John Brown came to the clinic after nine years of failed attempts to have a child. IVF treatment was carried out, and when the fertilized egg had developed into an embryo with 8 cells, it was returned to Mrs. Brown. A healthy baby, Louise Brown, was born through Caesarian section after a full-term pregnancy, on 25 July, 1978. IVF had moved from vision to reality and a new era in medicine had begun.

IVF is refined and spreads around the world

Edwards and Steptoe established the Bourn Hall Clinic in Cambridge, the world's first centre for IVF therapy. Steptoe was its medical director until his death in 1988, and Edwards was its head of research until his retirement. Gynecologists and cell biologists from all around the world trained at Bourn Hall, where the methods of IVF were continuously refined. By 1986, 1,000 children had already been born following IVF at Bourn Hall, representing approximately half of all children born after IVF in the world at that time.

Today, IVF is an established therapy throughout the world. It has undergone several important improvements. For example, single sperm can be microinjected directly into the egg cell in the culture dish. This method has improved the treatment of male infertility by IVF. Furthermore, mature eggs suitable for IVF can be identified by ultrasound and removed with a fine syringe rather than through the laparoscope.

IVF is a safe and effective therapy. 20-30% of fertilized eggs lead to the birth of a child. Complications include premature births but are very rare, particularly when one egg only is inserted into the mother. Long-term follow-up studies have shown that IVF children are as healthy as other children.

Approximately four million individuals have been born thanks to IVF. Louise Brown and several other IVF children have given birth to children themselves; this is probably the best evidence for the safety and success of IVF therapy. Today, Robert Edwards' vision is a reality and brings joy to infertile people all over the world.


Robert G. Edwards was born in 1925 in Manchester, England. After military service in the Second World War, he studied biology at the University of Wales in Bangor and at Edinburgh University in Scotland, where he received his PhD in 1955 with a Thesis on embryonal development in mice. He became a staff scientist at the National Institute for Medical Research in London in 1958 and initiated his research on the human fertilization process. From 1963, Edwards worked in Cambridge, first at its university and later at Bourn Hall Clinic, the world's first IVF centre, which he founded together with Patrick Steptoe. Edwards was its research director for many years and he was also the editor of several leading scientific journals in the area of fertilization. Robert Edwards is currently professor emeritus at the University of Cambridge.

References:

Edwards RG. Maturation in vitro of human ovarian oocytes. Lancet 1965; 2:926-929.

Edwards RG, Bavister BD, Steptoe PC. Early stages of fertilization in vitro of human oocytes matured in vitro. Nature 1969; 221:632-635.

Edwards RG, Steptoe PC, Purdy JM. Fertilization and cleavage in vitro of human oocytes matured in vivo. Nature 1970; 227:1307-1309.

Steptoe PC, Edwards RG. Birth after the reimplantation of a human embryo. Lancet 1978; 2:366.

Edwards RG. The bumpy road to human in vitro fertilization. Nature Med 2001; 7:1091-4.

(中央社記者黃貞貞倫敦4日專電)全球首創「試管嬰兒」技術的英國生理學家愛德華茲,在歷經逾半個世紀後,今天終於獲得象徵科學界最高榮譽的諾貝爾醫學 獎,這項技術在全球已創造400萬個新生命。

高齡85歲的愛德華茲(Robert Edwards)出生曼徹斯特,曾參與第2次世界大戰,先後在威爾斯大學及愛丁堡大學研讀生物學,1955年攻讀博士時研究老鼠的受精卵。

1958年愛德華茲在倫敦的「國家醫學研究中心」開始發展試管嬰兒技術,之後與英國外科醫師史泰普托(Patrick Steptoe)在劍橋創辦全球第1個人工受孕中心Bourn Hall Clinic。

愛德華茲與史泰普托當時研發的人工受孕新技術,受到教會甚至政府的反對,科學界也對他們的研究存疑,因此籌措研究經費時常碰壁,只能靠私人捐款,但他們始 終堅持不放棄。

1978年7月25日全球第1個試管嬰兒露薏絲.布朗(Louise Brown)誕生,寫下歷史新頁,露薏絲的父母嘗試懷孕9年未果,小女兒的誕生令他們喜出望外。

32歲的露薏絲現已升格當媽媽,生下健康活潑小男孩,再寫下試管嬰兒生育的新記錄。

愛德華茲目前在劍橋大學擔任榮譽教授,他曾說,「人生最重要的事莫過於生育小孩,世上沒有比小孩更特別的事物」

最令愛德華茲驕傲的事,就是在露薏絲.布朗後,有上千名嬰兒在Bourn Hall Clinic誕生,看著生命生生不息的傳承,愛德華茲甚感欣慰。

劍橋大學複製科學教授強生(Martin Johnson)對愛德華茲獲諾貝爾獎十分高興。他說,「愛德華茲早就該得這個獎了,不知道諾貝爾獎評審為何拖了這麼久,但愛德華茲很開心」。

強生表示,愛德華茲是位很有遠見的科學家,不只是人工受孕,包括在60年代就主張的「胚胎著床前基因診斷」(PGD)、70年代的幹細胞研究,他總是走在 時代的前端,不畏衛道人士的反對,堅持努力研究工作。

愛德華茲將獲得獎金1000萬瑞典克朗。他的研究夥伴史泰普托已於1988年過世,根據諾貝爾獎基金會的規定,得獎人若已亡故,不追贈獎項或獎金,除非是 在宣布得獎後過世。991004

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