The Evolution of the Assisted Reproduction Technologies

Abstract

It could be said that the first instance of assisted reproductive technology (ART) was when an eminent surgeon, John Hunter (1728–1793) of London (Figure 1.1), assisted a woman in becoming pregnant by taking a semen sample produced by her husband, who had hypospadias, and inseminating her with that specimen. This was an “assisted conception,” although it is not strictly within the definition of the present-day ARTs, which involve the manipulation of sperm, oocytes and embryos in vitro, and include: • in vitro fertilization (IVF) • intracytoplasmic sperm injection (ICSI) • gamete intra-fallopian transfer (GIFT) – now rarely practiced • zygote intra-fallopian transfer (ZIFT) – now rarely practiced • intrauterine insemination (IUI) of prepared husband/partner/donor sperm • oocyte and embryo donation • cryopreservation of sperm, oocytes, and embryos • gestational surrogacy • preimplantation genetic diagnosis and aneuploidy screening • in vitro maturation of oocytes • cryopreservation of testicular and ovarian tissue for future autologous use • transplantation of ovarian tissue or whole ovaries However, although John Hunter’s treatment of his patient was one of the first instances of outside interference with the human reproductive process, man’s interest in fertility and conception in animal species and in humans goes back thousands of years. As early as the fifth century BC, Hippocrates (c. 460–370 BC), who is commonly thought of as the “father of medicine,” believed that both males and females produced the “liquor” which blended within the woman’s body and created babies. Some one hundred years later, Aristotle (384– 422 BC) proposed the theory that children are the product of “the mingling of male and female seed.” This firmly opposed the then prevailing theory that children were from the male “seed” and women were merely the receptacle for the child. This latter idea prevailed until the sixteenth century, when William Harvey (1578–1657) (Figure 1.2), having studied the behavior and Figure 1.1 John Hunter (1728–1793) First reported person to successfully perform artificial insemination in a human