Development of in vitro fertilization in Australia.

In vitro fertilization (IVF) began in Melbourne in 1970 when Carl Wood founded a research group at the Queen Victoria Hospital. The group reported the first biochemical pregnancy from a transferred IVF embryo in 1973. The group included the Royal Women's Hospital Melbourne, and they were the first to report confirmation of the British group's pregnancies with the use of IVF in natural cycles in 1980. The group then split, and the Monash group pursued fertility drug-induced multiple follicle growth in controlled ovulatory cycles and demonstrated for the first time that they could achieve multiple pregnancies in 1980-1981. This became the basis of a sustainable procedure for treating infertile patients. Successful embryo freezing and thawing methods resulted in pregnancies for the first time and were adopted to cryopreserve excess embryos produced after superovulation. Embryo donation methods were devised for anovulatory patients and were the first reported use of oocyte in vitro maturation techniques (IVM) for polycystic ovarian syndrome patients. Sperm microinjection techniques were pioneered for enabling fertilization for severely infertile men, and micromanipulative techniques were published for embryo biopsy for potential use in preimplantation genetic diagnosis (PGD) for patients with inheritable genetic diseases. The latter research programs were hampered by creation of restrictive embryo research laws in the State of Victoria, handicapping their timely clinical applications. Work on cryopreservation of ovarian tissue for cancer patients enabled clinical application of this for patients at risk of loss of fertility. Vitrification was developed as an alternative to freezing for oocytes and embryos, and this has now replaced the original slow cooling methods. Blastocyst culture systems were devised and optimized to improve IVF success and PGD.

Pioneering contributions by Robert Edwards to oocyte in vitro maturation (IVM).

The history of in vitro maturation (IVM) of mammalian oocytes, especially of human oocytes, holds a special place for Robert Edwards. He was the first to comprehensively examine and demonstrate maturation of human oocytes in vitro and in so doing he changed the course of medicine by fertilizing them in vitro. In reviewing his contribution, we have examined the state of the field at the time and discuss his pioneering insights into mammalian oocyte biology. We will also discuss how some of the major concepts and challenges identified by Edwards 50 years ago remain among the major challenges facing IVM today.