When was the first embryo transfer performed?
Embryo cryopreservation
The first ever pregnancy derived from a frozen human embryo was reported by Alan Trounson & Linda Mohr in 1983 (although the fetus aborted spontaneously at ten weeks of gestation); the first term pregnancy derived from a frozen embryo was born in 1984. Since then and up to 2008 it is estimated that between 350,000 and half a million IVF babies have been born from embryos frozen at a controlled rate and then stored in liquid nitrogen; additionally a few hundred births have been born from vitrified oocytes but firm figures are hard to come by. It may be noted that Subash Mukhopadyay from Kolkata, India reported the successful cryopreservation of an eight cell embryo, storing it for 53 days, thawing and replacing it into the mother’s womb, resulting in a successful and live birth as early as 1978- a full five years before Trounson and Mohr had done so. A small publication of Mukherjee in 1978 clearly shows that Mukherjee was on the right line of thinking much before anyone else had demonstrated the successful outcome of a pregnancy following the transfer of a 8-cell frozen-thawed embryo into human subjects transferring 8-cell cryopreserved embryos." (Current Science, Vol .72. No. 7, 10 April 1997)
Emerich Ullmann
Ullmann was a pioneer of renal transplantation research. In 1902, he performed the first successful renal autotransplantation in a dog. Reportedly, the kidney remained functional for five days. Soon afterwards, he was unsuccessful in trying the first renal xenotransplantation (cross-species transplant) between a goat and a dog. Following an unsuccessful attempt to transplant a pig's kidney into a human patient, who was in the final stage of renal disease, he stopped research of kidney transplantation.
Uterus transplantation
The first uterine transplant performed in India took place on 18 May 2017 at the Galaxy Care Hospital in Pune, Maharashtra. The 26-year-old patient had been born without a uterus, and received her mother's womb in the transplant.
Stem cell controversy
In 1973," Roe v. Wade" legalized abortion in the United States. Five years later, the first successful human "in vitro" fertilization resulted in the birth of Louise Brown in England. These developments prompted the federal government to create regulations barring the use of federal funds for research that experimented on human embryos. In 1995, the NIH Human Embryo Research Panel advised the administration of President Bill Clinton to permit federal funding for research on embryos left over from "in vitro" fertility treatments and also recommended federal funding of research on embryos specifically created for experimentation. In response to the panel's recommendations, the Clinton administration, citing moral and ethical concerns, declined to fund research on embryos created solely for research purposes, but did agree to fund research on leftover embryos created by "in vitro" fertility treatments. At this point, the Congress intervened and passed the 1995 Dickey–Wicker Amendment (the final bill, which included the Dickey-Wicker Amendment, was signed into law by Bill Clinton) which prohibited any federal funding for the Department of Health and Human Services be used for research that resulted in the destruction of an embryo regardless of the source of that embryo.
Embryo culture
The duration of embryo culture can be varied, conferring different stages of embryogenesis at embryo transfer. The main stages at which embryo transfer is performed are cleavage stage (day 2 to 4 after co-incubation) or the blastocyst stage (day 5 or 6 after co-incubation).
Liver transplantation
As with many experimental models used in early surgical research, the first attempts at liver transplantation were performed on dogs. The earliest published reports of canine liver transplantations were performed in 1955 by Vittorio Staudacher at Opedale Maggiore Policlinico in Milan, Italy. This initial attempt varied significantly from contemporary techniques; for example, Staudacher reported "arterialization" of the donor portal vein via the recipient hepatic artery, and use of cholecystostomy for biliary drainage.
University of Louisville School of Medicine
In 2001, University of Louisville and Jewish Hospital physicians and researchers, Drs. Laman A. Gray, Jr. and Robert D. Dowling, performed the world's first implantation of the AbioCor Implantable Replacement Heart on July 2, in a seven-hour procedure at Jewish Hospital in Louisville, Kentucky. University of Louisville cardiothoracic surgeons have performed many other novel procedures, including Kentucky's first heart transplant, the world's first heart transplant following the use of a Thoratec left ventricular assist device, the world's first endoscopic saphenous vein harvest and the first ventricular remodeling in the region.
In vitro fertilisation
During the selection and transfer phases, many embryos may be discarded in favour of others. This selection may be based on criteria such as genetic disorders or the sex. One of the earliest cases of special gene selection through IVF was the case of the Collins family in the 1990s, who selected the sex of their child. The ethic issues remain unresolved as no consensus exists in science, religion, and philosophy on when a human embryo should be recognised as a person. For those who believe that this is at the moment of conception, IVF becomes a moral question when multiple eggs are fertilised, begin development, and only a few are chosen for implantation.
Müllerian agenesis
Uterine transplantation has been performed in a number of people with MRKH, but the surgery is still in the experimental stage. Since ovaries are present, people with this condition can have genetic children through IVF with embryo transfer to a gestational carrier. Some also choose to adopt. In October 2014, it was reported that a month earlier a 36-year-old Swedish woman became the first person with a transplanted uterus to give birth to a healthy baby. She was born without a uterus, but had functioning ovaries. She and the father went through IVF to produce 11 embryos, which were then frozen. Doctors at the University of Gothenburg then performed the uterus transplant, the donor being a 61-year-old family friend. One of the frozen embryos was implanted a year after the transplant, and the baby boy was born prematurely at 31 weeks after the mother developed pre-eclampsia.
Blood transfusion
In the early 19th century, British obstetrician Dr. James Blundell made efforts to treat hemorrhage by transfusion of human blood using a syringe. In 1818 following experiments with animals, he performed the first successful transfusion of human blood to treat postpartum hemorrhage. Blundell used the patient's husband as a donor, and extracted four ounces of blood from his arm to transfuse into his wife. During the years 1825 and 1830, Blundell performed 10 transfusions, five of which were beneficial, and published his results. He also invented a number of instruments for the transfusion of blood. He made a substantial amount of money from this endeavour, roughly $2 million ($50 million real dollars).
Heart transplantation
Norman Shumway performed the first adult heart transplant in the United States on January 6, 1968, at the Stanford University Hospital. A team led by Donald Ross performed the first heart transplant in the United Kingdom on May 3, 1968. An allotransplantation is the technical term for a transplant from a non-genetically identical individual of the same species. Brain death is the current ethical standard for when a heart donation can be allowed.
Oocyte cryopreservation
Almost 42,000 'slow frozen' (as opposed to 'vitrified') human embryo transfers were performed during 2001 in Europe (Andersen et al. 2005). In addition, it is estimated that between 300,000 and 500,000 successful human births have resulted worldwide from the transfer of previously ‘slow frozen’ embryos performed from the mid-1970s to 2006.
Mitochondrial DNA
An IVF technique known as mitochondrial donation or mitochondrial replacement therapy (MRT) results in offspring containing mtDNA from a donor female, and nuclear DNA from the mother and father. In the spindle transfer procedure, the nucleus of an egg is inserted into the cytoplasm of an egg from a donor female which has had its nucleus removed, but still contains the donor female's mtDNA. The composite egg is then fertilized with the male's sperm. The procedure is used when a woman with genetically defective mitochondria wishes to procreate and produce offspring with healthy mitochondria. The first known child to be born as a result of mitochondrial donation was a boy born to a Jordanian couple in Mexico on 6 April 2016.
Embryo transfer
The development of various methods of cryopreservation of bovine embryos improved embryo transfer technique considerably efficient technology, no longer depending on the immediate readiness of suitable recipients. Pregnancy rates are just slightly less than those achieved with fresh embryos. Recently, the use of cryoprotectants such as ethylene glycol has permitted the direct transfer of bovine embryos. The world's first live crossbred bovine calf produced under tropical conditions by Direct Transfer (DT) of embryo frozen in ethylene glycol freeze media was born on 23 June 1996. Dr. Binoy Sebastian Vettical of Kerala Livestock Development Board Ltd has produced the embryo stored frozen in Ethylene Glycol freeze media by slow programmable freezing (SPF) technique and transferred directly to recipient cattle immediately after thawing the frozen straw in water for the birth of this calf. In a study, in vivo produced crossbred bovine embryos stored frozen in ethylene glycol freeze media were transferred directly to recipients under tropical conditions and achieved a pregnancy rate of 50 percent. In a survey of the North American embryo transfer industry, embryo transfer success rates from direct transfer of embryos were as good as to those achieved with glycerol. Moreover, in 2011, more than 95% of frozen-thawed embryos were transferred by Direct Transfer.
Uterus transplantation
In Turkey, on 9 August 2011, the world's first uterus transplant from a deceased donor was conducted by a team of doctors at Akdeniz University Hospital in Antalya. The 21-year-old Turkish woman, Derya Sert, who had been born without a uterus, was the first woman in history to receive a womb from a deceased donor. The operation, performed by Dr. Ömer Özkan, Dr. Munire Erman Akar and their team, was the world's first uterus transplant surgery gaining long-term function, as evident by the fact that Ms. Sert has had six menstrual periods post-surgery and is said to have a fully functioning uterus. The Turkish medical team who performed the delicate surgery, however, is still cautious about declaring the operation a complete success. "The surgery was a success. But we will be successful when she has her baby", Ozkan said. "For now, we are happy that the tissue is living". On 12 April 2013, Akdeniz University announced that Derya Sert was pregnant. The statement made by the university hospital also added that Ms Sert would give birth by C-section to prevent any complications. On 14 May 2013, it was announced that Ms Sert had terminated her pregnancy in its 8th week following a routine examination where doctors failed to detect a fetal heartbeat.
Organ transplantation
The first successful corneal allograft transplant was performed in 1837 in a gazelle model; the first successful human corneal transplant, a keratoplastic operation, was performed by Eduard Zirm at Olomouc Eye Clinic, now Czech Republic, in 1905.
The first transplant in the modern sense – the implantation of organ tissue in order to replace an organ function – was a thyroid transplant in 1883. It was performed by the Swiss surgeon and later Nobel laureate Theodor Kocher. In the preceding decades Kocher had perfected the removal of excess thyroid tissue in cases of goiter to an extent that he was able to remove the whole organ without the person dying from the operation. Kocher carried out the total removal of the organ in some cases as a measure to prevent recurrent goiter. By 1883, the surgeon noticed that the complete removal of the organ leads to a complex of particular symptoms that we today have learned to associate with a lack of thyroid hormone. Kocher reversed these symptoms by implanting thyroid tissue to these people and thus performed the first organ transplant. In the following years Kocher and other surgeons used thyroid transplantation also to treat thyroid deficiency that appeared spontaneously, without a preceding organ removal.
Thyroid transplantation became the model for a whole new therapeutic strategy: organ transplantation. After the example of the thyroid, other organs were transplanted in the decades around 1900. Some of these transplants were done in animals for purposes of research, where organ removal and transplantation became a successful strategy of investigating the function of organs. Kocher was awarded his Nobel Prize in 1909 for the discovery of the function of the thyroid gland. At the same time, organs were also transplanted for treating diseases in humans. The thyroid gland became the model for transplants of adrenal and parathyroid glands, pancreas, ovary, testicles and kidney. By 1900, the idea that one can successfully treat internal diseases by replacing a failed organ through transplantation had been generally accepted. Pioneering work in the surgical technique of transplantation was made in the early 1900s by the French surgeon Alexis Carrel, with Charles Guthrie, with the transplantation of arteries or veins. Their skillful anastomosis operations and the new suturing techniques laid the groundwork for later transplant surgery and won Carrel the 1912 Nobel Prize in Physiology or Medicine. From 1902, Carrel performed transplant experiments on dogs. Surgically successful in moving kidneys, hearts, and spleens, he was one of the first to identify the problem of rejection, which remained insurmountable for decades. The discovery of transplant immunity by the German surgeon Georg Schöne, various strategies of matching donor and recipient, and the use of different agents for immune suppression did not result in substantial improvement so that organ transplantation was largely abandoned after WWI.
Bourn Hall Clinic
A breakthrough that occurred in Bourn Hall’s early days was the application of cryobiology to IVF, allowed embryos to be frozen for transfer at a later date. The first "frozen babies" were born in 1984. Bourn Hall also led the way in offering in vitro fertilisation surrogacy. They treated the first couple in the United Kingdom in 1988 and the first IVF surrogacy child was born in 1989.
Heart transplantation
Not having a human donor heart available, James D. Hardy of the University of Mississippi Medical Center transplanted the heart of a chimpanzee into the chest of a dying Boyd Rush in the early morning of Jan. 24, 1964. Hardy used a defibrillator to shock the heart to restart beating. This heart did beat in Rush's chest for 60 to 90 minutes (sources differ), and then Rush died without regaining consciousness. Although Hardy was a respected surgeon who had performed the world's first human-to-human lung transplant a year earlier, author Donald McRae states that Hardy could feel the "icy disdain" from fellow surgeons at the Sixth International Transplantation Conference several weeks after this attempt with the chimpanzee heart. Hardy had been inspired by the limited success of Keith Reemtsma at Tulane University in transplanting chimpanzee kidneys into human patients with kidney failure. The consent form Hardy asked Rush's step sister to sign did not include the possibility that a chimpanzee heart might be used, although Hardy stated that he did include this in verbal discussions. A xenotransplantation is the technical term for the transplant of an organ or tissue from one species to another.
Head transplant
A head transplant is an experimental surgical operation involving the grafting of one organism's head onto the body of another; in many experiments the recipient's head was not removed but in others it has been. Experimentation in animals began in the early 1900s. , no lasting successes have been achieved.
Morné de la Rey
Morné de la Rey (born 7 February 1970) is a South African veterinary surgeon and embryo transfer specialist. In 2003, he was one of a team of scientists and veterinarians from his company Embryo Plus and the Danish Agriculture Institute to clone a cow, the first animal to be cloned in Africa. In 2016, he was one of a team to use "in vitro" fertilisation successfully for the first time in the Cape buffalo.
Xenotransplantation
An American infant girl known as "Baby Fae" with hypoplastic left heart syndrome was the first infant recipient of a xenotransplantation, when she received a baboon heart in 1983. The procedure was performed by Leonard L. Bailey at Loma Linda University Medical Center in Loma Linda, California. Fae died 21 days later due to a humoral-based graft rejection thought to be caused mainly by an ABO blood type mismatch, considered unavoidable due to the rarity of type O baboons. The graft was meant to be temporary, but unfortunately a suitable allograft replacement could not be found in time. While the procedure itself did not advance the progress on xenotransplantation, it did shed a light on the insufficient amount of organs for infants. The story grew so big that it made such an impact that the crisis of infant organ shortage improved for that time.
Tetra (monkey)
Tetra was created using embryo splitting, a process where the cells in the embryo are split at the eight–cell stage to create four identical two cell embryos. This was the first time this technique had proven successful in monkeys, although it is often used in cattle. She was the first primate to have been cloned using this "splitting" technique. The first non-human primate derived from nuclear transfer was created in 1997 using a different technique for "cloning". Only two of the four embryos survived to a sufficient stage in which they could be implanted into surrogates, and Tetra was the only one to be delivered successfully after 157 days. The announcement of Tetra was made on 13 January 2000, when she was four months old. It was thought that by producing identical primates, advances in human medical research could be made. A further four monkeys, cloned using this same technique were due to be born in May 2000.
Organ transplantation in China
The first living related renal transplant was performed in China in 1972; the first allogeneic bone marrow transplantation was successfully executed in an acute leukaemia patient. The first recorded clinical liver transplant from a living donor in China took place in 1995, seven years after the world's first was performed in Sao Paulo, Brazil. Between January 2001 and October 2003, 45 patients received living donor liver transplantation (LDLT) at five different hospitals. In 2002, doctors at Xijing Hospital of the Fourth Military Medical University described three cases of living related liver transplantation. In 2003 a landmark brain-death case involving switched off ventilation came to the attention of the public and made a big impact on medical ethics and legislation. The first successful brain-death organ donation soon followed. From October 2003 to July 2006, 52 LDLT operations were conducted at the West China Hospital, West China Medical Center of Sichuan University. In October 2004, Peking University People's Hospital Liver Transplantation Center executed two cases of living related liver transplantation involving complex blood vessel anatomy. In 2002, the Chinese media reported surgeon Dr Zheng Wei successfully transplanted a whole ovary at the Zhejiang Medical Science University to a 34-year-old patient, Tang Fangfang, from her sister. In April 2006, the Xijing military hospital in Xian carried out a face transplant operation covering the cheek, upper lip, and nose of Li Guoxing, who was mauled by an Asiatic black bear while protecting his sheep.
Egg donation
Multiple birth is a common complication. Incidence of twin births is very high. At the present time, the American Society for Reproductive Medicine recommends that no more than 1 or 2 embryos be transferred in any given cycle. Remaining embryos are frozen, whether for future transfers if the first one fails, for siblings, or for eventual embryo donation.
Stem cell controversy
In 1998, James Thomson and Jeffrey Jones derived the first human embryonic stem cells, with even greater potential for drug discovery and therapeutic transplantation. However, the use of the technique on human embryos led to more widespread controversy as criticism of the technique now began from the wider non-scientific public who debated the moral ethics of questions concerning research involving human embryonic cells.7
Cardiac surgery
Norman Shumway is widely regarded as the father of human heart transplantation, although the world's first adult heart transplant was performed by a South African cardiac surgeon, Christiaan Barnard, using techniques developed by Shumway and Richard Lower. Barnard performed the first transplant on Louis Washkansky on 3 December 1967 at Groote Schuur Hospital in Cape Town. Adrian Kantrowitz performed the first pediatric heart transplant on 6 December 1967 at Maimonides Hospital (now Maimonides Medical Center) in Brooklyn, New York, barely three days later. Shumway performed the first adult heart transplant in the United States on 6 January 1968 at Stanford University Hospital.
Freeman Hospital
The hospital is one of the main organ transplantation hospitals in the United Kingdom, mostly well known for its successful rates of infant cardiology and transplantation for adults. In 1987 the UK's first paediatric heart transplant was carried out at the Freeman. It is funded and designated by the government as the UK's third transplant hospital. It made history when both the first successful single and double lung transplants in Europe were carried out at the hospital in 1990. The Freeman is the location of the Institute of Transplantation.
Transgender history
In Berlin in 1931, Dora Richter became the first known transgender woman to undergo vaginoplasty, along with removal of the penis, and following removal of the testicles several years earlier. The same year in Dresden, Lili Elbe underwent similar surgeries, including an unsuccessful uterine transplant, the rejection of which resulted in her death.
Genetically modified mouse
In 1974 Rudolf Jaenisch created the first genetically modified animal by inserting a DNA virus into an early-stage mouse embryo and showing that the inserted genes were present in every cell. However, the mice did not pass the transgene to their offspring, and the impact and applicability of this experiment were, therefore, limited. In 1981 the laboratories of Frank Ruddle from Yale University, Frank Costantini and Elizabeth Lacy from Oxford, and Ralph Brinster and Richard Palmiter in collaboration from the University of Pennsylvania and the University of Washington injected purified DNA into a single-cell mouse embryo utilizing techniques developed by Brinster in the 1960s and 1970s, showing transmission of the genetic material to subsequent generations for the first time. During the early eighties, Palmiter and Brinster developed and led the field of transgenesis, refining methods of germline modification and using these techniques to elucidate the activity and function of genes in a way never possible before their unique approach.
Embryo transfer
Prior to this, thousands of women who were infertile, had adoption as the only path to parenthood. This set the stage to allow open and candid discussion of embryo donation and transfer. This breakthrough has given way to the donation of human embryos as a common practice similar to other donations such as blood and major organ donations. At the time of this announcement the event was captured by major news carriers and fueled healthy debate and discussion on this practice which impacted the future of reproductive medicine by creating a platform for further advancements in woman's health.
Karl Bremer Hospital
On 3 December 1967, while Christiaan Barnard was performing the world’s first heart transplant in Groote Schuur Hospital, the heart donor,Denise Darvall also donated her kidneys and they were transplanted in Karl Bremer Hospital.
History of in vitro fertilisation
In 1977, Steptoe and Edwards successfully carried out a pioneering conception which resulted in the birth of the world's first baby to be conceived by IVF, Louise Brown on 25 July 1978, in Oldham General Hospital, Greater Manchester, UK.
Organ transplantation
The first attempted human deceased-donor transplant was performed by the Ukrainian surgeon Yuri Voronyi in the 1930s; but failed due to Ischemia. Joseph Murray and J. Hartwell Harrison performed the first successful transplant, a kidney transplant between identical twins, in 1954, because no immunosuppression was necessary for genetically identical individuals.
Domestic sheep reproduction
During embryo transfer (ET) a minor surgical procedure with almost no risk of injury or infection when performed properly, sheep laparoscopy allows the importation of improved genetics, even of breeds which may otherwise be non-existent in certain countries due to the regulation of live animal imports. Embryo transfer procedures are used to allow producers to maximize those females that produce the best lambs/kids either for retention into the flock or for sale to other producers. ET also allows producers to continue to utilize a ewe/doe that may not physically be able to carry or feed a set of lambs. ET can allow a producer to grow his flock quickly with above average individuals of similar bloodlines. The primary industry to utilize this technology in the United States is the club lamb breeders and exhibitors. It is a common practice in the commercial sheep industries of Australia, New Zealand, and South America.
Carl Wood
Professor Wood led the Monash University IVF team in the development of the IVF technique during the late 1970s and early 1980s. His team were responsible for a number of innovations including the world's first IVF pregnancy 1973, world's first IVF baby developed using a frozen embryo 1983, world's first donor egg baby 1983, world's first IVF baby using sperm retrieval surgery 1986 and world's first Microinjection Intra Fallopian Transfer (MIFT) IVF baby 1992. The most important development, however, was the use of pharmaceutical and hormonal stimulation of ovaries for more control of egg maturation and collection, which transformed IVF from an experimental technique to a successful clinical treatment.
Robert Edwards (physiologist)
The birth of Louise Brown, the world's first 'test-tube baby', at on 1978 at the Oldham General Hospital made medical history: in vitro fertilisation meant a new way to help infertile couples who formerly had no possibility of having a baby. Nurse Jean Purdy was the first to see Brown's embryo dividing.
Uterus transplantation
India's first uterine transplant baby, weighing 1.45 kg, was delivered through a Caesarean section at Galaxy Care Hospital in pune on Thursday. The surgery was performed by a team of doctors at Pune's Galaxy Care Hospital and led by the hospital's medical director, Dr. Shailesh Puntambekar.
Embryo transfer
Embryo transfer refers to a step in the process of assisted reproduction in which embryos are placed into the uterus of a female with the intent to establish a pregnancy. This technique (which is often used in connection with in vitro fertilization (IVF)), may be used in humans or in animals, in which situations the goals may vary.
Liver transplantation
Historically, LDLT began with terminal pediatric patients, whose parents were motivated to risk donating a portion of their compatible healthy livers to replace their children's failing ones. The first report of successful LDLT was by Christoph Broelsch at the University of Chicago Medical Center in November 1989, when two-year-old Alyssa Smith received a portion of her mother's liver. Surgeons eventually realized that adult-to-adult LDLT was also possible, and now the practice is common in a few reputable medical institutes. It is considered more technically demanding than even standard, cadaveric donor liver transplantation, and also poses the ethical problems underlying the indication of a major surgical operation (hemihepatectomy or related procedure) on a healthy human being. In various case series, the risk of complications in the donor is around 10%, and very occasionally a second operation is needed. Common problems are biliary fistula, gastric stasis and infections; they are more common after removal of the right lobe of the liver. Death after LDLT has been reported at 0% (Japan), 0.3% (USA) and <1% (Europe), with risks likely to decrease further as surgeons gain more experience in this procedure. Since the law was changed to permit altruistic non-directed living organ donations in the UK in 2006, the first altruistic living liver donation took place in Britain in December 2012.
Stem cell controversy
For many decades, stem cells have played an important role in medical research, beginning in 1868 when Ernst Haeckel first used the phrase to describe the fertilized egg which eventually gestates into an organism. The term was later used in 1886 by William Sedgwick to describe the parts of a plant that grow and regenerate. Further work by Alexander Maximow and Leroy Stevens introduced the concept that stem cells are pluripotent. This significant discovery led to the first human bone marrow transplant by E. Donnal Thomas in 1956, which although successful in saving lives, has generated much controversy since. This has included the many complications inherent in stem cell transplantation (almost 200 allogeneic marrow transplants were performed in humans, with no long-term successes before the first successful treatment was made), through to more modern problems, such as how many cells are sufficient for engraftment of various types of hematopoietic stem cell transplants, whether older patients should undergo transplant therapy, and the role of irradiation-based therapies in preparation for transplantation.
Transgene
The first transgenic organism was created in 1974 when Annie Chang and Stanley Cohen expressed "Staphylococcus aureus" genes in "Escherichia coli". In 1978, yeast cells were the first eukaryotic organisms to undergo gene transfer. Mouse cells were first transformed in 1979, followed by mouse embryos in 1980. Most of the very first transmutations were performed by microinjection of DNA directly into cells. Scientists were able to develop other methods to perform the transformations, such as incorporating transgenes into retroviruses and then infecting cells, using electroinfusion which takes advantage of an electric current to pass foreign DNA through the cell wall, biolistics which is the procedure of shooting DNA bullets into cells, and also delivering DNA into the egg that has just been fertilized.
Embryo transfer
The embryo transfer procedure starts by placing a speculum in the vagina to visualize the cervix, which is cleansed with saline solution or culture media. A soft transfer catheter is loaded with the embryos and handed to the clinician after confirmation of the patient’s identity. The catheter is inserted through the cervical canal and advanced into the uterine cavity.
Emory University Hospital
Transplantation
Cryobiology
In 1949, bull semen was cryopreserved for the first time by a team of scientists led by Christopher Polge. This led to a much wider use of cryopreservation today, with many organs, tissues and cells routinely stored at low temperatures. Large organs such as hearts are usually stored and transported, for short times only, at cool but not freezing temperatures for transplantation. Cell suspensions (like blood and semen) and thin tissue sections can sometimes be stored almost indefinitely in liquid nitrogen temperature (cryopreservation). Human sperm, eggs, and embryos are routinely stored in fertility research and treatments. Controlled-rate and slow freezing are well established techniques pioneered in the early 1970s which enabled the first human embryo frozen birth (Zoe Leyland) in 1984. Since then, machines that freeze biological samples using programmable steps, or controlled rates, have been used all over the world for human, animal, and cell biology – 'freezing down' a sample to better preserve it for eventual thawing, before it is deep frozen, or cryopreserved, in liquid nitrogen. Such machines are used for freezing oocytes, skin, blood products, embryo, sperm, stem cells, and general tissue preservation in hospitals, veterinary practices, and research labs. The number of live births from 'slow frozen' embryos is some 300,000 to 400,000 or 20% of the estimated 3 million "in vitro" fertilized births. Dr Christopher Chen, Australia, reported the world’s first pregnancy using slow-frozen oocytes from a British controlled-rate freezer in 1986.
Embryo transfer
In the procedure, an embryo that was just beginning to develop was transferred from one woman in whom it had been conceived by artificial insemination to another woman who gave birth to the infant 38 weeks later. The sperm used in the artificial insemination came from the husband of the woman who bore the baby.
Heart transplantation
On June 9, 1984, "JP" Lovette IV of Denver, Colorado became the world's first successful pediatric heart transplant. Columbia-Presbyterian Medical Center surgeons transplanted the heart of 4-year-old John Nathan Ford of Harlem into 4-year-old JP a day after the Harlem child died of injuries received in a fall from a fire escape at his home. JP was born with multiple heart defects. The transplant was done by a surgical team led by Dr. Eric A. Rose, director of cardiac transplantation at NewYork–Presbyterian Hospital. Drs. Keith Reemtsma and Fred Bowman also were members of the team for the six-hour operation.
Egg donation
Prior to this, thousands of infertile women, single men and gay male couples had adoption as the only path to parenthood. Advances in IVF and egg donation set the stage to allow open and candid discussion of oocyte and embryo donation as a common practice. This breakthrough has given way to the donation of human oocytes and embryos as a common practice similar to other donations such as blood and major organ donations. At the time of this announcement the event was captured by major news carriers and fueled healthy debate and discussion on this practice which affected the future of reproductive medicine by creating a platform for further advancements in woman's health.
Egg donation
The first child born from egg donation was reported in Australia in 1983. In July 1983, a clinic in Southern California reported a pregnancy using egg donation, which led to the birth of the first American child born from egg donation on February 3, 1984. This procedure was performed at the Harbor UCLA Medical Center and the University of California at Los Angeles School of Medicine. In the procedure, which is no longer used today, a fertilized egg that was just beginning to develop was transferred from one woman in whom it had been conceived by artificial insemination to another woman who gave birth to the infant 38 weeks later. The sperm used in the artificial insemination came from the husband of the woman who bore the baby.
John Buster
John Edmond Buster (born July 18, 1941) working at the University of California at Los Angeles School of Medicine, directed the research team that performed history's first embryo transfer from one woman to another resulting in a live birth. It was performed at the Harbor-UCLA Medical Center, reported in July 1983, and culminated in the announcement of the first human birth February 3, 1984. In the procedure, an embryo that was just beginning to develop was transferred from the woman in whom it had been conceived by artificial insemination to another woman who gave birth to the infant 38 weeks later. The sperm used in the artificial insemination came from the husband of the woman who bore the baby.
Mitochondrial replacement therapy
In the United Kingdom, following animal experiments and the recommendations of a government commissioned expert committee, the Human Fertilisation and Embryology (Research Purposes) Regulations were passed in 2001 regulating and allowing research into human embryos. In 2004, the Newcastle University applied for a licence to develop pronuclear transfer to avoid the transmission of mitochondrial diseases, and was granted the license in 2005. Following further research by Newcastle and the Wellcome Trust, scientific review, public consultations, and debate, the UK government recommended that mitochondrial donation be legalized in 2013. In 2015 parliament passed the Human Fertilisation and Embryology (Mitochondrial Donation) Regulations, which came into force on 29 October 2015, making human mitochondrial donation legal in the UK. The Human Fertilisation and Embryology Authority (HFEA) was authorized to licence and regulate medical centers which wanted to use human mitochondrial donation. In February 2016, the US National Academy of Sciences issued a report describing technologies then current and the surrounding ethical issues.
Science and engineering in Manchester
In 1978, after a decade of research by Manchester-born Robert G. Edwards and his colleague, Patrick Steptoe, Louise Brown, the world's first baby conceived by in vitro fertilisation. Louise Brown, was born at on 1978 at the Oldham General Hospital and made medical history: in vitro fertilization meant a new way to help infertile couples who formerly had no possibility of having a baby.
Kidney transplantation
The first kidney transplants between living patients were undertaken in 1952 at the Necker hospital in Paris by Jean Hamburger although the kidney failed after 3 weeks of good function and later in 1954 in Boston. The Boston transplantation, performed on December 23, 1954, at Brigham Hospital was performed by Joseph Murray, J. Hartwell Harrison, John P. Merrill and others. The procedure was done between identical twins Ronald and Richard Herrick to eliminate any problems of an immune reaction. For this and later work, Dr. Murray received the Nobel Prize for Medicine in 1990. The recipient, Richard Herrick, died eight years after the transplantation.
Evergreen Park, Illinois
Little Company of Mary Hospital, located at 2800 W. 95th St. in Evergreen Park, was the site of the world's first 
successful organ transplant. The pioneering procedure took place on June 17, 1950. Dr. Richard H. Lawler (1896–1982), a highly regarded general surgeon, led a team of doctors that performed the highly risky, controversial, and experimental operation. Dr. Lawler spent a number of years researching the possibility of organ transplantation and concluded the most probable means of achieving success for a patient would involve the kidney. After successfully practicing the procedure with dogs and realizing he had the opportunity to "get it all started", Lawler decided to attempt the medical-first on a desperate patient. The recipient of Lawler's first organ transplantation was Ruth Tucker, a 49-year-old Chicago-area woman who suffered from terminal polycystic kidney disease. The Evergreen Plaza, located on 95th and Western, was an indoor shopping mall originating from the early 1950s. In 1952, real estate developer Arthur Rubloff debuted the Evergreen Plaza in the heart of the southwest Chicago suburbs. A few years after the shopping mall's debut, Rubloff decided to enclose the mall thereby making it the first indoor shopping mall in the Chicago area. As a result, Rubloff changed shopping by allowing people the opportunity to pull up, park, and shop for various goods all in one place. Since the 1950s the Evergreen Park Plaza had seen more than $8 million in major internal & external improvements. Evergreen Plaza was shortened to be acknowledged as, “The Plaza”. The Plaza covered , and two stories. As of 2006, The Plaza had an annual visitor count of roughly 7 million people. The Plaza closed on May 31, 2013, after 61 years of operation and is presently under construction for re-development. The Plaza, in its new form, will re-open on October 18, 2018 and will be renamed Eddie Maloney Plaza of Evergreen Park.
Egg donation
An alternative to egg donation in some couples, especially those in whom the male partner cannot provide viable sperm, is embryo donation. Embryo donation is the use of embryos remaining after a couple’s IVF treatments have been completed, to another individual or couple, followed by the placement of those embryos into the recipient woman’s uterus, to facilitate pregnancy and childbirth. Embryo donation is more cost-effective than egg donation on a "per live birth" basis. Another study has found that embryos created for one couple, using an egg donor, are often made available for donation to another couple if the first couple chooses not to use them.
Taipei Medical University Hospital
The Center for Reproductive Medicine at Taipei Medical University Hospital was established in 1991. It is headed by Professor Tzeng Chii-Ruey. With advanced reproductive technology, this center has helped more than 400,000 infertile couples
conceive. In 1991, the first test-tube baby of the hospital was born. In 1993, the first case of microsurgical epididymal sperm aspiration in the country was successfully applied by the center. In 1995, the first baby using intracytoplasmic sperm injection was born in the hospital. In 1996, a frozen embryo was successfully applied in pregnancy after being thawed.
Altered nuclear transfer
Altered Nuclear Transfer is an alternative method of obtaining embryonic-like, pluripotent stem cells without the creation and destruction of human embryos. The process was originally proposed by William B. Hurlbut.
District Livestock Farm (Hosur)
District Livestock Farm has an Embryo transfer laboratory. Embryos from Red Sindhi cows are collected by multiple ovulation and embryo transfer technology, and are transferred to cross-bred recipient cows by non-surgical method. These recipient cows will carry the fetus till the rest of pregnancy and deliver the calf. So far, 286 calves have been produced through embryo transfer technology at this farm and field. Embryo transfer programme is also carried out in 15 districts from this embryo transfer unit. In the next project, indigenous calves like Red Sindhi, Kangayam, Pulikulam, Bargur, and Umbalachery will be produced through Embryo transfer and IVF technologies at DLF, HOSUR. Apart from these projects, pure Jersey and HF embryos have been imported and transferred to the recipient cows at the Government Livestock farms at Chettinadu, Pudukottai and Naduvur. Twenty imported frozen pure Jersey embryos were transferred to crossbred cows and ten became pregnant.
MIRA procedure
In 1989 Dr. Christoph Broelsch performed the first successful living donor liver transplantation in the University of Chicago. Nearly two years old Alyssa Smith was the first to receive part of a living’s person liver donated in this case by her mother. The remarkable results improved current prognosis on patients who required a liver transplant but even then there were far from meeting the demand and many hundreds to this date die waiting for a donor. This procedure has also sparked some controversial and legal issues for enticing organ trafficking and its practice is currently restricted in some countries.
Organ transplantation
The first pair exchange transplant in the U.S. was in 2001 at Johns Hopkins Hospital. The first complex multihospital kidney exchange involving 12 people was performed in February 2009 by The Johns Hopkins Hospital, Barnes-Jewish Hospital in St. Louis and Integris Baptist Medical Center in Oklahoma City. Another 12-person multihospital kidney exchange was performed four weeks later by Saint Barnabas Medical Center in Livingston, New Jersey, Newark Beth Israel Medical Center and New York-Presbyterian Hospital. Surgical teams led by Johns Hopkins continue to pioneer in this field by having more complex chain of exchange such as eight-way multihospital kidney exchange. In December 2009, a 13 organ 13 recipient matched kidney exchange took place, coordinated through Georgetown University Hospital and Washington Hospital Center, Washington DC.
Penis transplantation
In December 2014, the first successful penis transplant was performed on a 21-year-old man by specialists led by urologist André van der Merwe from the University of Stellenbosch in South Africa. The surgical team consisted of urologist Andre van der Merwe and plastic surgeon Frank Graewe. The immunosuppression was conducted by Rafique Moosa. The nine-hour procedure used microsurgery to connect blood vessels and nerves. The patient had lost his penis as a result of a botched circumcision procedure he underwent aged 18. As of 13 March 2015, the recipient was reported to have recovered function in the organ, including urination, erection, orgasm and ejaculation, but sensation is expected to take two years to return fully. The doctors who performed the transplant were surprised by this, as they had not expected the patient to recover fully until about December 2016. Given that circumcisions are performed frequently in parts of South Africa to mark a boy's transition to adulthood, and these are often unsanitary procedures, frequently carried out by uncertified amateurs, doctors have said that South Africa has some of the greatest need for penis transplantations in the world. In 2015, the recipient announced that he had successfully conceived a child.
Embryo transfer
It is not necessary that the embryo transfer be performed on the female who provided the eggs. Thus another female whose uterus is appropriately prepared can receive the embryo and become pregnant.
Embryo transfer may be used where a woman who has eggs but no uterus and wants to have a biological baby; she would require the help of a gestational carrier or surrogate to carry the pregnancy. Also, a woman who has no eggs but a uterus may utilize egg donor IVF, in which case another woman would provide eggs for fertilization and the resulting embryos are placed into the uterus of the patient. Fertilization may be performed using the woman's partner's sperm or by using donor sperm. 'Spare' embryos which are created for another couple undergoing IVF treatment but which are then surplus to that couple's needs may also be transferred (called embryo donation). Embryos may be specifically created by using eggs and sperm from donors and these can then be transferred into the uterus of another woman. A surrogate may carry a baby produced by embryo transfer for another couple, even though neither she nor the 'commissioning' couple is biologically related to the child. Third party reproduction is controversial and regulated in many countries. Persons entering gestational surrogacy arrangements must make sense of an entirely new type of relationship that does not fit any of the traditional scripts we use to categorize relations as kinship, friendship, romantic partnership or market relations. Surrogates have the experience of carrying a baby that they conceptualize as not of their own kin, while intended mothers have the experience of waiting through nine months of pregnancy and transitioning to motherhood from outside of the pregnant body. This can lead to new conceptualizations of body and self.
Mitochondrial replacement therapy
In the United States in 1996 embryologist Jacques Cohen and others at the Institute for Reproductive Medicine and Science, Saint Barnabas Medical Center in Livingston, New Jersey first used cytoplasmic transfer in a human assisted reproduction procedure. In 1997 the first baby was born using this procedure (Emma Ott). In 2001, Cohen and others reported that 10 single babies, twins, and a quadruplet at his New Jersey clinic and a further six children in Israel had been born using his technique. Using modifications of his procedure, a baby had been born at Eastern Virginia Medical School, five children at the Lee Women's Hospital Infertility Clinic in Taichung, Taiwan. twins in Naples, Italy and a twins in India. In total as of 2016, 30-50 children worldwide had been reported to have been born using cytoplasmic transfer.
Embryo transfer
Embryos who reach the day 3 cell stage can be tested for chromosomal or specific genetic defects prior to possible transfer by preimplantation genetic diagnosis (PGD). Transferring at the blastocyst stage confers a significant increase in live birth rate per transfer, but also confers a decreased number of embryos available for transfer and embryo cryopreservation, so the cumulative clinical pregnancy rates are increased with cleavage stage transfer. Transfer day 2 instead of day 3 after fertilization has no differences in live birth rate.
Brigham and Women's Hospital
In 1954, the Peter Bent Brigham hospital became the location for the first ever successful kidney transplant, performed by Joseph Murray, on Richard Herrick.
Uterus transplantation
In 1896, Emil Knauer, a 29-year-old Austrian working in one of Vienna's gynecological clinics, published the first study of ovarian autotransplantation documenting normal function in a rabbit. This led to the investigation of uterine transplantation in 1918. In 1964 and 1966, Eraslan, Hamernik and Hardy, at the University of Mississippi Medical Center in Jackson, Mississippi, were the first to perform an animal (dog) autotransplantation of the uterus and subsequently deliver a pregnancy from that uterus. In 2010 Diaz-Garcia and co-workers, at Department of Obstetrics and Gynecology, University of Gothenburg in Sweden, demonstrated the world's first successful allogenic uterus transplantation, in a rat, with healthy offspring.
Penis transplantation
The first such procedure was performed in September 2006 at a military hospital in Guangzhou, China. The patient, a 44-year-old male, had sustained the loss of most of his penis in an accident. The transplanted penis came from a brain-dead 22-year-old male. Although a surgical success, the patient and his wife suffered psychological trauma as a result of the procedure, and had the surgery reversed 15 days later. Following this, Jean-Michel Dubernard, who performed the world's first face transplant, wrote that the case "raises many questions and has some critics". He alluded to a double standard, writing:
I cannot imagine what would have been the reactions of the medical profession, ethics specialists, and the media if a European surgical team had performed the same operation.
Walter Heape
Walter Heape FRS (29 April 1855 in Brompton, London – 10 September 1929 in Tunbridge Wells) was a British zoologist and embryologist, famous for the first successful mammalian embryo transfer.
Harbor–UCLA Medical Center
This scientific breakthrough established standards and became an agent of change for women suffering from the afflictions of infertility and for women who did not want to pass on genetic disorders to their children. Donor embryo transfer has given women a mechanism to become pregnant and give birth to a child that will contain their husband's genetic makeup. Although donor embryo transfer as practiced today has evolved from the original non-surgical method, it now accounts for approximately 5% of in vitro fertilization recorded births.
Embryo transfer
This work established the technical foundation and legal-ethical framework surrounding the clinical use of human oocyte and embryo donation, a mainstream clinical practice, which has evolved over the past 25 years.
C.F. and Mary Singmaster House
C.F. Singmaster had this 2½ story Colonial Revival house built in 1893 on the site of an existing house. It was designed by Oskaloosa, Iowa architect Frank E. Wetherell. The residence follows an irregular plan. It is capped by a cross gabled roof that features two gabled dormers with pediments on the south elevation. It remained in the family until 1968 when it was sold to Dr. R.A. Carmichael who established the first bovine embryo transfer facility in the United States on the property. The house was listed on the National Register of Historic Places in 1998.
Liver transplantation
The first attempted human liver transplant was performed in 1963 by Thomas Starzl, although the pediatric patient died intraoperatively due to uncontrolled bleeding. Multiple subsequent attempts by various surgeons remained unsuccessful until 1967, when Starzl transplanted a 19 month old girl with hepatocellular carcinoma who was able to survive for over 1 year before dying of metastatic disease. Despite the development of viable surgical techniques, liver transplantation remained experimental through the 1970s, with one year patient survival in the vicinity of 25%. The introduction of ciclosporin by Sir Roy Calne, Professor of Surgery Cambridge, markedly improved patient outcomes, and the 1980s saw recognition of liver transplantation as a standard clinical treatment for both adult and pediatric patients with appropriate indications. Liver transplantation is now performed at over one hundred centers in the US, as well as numerous centres in Europe and elsewhere.
Sentara Norfolk General Hospital
In 1981 Elizabeth Carr was born at the hospital, becoming America's first in-vitro fertilization baby. The first heart transplant performed in Hampton Roads occurred at the hospital in 1989.
Embryo donation
No one knows for sure when the first true embryo adoption occurred. The term was used as early as the mid-1980s, in the legal literature. Devroey et al., Dr. Maria Bustillo in Florida, and Dr. Howard Jones in Virginia have reported embryo transfers occurring between 1986 and 1990 that clearly represented adoption of remaining embryos.
Oocyte cryopreservation
Cryopreservation itself has always played a central role in assisted reproductive technology. With the first cryopreservation of sperm in 1953 and of embryos thirty years later, these techniques have become routine. Dr Christopher Chen of Singapore reported the world's first pregnancy in 1986 using previously frozen oocytes. This report stood alone for several years followed by studies reporting success rates using frozen eggs to be much lower than those of traditional in vitro fertilization (IVF) techniques using fresh oocytes. Providing the lead to a new direction in cryobiology, Dr. Lilia Kuleshova was the first scientist to achieve vitrification of human oocytes that resulted in a live birth in 1999. Then recently, two articles published in the journal, "Fertility and Sterility", reported pregnancy rates using frozen oocytes that were comparable to those of cryopreserved embryos and even fresh embryos. These newer reports affirm that oocyte cryopreservation technology is advancing.
Embryology
Until the birth of modern embryology through observation of the mammalian ovum by von Baer in 1827, there was no clear scientific understanding of embryology. Only in the late 1950s when ultrasound was first used for uterine scanning, was the true developmental chronology of human fetus available.
List of Puerto Rican scientists and inventors
An organ transplant is the moving of a whole or partial organ from one body to another (or from a donor site on the patient's own body), for the purpose of replacing the recipient's damaged or failing organ with a working one from the donor site. Organ donors can be "living" or "deceased" (previously referred to as cadaveric). In Puerto Rico, the first Kidney organ transplants were realized in the city of Ponce between 1968 and 1972.
Pediatrics
Louise Brown
On 10 November 1977, Lesley Brown underwent a procedure, later to become known as in vitro fertilisation (IVF), developed by Patrick Steptoe, Robert Edwards and Jean Purdy. Purdy was the first to see her embryonic cells dividing. Edwards, as the only surviving partner, was awarded the 2010 Nobel Prize in Medicine for this work. Although the media referred to Brown as a "test tube baby", her conception actually took place in a Petri dish. Her younger sister, Natalie Brown, was also conceived through IVF four years later, and became the world's fortieth child after conception by IVF. In May 1999, Natalie was the first human born after conception by IVF to give birth herself—without IVF.
In vitro fertilisation
By 2017, many centers have adopted embryo cryopreservation as their primary IVF therapy, and perform few or no fresh embryo transfers. The two main reasons for this have been better endometrial receptivity when embryos are transferred in cycles without exposure to ovarian stimulation and also the ability to store the embryos while awaiting the results of pre-implantation genetic testing.
Vaginal transplantation
In a handful of cases, a woman with vaginal aplasia has received a successful vagina transplant donated by her mother. The first such case is believed to have occurred in 1970, with no signs of rejection taking place after three years. In at least one case, a woman who received such a transplant was able to conceive and give birth. In 1981, a 12-year-old girl with vaginal aplasia received a vaginal wall implant from her mother. She became sexually active seven years later, without incident. At age 24, she conceived and carried a child to term. The child was born via cesarean section.
In vitro fertilisation
In 1978 Louise Brown was the first child successfully born after her mother received IVF treatment. Brown was born as a result of natural-cycle IVF, where no stimulation was made. The procedure took place at Dr Kershaw's Cottage Hospital (now Dr Kershaw's Hospice) in Royton, Oldham, England. Robert G. Edwards was awarded the Nobel Prize in Physiology or Medicine in 2010. The physiologist co-developed the treatment together with Patrick Steptoe and embryologist Jean Purdy but the latter two were not eligible for consideration as they had died and the Nobel Prize is not awarded posthumously.
Johns Hopkins Hospital
Medical achievements at Johns Hopkins include the first male-to-female sex reassignment surgery in the United States that took place in 1966 at the Hopkins Gender Identity Clinic. Two of the most far-reaching advances in medicine during the last 25 years were also made at Hopkins. First, the Nobel Prize-winning discovery of restriction enzymes gave birth to the genetic engineering industry. Second, the discovery of the brain's natural opiates has triggered an explosion of interest in neurotransmitter pathways and functions. Other accomplishments include the development of HeLa, by George Otto Gey, head of tissue culture research in 1951; the first and arguably most important line of human cells grown in culture; identification of the three types of polio virus; and the first "blue baby" operation, which was done by surgeon Alfred Blalock in collaboration with Helen Taussig, a female Hopkins graduate specializing in pediatric cardiology and surgical technician Vivien Thomas which opened the way to modern heart surgery. Contributions to heart surgery were brought on by the discovery of heparin and the Blalock-Thomas-Taussig Shunt. Johns Hopkins has also published "The Harriet Lane Handbook", an indispensable tool for pediatricians, for over 60 years.
Xenotransfusion
Jean-Baptiste Denis, a French physician, and Paul Emmerez, a surgeon, performed the first documented xenotransfusion on June 15, 1667. The transfusion occurred between a lamb and a 15-year-old boy. Carotid artery blood from the lamb was introduced to a vein in the patient’s inner elbow, and the procedure ultimately resulted in a successful recovery. Denis and Emmerez performed multiple xenotransfusions together. On June 24, 1667, the duo performed a transfusion on a young Swedish nobleman. When they arrived, the patient had already lost his ability to speak and was practically unconscious. Shortly after the transfusion began, the patient was able to speak again. His health was improving until his condition grew progressively worse. A second transfusion took place, but it was unsuccessful, and the patient died.
Zhong Zhong and Hua Hua
Since scientists produced the first cloned mammal Dolly the sheep in 1996 using the somatic cell nuclear transfer (SCNT) technique, 23 mammalian species have been successfully cloned, including cattle, cats, dogs, horses and rats. Using this technique for primates had never been successful and no pregnancy had lasted more than 80 days. The main difficulty was likely the proper programming of the transferred nuclei to support the growth of the embryo. Tetra (born October 1999), a female rhesus macaque, was created by a team led by Gerald Schatten of the Oregon National Primate Research Center using a different technique, called "embryo splitting". She is the first "cloned" primate by artificial twinning, which is a much less complex procedure than the DNA transfer used for the creation of Zhong Zhong and Hua Hua.
James Hardy (surgeon)
Hardy also performed the world's first heart transplant and first heart xenotransplant when he transplanted the heart of a chimpanzee into comatose and dying Boyd Rush's chest during the early morning of January 24, 1964. This heart beat for approximately one hour, and then Rush died without regaining consciousness. The consent form did not include the possibility that a chimpanzee heart may be used, although Hardy stated that he included this in discussions with Rush's stepsister. Before the transplant attempt, Hardy asked the four doctors who would be assisting him to please vote about whether to proceed. One said yes, one abstained, and the last two nodded yes. This operation was also performed at the University of Mississippi Medical Center in Jackson, Mississippi.
Uterus transplantation
In 1931, in Germany, Lili Elbe, a Danish transgender woman, died from organ rejection three months after receiving one of the world's earliest uterine transplants. With the availability of in vitro fertilization in 1978, uterine transplantation research was deferred.
Preimplantation genetic diagnosis
Female embryos were selectively transferred in five couples at risk of X-linked disease, resulting in two twins and one singleton pregnancy. Because the Y chromosome region Kontogianni was amplifying contained many repeats, it was more efficient than trying to amplify a unique region. A band on the PCR gel indicated that the embryo was male and the absence of a band indicated that the embryo was female. However, amplification failure or an anucleate blastomere also resulted in absence of a band on the PCR gel. To reduce the risk of misdiagnosis, Kontogianni went on to co-amplify sequences on the X and Y (Kontogianni et al., 1991). At that time nothing was known about allele dropout, cumulus cell contamination, or amplification failure from single cells. During the 1980s, human IVF embryos were exclusively transferred on day two of development as the culture medium used was incapable of reliably growing embryos past this stage. Since the biopsy was to be performed on day three, the first diagnoses were all performed in one day, with transfer of the embryos late on day three. A comparison of day two and day three transfers indicated that this would not adversely affect pregnancy rates. The worry of embryos arresting was so high that some transfers took place in the early hours of day four so that the embryos were removed from culture as soon as possible. There were many evenings at the Hammersmith when a transfer was performed at 1 a.m. on day four and researchers returned to the laboratory at 7 a.m. to start the next case. Winston helped deliver most of the first PGD babies.
Prenatal development
Fertilization marks the first germinal stage of embryonic development. When semen is released into the vagina, the spermatozoa travel through the cervix and body of the uterus and into the fallopian tubes where fertilization usually takes place. Many sperm cells are released with the possibility of just one managing to adhere to and enter the thick protective layer surrounding the egg cell (ovum). The first sperm cell to successfully penetrate the egg cell donates its genetic material (DNA) to combine with the DNA of the egg cell resulting in a new organism called the zygote. The term "conception" refers variably to either fertilization or to formation of the conceptus after its implantation in the uterus, and this terminology is controversial.
Adrian Kantrowitz
On December 6, 1967, at Maimonides Medical Center, Kantrowitz's team, including Bjørnstad PG, Lindberg HL, Smevik B, Rian R, Sørland SJ, Tjønneland S, performed the world's first pediatric heart transplant attempt as well as the first human-to-human heart transplant in the United States. The donor infant was David McIntire Bashaw who was anencephalic baby with a brain which was "grossly malformed" and who had a poor moro reflex (infant's startle response). However, this infant could move its extremities and had a feeble cry. According to "Every Second Counts", both this infant and the recipient infant had their body temperatures cooled from 98.6 to 59 °F, at which time surgeons then waited for the donor baby's heart to stop beating.
Hillel Abbe Shapiro
He chaired numerous medical conferences and symposiums, including from 13 to 16 July 1968, the first Human Heart Transplantation Symposium in Cape Town that followed on soon after the first heart transplant had successfully been done by Christiaan Barnard on 3 December 1967. The latter part of his career mostly involved editing medical journals, consultant and expert witness work in criminal trials, and appearing for the surviving families in inquests into suspicious deaths of detainees in police custody during the Apartheid years.
Kidney Paired Donation
The first paper outlining the concept of paired exchange was authored by Rappaport and published in 1986. The first recorded paired exchange transplants were organized in South Korea by Dr. Park beginning in 1991. For nearly a decade, only Dr. Park and his team in South Korea utilized this novel approach to facilitate transplants for incompatible donor - recipient pairs. In 1999, the first KPD transplants were performed in Europe followed by the first KPD transplants in the United States in 2000. Over the next ten years the United States would become the most competitive KPD market in the world with more than a dozen KPD programs commencing operations and many KPD programs failing. Outside of the United States, most of the KPD programs have been organized or sponsored by governments which has limited innovation in these programs. Three of the important early KPD programs in the U.S. were the Hopkins program led by Dr. Montgomery and Dr. Segev, the New England Paired Kidney Exchange (NEPKE) led by Dr. Delmonico and Professor Alvin Roth and the Ohio Organ Consortium which later reorganized as two competing programs, the Paired Donation Network (PDN) led by Dr. Woodle and the Alliance for Paired Exchange (APD) led by Dr. Rees.
In vitro fertilisation
The number to be transferred depends on the number available, the age of the woman and other health and diagnostic factors. In countries such as Canada, the UK, Australia and New Zealand, a maximum of two embryos are transferred except in unusual circumstances. In the UK and according to HFEA regulations, a woman over 40 may have up to three embryos transferred, whereas in the US, there is no legal limit on the number of embryos which may be transferred, although medical associations have provided practice guidelines. Most clinics and country regulatory bodies seek to minimise the risk of multiple pregnancy, as it is not uncommon for multiple embryos to implant if multiple embryos are transferred. Embryos are transferred to the patient's uterus through a thin, plastic catheter, which goes through her vagina and cervix. Several embryos may be passed into the uterus to improve chances of implantation and pregnancy.
Jean Purdy
Jean Marian Purdy was a British nurse and embryologist and a pioneer of fertility treatment. Purdy was responsible with biologist and physiologist Robert Edwards and obstetrician and gynaecologist Patrick Steptoe for developing in vitro fertilization. Louise Joy Brown, the first test-tube baby, was born on 25 July 1978, and Purdy was the first to see the embryonic cells dividing. Edwards was awarded the 2010 Nobel Prize in Physiology or Medicine for his work on the development of in vitro fertilization, however because the Nobel Prize is not awarded posthumously, neither Purdy nor Steptoe were eligible for consideration. Purdy was a co-founder of the Bourn Hall Clinic but her role there and in the development of IVF was ignored for thirty years.
Embryo transfer
A major issue is how many embryos should be transferred. Placement of multiple embryos carries the risk of multiple pregnancy. In the past, physicians have often placed too many embryos in the hope to establish a pregnancy. However, the rise in multiple pregnancies has led to a reassessment of this approach. Professional societies and in many countries, the legislature, have issued guidelines or laws to curtail a practice of placing too many embryos in an attempt to reduce multiple pregnancies. The appropriate number of embryos to be transferred depends on the age of the woman, whether it is the first, second or third full IVF cycle attempt and whether there are top-quality embryos available. According to a guideline from The National Institute for Health and Care Excellence (NICE) in 2013, the number of embryos transferred in a cycle should be chosen as in following table:
Male pregnancy
Since 2000, several hoax web sites have appeared on the Internet purporting to describe the world's first pregnant man. While some rely on legitimate scientific claims, no such experiment has ever been reported. Fertility clinician Cecil Jacobson claimed to have transplanted a fertilized egg from a female baboon to the omentum in the abdominal cavity of a male baboon in the mid-1960s, which then carried the fetus for four months; however, Jacobson did not publish his claims in a scientific journal, and was subsequently convicted on several unrelated counts of fraud for ethical misconduct.
ABO-incompatible transplantation
Intentional ABOi heart transplantation in infants was conceived in the 1960s by Adrian Kantrowitz, with clinical evidence first being shown by Leonard L. Bailey's team in the mid-1980s, which he termed "immunologic privilege." It was first conducted in practice in 1996 by a team led by Dr. Lori J. West at the Hospital for Sick Children in Toronto, and published in a seminal 2001 study. In the United Kingdom, policy since 2000 is that ABOi heart transplantation is "de rigueur" for infants, and is considered for children under age 4, though proactive measures are often taken to lower titer levels.
Organ transplantation
In 1954, the first ever successful transplant of any organ was done at the Brigham & Women's Hospital in Boston, Ma. The surgery was done by Dr. Joseph Murray, who received the Nobel Prize in Medicine for his work. The reason for his success was due to Richard and Ronald Herrick of Maine. Richard Herrick was a in the Navy and became severely ill with acute renal failure. His brother Ronald donated his kidney to Richard, and Richard lived another 8 years before his death. Before this, transplant recipients didn't survive more than 30 days. The key to the successful transplant was the fact that Richard and Ronald were identical twin brothers and there was no need for anti-rejection medications, which was not known about at this point. This was the most pivotal moment in transplant surgery because now transplant teams knew that it could be successful and the role of rejection/anti-rejection medicine.
John Zhang (scientist)
In 2003, while working with researchers at the Sun Yat-Sen University of Medical Science, Zhang experimented with a mitochondrial donation technique called pronuclear transfer to help a Chinese mother who had an infertility problem. He used a healthy egg cell (ovum) from a donor woman, from which he removed the nucleus. He extracted only the young nuclei (pronuclei) from the mother and her husband, and introduced them into the host egg cell, hence the popular name "three-parent baby". There was about 70% success in fertilization. Five embryos were implanted in the mother's uterus, and she was normally pregnant. Zhang published a preliminary report in 2003 in the journal "Fertility and Sterility". However, he was careful of the outcome and did not disclose the full data and results. He had regret for breaking the news so soon, blaming his collaborator as "so eager to be famous". As it happened, none of the embryos survived to full term. He made the full report only after 13 years, in October 2016.
Hutzel Women's Hospital
1993: Development of the world's first embryo fetoscopy procedures.
Embryo transfer
In the process of zygote intrafallopian transfer (ZIFT), eggs are removed from the woman, fertilised, and then placed in the woman's fallopian tubes rather than the uterus.
In 2015, the American Society for Reproductive Medicine developed a medical simulation of the Embryo Transfer procedure with Swiss company VirtaMed, designed for the education and training of clinicians. The virtual reality simulator, which includes real-time simulation of ultrasound guidance, was launched at the annual conference of the American Society for Reproductive Medicine.
Embryo transfer
After insertion of the catheter, the contents are expelled and the embryos are deposited. Limited evidence supports making trial transfers before performing the procedure with embryos. After expulsion, the duration that the catheter remains inside the uterus has no effect on pregnancy rates. Limited evidence suggests avoiding negative pressure from the catheter after expulsion. After withdrawal, the catheter is handed to the embryologist, who inspects it for retained embryos.
Intestine transplantation
Intestine transplantation dates back to 1959, when a team of surgeons at the University of Minnesota led by Richard C. Lillehei reported successful transplantation of the small intestine in dogs. Five years later in 1964, Ralph Deterling in Boston attempted the first human intestinal transplant, albeit unsuccessfully. For the next two decades, attempts at transplanting the small intestine in humans were met with universal failure, and patients died of technical complications, sepsis, or graft rejection. However, the discovery of the immunosuppressant ciclosporin in 1972 triggered a revolution in the field of transplant medicine. Due to this discovery, in 1988, the first successful intestinal transplant was performed in Germany by E. Deltz, followed shortly by teams in France and Canada. Intestinal transplantation was no longer an experimental procedure, but rather a life-saving therapy. In 1990, a newer immunosuppressant drug, tacrolimus, appeared on the market as a superior alternative to ciclosporin. In the two decades since, intestine transplant efforts have improved tremendously in both number and outcomes.