In vitro a lifeline for many

One of first clinics was in Atlanta

When a British scientist was awarded the Nobel Prize on Monday for pioneering in vitro fertilization, a north Fulton County woman got chills.

Kim Saunders knew that had it not been for the work of Robert Edwards at Cambridge, she would not be taking a daughter to piano lessons that afternoon.

“I recalled Louise Brown being the first IVF baby, and I thought Audrey wouldn’t have even had this opportunity to live had it not been for the work he did,” said Saunders, whose daughter is 7.

Edwards won the Nobel Prize in medicine for developing an extraordinary procedure that has since become so commonplace as to be unremarkable. With his research partner, the late gynecologist Patrick Steptoe, Edwards revolutionized reproductive medicine with the technique, in which a woman’s eggs are removed, fertilized in the lab and transferred to her womb. About 4 million children have been born through in vitro worldwide since Brown was delivered in Britain in 1978.

One of the first in vitro clinics in America — Reproductive Biology Associates — was in Atlanta. And one of the founding doctors was Hilton Kort, who trained with Edwards at Cambridge.

“Just being in his presence you knew that this was one in a million, that this was an incredible human being,” Kort said. “Our understanding of the science today is largely because of him. He is a giant.”

Edwards, 85, is in failing health and was unable to comment Monday on the honor he had won, his wife said. In 2003, Edwards told The Times of London that he was “not terribly bothered” about not getting a knighthood. “I’m a very left-wing socialist and I won’t shed a tear. But if you can organize a Nobel, please go ahead,” he joked.

About 7,000 babies have been born as a result of in vitro treatments at Reproductive Biology Associates. Those working in the field say the total number of Georgia babies born through in vitro probably numbers in the tens of thousands.

“In the early 1980s, [in vitro fertilization] was stigmatized, it really wasn’t that accepted,” Kort said. “Today it’s as mainstream as someone having cardiac surgery.”

Kort was Janet Caputo’s doctor when she became the mother of Georgia’s first in vitro baby.

Caputo said on Monday that she consulted with a child psychologist before her daughter Jeanna was born in 1984. She and her husband wanted to consider what it would be like, if they were successful, for their child to grow up as one of the first wave of babies in the world to be conceived in a lab.

“I remember saying that by the time this child is old enough to understand this, there will be so many others out there,” Caputo said. ‘That was just a prediction at the time. But that’s what has happened.”

Jeanna Caputo is 26 and teaching music abroad. The Caputo family includes three other children — another daughter conceived through in vitro and a daughter and a son the couple conceived naturally after the births of the first two.

By the time Kim and Stuart Saunders turned to in vitro — 25 years after Brown’s birth — the procedure was well-established. The couple had undergone treatment for infertility for about five years and had almost given up on ever having a child. But when Kim was 39, they decided to try in vitro and use a surrogate to carry their biological child: Their doctor thought that would be their only strong shot. It worked.

“In Audrey’s prayers each night, we say thank you, God, for all the doctors and for Brooke [the surrogate] and the people who helped her get here,” Kim Saunders said. “We are so grateful.”

In vitro was common by then, but the use of surrogates was still relatively rare. The process went off without any complications, and Audrey today is a first-grader who loves to sing and dance, takes piano lessons and is fascinated by science.

While Edwards laid the groundwork, intense research continues to improve and fine-tune in vitro. Success rates have increased dramatically, from maybe 5 percent in the early days to pregnancy rates as high as 50 percent to 60 percent today — often after multiple procedures — said Dr. Andrew Toledo, an infertility specialist at Reproductive Biology Associates.

In 2007, each round of in vitro had a 29 percent chance of leading to a live birth, according to the U.S. Centers for Disease Control and Prevention. Researchers today are working hard to improve success rates even further, said Dr. Lisa Hasty, another Atlanta infertility specialist, by knowing which patients have the best odds of being helped, something that wasn’t as clear in the past.

Many patients must undergo three rounds of in vitro to achieve a pregnancy, and some do not succeed even after that. Each round of in vitro costs about $10,000 to $15,000, Toledo said, and most Georgia insurance plans do not cover it.

Toledo, whose wife got pregnant through in vitro, said some states mandate that insurers cover the treatments. But the Georgia General Assembly has not approved such a measure, he said.

In fact, Toledo said, the state Legislature has considered measures to try to restrict some aspects of in vitro fertilization. But so far, those measures, which often hinge on determining whether or not an embryo is a person, have not become law.

Highly publicized reports of multiple births prompted legislation to limit the number of embryos that could be used in a procedure, and concerns about discarded embryos being destroyed in stem-cell research have also sparked intense debate.

The Roman Catholic Church remains opposed to in vitro fertilization and received Monday’s Nobel news with guarded praise for Edwards.

Monsignor Ignacio Carrasco de Paula, the newly appointed head of the Pontifical Academy for Life, said awarding the Nobel to Edwards is “not completely out of place.”

But Carrasco charged that Edwards had created a “market of eggs.”

“Without Edwards, there wouldn’t be freezers full of embryos waiting to be transferred in utero or, more likely, be used for research or to die, abandoned and forgotten by all,” he said.

Kort describes his work as “probably the most rewarding job on Earth.”

“I always say that what we do is an incredible privilege, and it has to be done with the greatest respect,” he said.

Kort said he doesn’t worry about running afoul of lawmakers “as long as we remember to never abuse what we do and always do what’s best for the patient.”

The Associated Press contributed to this article.