On April 16, 1982, at the University Hospital in Erlangen, Oliver, Germany's first test-tube baby was born by Caesarean section, weighing in at a healthy 4,150 grams (just over 9 pounds).

The event caused quite a stir, prompting strong reactions from the public and the scientific community, and sparking heated debates between supporters and opponents of in-vitro fertilization (IVF), artificial insemination that takes place outside the body.

Some welcomed the then-revolutionary method, while others thought it scandalous to have created life in a test tube. Siegfried Trotnow, the doctor who "fathered" the first test-tube baby, met with considerable resistance from experts in his field.

A routine procedure today

Today, IVF is a routine procedure. In more than 120 clinics across Germany, infertile couples can turn to the method to help them conceive their long-awaited first child. In Germany, there are around 50,000 artificial inseminations every year, with roughly 10,000 of those resulting in a pregancy.

The potential mother's age plays a huge role here, with nearly half of women under 30 likely to get pregnant. In women over 45 years of age, the success rate is down to 5 percent.

When IVF was still in its infancy, the extraction of egg cells was only possible by laparoscopy, through the abdominal wall. This was the process used for the first German test-tube baby. But just two years later, a new method was developed.

"By extracting egg cells through the vagina, it was much easier than ever before," explained Thomas Katzorke, director of the Center for Reproductive Medicine and Infertility in Essen, in an interview with DW. This simple extraction method led to a veritable triumph for reproductive medicine, according to Katzorke. Since then, around four million test-tube babies have been born worldwide.

Today, the process is still very much the same, with the sperm cell being inserted into the egg cell using a micropipette, a very slender graduated tube. "Amazingly, the classic IVF method, in which many sperm cells are introduced to an egg cell outside the body, has not changed," says Ralf Dittrich of the University Hospital Erlangen.

But now, he adds, it is possible to treat infertility in men as well. If there are too few sperm cells present for the standard IVF treatment, now even a single sperm can be inserted into the egg cell.

"If a genetic disorder is known ahead of time, we can also perform an additional treatment, namely the so-called pre-implantation genetic diagnosis (PGD)," says Dittrich. Since a change in the law last year, PGD is now also permitted in Germany, at least in certain exceptional cases. A routine IVF, however, does not examine whether the embryo carries a genetic disease.

Help for cancer patients

Modern reproductive techniques have also benefited many cancer patients. It was often impossible to successfully conceive a child after cancer therapy, since the ovaries were often permanently damaged by medication.

Today, however, ovarian tissue - containing a woman's egg cells - can be removed and frozen. If the patient survives the cancer, the ovarian tissue can be re-implanted.

"Normal eggs can then develop from this tissue, and the patient is able to conceive naturally," says Dittrich. In Erlangen, some 250 women have had their ovarian tissue frozen; seven have had the tissue re-implanted. Of those seven, one patient became pregnant and gave birth to her baby in Dresden. And both mother and baby are doing well.

Author: Gudrun Heise / cmk
Editor: Nicole Goebel