Treating Infertility - A Brief History of Fertility and Its Treatment
Today, most Americans consider infertility to be a medical issue, like having the flu or a given hair color, and for many people seeing a fertility specialist has become a relatively normal part of modern life. However, people have always been concerned with fertility, as the earliest human records show, and infertility has been a problem that centuries of families have struggled to overcome. Unfortunately, the complexity of the reproductive system beguiled scholars and authority figures for centuries. Only in the last several hundred years has real progress been made toward curing infertility.
The earliest treatment for infertility can be found in Shang Han Lun, a Chinese medical textbook written around 220 AD that recommended the use of acupuncture. A thousand years later, another Chinese text, The Complete Book of Effective Prescriptions for Diseases of Women, discusses the elemental forces causing the harmonic flaws behind fertility problems. In other parts of the world, religious texts largely held sway over family planning decisions; a "barren" woman could be killed for failing to produce children in some cultures. This practice has unfortunately been seen in recent examples of so-called "kitchen burnings" in India.
For most of the Western world, Biblical lessons colored views on fertility, with the Biblical figure Hannah held up as the instructive figure. Preachers recommended turning to God for help because infertility was seen as a sign of insufficient piety. However, in 1677, Anton Van
Leeuwenhoek made the first real breakthrough in fertility science by discovering the presence of spermatozoa in seminal fluid. For those seeking treatments outside the church, though, the options were limited. For most of the 1700s, folk remedies predominated, including several ostensibly scientific treatments, such James Graham's "electrotherapy," a stimulatory device that did not result in any pregnancies.
The first important discoveries in reproductive medicine occurred in the 19th century, as newly confident surgeons began utilizing original tools in a quest for answers. One physician, J. Marion Sims, invented the speculum that doctors use (in a modernized form) today. Still, ignorance predominated, with Harvard professors suggesting that education adversely affected female fertility. Eventually, doctors such as Emil Noeggerath began to link infertility with diseases like gonorrhea, and researchers experimented with intrauterine insemination. By the turn of the century, fertility science was poised for a series of important breakthroughs.
By the end of the 1920s, researches had discovered the fertility hormones estrogen and progesterone, in addition to tests for fallopian tube blockages. The end of the 1930s saw the first successful donor insemination, the standardization of sperm count and quality testing, and the discovery of male sex hormones. Synthetic hormones were quickly developed to fill the gap for those in need, and by 1944, Dr. John Rock succeeded in fertilizing a human egg in vitro.
The following decades witnessed the appearance of drugs like Pergonal and Clomid, as well as the opening of America's first commercial sperm bank. In 1978, the first in vitro fertilized baby was born. While the religious and ethical issues that bedeviled earlier generations continued to create a healthy debate among physicians and the public, the advent of in vitro fertilization has led to a new era of fertility treatment. Today, as procedures like preimplantation genetic diagnosis become increasingly common, the next generation will have to face a new set of ethical conundrums.