Book Review: Breakthrough Babies - An IVF Pioneer's Tale of Creating Life Against All Odds

Dr Simon Fishel, founder of the CARE Fertility Group, has a long and distinguished career behind him. As a young biochemist he began his research career at the University of Cambridge with IVF pioneer Professor Robert Edwards, who together with Dr Patrick Steptoe was responsible for the birth of the first IVF baby, Louise Brown, in 1978.

Dr Fishel's new book, 'Breakthrough Babies' charts a life devoted to IVF. It is a deeply candid perspective of the institutions and personalities that have shaped his professional life.

Working 'at the limits of what's possible' seems to be a powerful motivation for Professor Fishel, whose career in a sector full of driven, ambitious individuals requires a high level of tenacity and self-belief. It will come as no surprise to clinicians and scientists who balance ground-breaking scientific work with ethical and legal considerations, that Dr Fishel details plenty of office politics and rivalries thrown in for good measure.

His journey so far has not been without drama. From the early days of working in portacabins at Bourn Hall, the first IVF clinic, to the later establishment of NURTURE and CARE Clinics, Dr Fishel has faced challenges that would have defeated someone with less drive and self-belief. The stark account of his battles with the University of Nottingham and his consequent brush with bankruptcy makes tough reading. He is frank about the personal cost of this period to his public and family life.

Ever resilient, in collaboration with his wife, Judy, he sets about the task of reviving egg donation IVF at CARE using the egg-share donation system to encourage women to come forward to donate their eggs (see BioNews 993). To this day, CARE is the largest egg donation centre in the country.

What shines through in this engagingly written memoir is a sense of irrepressible determination in the face of challenges; when faced with a medical dilemma, Dr Fishel's reaction is always to find a way through that will benefit his patients, even if it means locking horns with the Human Fertilisation and Embryology Authority (HFEA). One notable example is when seeking permission for a pioneering technique of retrieving viable sperm (Multiple Ejaculations Resuspensions and Centrifugation, or MERC) from men previously thought to produce no sperm at all. His impatience with the process of consultation is obvious: 'What was I allowed to do with an immature sperm, such as a spermatid, I asked? The HFEA had never replied to me.'

A younger generation of clinicians will be fascinated with Dr Fishel's descriptions of the techniques used in the 1970s. His highly individual account offers insights into social and cultural changes as well as innovations in techniques and bespoke medical equipment in the 40-plus years since IVF was first performed. The sheer speed of progress within the field is dizzying and has inevitably created many challenges for those working at the cutting edge of this technology.

The penultimate chapter in the book, 'The DNA of IVF', provides a fascinating insight into the potential applications of using stem cells to restore the sight of those suffering from macular degeneration (a medical procedure seen recently in Russell T Davies' dystopian drama 'Years and Years' on BBC). Other cells too, might in time be de-programmed and taken back to an 'ancestral phase where they don't know they're "you"'. This unlocks the startling possibility of transforming such cells into egg or sperm cells.

The implications of this are the stuff of science fiction. But one gets a clear sense of how exciting this prospect is for a scientist who, having been involved with IVF since its inception, wants to push even further into ever more ground-breaking discoveries, even as the rest of the world struggles to negotiate an ethical and legal framework in which these procedures might operate.

The lively, conversational tone of this book – interspersed with descriptions of complex procedures and scientific explanations that never descend into dry jargon – makes this an ideal read for anyone who has ever wondered what drives the men and women who are responsible for offering the possibility of parenthood to those who, just a few decades ago, could never have contemplated it.

For patients, it helps place IVF into a clearer socio-historical context and provide a useful insight into the daily challenges faced by clinicians and research scientists. For those working in assisted conception, it provides a comprehensive account of the history of IVF in the UK through the eyes of a pioneer in this intensely competitive field.

Buy Breakthrough Babies: An IVF Pioneer's Tale of Creating Life Against All Odds from Amazon UK.