Transitions in fertility research

Abstract

History reveals that the genesis of progress in fertility research comes chiefly from animal research, and that subsequent applications of this research to humans have touched on many sensitive beliefs, prejudices, religions, and philosophies. Developments in fertility research, when applied to the human, diverge into two sensitive and very complex applied research categories-assisted reproduction and contraception. History also shows that these concurrently progressing research disciplines have undergone vacillating interludes of progress and of being blocked or restricted. Many of the technological improvements considered to be major transitional states in the progress of each of these categories are identified. They include artificial insemination, the invention of the sheath and the intrauterine device, the identification of hormones, and the elucidation of their activities as well as their interdependent relationships, the social acceptance and rejection, early embryo manipulation techniques, enzyme and sperm capacitation, and certain modern techniques involved in assisted fertility. Giant steps occurred in the 1950's with the rapid and seemingly unrestrained upward movement in chemical and clinical research that produced the hormonal contraceptives. This continued into the 1960's with additional advances providing improvements and popular choices such as intrauterine devices. In the following decades, many improvements were realized in both disciplines; however, changes in the legal environment, the litigious attitude of the public, sources of financial support, and basic priorities by industry and governments have caused uncertainty in many areas. The progressive moves seem to have occurred at certain periods when our population was not preoccupied with other matters and tended to pursue intellect and logic. This paper attempts to summarize a portion of the history of discoveries and developments in fertility research within each of the two applied research categories, and thereby to reveal and discuss a few of the underlying factors and the human qualities that impacted on the evolution of fertility research.