The end of infertility is within sight, scientists said yesterday, anticipating the possibility within a decade of solving the biggest remaining problem by growing new eggs and sperm from stem cells for people who can no longer produce them.
Most of the reasons for childlessness have been overcome, leading fertility experts said, commenting on the progress in in-vitro fertility treatment (IVF) since the first test-tube baby, Louise Brown, was born 25 years ago today.
"I'm certain in the long term we will be able to help everybody," Alan Trounson of the Monash Institute of Reproduction and Development in Victoria, Australia, said.
Couples with a family history of genetic or chromosomal abnormalities could already have healthy babies by the testing and selecting of unaffected embryos created in the lab, and there were few uterine problems that were still an issue, he said.
The last big group in need of help were men who had no sperm and women who had no eggs, usually because they had undergone treatment for cancer.
"In the long term the message is that this is potentially possible," Professor Trounson said. "In 10 years we might have a way that is very well worth trying for someone who has had cancer or has lost all their sperm."
Studies in mice had shown that it might be possible to take a cell from the adult with fertility problems, insert it into the emptied nucleus of a donated egg and trick it into reverting to a cluster of stem cells - the building blocks that have the potential to become any part of the human body.
"In future we'll be able to take cells and reconstruct the equivalent of sperm and eggs," he said. A great deal more basic research was necessary, however.
Allan Templeton, honorary secretary of the Royal College of Obstetricians and Gynaecologists, believes that even the problems of women who leave it too late to have a family and find they have run out of eggs in their late 30s and early 40s will eventually be resolved.
"By 41 on average they no longer have the capacity to produce a potentially fertile egg. That is something that can be addressed possibly in the future through technology that looks at how eggs age and whether that can be halted or altered in some way."
But more had to be be done to educate women about their fertility and warn them of the dangers of infections, such as chlamydia, which can block the fallopian tubes, preventing eggs from descending to the womb.
He stressed that the biggest threat to the health of IVF babies was the decision to put several embryos back in the womb, resulting in multiple births. Triplets were 10 times more likely to die at or shortly after birth than single babies, and had a greatly increased chance of cerebral palsy.
Prof Trounson, who has been involved in fertility research from the beginning, said amazing progress had been made. "If you'd told me back in 1979-80 that there would have been 1 million babies by now, I'd have said 'Get real'. At that time [the success rate] was one in 20. Now I'd have thought it was about 75%."
IVF had made it possible to study early cell development of human beings, invisible in the womb, and led to the possible repair of human tissue through stem cells.
"These cells will be used very widely in therapeutic techniques," he predicted. "I think there will be a major paradigm shift to cell therapies and this would not have happened if it was not for IVF."
Stem cell research is allowed in Britain but not everywhere, because although it is possible to grow them from adult cells, the most useful are derived from embryos. The cost of IVF is still prohibitive for many people in Britain.
Kirsty Horsey, of the Progress Educational Trust, said Louise Brown's birthday was a painful reminder to many women that they would not be able to afford the help they needed to have a baby because of the shortage of public funding.
