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Thirty years ago, no one knew about the internet, iPods or even that cars could park themselves.

In medicine, the MRI had not yet transformed imaging technology, the use of coronary stents was not commonplace, and physicians had no effective or efficient solution for infertility, a problem affecting one in six couples throughout the world.

In the late 1970s, Lesley and John Brown, an English couple who had been trying to conceive for nine years, came to Dr. Robert Edwards of Cambridge University for help. Edwards and collaborator Patrick Steptoe were working on a technology called “in vitro fertilization” (IVF) for the treatment of human infertility but had not been successful at achieving a pregnancy.

Like many discoveries in medicine, the discovery of IVF came about by a cross-fertilization of independent ideas. Steptoe, a scientist, and Edwards, a physician, had met by chance through an article in the English medical journal, Lancet.

Between 1968 and 1978, Edwards and Steptoe collaborated on the concept that a mature egg, aspirated from an ovary, could be combined with sperm in the laboratory and reintroduced to the mother’s body as an embryo.

The team had to overcome formidable technical problems: how to induce ovulation, how to collect mature eggs from ovaries, how to incubate the eggs in vitro in a test tube with sperm so that fertilization would occur, and how to implant the embryos into the mother’s uterus so that a normal baby could develop.

In 1978, the world’s attention focused on their success by the sensational announcement of the birth of Louise Joy Brown, a healthy baby girl, conceived in vitro, who became known as the world’s first “test tube baby.” Many considered this birth to be as astonishing a scientific feat as the first moon landing.
More than one million IVF babies have been born worldwide since 1978, according to The American Fertility Association.

Dr. Gary DeVane, who grew up in Orlando, was just completing his OB-GYN training when Louise Brown was born. He had graduated from Davidson College in North Carolina, received a scholarship to Baylor College of Medicine in Houston, and decided he wanted to specialize in obstetrics and gynecology.

After graduating from medical school, he continued his training at the University of California in San Diego, completing an internship and residency in OB-GYN with a special six-month elective in gynecologic endocrinology under Dr. Samuel Yen, chairman of the department. He then served for three years at the Army Medical Hospital in Landstuhl, West Germany.

DeVane returned to the states to serve as a post doctoral fellow at the Cecil H. and Ida Green Center for Reproductive Biology Sciences at the University of Texas’ Southwestern Medical Center in Dallas from 1978 to 1980.

The announcement in 1981 of the birth of the first American IVF baby came while DeVane was teaching in the Division of Gynecologic Endocrinology at the University of Florida Medical School in Gainesville.

Academic and public health facilities were hesitant to challenge the political controversies surrounding the new procedures, and DeVane decided to leave teaching to learn all he could about the IVF process. He went to England and studied with Edwards and Steptoe and returned to Orlando in 1985 to open the state’s third IVF clinic, one of only 30 or 40 clinics offering IVF in this country.

DeVane says that, from its beginning, the clinic got good training and support from British experts who were eager to come to Orlando — he acknowledged that “Disney World could have been a draw even for these esteemed scientists.”

His clinic, Center for Reproduction Medicine (CRM), had its first IVF birth in 1986, and now has a “family” of hundreds of babies born to its patients. DeVane has been joined in the practice by Drs. Randall A. Loy, Sharon B. Jaffe, and Samuel E. Brown. In 2005, the CRM became the only office-based infertility surgery facility in Florida accredited by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO). The JCAHO determined that “CRM shows an extraordinary commitment to providing safe, high quality care and a willingness to be measured against the highest standard.”

Success in freezing human eggs came in 1987, which expanded the horizons of IVF for women who needed to postpone their pregnancies and wanted to preserve their own eggs. DeVane said freezing “was at first met with resistance because of some misunderstandings about the intent of the procedure, but is now widely accepted.”

In the early 1990s, scientists in Belgium reported the first deliveries of babies conceived using ICSI (intracytoplasmic sperm injection), a process that successfully microinjected a single human sperm into a living egg. This was a revolutionary step in the treatment of male infertility where frequently, even when using IVF, the sperm were unable to spontaneously penetrate the egg.

DeVane observed: “This was a big deal. It gave a whole subset of infertile couples the means to achieve a pregnancy, and overnight there was a new group interested in the procedure.”

Now that technological issues can be less problematic, DeVane believes the main issues facing those who offer IVF are “what we can do versus what we shouldn’t do.”

Technology has advanced to the point where embryos can be screened for congenital defects and enzymatic disorders, as well as for genes that carry diseases, such as adult onset diabetes, which can be identified very early in the cell division.

Despite the fact that in California and New York there has been a trend of “family balancing” to allow gender selection for parents of IVF babies, DeVane hopes new technical capabilities will not lead to producing “designer babies.” He does, however, feel that “it is valid to use technology to prevent significant inherited diseases that can be selected out.”

DeVane attributed much of CRM’s success to the gentle, careful way the embryos are treated in the CRM labs, and the training of the lab personnel. “The quality of the labs, which have the best equipment and use best media for growth, and the skill of the embryologists who evaluate chromosome defects, is key,” he said.

For DeVane, realistic communication with prospective parents is very much part of what they do at CRM — “we don’t play games and are very honest with them about the results they can expect,” he explained.

DeVane and his wife, Barbara, have two daughters and a son, and are excited to have their two young granddaughters nearby. He enjoys snow skiing and bicycling.
How long does he plan to continue practicing? He answered with a laugh, “Why stop now? I’m having fun everyday — helping people achieve what they want.”



August 2007

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