Harnessing the miracle of life: Tracing the birth of the first test-tube baby in mainland China丨Today in the history of science and technology

On March 10, 1988, the first test-tube baby was born in mainland China.

According to CCTV.com, the infertility rate among couples of childbearing age in my country has climbed to about 12%-18% in 2021.

For a long time, having children has become the wish of many families. Fortunately, with the rapid development of assisted reproductive technology, many families can realize their dream of having a baby through modern medicine.

According to data from the National Health Commission, my country's assisted reproductive technology has developed rapidly in recent years, with the total number of technical service cycles exceeding 1 million and the number of babies born exceeding 300,000 each year. Modern medicine has given new life and new hope to one family after another.

The birth of these new lives can be traced back to 36 years ago today.

On March 10, 1988, with a cry on the operating table, the first test-tube baby in mainland China, Zheng Mengzhu, weighing 3.9 kg, was born, opening a new journey for the development of assisted reproductive technology in my country. Her name also has a deep meaning. "Meng" means sprout, and "Zhu" comes from her creator, Zhang Lizhu, an obstetrician and gynecologist. The child's parents used this way to thank Zhang Lizhu for her efforts in the birth of this new life.

Professor Zhang Lizhu holds the first test-tube baby

Zhang Lizhu, known as the "mother of test-tube babies in mainland China," is closely linked to the development of reproductive medicine in my country. In 1958, the Third Affiliated Hospital of Peking Medical College (now Peking University Third Hospital) was established. Zhang Lizhu, who had just returned from studying abroad, directly participated in the establishment and became the founder of the hospital's obstetrics and gynecology department.

"It was only after I received more than 6,300 letters for help that I realized that Chinese people also need to solve the problem of infertility," said Zhang Lizhu. In the 1980s, Zhang Lizhu developed IVF technology based on the limited experience she could obtain from overseas and combined it with China's national conditions. Starting in 1984, Zhang Lizhu and her research team began to try to solve the problem of infertility by solving female gynecological diseases and conducting research on in vitro fertilization and embryo transplantation technology. In 1986, she presided over the national "Seventh Five-Year Plan" project "Eugenics-Protection, Preservation and Development of Early Embryos", and launched the first domestic application research on IVF technology.

**"Test-tube baby" is the common name for in vitro fertilization combined with embryo transfer technology. **It refers to the extraction of sperm and eggs from the male and female bodies, and then fertilization and cultivation in vitro, and then transplantation back into the female's uterus after the early embryo is formed. Among all assisted reproductive technologies, it is the one with the highest attention and utilization rate.

"Foreigners use laparoscopes to observe the surface of the ovaries, and they puncture wherever there are follicles. However, the main cause of infertility among Chinese people is blocked fallopian tubes. Many patients have pelvic adhesions due to tuberculosis, and the laparoscope cannot see the fallopian tubes or eggs at all. The conditions are different, so the treatment methods are also different. " Since she couldn't learn from foreign countries, Zhang Lizhu had to find a way. She retrieved eggs from the patient while performing abdominal surgery. Even if she couldn't retrieve eggs, she solved the patient's pelvic problem.

Zhang Lizhu had a hard time figuring out how to find the eggs and when to retrieve them. "We just reached in, felt the ovaries and follicles, and punctured them," Zhang Lizhu said. At that time, the conditions were very difficult. We didn't know anything about eggs, and we had never even seen their shape. We didn't know when they would mature. Only mature eggs could be fertilized. If they were immature, they would be useless, and if they were overmature, they would be useless. Sometimes, in order to retrieve the eggs, we had to observe them for several days and nights.

**In addition to having to figure out the technology on her own, Zhang Lizhu was also troubled by the poor hardware environment. **The conditions were very difficult at the time, and she had to find ways to solve even the instruments and equipment on her own. There were not enough utensils and culture dishes, and they had to be disinfected and used repeatedly; there were not enough egg retrieval needles, and one had to be used again and again, and when it was blunt, it had to be sharpened, and some had no threads and had to be thrown away. "I took this needle and ran to the watch shop to sharpen it. There was also an earlier time, because the eggs were extremely sensitive to cold, and the egg retrieval room was far away from the egg search research group, we had to put the test tubes containing follicular fluid into a thermos, then put it in our arms, and trot across the playground to deliver it." Zhang Lizhu recalled.

But Zhang Lizhu told her team members: " Conditions are one thing, but persistence is the most important thing ." Failure, try; fail again, try again... After 12 failed cases, in 1987, Zhang Lizhu met the 13th subject, Zheng Guizhen from Li County, Gansu. Due to bilateral fallopian tube blockage, Zheng Guizhen had been infertile for many years after marriage. Eager to have a child, she went to Beijing to seek help from Zhang Lizhu.

Fortunately, after the egg retrieval operation, in vitro fertilization was successful. The fertilized egg began to divide, and Zhang Lizhu used a special plastic tube to implant the fertilized egg into Zheng Guizhen's uterus. Seven weeks later, the fetus's primitive heart beat vigorously, and the clinical pregnancy was successful. On March 10, 1988, Zheng Guizhen successfully gave birth to Zheng Mengzhu, the first test-tube baby in mainland China.

The first test-tube baby was born in mainland China. Photographed by Sun Yuliang, who won the first prize of Beijing Daily News Photography that year.

The technology of each link of IVF has also developed rapidly. At the end of 1989, Zhang Lizhu pioneered the method of extracting eggs with a needle under vaginal B-ultrasound, which was listed as the "conventional egg extraction method" because of its low trauma and repeatability. She led the team to conduct more than 1,300 IVF cycles, raising the clinical pregnancy rate from 6.4% in the early stage to 32%, and the live birth rate reached 20%. China's IVF technology has been among the best in the world since its inception.

**Since then, a new page has been opened in the clinical and basic research of assisted reproductive technology in my country. **Afterwards, the first gamete fallopian tube transfer test tube baby, frozen-thaw embryo test tube baby, and triple-frozen (frozen eggs, frozen sperm, frozen embryo) test tube baby were born one after another, reproductive medical centers were established in various parts of the country, assisted reproductive technology was promoted nationwide, and China's assisted reproductive technology developed rapidly.

Since the birth of the first test-tube baby in mainland China at Peking University Third Hospital in 1988, the clinical application of test-tube babies in China has evolved from the first-generation in vitro fertilization-embryo transfer (IVF-ET) to the second-generation intracytoplasmic sperm injection (ICSI) and the third-generation preimplantation genetic testing (PGT).

As of December 31, 2022, there are more than 550 medical institutions in my country that have been approved to carry out human assisted reproductive technology, of which more than 430 are able to carry out in vitro fertilization-embryo transplantation, and there are more than 10,000 professional practitioners engaged in human assisted reproductive technology.

This is a relay between the old and new medical workers. With the pioneering efforts of the older generation of medical workers and the efforts of the new generation of medical workers, China's assisted reproductive industry is constantly advancing and becoming world-class. At the same time, each new life brings new hope and vitality to each family.

Planning and production

Source: Comprehensive from People's Daily Online, CCTV.com, China Women's News, Beijing Daily, Peking University News Network, The Paper

Editor: He Tong