Monash University Publishing: Advancing knowledge

Launch of
Test Tube Revolution

On 16 September 2013 Alan Trounson launched John Leeton's book Test Tube Revolution: An Early History of IVF at Monash University, Clayton, Victoria. We are pleased to be able to provide Professor Trounson's full launch speech here:

We have needed a book on the extraordinary people and events in Melbourne through the 1970s and 80’s that was a revolution in reproductive medicine. The core of these accomplishments involved the team led by Carl Wood – the founding Chair of Obstetrics and Gynecology at Monash University. Who better to author this than Carl’s close friend and colleague – John Leeton, aided by journalist Robyn Riley. It is an easy read for one of the genuine milestones in human medicine. Dr Robert Edwards received the Nobel Prize for Medicine for IVF in 2010 for his work on initiating human IVF. Carl and his team actually created most of the technology that was, and is actually used, to produce the 5 million +  IVF babies worldwide 1978-2011. John tells an incredible tale of the Melbourne group and their energy, innovation and shear bravery in the face of frequent and concerted opposition.

Carl Wood was arguably the best known medical academic working in world reproductive research in the 1970-1990s. He was certainly the most recognized Monash person in the world. I remember comments from successive Vice Chancellors about the repeated recognition of the Monash IVF team and its leader Carl Wood – when they travelled the globe. Vice Chancellor Professor Mal Logan considered Wood Monash’s best asset for recognition of the University’s academic achievements.

This was partly because the IVF research team around Wood was creative, brave and determined. They were successful and continually rolled out breakthroughs – IVF using fertility drugs, embryo freezing, egg and embryo donation, sperm injection into eggs for treating severe male infertility, embryo biopsy for inherited genetic disease (PGD) and successful surrogacy. They were ahead of the other teams in the world and were recognized as a close knit unit under Woods guidance. Wood was also the master advocate and was extremely good at promotion of the medical advances the team was making. His essential charismatic personality and photographic good looks were helpful but he was often prepared to explore areas beyond those the team supported eg. cosmic embryo travel.  There were times of disappointment because it seemed Carl was the sole intellect behind the research. Australians love a winner!

The team was closely knit under his Carl’s leadership and he was able to extract an incredible commitment to succeed. He didn't really see barriers, only hurdles to overcome. I remember so many times that it was John Leeton who agreed to try the “impossible” and Jillian Wood who always organized the clinical program to establish the so called “the proof of concept” for the new approach. Leeton’s determination to help Maggie Kirkman fulfill her dream for a child – involving surrogacy was testament to John’s skills and courage in the face of aggressive opposition.

Leeton was a special component of the team – he carried most of the responsibilities for patients in the early days. He and Mac Talbot carried out the bulk of the laparoscopies and he had to take head on the cynicism of medical colleagues and the hospital towards the IVF procedures. He was very different to Ian Johnston who ran the Royal Womens’ Hospital IVF program. Ian was the energy behind the formation of the Australian Fertility Society and took a major role in international conferences and societies. John was involved but didn't seek the high offices of professional societies or conference leadership. In some respects Ian overshadowed John in the media and professional societies but it was Leeton who will be recognized for the innovation that made IVF so successful.

You will be reminded of the opposition – in the early days from academics and some highly respected scientists about the potential dangers of IVF. The conservative Catholic Church, feminists – particularly Feminist International Resistance to Reproductive and Genetic Engineering “Finrage” section of the radical feminist movement, catholic ethicists and others. Initially politicians were aloof, then proud of their scientists making major breakthroughs, then opposed as they legislated and  regulated on the so called “slippery slope”. But there were others who were very supportive – including ethicists such as Peter Singer, lawyers such as Michael Kirby, Vice Chancellors such as Mal Logan (indeed most if not all Monash VCs) and most of all – the infertile couples. Wood reveled in the debate and argument – he saw the pain of infertility first hand and was cynical about the church’s claims of sovereignty over conception. The rest of us found it more challenging, particularly when the legal and regulatory rules snuffed out any capacity to continue the innovation that had created the reproductive revolution. Critical scientists – Leeanda Wilton and Andrea Laws-King left the field and Australia because of the suffocating research environment.

What makes historical developments from rather ordinary ingredients – a cause (infertility without resolution), a leader (Carl Wood), a “can do mentality” (if it works in animals it must in humans), disciples willing to try the unlikely (Leeton, Talbot), professional expertise (Jill Wood, Peter Renou, Paul Shekelton, Beresford Buttery, Janice Webb), scientists wedded to making a difference (Maha Mahadevan, Linda Mohr, Peter Lutjen, Lesley Freeman, Catriina Caro, Luca Gianaroli and many others including David de Kretser, Peter Temple-Smith, Graham Southwick and Rob McLauchlan – in male infertility) and guts to never give up. All these ingredients were there. It was a blast. The team was recognized internationally – from the moment that I presented our first raft of 16 pregnancies using fertility drugs at the World Congress of Human Reproduction in Berlin 1981. We became the center for teaching the rest of the world IVF (Edwards and Steptoe didn't encourage training in those early days). The path to Monash Melbourne was deep and well traveled. Leeton and his colleagues were the clinical front line for this training. Most of the world’s leading fertility clinicians came to Monash for help. The younger clinicians – Gab Kovacs, Nick Lolatgis, Bruce Downing, David Healy, Mark and Tony Lawrence – blossomed in the environment.

Wood never craved reward for his success in IVF or other areas of medicine. He didn't take part in many of the world conferences on IVF, he didn't join professional societies or seek power and influence through these memberships. He was not as well known in the “industry” as Ian Johnstone or John Leeton – he was the enigmatic professor doing his own thing. Perhaps he should have shared the Nobel Prize with Bob Edwards but he wouldn't have cared too much about this. He had a holistic approach to medicine and cared very deeply for the needs of women. The Prize wouldn't have been significant for his philosophy, but he was pleased for awards to others.

There is a time when all things must pass. Monash IVF that was created by Carl, John and myself – was sold. Monash University received the largest benefit of ~ $100M – the largest contribution from any research activity at the University. Monash should be thankful to Peter Wade – the University Comptroller who saw the vision we were creating. Carl and John left before the spoils were divided. The University couldn't see the merit of continuing the support of the science still evolving from scientists such as Drs. Jillian Shaw, Orly Lacham-Kaplan, Gayle Jones and David Cram – despite their contributions to human IVF medicine in the world scientific journals. Professor Euan Wallace was given a bequest to carry on research in Obstetrics & Gynecology and we are proud of what he and his colleague Graham Jenkin are now achieving at the Richie Center. In the early 2000s the reproductive  revolution initiated at Monash was over.

Looking back and looking forward, it is hard to imagine a life that hadn’t included Carl Wood. He was so important for mine – always pushing me to try out the latest hypothesis – make a difference he would say and don't be afraid if it doesn’t work the first time – try again and again. We lost the first frozen embryo pregnancy at 20 weeks – there was nothing wrong according to the pathology reports – I was so disappointed! I think a little annoyed with her doctor Mac Talbot for no reason – Carl said – “just do it again Alan, and again if needs be”. Of course Mac had done everything possible in looking after his patient. Zoe Leyland turned up 10 months later. When I wanted to leave the field and develop embryonic stem cells – Carl was the first to encourage me. This began another revolution of stem cell based therapies in human medicine. I kind of hope that Monash sticks with the creativity that made it a household name – I enjoyed the ride with John and Carl.

— Alan Trounson, 16 September 2013

About Test Tube Revolution by John Leeton


MC Helen Szoke introduces John Leeton

John Leeton speaking about Test Tube Revolution

Alan Trounson launching Test Tube Revolution to a full house

Linda, Alice and Maggie Kirkman. Alice was the first Australian to be born through surrogacy.

John Leeton and Nick Lolatgis at the launch of Test Tube Revolution
John Leeton signing a copy of his book for Dr Nick Lolatgis

Alan Trounson and guests at the launch of Test Tube Revolution

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