Transvaginal ultrasound-guided oocyte retrieval, also known as egg retrieval, is a surgical technique used by medical professionals to extract mature eggs directly from the women’s ovaries under the guidance of ultrasound imaging. In 1982, physicians Suzan Lenz and Jorgen Lauritsen at the University of Copenhagen in Copenhagen, Denmark, proposed the technology to improve the egg collection aspect of in vitro fertilization, or IVF. During IVF, a healthcare practitioner must remove mature eggs from a woman’s ovaries to fertilize them with sperm outside of the body. Transvaginal ultrasound-guided egg retrieval is a surgery that can be completed in a medical office setting in twenty minutes. Transvaginal ultrasound-guided egg retrieval increased mature egg collection and rates of successful fertilization, becoming the new standard for egg collection in IVF.

In 1972, David Whittingham, Stanley Leibo, and Peter Mazur published the paper, “Survival of Mouse Embryos Frozen to -196 ° and -269 °C,” hereafter, “Survival of Mouse Embryos,” in the journal Science. The study marked one of the first times that researchers had successfully cryopreserved, or preserved and stored by freezing, a mammalian embryo and later transferred that embryo to a live mouse who gave birth to viable offspring. Previously, scientists had only been successful cryopreserving single cells, like red blood cells. Mammalian embryos, on the other hand, were more difficult to cryopreserve because they are more complex and therefore more easily weakened or destroyed by the formation of ice within its cells. Whittingham, Leibo, and Mazur’s work provided a successful model for mammalian embryo cryopreservation, a technology that later expanded to cryopreserve more complex embryos, such as human embryos.

Researchers Geoffrey Sher and Jeffrey Fisch gave Viagra, also known as sildenafil, to women undergoing fertility treatment to test whether the medication could improve fertility and pregnancy rates. The researchers proposed that Viagra, typically indicated to treat erectile dysfunction in men, would help women with a history of failed past fertility treatments by thickening their endometrial lining, which is the layer of tissue in the uterus where an embryo implants during pregnancy. Sher and Fisch gave the women Viagra during in vitro fertilization, or IVF, an assisted reproductive technology. They summarized their findings in the article “Effect of Vaginal Sildenafil on the Outcome of In Vitro Fertilization (IVF) After Multiple IVF Failures Attributed to Poor Endometrial Development,” published in Fertility and Sterility in 2002. Although they noted additional research was needed, Sher and Fisch concluded that the prescribed combination treatment of Viagra and IVF resulted in an increased thickening of the endometrium lining which enabled the embryo to implant and result in a pregnancy.

Peter Mazur was a researcher in the US who developed new ways of preserving biological material by freezing it, a process called cryopreservation. If done correctly, cryopreservation enables scientists to store or study biological material for an extended period of time. If done incorrectly, cryopreservation can easily harm or destroy biological material. Mazur worked to find the best ways to cryopreserve different cells, embryos, and organs in order to minimize the damage caused by freezing. Throughout the 1960s and 1970s, Mazur and his colleagues published a series of papers that ultimately led to the discovery of previously unexplored factors that can cause harm to cells during the cryopreservation process. He called that discovery the two-factor hypothesis. That same year, Mazur also contributed to one of the first successful attempts at cryopreserving viable mouse embryos. Mazur’s work to improve the cryopreservation process helped to establish foundational knowledge that was later used in many different fields, such as reproductive health and conservation.

Multiplex Automated Genome Engineering, or MAGE, is a genome editing technique that enables scientists to quickly edit an organism’s DNA to produce multiple changes across the genome. In 2009, two genetic researchers at the Wyss Institute at Harvard Medical School in Boston, Massachusetts, Harris Wang and George Church, developed the technology during a time when researchers could only edit one site in an organism’s genome at a time. Wang and Church called MAGE a form of accelerated evolution because it creates different cells with many variations of the same original genome over multiple generations. MAGE made genome editing much faster, cheaper, and easier for genetic researchers to create organisms with novel functions that they can use for a variety of purposes, such as making chemicals and medicine, developing biofuels, or further studying and understanding the genes that can cause harmful mutations in humans.

Irving Freiler Stein Sr. was a physician who studied women’s reproductive health during the twentieth century in the United States. In partnership with his colleague, Michael Leventhal, Stein identified a women’s reproductive disorder related to elevated male sex hormones, or androgens. The syndrome was originally called Stein-Leventhal syndrome and later known as polycystic ovarian syndrome. While studying the syndrome, Stein also helped establish a treatment for the condition, through the surgical removal of ovarian tissues. Stein identified the symptoms related to the condition polycystic ovarian syndrome, a hormonal imbalance estimated to be the most common female reproductive disorder as of 2017.

Revive and Restore is a California-based nonprofit that uses genetic engineering to help solve conservation problems, such as saving endangered species and increasing the biodiversity of ecosystems. To facilitate their solutions, Revive and Restore utilizes genetic engineering, which is the process of making changes to an organism’s DNA, or the set of instructions for how an organism develops and functions. One of their broad solutions is genetic rescue, which involves imbuing populations of endangered species with a wider variety of traits to make them more adaptable to a changing environment. Their other solution is de-extinction, which takes a more radical approach by attempting to recreate extinct species that performed important roles in their ecosystems. While scientists working with Revive and Restore have helped advance genome editing technology on a theoretical and technical level, their research has also prompted practical and ethical concerns over the extent of permissible human interference with nature, even when attempting to conserve it.

Marshall Henry Klaus was a scientist and pediatrician who studied maternal-infant bonding in the twentieth century in the United States. Maternal-infant bonding is the psychological and chemical attachment between mother and infant. Klaus cofounded DONA International, an organization that trains birthing aides, called doulas, to provide physical and emotional support to laboring mothers. He also studied the differences between the layouts and quality of care provided in nurseries and birthing centers in different countries and compared them to those found in the United States. Klaus’s study influenced national and international initiatives to create hospital policies focused on promoting early bonding between mother and infant. Klaus catalyzed the advent of doulas and international policies that emphasized interaction between new mothers and their infants.

On 9 July 1990, in Moore v. Regents of the University of California, the Supreme Court of California ruled in a four-to-three decision that individuals do not have rights to a share in profits earned from research performed on their bodily materials. In its decision, the Supreme Court of California ruled that cancer patient John L. Moore did not have personal property rights to samples or fluids that his physicians took from his body for research purposes. Moore created the precedent in California that although physicians are required to disclose their research interests to their patients, patients do not have property-related claims to any samples that their physicians take from their body. The Supreme Court of California’s decision in Moore v. Regents of the University of California enabled physicians and researchers to retain legal ownership on samples taken from their patients’ bodies so that they can conduct what the court describes as socially important medical research, such as work on reproductive cancers or developmental disorders.

In the twentieth century, researchers developed the oral glucose tolerance test, or OGTT, as a method to diagnose different types of diabetes, a medical condition that causes blood sugar levels to become abnormally high. During the test, a healthcare provider measures a person’s blood sugar levels before and after the person consumes a predetermined amount of glucose solution. While not exclusively used for pregnant women, an OGTT may test for gestational diabetes which, according to the International Diabetes Federation, affected one in six pregnancies worldwide in 2019. Generally, the results from an OGTT can inform a patient and her physician how her body is responding to glucose during pregnancy, and high levels may increase her risk of developing adverse pregnancy outcomes such as heavy bleeding during delivery and a high blood pressure condition known as preeclampsia. An OGTT can help to accurately diagnose, treat, and monitor gestational diabetes in pregnant women, which can reduce health and pregnancy complications for the woman and the fetus.