TWENTY YEARS AGO, the world's first "test-tube" baby was born in England. Louise Brown's arrival by in vitro fertilization (IVF) revolutionized medical treatments for infertility, making it possible for thousands of women to conceive. The term "in vitro" is Latin for "in glass," because conception takes place in a laboratory dish. Louise Brown's birth caused an international sensation, with some critics denouncing conception outside the body as immoral. Twenty years later, the technology for making babies still seems remarkable - yet also increasingly mundane.

On July 25, 1978, a blonde, blue-eyed, squalling little baby entered this world swaddled in news headlines. The Associated Press declared her a "truck driver's miracle child." Good Housekeeping magazine gasped that her in vitro birth was "the most extraordinary birth in human history." But University of Minnesota historian Elaine Tyler May remembers that Louise Brown's conception also provoked deep social fears of science gone amok.

"If you look back to the way IVF was discussed in 1978, people were talking about human-animal hybrids, monstrous babies, eugenics, and all kinds of scary reproductive engineering," May said. "Eventually that whole discussion calmed down."

In vitro fertilization was a medical breakthrough because it helped doctors overcome intractable problems with a woman's fallopian tubes or a man's sperm count. Scientists had been working on the technique for decades, stirring controversy in public as they mixed sperm and eggs in the lab. The first American test-tube baby, Elizabeth Jordan Carr, was born in 1981. The husband and wife medical team of Howard and Georgeanna Jones performed the procedure at their clinic in Norfolk, Virginia, the first IVF center in the U.S. "The thing that was a watershed about in vitro was that with one procedure, suddenly it became possible to overcome a great many difficulties which seemed almost insurmountable prior to that," Howard Jones said.

Today, IVF is practically commonplace. More than 350 American clinics perform the procedure some 40,000 times annually. An estimated 45,000 American offspring have been conceived by IVF since 1981. But the big numbers do not mean this technique is widely accessible. Few insurance companies will pay for IVF, so most infertile couples pay the costs out-of-pocket. According to the American Society for Reproductive Medicine, the average cost of a single IVF cycle is $8,000 - $10,000. That price tag excludes many infertile working-class and poor couples.

Next: Meet a Family from the IVF Lab

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