Albert Lasker
Clinical Medical Research Award

Madame President, distinguished guests and colleagues,

I am deeply honoured to receive the Albert Lasker Clinical Medical Research Award, 2001. I wish to record my grateful thanks to so many people, family, teachers, collaborators, students and friends who in their own way have helped at every stage. First, my wife has been there through triumphs, disasters, long absences from home at work or conferences, and always ready with love and advice. It is nice to thank Dean, my nephew, for coming at the last moment to represent all my wonderful family and relations. I regret Patrick Steptoe cannot be here. It is an honour to share this platform with my fellow prizewinners, whose work has long stimulated my own interest in my field of study.

As I grow older, I remember with increasing affection and admiration how my teachers in school led me gently into science. They stimulated my interest in genetics, which remained firm throughout four years of service in the British Army, and even as my University career began so disastrously, reading Agriculture. Two professors, Rogers-Brambell and Conrad Waddington, rescued my careers, and Alan Beatty was a superb Ph.D. supervisor into the complex world of mammalian embryological genetics. They set me firmly on my career, where I have been lucky to meet so many admirable men and women scientists and clinicians, all working for their patients. Entering medicine in a most unconforming manner added immensely to my understanding and appreciation of patient care, achieved by the constant kindness of so many medical specialists. My colleagues and students, assistants and fellow publishers, have given unstinting help over more years than I care to remember. Without such support, research would have been immensely more difficult or impossible.

Today, we witness a biomedical revolution. Advances thought virtually impossible have become commonplace. Beginning in 1962, assisted human conception passed through ethical objections, through a series of stages of oocyte maturation and fertilization in vitro, and giving mild forms of gonadotrophin stimulation to patients to stimulate the growth of several follicles. Patrick's superb laparoscopy enabled mature human oocytes to be aspirated, fertilised, and grown to blastocysts in vitro. Embryo transfers began in 1972, rewarded by a first clinical pregnancy in 1976, unfortunately ectopic, and the birth of Louise Brown in 1978. We could not have wished for a finer family than the Browns, who maintained their dignity and common sense throughout very trying times before and after Louise's birth. I am deeply sorry they could not come today, in view of John Brown's illness which caused the family withdrawal.

IVF has now exploded worldwide. One million babies have been born. Advances along the way have formalised ethics and legislation in innumerable countries. Embryo research and cryopreservation, gamete and embryo donation, and surrogate pregnancies have become very well known, even on endless soap operas. ICSI now enables men with virtually no spermatozoa to conceive their own children. Preimplantation genetic diagnosis and the therapeutic use of embryo stem cells, also started in Cambridge and with immense contributions from my fellow prizewinners, attract novel ethics in such affairs as designer babies or the preimplantation diagnosis of late age-onset diseases, perhaps the greatest fear of middle age. The breadth and scope of the field constantly widens, as it imposes on conditions heretofore untreatable.

And the world of molecular genetics has now arrived. Scarcely believable opportunities for identifying, transferring, switching on and switching off single genes begin to revolutionise our outlook on what is possible. Modern genetic technology tells us that 10,000 or more genes are active in embryos between fertilization and the blastocyst. How do we cope in interpreting the additive effects of such a huge number of complex genes! Comparative studies show how we humans utilise the same genetic systems as flies, nematodes and amphibians, placing us in our evolutionary place and opening innumerable studies on homologies between these widely spaced species. Young scientists and clinicians now have an armoury for diagnosis and intervention undreamt of by their teachers, as advances speed up every day. The new world of proteonomics has already arrived, promising even more novelties.

Madame President, I repeat my deep fortune in receiving this honour. And this is reinforced by the knowledge of how much the Lasker Foundation has done to honour knowledge and medicine. This day will long remain in my memory. The award has made this one of my finest.