The History of the BFS : 1972-1997
By H. E. Reiss
In October 1972, during the third European Sterility Congress (ESCO)
meeting in Athens, Patrick and Sheena Steptoe hosted a drinks party
in their suite at the Hilton Hotel (Patrick liked to do things in
style). Among those present were Elliot Philipp, Arthur Williams,
Hamis Chalmers, Harold and Winifred Frances, Jimmy Steele, John
Frankenberg, John Newton, myself and our wives. The possibility
of forming a British Fertility Society, similar to those existing
in other European and American countries, was first mooted on this
occasion.
On July 18th 1973, Patrick Steptoe, Elliot Philipp, Victor Lewis,
Wendy Love and myself met at the Royal Society of Medicine to discuss
the aims, constitution and membership of the proposed Society, and
it was agreed to form a provisional committee and that Patrick would
write to some 50 gynaecologists, known to have a special interest
in infertility. Further committee meetings were held in September
and October 1973 and January 1974. The first clinical meeting of
the British Fertility Society (BFS) was held on March 21st 1974
at the Royal Northern Hospital in London, at the invitation of the
local consultants: Elliot Philipp, Ian Donaldson and Michael Pugh.
At the business meeting following the clinical demonstrations, attended
by 22 members, the BFS was officially constituted, the aims and
membership were agreed and officers and an executive committee were
elected.
It is relevant to discuss the motives of those who combined to
form a new Society. Primarily it was felt that the Society should
provide a forum for British gynaecologists with a special interest
in infertility. Originally it was intended to keep the membership
small enough to form a travelling club where members or invited
guests could demonstrate surgical procedures in their own hospitals.
This was entirely appropriate at that time when, in the pre-assisted
reproductive technology era, gynaecologists had a one-to-one relation
with their infertility patients, with small contributions from andrologists
and endocrinologists and when surgery was the only treatment available
for women with damaged tubes, however severe the damage. Indeed,
at the first clinical meeting at the Royal Northern Hospital (1974),
Professor Kurt Swolin from Gothenburg demonstrated microsurgical
salpingostomy, Patrick Steptoe laparoscopy and Kenneth Shuttleworth
male infertility surgery. At the second clinical meeting, in Oxford
(1975) Arthur Williams demonstrated reversal of sterilization and
John Bonnar utriculoplasty.
There were two other reasons behind the foundation of the Society.
One was dissatisfaction with the Society for the Study of Fertility
(SSF) which appeared dominated by animal scientists with minimal
human clinical concerns; the other was the desire to affiliate with
the rapidly developing International Federation of Fertility Societies
(IFFS) whose constituent members were not individuals but national
societies.
Aims of the BFS
These were agreed at the first clinical meeting, i.e. to encourage
the study of problems of human reproduction; to organize clinical
meetings in Britain and abroad, and to affiliate with the IFFS.
In 1993 these aims were re-affirmed and expanded to include the
promotion of research, the holding of joint meetings with Societies
with related interests, to seek support for training fellowships
and other awards for junior members, to publish material aimed at
promoting standards in the discipline, to promote high standards
of training, to liaise with professional, government and patient
organizations and to be an effective voice projected to society
to explain and promote principles and good practice (including ethics)
in areas of competence.
Membership
Originally Patrick Steptoe, in 1973, wrote to some 50 practitioners
inviting them to join. By the time of the first clinical meeting,
34 had joined; the majority were gynaecologists but Robert Edwards,
Jean Ginsburg and Bill Hendry were founding members from other specialities
who contributed significantly from the beginning to the development
of the Society. Initially it was intended to limit membership to
75 individuals and this number was reached by 1979. At the meeting
at St Thomas' Hospital in 1983, Bob Edwards and Michael Hull proposed
a radical change in the membership to increase numbers and include
more scientists and laboratory practitioners as well as nurses,
junior doctors and counsellors. This was subsequently accepted and
by 1986, there were 108 members, by 1990 there were 373, by 1995,
766 and now the total is over 800.
The initial yearly subscription was £3 and members were encouraged
from the outset to pay by standing orders. Two members, unbeknown
to them, contributed £3 monthly for some time until advised
by the Treasurer. The subscription was increased to £5 in
1979 and to £10 in 1983; with inflation, growing numbers,
the need for computerization and for secretarial assistance, it
has now risen to the current fees.
Officers
Patrick Steptoe was the first chairman (1974-1986) and was succeeded
by Herbert Reiss (1986-1989), Robert Winston (1990-1993), Howard
Jacobs (1993-1996) and Ian Cooke (since 1997). Patrick, on relinquishing
the office of chairman in 1986 became the first President of the
Society from 1986 until his death in 1988. He was succeeded by Bob
Edwards (1988-1992), Sir Malcolm Macnaughton (1992-1995) and Anne
McLaren (since 1995).
Victor Lewis was the first secretary (1974-1986), to be followed
by Mike Hull (1986-1989), John Newton (1989-1993), John Mills (1994-1997)
and Peter Wardle (since 1997). I acted as treasurer (1974-1986)
and was succeeded by Frank Loeffler (1986-1991) and Tony Rutherford
(since 1992). Wendy Love and Elliot Philipp were the first meetings
secretaries.
It was during John Newton's tenure of office that the phenomenal
growth in membership took off; he was also responsible for setting
up a modern office organization and arranging lasting links with
a number of large pharmaceutical concerns. Recognition for his outstanding
contribution to the development of the Society was paid by a presentation
at the Society's dinner during the meeting at St Catherine's College,
Oxford, in 1993.
Clinical Meetings
The pattern of two meetings a year has been maintained without
interruption since the Society's foundation. Most major centres
in England, Wales and Scotland have hosted meetings; it is a particular
pleasure to acknowledge the enormous amount of work undertaken and
hospitality and generosity shown by the various centres. Six overseas
meetings took place between 1976 and 1987. In 1976 we were the guests
of Professor Hans Frangenheim at Konstanz, Germany, when 20 members
attended. Laparoscopy demonstrations and a visit to the Storz factory
were highlights of the meeting. In 1977, 24 members visited Louvain
at the invitation of Professor Ivo Brosens; microsurgical techniques
and male infertility were the principal subjects demonstrated and
discussed. In 1980, 26 members were entertained by Professor Alain
Audebert and the French Fertility Society in Bordeaux. There were
joint meetings with the Greek Fertility Society in Rhodes in 1983,
attended by 19 members, and with the Canadian Fertility Society
in Vancouver in 1984, hosted by Victor Gomel. In 1987, a party of
11 members visited Israel and were entertained by Professor Jo Schenker
in Jerusalem and Professor Vaslav Insler in Beer Sheva. At all these
meetings, clinical sessions consisted of contributions both from
our hosts and from our members.
It has been a happy tradition that meetings are followed by a dinner
and there have been many such memorable occasions; dinners in the
Senior Common Room of Oriel College, Oxford (1975), hosted by Alec
Turnbull; at Thornbury Castle during our first Bristol Meeting (1978);
at the Royal College of Surgeons. Edinburgh; at the Botanical Gardens
in Birmingham and in the magnificent Old Hall of Queen's College,
Cambridge, are among the many that will be remembered. Among our
overseas meeting dinners, the most memorable were at the Insel Hotel
at Konstanz and, above all, a banquet at Chateau Palmer during the
1980 Bordeaux meeting.
Numerous clinical meetings have been held with other societies.
Particularly successful were the joint meetings with the British
Andrology Society in Sheffield (1987) and Warwick (1995) and with
the Society for the Study of Fertility in Bristol in 1992. There
was a joint meeting with the Blair Bell Society (1986) and we contributed
a session on ectopic pregnancy at the Third Annual European Society
for Human Reproduction and Embryology (ESRE) meeting in Cambridge
(1987). A major joint meeting with the Society for the Study of
Fertility and the British Andrology Society took place in York in
July 1997.
As befits a Society with expanding interests and membership, two
well attended 'International Meetings', each lasting 3 days, were
held at the Hammersmith Hospital, London (December 1991) and in
Glasgow (May 1994). Lectures by distinguished scientists and clinicians
from aborad supplemented contributions from our own members. During
the Hammersmith meeting in 1991, Professor Robert Edwards delivered
the first Patrick Steptoe Memorial Lecture. This lectureship, sponsored
by Organon, has become a regular feature; the lecturer is presented
with a scroll and commemorative plaque. Subsequent lectures have
been given by Howard Jones (1992) on 'Assisted Reproductive Technology:
a Report from a (former) Colony', Professor Alan Trounson (1994)
on 'Scientific Developments in New Reproductive Technology' and
by Professor Andre van Steirtegham (1996) on 'Intracytoplasmic Sperm
Injection'. The fifth Patrick Steptoe Memorial Lecture was given
by Professor Roger Short at the York meeting (1997).
Special Symposia as well as Free Communications and Poster sessions
were introduced into clinical meetings at an early date and have
assumed increasing importance. The latter also present an opportunity
for junior members to make perhaps their first public presentation,
and prizes are now available to encourage them to do so.
Honorary Officers and Fellows
At the first clinical meeting, Professor S J Behrman (Ann Arbor,
MI, USA), President of IFFS and Professor Stanley Clayton, President
of the Royal College of Obstetricians and Gynaecologists (RCOG)
were invited to become Honorary Presidents' both accepted. It has
been customary for a new PRCOG to become an Honorary President since
then. At the same time Dr Kurt Swolin was elected as our first Honorary
Fellow. Other honorary fellows elected since include Alain Audebert,
Ivo Brosens, Jean Cohen, Dame Mary Donaldson, Hans Frangenheim,
Howard Jones Jnr., Anne McLaren and Markuu SeppŠlŠ.
Links with the pharmaceutical industry and instrument makers
Cordial and lasting relations with many of these have been established
since the formation of the Society. Generous financial support has
been given by many companies, without which the Society could not
have functioned or achieved its aims. Exhibition stands are a regular
feature of all clinical meetings and most BFS members have, over
the years, come to know and respect the representatives. Some of
the latter have been admitted to Associate membership. Among the
most important sponsors are Organon (the Patrick Steptoe Memorial
Lecture), Serono who have sponsored the Serono-BFS scientific training
fellowship and Casmed who are financing selected juniors' travel
and accommodation expenses to attend meetings. There are special
prizes donated for the best free communication, poster and nursing
presentations at meetings.
Recent developments
These reflect the ever increasing role played by the Society. We
have become spokesmen on our speciality recognized both by the Human
Fertilisation and Embryology Authority (HFEA) and by various patient-consumer
groups with whom joint meetings are held. Close links have been
established with the Fertility Nurses Group of the Royal College
of Nursing (RCN). Workshops on endoscopic surgery, andrology, reproductive
endocrinology, nursing and counselling are now a regular feature
of the clinical meetings. Our activities reflect the multidisciplinarian
approach which is essential for the functioning of modern assisted
conception units. Scientists, nurses and counsellors now constitute
a large proportion (>25%) of the membership. Guidelines on diagnostic
classification, basic diagnostic procedures, data collection and
audit in infertility practice have been produced.
After prolonged discussion, with appropriate consultation with
lawyers and financial advisers, the BFS became a Limited Company
in March 1997. It is hoped that Charitable status for the Society
will follow. Other measures to develop the Society's role further
are the establishment of subcommittees dealing with policy and practice,
ethics and finance. Perhaps the most exciting new venture has been
the decision to publish the Society's own Journal. For many years
abstracts of presentations at clinical meetings have been published,
first by the Journal of Obstetrics and Gynaecology, and later by
Human Reproduction. It was felt that with the increasing membership
and attendance at meetings, full publication of presentations, rather
than just brief abstracts , was not only desirable but would also
present the Society's views more cogently to other bodies such as
the RCOG, the HFEA and the RCN. The publication of the Journal of
the British Fertility Society as a supplement to Human Reproduction
further emphasizes the close relationship between the BFS and ESHRE.
The development of the BFS has been exciting and spectacular. It
now holds a pivotal position in the recognition and management of
problems (clinical, scientific and ethical) of reproductive medicine
in the UK. This has been achieved by the untiring effort of the
Society's officers and members and above all by the vision and pioneering
spirit of Patrick Steptoe. We can be rightly proud that he was the
Founder, first Chairman and later first President of this Society.
I have written elsewhere of his many accomplishments and quoted
'Si monumentum requiris, circumspice': if you require a monument
for him, look around you. Such a look will include the BFS.