TITLE:
Case Study: A Human Pre-Natal Experiment in 1944—“Do No Harm”
AUTHORS:
D. Bercovich, K. Shlush, G. Goodman
KEYWORDS:
Human Infertility, Pregnant Mare Serum Gonadotropin, Fetal Neurodevelopment, Multiple Sclerosis, Jacqueline du Pré, “Do No Harm”
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.6 No.3,
March
1,
2016
ABSTRACT: Iris du Pré, a professional pianist, wanted a second child, did not
conceive quickly and was injected in 1944 by a doctor in Oxford with pregnant
mare serum gonadotropin (PMSG). The doctor joked “This child will be a
racehorse winner!” In January 1945, Jacqueline du Pré, the remarkable,
world-famous cellist was born. In the 1920's and 1930's, animal experimentation
and clinical studies had shown that pituitary glycoproteins stimulated the
ovary (follicle-stimulating hormone, FSH) and the corpus luteum
(luteal-stimulating hormone, LH) which prepared the human womb for embedding a
fertilized ovum and that pregnant mare’s blood and urine contained the glycoprotein,
PMSG whose origin was placental cells, but surprisingly in humans had the
actions of both FSH and LH. However, the PMSG serum alone did not bring about
pregnancy. The doctor did not know that without subsequent injection of another
factor in correct sequence and timing, PMSG was pointless. In 1947, a placental
glycoprotein, found in the 1920's in urine of pregnant women (human chorionic
gonadotropin, hCG), when injected in mice subsequent to PMSG, achieved ovulation
but not pregnancy. Human application of those findings was extremely risky due
to impurities (up to 95%). The Federal Drug Administration (FDA), established in
1938, requested easily bye-passed marketing safety. Companies offered material “sufficiently”
purified; professional bodies negated clinical use, tempting to a few. Evidence
also suggests that, to sustain pregnancy the doctor also prescribed the new “eostrogen”,
diethyl stilbestrol (DES) of negative fame. In 1947, the Nuremberg Code of
ethics demanded human experiments by qualified personnel and trials preceded by
adequate animal studies. It is not the case here. From five, du Pré had a most
exceptional musical memory, almost obsessive musicality and a very difficult
school-time socially. Later history: adult masculine build, awkward gait,
tendency to recurrent depressions from mid-adolescence, unbalanced thyroidal
metabolism, symptoms of numbness in late teens, long breaks for rest from age
25, MS diagnosis at 28 when unable to play, death aged 42. Yet at sixteen and
after, she astounded all with technique, passion and unique musical
interpretation. Her husband, an outstanding musician: “She had a capacity to
imagine sound such as I never met in any other musician”. A close musician
colleague: “... it was done before she was born”; perhaps much closer to the truth than realization, for her history it may
suggest a fetal neurodevelopment abused in the womb.