The Fertility Doctor: John Rock and the Reproductive Revolution (review)

July 2008 marked the thirtieth anniversary of the first successful birth by in vitro fertilization. The child resulting from the procedure, Louise Brown, was born in England, her mother having been successfully guided through the procedure by Drs. Robert Edwards and Patrick Steptoe. The event ushered in a new and controversial era of fertility treatment, and the anniversary makes The Fertility Doctor, by historian Margaret Marsh and physician Wanda Ronner, particularly timely. It is a revealing biography of Dr. John Rock, whose work on women’s reproductive biology and fertility was foundational to subsequent IVF advances.

Early chapters focus on Rock’s Irish Catholic upbringing and his formative medical training. By the age of thirty-six he was director of the sterility clinic at the Free Hospital for Women in Boston, where he worked with women who struggled to conceive. The authors are diligent in presenting Rock’s patients as more than background to his story. Their experiences under his care—and as participants in his studies—are well-researched and provide valuable insight into Rock’s character as a practitioner.

In 1944, after years of research into the timing and mechanism of ovulation, Rock and his assistant Miriam Menkin achieved the first successful fertilization of a human egg in vitro. Though survival of a fertilized egg and subsequent uterine implantation were still decades off, the accomplishment was groundbreaking. Six years of harvesting eggs from women undergoing hysterectomies paid off, and Marsh and Ronner’s account of the clinical and lab work leading up to this moment provides a robust picture of the medical and social context for this reproductive development.

The authors do justice to the other aspects of Rock’s practice as well, including his study and treatment of infertile men. He often requested that the spouse of any woman seeking fertility treatment be evaluated, despite reluctance on the part of many men to undergo examination. Rock was among the earliest physicians to support the use of donor sperm and he did pioneering work in the concentration and freezing of sperm for later use. Conversely, women who sought to limit their fertility were also part of Rock’s practice. In an era when birth control was illegal in many states, Rock was a constant voice in favor of family planning. At his rhythm clinic at the Free Hospital women were taught about various forms of contraception, in addition to the traditional rhythm technique.

The authors devote the latter chapters of their biography to Rock’s role in the development of the birth control pill, for which he is still best known. With financial assistance from Katherine McCormick and the support of Planned Parenthood’s Margaret Sanger, Rock orchestrated a series of studies to prove the efficacy of progestins as effective birth control agents. The history of the pill has been covered by many historians, but March and Ronner do a good job here of explicating Rock’s particular role. The dynamic that developed between Rock, McCormick, and Rock’s collaborator Gregory Pincus is especially interesting and reflects the tensions that emerged between eager drug companies, physicians running trials, and patients.

Overall, Marsh and Ronner have done an admirable job detailing the nature of Rock’s work and his medical contributions. Though he has come under fire by some for less-than-rigid research standards, the authors here contextualize Rock’s studies without being apologists for him. By modern measure, a good deal in the trials carried out by Rock and his peers are problematic, but the authors refrain from anachronistic judgment. Rather, they demonstrate the myriad ways that Rock’s work was both progressive and sensitive to the women who sought his care.

The book, though well-researched, would have benefited from additional editing. In several places, the material is repetitive and certain larger claims begin to seem redundant. Marsh and Ronner aspired to write a biography that was both scholarly and accessible...