TRIGGERnometry - The IVF Pioneer Who Says His Own Industry Is Lying - Professor Robert Winston

Episode Date: September 26, 2026

Triggernometry is proudly independent. Thanks to the sponsors below for making that possible: - We use Ground News to escape the echo chamber and stay fully informed. Go to https://ground.news/triggernometry to save 40% on the Ground News unlimited access Vantage plan. - Shopify! Sign up for a $1 per month trial at https://www.shopify.co.uk/trigger/ - Expat Money: download the report to understand offshore banking, second passports, asset protection and international businesshttps://expatmoney.com/triggerHead to https://policygenius.com/TRIG to compare life insurance quotes from top companies. Join our exclusive TRIGGERnometry community on Substack! https://triggernometry.substack.com/ OR Support TRIGGERnometry Here: Bitcoin: bc1qm6vvhduc6s3rvy8u76sllmrfpynfv94qw8p8d5 Shop Merch here - https://shop.triggerpod.co.uk/ Advertise on Triggernometry: https://trigger-brands.com | or enquire at [e-mail] Find TRIGGERnometry on Social Media: https://twitter.com/triggerpod https://www.facebook.com/triggerpod/ https://www.instagram.com/triggerpod/ About TRIGGERnometry: Stand-up comedians Konstantin Kisin (@konstantinkisin) and Francis Foster (@francisjfoster) make sense of politics, economics, free speech, AI, drug policy and WW3 with the help of presidential advisors, renowned economists, award-winning journalists, controversial writers, leading scientists and notorious comedians. Learn more about your ad choices. Visit megaphone.fm/adchoices

This episode is brought to you by Animals. How far would you go when someone threatens everyone you love? Who can you trust? From Academy Award winner Ben Affleck. Animals stars Affleck, Carrie Washington, Jillian Anderson, and Stephen Young. When a Los Angeles mayoral candidate's son is kidnapped, he and his wife are pulled into a web of deception, forced to make choices that could tear their world apart. Watch Animals only on Netflix on October 9th.

rated R. Well, the fact of the matter is we, as a professional, I'm not telling the truth. I'm very disappointed. We all agreed that a lot of people needed this, and we were not going to charge private money. Unfortunately, it became massive industry. The truth is that a vast amount of in vitro fertilization is unnecessary. It fails, but then a few months later, suddenly gets pregnant spontaneously. After six attempts at in vitro fertilization, only 34% of patients have a baby after six attempts. That's never said anywhere. How long do you think it's going to be, Robert, before, you know, people walk into a clinic

and they're given the menu and say, look, we can dial this up, this particular gene up, you can dial this gene down, and even just go, well, you know what, we've got two girls, we'd really like a boy, I want a son. That's already happening. We're not saying it's happening, but I'm sure it is happening. Are you too popular? Is life too easy? Then head over to our merch store and change your life forever by telling the world you watch

You'll be able to buy hoodies, t-shirts, caps, stickers, posters, and of course, the world-famous trigonometry mug. Go to shop.triggerpod.co.com.uk. That's shop.orgot.org.com.com. dot, UK, and become part of the show. Professor Robert Winston, what a pleasure is for us to have you on the show. Thank you so much for being here. Thank you for having me.

Oh, it's great to have you. Lots to talk about. We really want to talk about science and medicine, and particularly in there of fertility. of fertility and maybe a little bit more. But before we get into that, can you tell, because I think it's important for people to understand your expertise, a little bit about your medical career, your pioneer of several things as part of IVF.

Can you tell us a little bit about your experience and your life in medicine and particularly in this area? I mean, going into medicine was a complete mistake. I didn't expect to do that. I mean, I had a bad time at school, and I think it's partly because my father died, I was eight, and I missed that male figure in a very male society, which I was in, because I was in one of these elite schools.

And my mother had no money because she'd, you know, she was supporting three children, and I was the oldest. And I got a scholarship, which was very helpful. But I always have this odd feeling that, you know, I was going to die at the age of 42, because that's why my father did and therefore you know why bother to try and I wasn't academically inadequate but I stopped scoring during my time at school so by the time I mean GCSEs or the equivalent O levels are all right but I don't want to bore you with all this stuff but when it came to a level I really performed very badly in the mock A levels and my school said well he's never going to university and just sort of

pretty well wrote me off actually which was quite common in those sorts of schools And so I left school actually with quite good A-levels, because I suddenly realized I had to work. And but with no clear idea what I wanted to do, I had a place at Cambridge, but I wasn't sure that I wanted to do natural sciences. And I thought, actually, medicine's so glamorous, you know. And it was, it was, it was, there are interesting people.

It was nothing to do with what you'd now ask a medical student. And I think it's very important that we understand that, It's really useful for young people not to know where they're going, not to be too concerned about the usual channels to get into a particular place and to remember that if you're sensible, you're going to change direction again and again anyway. And I think I've done that a bit. And so, I mean, during school and then later on,

because I wasn't doing my academic work very, I got really involved with theatre, and I decided I really wanted to do theatre. In fact, at university, I produced plays and ended up doing a play the other than professor, which did incredibly well commercially. And I then came to my senses and realized, actually, I should be doing something which is what I've been trained to do. So I went in to do clinical medicine, but that was unsatisfactory because it wasn't really a challenge in the way that I wanted. It was the intellectual side, which turned out to be really interesting. I wasn't, you know, wasn't the great scientist, of course not.

But it was just the way of thinking about puzzles, about stuff, and thinking, well, that really does mean something because you could change things. And so I was incredibly lucky because when I came down, came from Edinburgh, I couldn't get a job because I've been a hippie. And I've been four years trying to get jobs in medicine and doing that for a while.

But once I'd been to Edinburgh, nobody would take me an interview. And I wanted to do women's health because it seemed to me to be an unused area of medicine. which was not then very popular. And I was, I mean, those interviews were horrible, actually. They were, you know, I remember one interview in the West End of London for a very famous hospital. There were 14 people round the table and me.

They all had their backs to the light, so I couldn't really see their faces. They were all in three-piece suits. They were all male, except three of them were in morning dress because they'd been to their private practice in Harley Street, which was quite usual to be in, quite usual to be in morning dress and with a wing collar. So I knew as I walked into the room, I wasn't going to get this job. And of course, one walked out backwards and bowed as I don't

through the door. I think I tried to bow and did it very unsuccess for me. I thought, well, you know, what a waste of time that was. And I was really lucky. I was out of work for a little while, and then I wrote a letter to somebody who I thought was really eminent in a man called John McClure Brown. And remarkably, I got a little bit of a little bit of a little bit of a little a letter by return of post handwritten saying, I don't have a job for you, but if you want to come and chat about a career, you want to come along seven o'clock one evening.

And he got me onto the idea of doing an academic medical job. And my first project grant was something I was completely unchat, I had no qualifications to do that research. It was an organization which didn't have any expertise in that particular area. I had no funding, I had no chance of getting the need. And bizarrely, I got this letter, or my boss got the letter to say that they wanted me to do the project I had applied for.

And that seemed like a DEREN because it didn't seem to go anywhere. And yet, of course, in time, that led to about 40 or 50 publications over many years, which led onto all sorts of areas which were much more relevant. IVF was one of them actually, but not the key one. So, you know, I was very lucky. And over time, I was working very much on my own, but I was very supported in the department by McClure Brown. He was amazing to me, actually, in many ways.

And every time he had a foreign visitor, they were always foreign visitors. He would invariably say, oh, you don't want to come, you don't want to come sit, watch me operate, go and see what Winston's doing down in the corridor. He would always do that. And he really promoted. my feeling that maybe I could do something. Maybe you just didn't like foreigners. Well, it's fascinating hearing a story,

and you often find people who've gone on to accomplish a lot, actually do it in a very non-linear way, as you say. For people who, I mean, IVF has become such a big part of our public discussion now, for a lot of reasons. One of them is people are delaying having children, and you've had a lot to say about it, which we'll get into. But for people who are unfamiliar with the whole, thing. Can you just explain what IVF is in basic terms for the layman?

Yes, IVF stands for in vitro fertilization, in vitro being in glassware. So what you're doing is fertilizing a human egg outside the body. And people have been trying to do that since about 1900, really, so about 100 years. And nobody got it going at all. There were some suggestions that people in the late 30s, around time just before the First, Second World War, got fertilized eggs. I've seen their photographs. and I doubt if those eggs really were fertilized. And we tried that eventually. But on the meantime, at that stage,

I was doing reproductive medicine and not really interested in IVF. I thought it was a dead end. I didn't think it would work. And I went to America. And I was in a university, which, of course, like all American universities, was absolutely forbidding any kind of work with human embryos

because that was actually considered disgraceful. And there were religious reasons why the university said this, and they couldn't get funding at all from central states. So eventually, when it became obvious that it might be successful, I met a man called Chang, who was a Chinese individual, who'd been trained, he'd got his PhD in Cambridge, but then he went to Massachusetts. And he was a Chinese elderly withered individual

who'd been working in the fields in China, had escaped that. It was very bright. He was completely unintelligible. You know, when he spoke rapidly, you didn't know what he was saying. His lectures were phenomenal. And this guy was incredible because he was the first person to do in vitro fertilization in a mammal. And he did five different mammals. And at the same time, I met Anne McLaren, who was on the World Society.

And I visited her lab and said, look, I'm trying to get human eggs to fertilize like Chang. but they don't work like his mammals, his other amyles do. And she looked to me, she said, well, with my mice, she said, she was doing this in mice. She said, with my mice, I think it's something to do with the sunspots. And I thought, she's not really an astrology person, is she? What she was saying was she hadn't got a clue. Anne was an amazing scientist, and she was very, very supportive of what we were trying to do.

And she visited my lab, and she said, what you're doing is great. And so we were doing this at the same time. when SEPTA and Edwards were doing this up in Oldham and in Cambridge. And although they got the first, well, they didn't get the first pregnancy, the first pregnancy was actually in Australia, but it miscarried. That was a few years earlier. And then they got Louise Brown, and then we got pregnancies very quickly. But they were very, very unsuccessful initially, as we all were.

And I think I was extremely lucky because I realized that the key success would be nothing to do with fertilization, but much more. more to do with the hormonal control of how the eggs actually developed in the ovary and when you collected them and so on. And I met an amazing man called Steve Hillio, who was my sort of age group. And Steve had worked in,

he advertised for somebody who was interested in IVF. He wrote back saying, I don't know anything about IVF, but I do understand hormones. I thought, that's the sort of reservoir I want. Steve came in and he'd been developing hormone assays. And we were doing a lot of interest in chemistry at Hammersmith, where I was working at the time.

time and Steve was really successful and he was really I think very very important in the regular pregnancies we got with IVF in a way that nobody else was getting anywhere in the world and so much of the credit should go to him really he organized the lab he did everything I think I can say this now probably on the on the on the on a podcast but early on we somewhere persuaded the Prince of Wales to come and visit the laboratory. And Steve had decided that we should separate the egg laboratory from the sperm laboratory.

If you think about it, it was an obvious thing to do. Nobody else was doing that, and nobody did it a long time. But of course, eggs have to be kept in a sterile environment, free of bacteria. It's impossible to do that with sperm the way they're collected, obviously. And so when the Prince of Wales came in, he was relatively young then, he came in. Unfortunately, a journalist behind him,

and he said, what's this small room? I said, well, so this is where we collect the sperm. He said, well, I certainly wouldn't want to do it here. Prince Wales being the current king, of course. Of course, yes. And he was absolutely wonderful because he, you know, he, I mean, obviously since, and I've seen him pretty often, but he was, I mean, he was really interested in young people. His interest in music was something which I, you know, obviously was in tune with.

And actually, he was, he's been very, he's been very, he was very helpful in all sorts of ways with some of the projects we were doing. And it was nice to think that he was preferred to listen to that stuff when it was considered really outrageous. And it's difficult to believe that it's true. You know, I'd come back from America

because it was so, you know, not acceptable there. It wasn't acceptable in Britain either. And, you know, it was highly controversial. And the first thing I probably had to do, you know, if you're not a very good scientist, what you do is you try and communicate it, perhaps, you know, because that becomes important.

And so I think my real success was actually getting on the media very often. And at the same time, it's starting to do a bit of television work. And so I was fortunate, I think, really, in that respect, that the BBC and many other channels had all sorts of discussion programs. And we had the usual people thumping at the table saying that this is, you know, this is against the either of life and protecting life and so on. So, yeah, I mean, looking back, when the first votes in the House of Commons and the House of Lords were held, there were two-thirds of majority in both counties that this was not something that was acceptable, it should not, it should be banned.

And that was in 1984, that vote. And then it was not until 89, sorry, it was 89, it was 89, it was 89, that's right, it was 89, that's right. and then 1990, when the Act of Parliament came through, which in fact was finally approving of a vitro fertilization, but it needed to be regulated. And the nature of the concerns is because you're taking a fertilized egg and some of them are discarded. And if you believe that life begins a conception, then once a egg is fertilized, that's a human being.

You're dealing with a human being, that's the idea. And the question, of course, is you're starting, you're creating life. We're not creating life, because the sperm and egg are already alive. And of course, most human embryos don't survive the first few days in the uterus. Most embryos, in fact, don't implant properly. Those that do many miscarry. So, for example, a miscarriage occurs for about 25% of pregnancies. Many people don't even realize they're pregnant when they actually have that period.

It's just a bit delayed, and they don't notice. But in fact, they've lost a pregnancy. So nature herself does not actually respect the human embryo as being a sacrosanct person. And indeed, my view, and that of Anne McLaren's view, and I was very much persuaded by her, was that the important thing was that when can you see life really beginning? And it's actually when you've got consciousness. So the earliest stage that you can see a brain or anything like a nervous system is really in about 14 days when the primitive streak up the side of the embryo

shows the spinal cord and the beginning of the brain. And Anne was very influential in making that the 14-day limit. And actually, that eventually had a lot of effect. And that was something I very much promoted. And we were able to demonstrate that was the case. I think that was important. You know, it went back because often a lot of Christians were very adamant because Christian is absolutely opposed to this.

And I thought, well, you know, Thomas Aquinas talks about Cairo and Anima. Anima is the mind and Caro is the flesh, and he says that the flesh is there 40 days before it's a human being. And Christians were really upset by my pointing that out, because I didn't really want to know what Thomas Aquinas had said, you know, in the 14th century or 15th century. And that was a widely held view by many theologians in different religions, including Jews. I mean, the Jews in the Talmud, which goes much earlier, was saying that the embryo, is mere ba alma, mere fluid, just water. And therefore, in fact, somebody who miscarried would not need to grieve for the birth,

did not need to have a burial, did not need to have a whole lot of things that we go through with the rights of mourning. Which is very interesting. So this is an ancient idea, which it was convenient to forget. I mean, it shouldn't matter. I mean, I have nothing against religious views,

but of course, when you impose your particular version of the religious view on other people in democracy, you're running big risks. We're seeing that now with assisted dying, of course. There are many people who would like to see assisted dying to relieve suffering to make it possible for some people who really have no chance of surviving more than a few more weeks,

to actually at least have a few more weeks in comfort. But it's been opposed by a group of people in the House of Lords who are adamant that actually they are right because in fact this is what their faith tells them. And I feel that that's a great disadvantage to science. Science and religion are very similar. We do religion and we do science because we're uncertain. We're uncertain where we are, how we came here, where we're going to.

Nobody knows what happens after life. That uncertainty is a part of the basic human need. We have to understand certainty and deal with it. The trouble really is that certainty is dangerous, and certainty is as dangerous in religion as it is in science. And Robert, looking at how the industry began, your involvement in it, has it surprised you that the way it's gone and how it's become, well, it's become a mainstream industry now?

Yes, I'm very disappointed. You know, I don't want to sound like a saint because I'm not. But in my group, I built up a large group of people, you know, who are, you know, very clever and very happy to take quite modest incomes, which, of course, academic things are. all agreed that a lot of people needed this and we were not going to charge private money and we didn't. So any private fees that we got from overseas patients, they were all pulled and they went back into a research pot. And that actually led to an organization called the Genesis Research Fund, which over the years, with all its appeals, has raised about just over 100 million for research,

mostly at Imperial College. But of course, we have control of how that money is spent. And currently, we've got 11 employees on those funds which are from which go way back unfortunately now of course it's become very difficult to persuade young people not to take a private income understandably but houses are so expensive very different from how it was in the 80s so you know we weren't being particularly generous it was just in fact we benefited from that research actually to be fair so we weren't disinterested and i think that's really important to understand that but it did mean we could limit the amount of the fees we charged, we could often give it free.

The health service was very helpful in that respect, and for a while that worked very well. I think, unfortunately, it became massive industry. It's now $23 billion industry across the world, and the fees are huge in all countries. I think very often there's a lot of overcharging, and there are certain areas where free, huge money is being made. unfortunately. And in Britain, like everywhere else, it's the same. You read the news and think you're informed. You're actually just selectively informed. Modern media doesn't just report the news. It quietly decides which stories you never even hear

about. Your blind spots aren't accidents. There's someone else's decisions. That's why I use ground news. Every day, they gather thousands of stories from across the political spectrum. Compare how different outlets are covering the same story side by side and contextualize. it, including specific differences in how each side is reporting it. That's how you see what whole audiences are not being told. My favorite feature is their blind spot feed. Every day, it flags upwards of 20 stories that are being ignored by either the left or the right.

Let's look at some examples. Follow along at ground.news slash trigonometry. Take this story. A pure research survey found that 56% of Americans now support banning social media for anyone under 16, with a majority of Republicans and a majority of Republicans. Democrats behind it. Genuine, bipartisan agreement is rare enough to be newsworthy on its own. And yet, coverage came almost entirely from the right. The left barely touched on it. On the other hand, look at this. An AP poll found that 66% of Americans now say democracy is central to what it

means to be American, down from 80% five years ago. That is a serious story about how the country sees itself, especially on its 250th anniversary. And it got three times more coverage from the left than it did from the right. Ground news puts all of this in one place, headline comparisons, bias breakdowns, ownership insights, and context so you can actually understand what's going on, not just react to what you're told.

Go to ground. dot news slash trigonometry or click the link in the description of this episode. Get 40% of their vantage plan, the same one that we use, and stop being managed by the media. Because I suppose one of your criticisms of it is when people are in front,

fertile or they have issues with their facility, that becomes a diagnosis. People don't actually want to understand the reasons or not looking at the reasons. You're spot on. That's exactly the problem. And it happened in a debate in Holland recently when one of my colleagues, a doctor, said that infatility is not a disease. It's not a symptom because I just said it was a symptom. Of course, that statement was completely inadequate from a doctor who's done in vitro fertilization.

So I was horrified to hear that because, of course, actually, you're completely right. It's something that's gone wrong with the system. It's not there. We often don't know what the reason is, but so often, once you make a diagnosis, you don't need in vitro fertilization. And the truth is that a vast amount of in vitro fertilization is unnecessary. It fails, but then a few months later, some of it. gets pregnant spontaneously, but people get so panicked, they go to a private clinic and they get IDF. And of course, that's to the disadvantage of the patient and to the NHS, of course.

So the NHS is funding treatments, which really are quite likely to be unsuccessful, but will be successful indirectly because they get pregnant anyway. Actually, you know, it sounds obvious, but it's important to understand the effect of infertility on a couple. It really changes their eyes. You know, they feel very guilty, very normally feel quite guilty. They feel they've damaged themselves. They feel that something happened in the past, maybe a miscarriage, maybe an abortion. They had, whatever it was, some flu infection has affected them. And they get very concerned that they've done something wrong to themselves. And the depression and emotional change is massive. Every menstrual period that follows becomes a real turmoil for some women, not all, but it's very

very, very common. And it ends up, of course, inevitably with fracture between male and female. Because although male zoically feel also this grief, they deal with it in different ways. And so you end up actually not having intercourse. And so actually, as the statistics show, well before IVF, the more you have sex, the more chance you have of getting pregnant. And the timing of it is not nearly as important as people believe. There are many ways of timing ovulation. which are sold over the counter and chemist shots, best not to use them. It's best actually just to enjoy what you're doing in bed

or on the hothrug or maybe on holiday as often as possible. Because actually that's a good way of at least making sure that you are genuinely infertile. It takes, on average, the average couple about four to five and a half months to get pregnant. Something like that is about,

that's the sort of distance. You seldom get pregnant immediately, some people do, but it's not really, you're not really infertile until you've been trying if you're a young woman for a year, because that's how the statistics just work out. Now, we don't understand that, but clearly we can do things to enhance it. I mean, you know, one of the things, of course, is just to really help people to come to terms of what they're doing and to recognize their partnership may be more important in all sorts of ways than they realized. And of course, in vitro fertilization becomes a torture because you end up with women, if they can afford it, going for 18 cycles of IVF. And they've become professional patients. And they know all about IVF, but they don't understand actually why it's not working, because nobody understands why it's not working. Now that, of course, when they go back to be investigated, we find, for example, in our clinic they've got a simple thing that's wrong with the uterus or simple thing that's wrong with the tubes, and if you correct that,

which often is very minor, minor, inexpensive thing to do. you can get a pregnancy, and that happens again and again. So a lot of our pregnancies were generated when we were doing the large numbers of IVF. I don't do it anymore, but we're getting patients pregnant with not doing IVF. Robert, we both have a lot of friends, and we know people who are going through this process,

and it's obviously incredibly painful emotionally and the effect that it has on the female body, particularly. Let's actually talk about what are the... the stats? What are the actual likelihood of becoming pregnant with this technology, freezing eggs and all of this? Because this is really important so that people actually understand what it is that they're getting into when they begin this medical intervention. Well, the fact of the matter is we, as a professional, I'm not telling the truth, because we give encouraging people to think that IVF is the best way forward and actually is the most successful way of getting pregnant.

And the problem, of course, is that what most people don't recognize is that IVF is a very complex process, which takes about a month, really, each time you do it. So the first thing that you have to do is you have to ensure that there's nothing which is preventing somebody getting pregnant, which might just be some different disease or some other process. So often you may need to look more carefully at the general health of that person. certainly, for example, their weight would be one thing, really important. Losing weight can make a very big difference, but many clinics don't bother to let people lose weight or encourage them,

but actually, why bother, you know, just get into, get the treatment? Because people want to have IVF rather than losing weight. But, you know, it's going to be less successful. The first thing to point out is that the first real stage are the eggs inside the ovary. Now, what are the problems is that in each mental cycle, well, let's go back a bit. If we take a little child at birth, she probably has a million eggs in her ovaries. By the time she's 16, having periods and potentially fertile, she'll only have about 300,000 of those eggs left. That's what our figures tend to show.

Wow. And various other research groups have shown the same thing. So women are losing eggs from the moment they're conceived, actually. Unlike you and me, we're making sperm as we sit here. So while a woman during a month we'll be losing, you know, a few hundred eggs, we'll be making millions of sperm. We're different. Actually, there are fundamental differences between men and women,

but we won't go into that because that's a different subject. Oh, we will, but later. But it's very important to understand that. And so what happens with each menstrual cycle, the hormone cycle, if it's working properly, will recruit a number of eggs from the ovary to start maturing. And that maturation is very complex

because it requires the right hormones to be there in the right quantity, and it requires, therefore, the right genes to be switched on. There are a number of different genes, a gene which needs the egg to be penetrated, a gene which requires the first cell division for the first embryo start development.

All that sort of stuff has to. happen. So the first thing is you need to have eggs which are ripe. You know, actually a hard, unripe pear tastes bad. It doesn't taste very good and it won't really make much of a meal. You have to have the egg properly matured. Steve Hillier understood that. That made a very big difference to our program because he got the hormones really as close to nature as he could do. And we did all sorts of tampering with that over a few years which made it more and more successful. But it's still meant that even so, at the end of that time, when you collect eggs which you think are fertile, at least 50 or 60% of them probably won't fertilize. So half those eggs won't fertilize, and there may be reasons.

First of all, there may be reasons you didn't realize that the sperm are not working, or there may be other problems actually with the nature of the genetics of the egg or so on. Once you've got an embryo, we then put it in a fluid for culture, and it will go into that culture in a black box, literally, a dark container full of fluid, which is the culture medium in which it grows. And for five days, it is left in culture and then taken out as an embryo. Now, during that time, many of those fertilized eggs, because not all the fertilized, don't actually develop. They don't develop any of themberries. and there are lots of reasons that all sorts of things go wrong with human fertilisation. We don't know whether that's a natural problem or whether it happens only because of the fluids we're using.

One of the problems is the fluids we use are not properly understood. We're using commercial media, which seem to work, but very little research is being done, even now, on the best methods of trying to improve that culture fluid. But you think about it, that's the first five days of life which is critical to the development of human being when genes are being switched on and being programmed by the environment.

So they're actually responding to the environment. So it's been one of the research areas that we're working on at the moment. But you see then you get to the stage when you've got an embryo, that precious embryo. And then after, you know, let's say five, six days in that environment, you're going to put that embryo back into the uterus

and most of them don't get pregnant. about 20% of embryo transfers result in a life baby. But that doesn't represent, of course, at the beginning, because you're failing from the very start of the stimulation of the ovary to get enough eggs. So every stage is important. Now, of course, many clinics will not actually state their failures at different stages.

The government doesn't even keep proper statistics on that. So we don't really know, even now, how many eggs are actually, stimulated from the ovary in an average clinic. It varies so much. The records are not good, and yet they should be there because the human fertilisation embryology authority was set up with a statutory obligation to provide better information to patients. That's one of my biggest grumbles about the situation at the moment. That needs to change, but it's very difficult to persuade the Department of Health. They don't really want to get involved with something which isn't supported by

politicians one way or the other. To them it's not really important. There are more important things because the health service needs so many other things. But actually, it is really important because it affects health service money. It's expensive for patients and it's deeply distressing to fail two or three times. For the clinic, if you fail, great, they'll come back again. If you treat them nicely and kindly, they'll come back. So, you know, actually that increases the revenue to the clinic, but it doesn't necessarily improve the chance. We know from very good statistics which have been done looking at five different countries, including Britain, Switzerland, France, Germany, that actually after six attempts of in vitro fertilization,

six attempts, separate attempts using the full cycle, only 34% of patients have a baby after six attempts. Now, that's never said anywhere. That was published a few years ago, but I doubt if the figures have changed that much, but it never comes out in the figures. So you're only looking at about 5% success rate per attempt? Well, I don't think that's true. I think it's more than that, because I think you can improve egg quality and great, and of course, if you treat young patients only, you'll do better.

Yes. And if you can, and you can choose your patients. And of course, many clients do that, they'll choose the patients they think of. And if you've been pregnant before, which many people have or have had a miscarriage, that will improve their chance because already they're of proven fertility. So the success rate is not 20%, but that's what will be advertised, but it will be somewhere. Who knows exactly what?

world. And one of the things that, and correct me on this, if I'm wrong, I'm just telling you from a kind of layman talking to people perspective, I think we're increasingly due to various social changes in society, women wanting to pursue careers for longer, all sorts of things. We're now in a place where, I don't know, big companies routinely offer egg freezing to female employees as a way to manage this situation, let's say. But with these kind of success rates, are we telling women lies, about the fact that this is a way to mitigate the problem? You know? I think it's a harsh, harsh thing to say.

I think, you know, we were working on egg freezing in Malabar in free well before it was being done, and we were looking actually not only freezing eggs, which have been collected, also freezing an ovarian tissue, which we think you could use perhaps to mature eggs, because you'd have better control. It's questionable that, but, you know, it's never really been, successful one or the other eye. If you look at really carefully conducted figures, what you see, of course, is that freezing brings a huge, it's a massive change to the embryo. It's change in a fraction

of a second is a vast change in temperature. It's called vitrification. And this process has been shown to disrupt all sorts of functions in the egg. Also, of course, the anti-freeze which is used is not in fact it's not a not a something you not liquid you drink for obvious reasons in fact it might be a very good way of getting rather rather simulating to the brain I mean not the radio bought you know it'd be sleepy at best no I mean seriously that's a problem so it's it's also true that when you freeze a lot of eggs sometimes say tendency in a clinic is to stimulate their ovary as much as possible to get as many eggs as possible. But of course, that then denies the possibility of the proper timed maturation of that egg

at the best time when it's collected. Thereafter, it's going to be frozen. And we know that, of course, a huge proportion of frozen eggs don't thaw. I have the figures going back from when they did collect them at that HVA. And I've looked at literally data from several hundred thousand patients. I mean, it's a large number. And we can see that actually if you take from the moment of thawing using vitrification, which is still the best method, the chances of a single egg becoming a baby is about 1%, 1.7%.

Now, of course, you can produce lots of eggs. But the trouble is those batches of eggs have to be thawed at the same time. You can't just bring them, because you take a lot, you have to thaw them because you're going to still want, you want to get an embryo. So the problem is there, which has never been under stuff. We don't know how many eggs are being thawed by different clinics. There's no standardization of this.

And so I think that's one of the things we should be recording in the Department of Health, much more carefully, by the HFEA. And, of course, they're not recording on many of these statistics, so we don't know how many eggs that are thawed are being fertilized, how many actually become an embryo, how many of those embryos are normal, and how many are actually put back into the uterus. All we know is the number of embryos which are actually transferred to the uterus and produce a pregnancy. With those statistics, what we can see from, we now have, apart from the

publication of the stuff which I can get through Parliament by a parliamentary question, which I think is probably accurate, but now, of course, they're not keeping complete figures, so even that is difficult. There are five or six publications from different countries which show that at best, about 4% of eggs, usually less actually will produce, after thawing, will produce a pregnancy, a live birth. The miscarriage rate is still not recorded. The trigonometry merch store is built on Shopify, because the moment someone's actually ready to pay, Shopify make sure they can. And if they've bought before, their details are already saved, so it's one.

one tap and done, that's time back to grow the business instead of running it. If you want to start the same way, that's Shopify.co.k.U.k. Slash trigger. With Shopify, nothing stands between your idea and a real business. So go make it one. Start your free trial at Shopify.com.uk slash trigger. Start your free trial at Shopify.com.ukh. I didn't mean to put it as strongly as I did perhaps. I guess what I'm getting at is, given everything that you're saying, I think if you talk to the average person who's not an expert on this,

I mean, like I say, companies offering egg freezing to women to induce them to delay having children. In the mind of the average person who hasn't looked into this, if you freeze your eggs now, well, you'll have your babies later. It seems like a linear thing where you could do it now, or you could do it 10 years from now. It's not quite linear because, of course, the younger you are when you produce eggs, the more fertile a woman will be.

because your fertility is partly related to the quality of the eggs you're producing and the way they're matured. So a woman of 25 has a much higher success rate at IVF. A woman at 30 still has a higher success rate. Once you're over 35, freezing your eggs is probably not worth doing, as in fact IVF has become as much less likely to be successful. But of course, so many women are in fact being encouraged to start before 35, but a huge number of women, the big proportion of them, have already too late.

Now, you can argue that more education should be needed, but what we need, actually, are proper statistics for successive pregnancy at any stage, and that's not being recorded. What I'm getting at, Robert, is I think, based on the things you're saying, and please do correct me if I'm misunderstanding or misrepresenting, is the reason I use the word lie is

there is this perception in the culture that the success rate, in most people's heads, this will be how this is. Success rate is the same at any point. So you could have your children at 25, or you could have them at 40, and you just, you know, your freeze eggs at 25, and then 15 years later, boom, you're good. I mean, I had, it was quite a shocking thing to hear,

but I had someone come up to me. My wife and I were out with our newborn at the time doing something, and someone came up to us, we had a nice chap, had the baby, and then we said, Tom, have you got? My wife said, have you got kids? And the guy, because it would be a guy saying something this dumb, he went, yeah, we have two frozen ones.

In people's minds, what I'm getting at is they think that a frozen egg is a baby, that they just pull out of the drawer, boom, it's ready to go. And what you're saying is that's not remotely the case. No, it isn't quite right. And I mean, for example, I do have some statistics which bear some relationships. I've looked at some statistics which were, which I challenged the minister in Parliament about, of 40,000 eggs that have been thawed for the purposes of in vitro fertilisation, all-aged women, I don't know, and there were 604 pregnancies. And some of those, about 18% I think miscarried.

So you can begin to see that actually we're not really telling the truth. And I think those figures are probably quite accurate, but who knows because, of course, how things are being developed, how many eggs are being produced is difficult to follow. And we need much clearer evidence before we do to get women to delay unnecessarily. It's very difficult because, of course, we're living in a totally different society. It's important to understand, of course, we do understand that people want to work. They want to do things when women want to use their unique credentials to do different. things and as late as possible. And as indeed my own wife did before she died. I mean, she produced three children, but she was already in the late stages of, you know, of fertility, but she was relatively

lucky. So, I mean, I think that that is the problem that we, there's the inevitable pressure, which women impose on themselves, but society doesn't help to actually try to come to do this. But, you know, the answer, of course, is quite clear. what we're doing is asking women to pay 5,000 pounds or more to freeze their eggs, often a lot more,

sometimes some clinics will charge 10,000. It's quite common, and more in America. And of course, nobody is using that money to do research, which comes back to my original point. We need to be doing far more research.

And in Britain, sadly, the amount of research is going on generally in the in vitro air, fertilised area, is not very good. If you look at the number of projects which are being funded by the research councils,

by UKRI, for example, very few research projects are being funded. That's simply not because it's because they're not good enough. We've lost the science. We're not doing good science. We're not producing good projects. We're not thinking about it.

Because actually, when you've got a massive market, if you're a young person, of course you're going to go and work in a, clinic, it would be stupid not to because you earn immediately five or six times what you'd earn in the public sector. So, I mean, you can't blame people for doing that, but it's very difficult to do really useful research in a commercial environment. You can't easily do statistically an analyzable research comparing one treatment with another treatment because patients want the best treatment they think quite rightly. So that becomes a no-no. And that's a

big problem. And so we actually have to understand that we need to look at ways of doing research more effectively because there are ways we could do this. But the amount of experimental implementation we're doing, for example, on the cultural embryos, is negligible. Very few projects looking at culturing human embryos in Europe at the moment. But that is clearly five days of critical importance in IVF. And it will be, of course, in egg freezing as well, because we all have to go through that process. We want to try and mimic what happens in the uterus, but the uterus is a black box.

We've no idea what goes on there. It's very difficult. You can't, the ideal experiment would be to persuade a whole lot of women to come and have a laparoscopy or an egg collection just routinely after they've had sex. That is not going to be something which would be acceptable,

and it's not actually possible. for very good reasons ethically. It will be unethical. So we can't do the obvious experiment we can do in the rabbit or the rat, but unfortunately, mammals, as in fact, Anne McLaren showed, are totally different from humans

because we are unusual. We menstruate, and that makes a very big difference to the whole hormonal cycle. So we're quite different from the animals we can work with, and we could work with a few monkeys, but that's going to be increasingly impossible

because we feel that humans and monkeys are too close to each other, you know, for very good reasons. That brain is an advanced brain, and now doing primate research in this sort of field would be unacceptable, quite rightly. Robert, one of the things that you've spoken about is the epigenetic effects of this technology. So let's talk about that.

Firstly, before we get into it, explain to people who might not know what epigenetics is, and then we can talk about the effects. Yes, epigenetic. Well, wonderful, you brought that up. I hadn't thought about talking about that. But, of course, basically, we think that genes are genes for things.

You have genes for blue eyes. You have genes for, let's say, some liver enzyme. But actually, of course, genes work, depending on the amount of expression, how they're working. So, in fact, large amounts of expression or less expression, that will change the nature of what the gene is doing and how that will work. And also, of course.

Sorry, just to make this understandable for stupid people like me, when you say expression, what do you mean? Just explain that bit a little bit. It's working. So basically the amount of, let's say, message the gene is giving to the cells. So it's not binary, it's... No, it's not binary. I see. So for example, you can get genes to overexperse and under-express.

It's analog. Yes, and we can do that by changing the chemistry of the gene, and that is how much. So epigenetics is partly how much. the genes are affected by the environment. Because obviously it's the environment. What we forget actually is we've been thinking for years about, you know, development. Development is either nature or nurture. Okay.

Actually, of course, nurture is just as important as nature, but we've always been hawked on genes, nature. Now of course, there's actually nature, nurture and development. And the interesting thing, of course, is development is really important because development is actually a response to some extent to what is happening in your environment. It's highly controversial, but there's increasing evidence that if you're subjected to all sorts of unfortunate environmental influences, particularly when you're young, you may have all sorts of things happening later on in older age. So, for example, without going into great detail, there was one very, very important study years ago, which nobody believed, including me. when I read the paper, as there was nonsense, where they showed that little boys age nine,

if they were in a good environment in one part of Sweden, where there was a good harvest in the 19th century, at the beginning of the 19th century, the end of the 18th century, their male grandchildren were more likely to die young. Having had a good environment at the age of nine, that made no sense at all. And truly being to realize that the genes,

perhaps, are being programmed, to accept what's going to happen when, in fact, you have a different change in your diet. So possibly the reason why heart disease and hypertension and other diseases were common in that cohort might be due to changes in the body ability to regulate itself in different environments. So we are programmed by the environment we're in. We understand that increasingly. That's epigenetics, if you like. Now, of course, I don't want to push this because there's a lot more work being done

that but for example epigenetics occurs in all sorts of areas including cancer biology we can now you know modify our genes express perhaps and that may make a difference I think the point is this that we have clear experimental evidence in animals rodents for example that changes in the environment can make a major difference for example to brain development so for example one experiment done in 2016 in McGill University showed that actually if mother rodents didn't lick their offspring, they fed them milk, but they didn't lick and cuddle them. Those mice or rodents were more likely to have different development, more likely to be

unable to get out of a maze successfully, were slightly more likely to be aggressive. They passed that trait onto the next generation when they, in turn, are pregnant. Wow. That seems to be an epigenetic effect. And we now know that we can see changes in the gene expression of a particular molecule which affects estrogen. So it's intergenerational. So it's not, you know, you were neglected as a kid, you had a bad life.

You pass it on. Well, of course, it doesn't help either. No, no, no, of course. But actually, of course, it's relevant, of course. It's really complex because we should argue, of course, that we should be, we should not be so absolutely intense on geneans, but much more about... what we can do for the environment of our children. That certainly includes, of course, Shaw Start, for example,

primary education, because once primary education is finished, that brain is no longer quite as plastic as it was, for example, when the child was three or four. So actually how we start to interest them in doing things, which would include music or experimenting, but actually teachers in primary schools are not given the chance to do that. They don't have the background sometimes, or they don't, they don't generally, very few are scientifically qualified. They might have an A-level in science, but that gives you very little experience to do experiments with a child.

Because, of course, most teachers will be nervous about doing experiments. It might be dangerous. It might cause an accident. It might be something which takes up too much time and it's too costly to do. Much easier to tell the story didatically. That's a real problem, I think, in our education. And we're increasing that now, of course, with the new methods of education, where in fact all sorts of practical work is becoming less important in all fields.

Now, it's interesting to see how the government's relating to apprentices, apprenticeships at the latest stage. But in my view, we should be offering manual skills of all sort much early on. There's a lot of experimental evidence in the world. music, for example, that music actually can certainly it improves dexterity. Secondly, you can show that some people who are exposed to music early actually become much more appreciative of music later on.

You can show also that it improves memory. It certainly changes actual physical views at certain analytical observations. It's musicians and scientists actually have quite a lot in similar. Actually, scientists generally like music. And, of course, musicians are often quite good at science. They're not trained, but if they are, they become very good. In my laboratory, I had a lot of people who are musical,

who are some of the best scientists, much better than me, actually, far better. I was a poor scientist by comparison with some of the people in the lab. What you do there, of course, when you're the poor scientist, you want you make sure you recruit the right people because one of the great advantages that we'll have is collaboration and collaboration is what actually is really important but we don't teach that in school either and of course music does teach collaboration

and so do we know what what the long-term effects of this technology are for the people who are the product of it no I don't think we do and of course I don't want to say IVF is dangerous because there's no evidence that it is But I think, to be fair, as we found with that Swedish experiment, that wasn't recognized for a very long time. It was only, in fact, when in fact it was the male grandchildren of a male grandchildren of a male father. Because then it was a wonderful man called Pembray, Dr. Pembre who's in Bristol. He pointed out to me, he said, you know, there may be something at us all this is nonsense.

He said, no, no, Marcus Pembrey said to me, you know, actually, think about it. That's sex-linked. That must be genetic. And he thought about that. It was very clever. I don't think anybody realized when the paper was published why that was important. Now it's different because we've got much more evidence that genes are being changed by the environment.

The people who watch this show have generally done more thinking about how governments operate the most. But there's a difference between understanding the problem and having actually built insulation against it. That's the world, Michael Thorup operates in. He's been living as an expat for over 25 years, visiting more than 110 countries and calling nine of them home. He founded expat money nearly a decade ago to help

others do the same. When he helped someone build an international plan B, the knowledge he brings is entirely firsthand. Every recommendation comes from something he has already done himself. Expat money works specifically with freedom-minded families and investors who want to reduce their exposure on any one government or any one system. Second residences, second citizenship, offshore banking, international real estate, legal structures that spread your life across borders. McKell has put together a free report called Plan B Residencies and Instant Citizenships. It covers five routes to a second passport, including one that almost never gets discussed,

how a foreign residency functions as genuine political insurance, which countries actually make sense depending on what you're trying to protect, and what it realistically costs. Go to expatmoney.com slash trigger or click the link in the description of this episode to download the report. There's no charge, no catch. That's expatmoney.com slash trigger.

And Robert, one of the topics that we haven't addressed in this, and I know you're an expert in female fertility, is male fertility. Because when we talk about infatility, we automatically think it's the female body, there's something going wrong there. All that isn't always.

the case and we have a very real issue with male fertility, so let's talk about it. Well, if you look at the statistics, it's probably fair to say that with an infertile couple, at least 30% of the time it's probably both partners. And some of the time, maybe another 30% it'll just be the male and another 30% will be the female, very armatory sort of figures, but, you know, so actually male fertility is very important. We don't look at that nearly enough. I think there are a lot, there's a lot of quite excellent expertise in Britain, there's some very good male experts. Unfortunately, they're not often called in to help with IVF. It's great pity that in fact, clinics doing regular in-fetro fertilization don't subject themselves more to advice from male experts, andrologists, who I think should be encouraged to give much greater credence to what they do. But we also need to say that we need to do much more research. It's not just bad genetics because the sperm's don't work.

There are things that I think should be able to be done better to encourage fertilisation. We have some mechanical ways of doing this. We can inject sperm directly into the egg if they don't swim. But that in itself may carry risks that we don't know about yet. Although of course it's being used so often, we haven't seen abnormal babies. Nonetheless, it's very questionable, you know, whether it really increases fertility in most couples or not you know, this injection. We were, again, doing this very early on. And we tended not to want to use it as a routine treatment ever in our laboratory. And I think that's still the way how we left it. There's a narrative in the media that the quality of sperm is declining. Yes, I know. Is that accurate?

Well, you know, it's very difficult to understand that. You know, there are a lot of very good papers on this now which show that in fact. But the problem, I think, this, decline in fertility, this decline in sperm function hasn't really equated with loss of childbearing. And I think one of the problems may be that what I did was to look at the figures of Hammersmith Hospital because that was one of the first clinics that collected sperm over 60 years ago. So we have a lot of experience. And we went through the ways the sperm were collected and we looked at different in motility, for example, and structure. And it wasn't obvious that there was much different

over 60 years or so. Now, that's not a good paper. It's not a good, it was a rule of thumb, rough idea. Because actually, one thing is, the way we collect sperm now is much more sophisticated. The way we photograph sperm is much more sophisticated. So in fact, we're not bubble as see much more things. And now, of course, we do do things like electron microscopy,

which of course able to look at the sperm in very, very high magnification. But we don't really fully understand all the chemistry in great detail. So there's more to be done. And I think it's true to say that that's true of fertilization as well because it's different in different species. And it's very difficult to get eggs to actually fertilize because obviously people, if they're going to give eggs, want to actually have a baby or they want to have their eggs frozen.

So there is a real ethical problem there as well, persuading women to give up some of their eggs, you know, for experiments which are helping to get pregnant. So a lot of the things we hear in the media, so these definitive narratives is not. I'm not, I think the data are fuzzy. I think it's very, I mean, I'm not entirely persuaded that that is a serious issue. Fertility is unquestionably declining in the Western world, but there are so many good reasons for that. And what are they? Oh, well, I think for the women working later in life, clearly, I think, people having fewer children. I think the changes, you know, I think the changes in

family finances where both couples need to get an income to make it justifiable, more of all people having single children. I mean I think, and many people perhaps deciding that it's perfectly reasonable to have children at all. Many people I think are starting to feel do we really want to bring a child up in this world? I mean there are all sorts of issues we're now never, we've never thought about in the 40s. So I think those things are, you know, after the war, there's always a burst of fertility. There wasn't in the early 40s. Interestingly, after some wars, particularly after the 30 years war, the 30 years war in 1618, well, that's when it started, finished in 1648, there's some suggestion

that not only did fertility increase in Europe, but more male babies were born. Yeah, we had to say, so I was born in the Soviet Union, and I don't know if it's factually correct, but the narrative in Russia is there was a huge increase in male babies being born after World War II. Yes, absolutely right. That is, I think that that is, but it's not being, it's very difficult to do that retrospectively, because unless you're following up couples all the way through in their behavior.

But yes, I think it's so, you know, it's an interesting question, but certainly it's not just the first and the Second World War. goes right back to the 17th century and the statistics aren't entirely entirely. You know, perhaps nature needed more males at that stage because, of course, males were depleted in society. Can that be true? Can there be something influencing whether you have more male bearing sperm than female sperm? It must be on the male side. So it's an interesting question. I don't think the woman has any influence, as far as we know, on which sperm actually chooses the egg. But maybe we don't know. So to tie a bow on the whole fertility conversation,

because I want to move on to a different issue, if you were to just give a sort of public information announcement about fertility, I mean, one of the things we talked about is how it changes over time. For men and women, what does it look like in your late teens to 20s to 30s to 40s? How does it look? Well, first of all, most couples will get pregnant without any treatment. And although a lot of my colleagues talk about infertility effects, one in five couples, one in six couples, I don't think there's a flawed figures. They're based on a study which was done in Bristol University many years ago by a colleague

of mine who I greatly admired and tested. But actually, he was not looking at the underlying calls. of the infertility. And I think that actually it's probably much closer about one in ten. So it's not quite as common as we would boast. So you're looking perhaps at really one in 20 people, you know, because most of them will be from one or the other person.

But I think I would say that it's now undesirable, unfortunately, because it's so expensive to investigate the causes of the fertility. But I think that we need to be doing that more often. often. I think unless we're making a diagnosis, we shouldn't be doing IVF so readily, because so often if we do a diagnosis, we find there are other things we can fiddle with which are much cheaper and more successful. For example, if you have, let's say, an abnormal uterus, which is congenitally abnormal, a very simple procedure can often correct that without IVF. Same applies to polypinside the uterus. The same applies to many hormonal conditions, which are associated with

and fativity, changes of sugar, metabolism, for example, changes in your hormone output. So we're not doing enough of that really, in a sophisticated way. We're doing routine spot tests, which is not proper diagnosis. Now, of course, the problem is that's expensive.

In the short term, it's expensive. In the long term, it's probably cheaper. Because IVF is so expensive. Yeah, I see what you're saying. I had a guy come around to my house to do some work and got chatting to him. He was telling me they had 12 miscarriage carriages in 11 years, and then they went to see somebody when, oh, you know, you're basically herfalopian tubes are tangled. We need to sort that out. He sorted it out and instantly had a

child. So continuing to do IVF on someone like that, it's, I mean, it's crazy, right? Well, it is. I mean, in fact, of course, tubal function has been one of my big areas of research, and I think we don't understand tubal function at all. It's another black box where the embryo is fertilized. Fertilization doesn't occur in the ovary, doesn't occur in the uterus. It occurs in the fallopian tube. And it's not just a pipe. We spend all of us, if we didn't have IVF to produce us, spend about 48 hours in the fallopian tube at the beginning before we go into the uterus, which is even more darker. And that jury is something we completely ignore. So yes, I think that's true. And certainly, I think one of the reasons why we were a bit more successful

that IVF early on, was because we were looking at the fluids inside the flopian tube. I was doing that with Henry Lees, who was working in the north of England, in New York. And certainly we looked at actually some things which might affect fertilization and development, which possibly were helpful. So I think that we don't do that research enough. It's not easier to do, but it's certainly possible. Yeah. Where do your question start?

Well, my question started actually is I was hoping you would give a kind of consumer retail version of what the average person's fertility, the average woman's fertility and the average male's fertility looks like so at a time in terms of the decades in your life. All right. Well, I would say the average couple will have a one in four chance per month for the first four or five months. Then it gets reduced if they, because they obviously may have something more likely to be wrong. So certainly for the first five months, it would be wrong to do investigations unless you've had something clearly identifiable. For example, an operation which had infection, an appendix might be appendix removed in somebody who's of childbearing age might cause adhesions, that sort of thing. So that might be some reason. And then in that case, division of those adhesions might be more successful than IVF, but it's not being done enough.

And of course, the surgery to repair shoes is not done nearly enough because it's one. complicated but actually a long run it is cheaper so on the male side I think we should be doing much more about male health and I think also there's still more need to look at female fertility from the point of view of looking at the hormones mm-hmm and what about lifestyle what are things that people do and don't do that can improve they don't have sex enough all right I'm going home armed with that information tonight I don't think changing lifestyle changes as much at all You know, I think sex on the hathrug is a really good way of doing it.

And, you know, because I'm not speaking from experience, so I don't understand. You're speaking as a scientist, which is even more important. Yes, actually. Yes, of course. Pleasure is important. We don't even know what effect human orgasm has, female orgasm. But it certainly seems to produce more sperm in the fallopian tube, but we can't easily do those experiments.

Imagine that's quite a challenge. Yeah. But, you know, actually, there's a lot of reason to suppose that that can help. But, of course, that requires perhaps a different approach to one's lovemaking. And, you know, I did start to do years ago when IVF was in its very infancy. I'm sorry, there's a pun, but you know what I mean. I had a wonderful young woman who was medically qualified who wanted to look at this. And so we set up an experiment where we asked patients,

where they had unexplained infatility what their background was with sex. And of course, she as a woman was able to really go through their sexual experience. And she thought that what she saw was that women who were having orgasm during it, of course, were slightly more likely to have infection in their fallopian tubes sometimes.

It's interesting. But also, overall, were more likely to get pregnant with unexplained infertility. So that is something which we've never published, and it would be dangerous to publish it with the data I've got, because actually we should have done much more study. But it's a complex thing to do. You need a large cohort of women, and you need some very sensitive people to go through those things, and you still don't know whether people are going to tell you the truth.

And of course, when I said lifestyle, I mean lots of different things, because I know anecdotally things like acupuncture sometimes will help people get pregnant or talking therapies can help people address emotional blocks and whatever and so stress levels and all sorts of other things I just anecdotally seem to to to it's a very interesting question you know because I was I used to think stress was important and then I went to a lecture in San Diego by a very very famous endocrinologist who was then in his late 80s is he's He's now dead, he's no longer, but he was doing work on stress.

And he said, one of the most important things to help populations is stress. He said, people who are stressed, actually are more likely to get pregnant. And he said, it depends on the kind of stress, and we don't really understand that. And I think actually, on the other hand, I've seen so many women who, when they're no longer stressed, have got pregnant, and you do wonder about that. story it's a long story but I'll try and keep it as truncated as possible years ago when we were not very good at identifying the cause of infertility I had a woman who came to see me who been trying for a pregnancy very conscientiously for about four years and she'd not got pregnant

and I was sure that there was nothing wrong with her we looked to her husband there was nothing wrong with him and she said to me you know it can't be my husband it's got to be me because, in fact, my husband was responsible for a pregnancy, which he never told me about until recently. And I said, well, that doesn't necessarily mean his husband what we'd expect he would be fertile. It means that actually, you know, there's something else going on that we don't understand. You know, she continued to see me and she never got pregnant. And finally, one day she came into my clinic, she said, you know, I've got a boyfriend. Our marriage is breaking up and we're quite serious. And, you know, I wonder whether that will make a difference

to my fertility. And I said, well, I don't, I don't know. And she was having regular sex with this man for two years. She came back. She said, I've had two years of regular sex with my boyfriend, and he's been pregnant, he's had his wife pregnant as well. Are you telling me it's not my fault? I said, I really don't know. She rang me from an airport. I'm she. She rang me from an airport. I'm I'm off to Australia. We've decided to go to Australia. She was pregnant three weeks later with that man. So it was the country. It was England. It was England. England was ruining her fertility. But, you know, she had decided to change her life. Yes. I was kidding. Of course. She was changing who she slept with regularly. There was no guilt, I suppose. There was a new period. And she got pregnant quickly.

Yeah. I don't know where she got pregnant a second time. because I lost contact with her. But those stories are not uncommon, and they're interesting. It's fascinating how little we know about it. Yes, it is. I quite agree. It's why the research is so important, because at the moment it's all anecdotal.

So much of this stuff is left less to, you know, sort of anecdotes. But actually, there should be much more identification of where we do have things to test and the things we can investigate better. None of us plan our lives around insurance. We plan around whatever life actually throws at us. We had our second child this year, which quickly reorders your priorities. Let me tell you. Nobody sent a warning.

That's exactly the type of situation where you'd want to use PolicyGenius. They're not an insurance company. They're a marketplace. PolicyGenius is a free service that compares life insurance quotes from America's top insurers side by side. Their licensed team handles the paperwork. No guesswork, just clarity on coverage, price and terms, backed by thousands of five-star reviews on Google and Trust Piler.

With Policy Genius, you can find 20-year life insurance policy starting is just $276 a year for $1 million in coverage. Head to policygenius.com slash trig to compare life insurance quotes from top companies and see how much you could save. That's policygenius.com slash trig. Robert, there's something that I really wanted to talk to you about, and it's this term, again, it's a media term, which is designer babies. Is this something that is widely discussed, as in it's going to be the future of...

Well, don't forget we were responsible for that because, of course, you know, we were the first team to identify genetic defects in a couple that might cause a hereditary problem, which would cause an abnormal baby. You'd have that defect. And with Alan Handyside, I mean, the two of us spent, and Kate, I should say, also Kate Hardy, we spent five years trying to work out how to do the chemical tests on the genetics and also how we could work out whether or not. or not taking a cell from the embryo to make a diagnosis of the genetics was a safe thing to do and then transferring an embryo which would be free of that particular defect in that family and putting it back and the first babies were born oh 1980 year in the 1980 in the 1989 i think i'm think tracts uh 1980 must be that's right there must be there must be over 40 years old because because they've had children.

So that's now used worldwide. And it's still limited because at the moment, you're looking at defects which are causing death in the baby, and that's allowable by law. However, there's no question that increasingly a lot of clinics are looking at what's happening in America and some are looking in England, looking at genes which might affect hereditary

and whether you could test that in the embryo. It's sort of, you know, intelligence, for example, what might cause particularly good health or desirable characteristics. Will that happen? Yes, I think it will happen. I think it's inevitable it's going to happen because I think we are getting to the stage when we will be able to analyze a complex number of tech genes

and with big data, we'll be able to actually identify characteristics which we think are associated with that sort of individual. Is that wise? No, it's not wise. It's really dangerous because, of course, we will, we might well make people much more intelligent possible who get born slightly more intelligent because actually intelligence is not nearly as important as genetics

as the environment in which you're brought up in. But actually nonetheless, it is important because, of course, eventually somebody will make a mistake or find a baby that is more intelligent and also highly aggressive or autistic or something else. So, you know, I think this is tampering in a way that's really not wise but I think it's very difficult to control

because there's massive money involved in this and certainly in the States this I think will be the first place for it to happen. And it's also not particularly great as well because if you think about a lot of the people who actually push humanity forward or in a scientific sense or great artists, these are people who invariably are quite flawed psychologically

or they have, you know, they're highly autistic. If we eliminate those traits, we're also going to eliminate the outliers who actually provide us with wonderful technology, art, etc. Well, look at Beethoven. You know, perhaps the man who more than anybody else has changed Western music, you know, this is a man who completely antisocial, who sits on his own with a broken piano,

is going badly death and actually going deaf from quite an early age, and he becomes, as he feels a failure, at one stage in his later life, he's hardly producing anything. And now he's on the alcohol, he's got liver damage, and he's wheeled into the police station in Vienna in a wheelbarrow because they found him in the wood and they went to who he is. And the policeman says, oh, that's Beethoven.

He was known. He had form. And you think, you know, those sorts of things occur in art hugely. And you look at Picasso and you think those images. I was recently looking at the Picasso Museum in Lucerne, and it's amazing to look at those images. They're so improbable. Are they human? And yet, when you look at them for long enough,

you start to see what he sort of seems to be thinking. It's an amazing experience to say how little we understand about our nature, about our whole way our brain works. You know, we don't know how the brain works. We tamper at it at it. great risk, I think. And certainly you mention, particularly, for example, people who are different. Classically autism, the number of autistic people who have been rejected in the past, but now,

I'm glad to say, for example, at Imperial College, for example, we're suddenly taking people like that really seriously as good candidates for doing science. You know, it's very different. That's changing very much. I think we could do much more by being less attitudinous about what we see and recognizing that people have all sorts of abilities that we need to nurture. And nurture again comes back again again and again. But nurture obviously is going to be better when you're young.

It's much more difficult later on that. But unfortunately, if you're autistic, in a young class where teachers are under pressure, very difficult to give that child the kind of environment that it really needs, he or she needs, because, of course, they're disrupting the class and they're disrupting what is needed by the curriculum.

How long do you think it's going to be? be Robert before, you know, people walk into a clinic and they've given the menu and say, look, we can dial this up, this particular gene up, you can dial this gene down, and even just go, well, you know what, we've got two girls who would really like a boy, I want a son. Take that box. That's already happening. We're not saying it's happening, but I'm sure it is happening.

I don't think it's openly happening in this country because the HFIA would not give approval or a license. but I don't believe that it's not happening even in this country. It's certainly we're sending patients to other countries, Spain particularly, Cyprus particularly, where they can get sex selection. If you're a billionaire in America, you're picking. And, you know, I have to say when we,

because of course we were the first people to choose the sex of a baby because we were interested in sex-sling disorders. So we were worried about the particular muscular dystrophy where babies don't, males die. And so we realized this was a legitimate. and we decided, you know, and we persuaded parliamentarians that this was a good thing to do and they agreed and we did. So that would be the first sex election.

That was the first in the world. And yeah, I had so many offers of massive sums of money from certain countries and you can guess which countries they were for, well, you know, I need a sum. I mean, that was really quite a... It was, and I, you know, it was obviously we're not going to do that because once you start doing that, you bring the whole technology into disrepute and yourself eventually. But there are a lot of people who would just say, you know, who are very good at what they do,

they're very, in one word, reputable, who think to themselves, well, I can earn a fantastic amount of money doing this. I'm not doing anything wrong in inverted commerce. I'm providing a service people won. Yeah, exactly. Well, you know, don't forget, of course, that the first manipulation of a human egg was done in China several years ago. And of course, the guy was pilloried. Dr. Hay. He ended up, of course, in prison. So it was possible for him to learn the techniques that we were doing in labs in America and here. And, you know, he copied them in China. But of course, he used them purely because he wanted to be famous. I don't think he wanted money. I think he wanted to be famous. You know, we have this ridiculous society that we think being famous is really important.

It's terrible. Actually, being famous is not important, actually. It's something which we should understand that we should be teaching people. Be useful, yes. Be learning, yes. Be famous.

Because eventually you'll not be famous. Every person who goes to the parliament at the moment thinks they're going to be more than they are. You know, we have a new prime minister. Like every other prime minister, he's going to end feeling he could have done something totally different. Actually, you know, I feel very sorry for Kirstama, actually, who I think was treated abominably

by his own party. But, you know, he would have awfully gone to that stage and that job thinking, finally, I can do something for society. But it's that famous greasy poll which has been described again and again by every politician that gets into the cabinet pretty well. You know, fame is meaningless, doing something which actually might help other people. And what we're not doing is really important is to teach our children to be kind, to be able to listen, not to argue without actually listening to the argument. And we don't do that well. I don't do that well enough either.

You know, we need to do it much more. But actually ending up with emotional intelligence is going to be as important as being famous. It's actually going to be as important as being successful at science or successful at the art. emotional intelligence is the key to improving society. And kindness is one example which we don't talk about very much. But I feel when I talk to graduate students, PhD students, very mind you're in your lab, just find a lab that's kind, because actually that environment will be helpful to you.

Robert, there's one other area we wanted to discuss before we wrap up, which is something you've commented on frequently. I remember famously a conversation you had on question time with Fiona Bruce, who I like, and I think actually is generally pretty balanced in my experience, having done question time a few times. But you were trying to explain the science of sex and what makes someone male and what makes someone female. You did it, and she concluded by saying, I think something like some people may disagree with this. I mean, you've mentioned Kathleen Stock and that's a trans issue, but obviously academic freedom has been talked about in a number

of areas in recent years. I was rather hoping that you'd be interested in my opinion. as a biologist which seems rather more important because I'm just saying only because the issue of academic freedom isn't solely I'm about to say something which will mean that you'll probably want to edit the program when I finish but basically right okay I will say this categorically that you cannot change your sex your sex actually is there in every single cell in the body you have a chromosomal sex you have genetic sex you have hormonal sex you have all sorts of different kinds of psychological brain brain sex, they're all different. And we are very confused about this, unfortunately.

And regrettably, it's got into this argument that people will now accuse me of being transphobic. Well, there are trans people who say you absolutely can do that. Well, unfortunately, you can't say this publicly. This is one of the big problems. Even saying this on this programme, undoubtedly, will result in my getting a huge amount of hate mail. It always does.

But I do think it's a big issue about the attitudes. are, of course, issues which are important about young people who are confused about their sex, but we won't go down that route here. But it does affect a whole lot of issues in schools and elsewhere in our society. Of course we should accept people as they are. Overall, I think it's a very sad thing that we can't discuss biological science without actually getting completely caught up emotionally with something which is really completely wrong. Well, as I say, there are people who would vehemently disagree with you, so I'm just going to make that clear.

It seems to me that we've lived through this strange period where in the area of the trans debate, science has become sort of just gone completely by the wayside and people's feelings have come to the fore. Is that fair assessment? Yes, I quite agree with that. I mean, I think Fiona did an injustice to the argument, actually on that occasion.

She didn't listen to what really was saying. I'm not in any way prejudiced against people of a transgender. It's not the issue at all. The fact of the matter is that there's a difference between gender and sex. Sex cannot be changed because it is inherent. All your genes will carry the Y chromosome, all your cells, every cell in your body, the trillions of them will have the Y chromosome. Mine too. And that actually fundamentally changes our development. The same for women who have two X chromosomes. And we should celebrate that. Now, of course, there may be some people who feel uncomfortable with their sex

and they want to change it. But they're changing their gender. They're not changing their sex. They're changing what's kind of acceptable by manipulation. And that is a big problem. Sometimes, in fact, I found in my clinic so many women who came in infertile who were desperate because they changed their sex

and now felt they made a big mistake, were deeply depressed. And that was with men as well. And we forget that because, of course, we're doing this sort of thing because we don't understand this. And so I think remarks like that were deeply unhelpful, actually. I think Fierna Boos didn't help the conversation. No, I don't think she did, but I understand why she didn't.

This is my point, which is people are so sensitive about the subject. No one cares about what the truth is anymore. It's about let's just make sure we don't offend anyone. It's interesting, though, that, you know, I used to come on question time pretty regularly. I've never been asked on since that time. Really? Yeah. Do I care?

No, of course I don't, because actually I don't think if a program can't listen to a sensible argument, which I think it was a reasonably sensitive. It was a very brief statement. Yes. And you're a fairly eminent scientist, so your contribution to this debate should be indexed quite highly, in my view. Well, fairly eminent, you know, I'm a scientist. No, sorry, sorry, hold on the second. Sir Lord Professor Robert Winston, is not right.

It might not. It's a serious point. This is a serious point. When we're having a public debate about something that involves scientific facts, the contributions of people who are scientists matter more than the contributions of media personalities and politicians and other people who don't understand any of this. And what I'm getting at is I think without personal animosity towards Fiona in that situation directly, I'm just talking about the broader issue and the debate and the way is being had

is we are prioritizing people's sentiments over scientific truth. Of course, it's as popular where it's the current trend. I would say one thing though in her defence or indeed in anybody's defence. You know, scientific facts are only relevant at the time when they are there. When I look back at the papers I've published, within four years they're out of date because actually we realized what I was thinking was factual is different. is different. And so often, I got it wrong.

And I think we have to be much more aware of that. However, I do think it's difficult to define sex in the way that's being defined. Because I think it's very clear there. So whether it's a scientific fact or not, we have to understand that, you know, facts are not the only way that you make legislation, of course. Of course.

And, you know, that's something that we have to consider because it's also what is supported by a, democratic society, what is actually, which is, let's say, ethical and so on, a whole range of things. But in particular, of course, I've no doubt that Fielder was considering some people who are desperately worried about their sexuality, who are, and who actually are going through a tough time with their parents,

and, of course, you know, maybe at school and all sorts of, with their friends, as we found, for example, with homosexuality. You know, you look at that wonderful program, with Ian McCullen discussing his homosexuality. You think, what an amazing man, but have to go through that, you know, not to be able to tell his beat parents that actually he was gay. It's a great, it was a great thing he, the way he presented,

and he's done that for a long time, of course, but it was wonderful to see that on the BBC. But I think that's very, very different to this issue. Yes, it is different. It's very different. It is, but we muggle up, we muggle up those issues. Yes. And sometimes it's probable, according to psychiatrists who, one respects, who've got a good background, who feel that actually some of the people who are requesting sex change, actually,

of course, are probably really homosexual at the background. I don't know whether it's true or not. But, you know, it's a different issue. Could be a different issue. So can you explain what sex is and what gender is in a simple way? Yeah, I mean, you know, your gender is really basically. if you like your visual phenotype, your how you look, how you are. How you present?

Yeah, how you present. Okay. And your sex is actually something which is inherent in every cell in your body and may cause differences which are very wide. So some people, for example, many women will be extremely feminine in the way they're talking, others will be very masculine. I went to the or aureseeer yesterday and there's Agamem, or, you know, who's a, who's fairly masculine.

A giant, my man, you know. I think it's important that, you know, we don't think about nuance enough. Yes. And that's probably why I was mistaken question time. But, you know, to some extent, you know, you want to give a fair point. The number of emails I had after that statement

was phenomenal. The number of women who wrote to me saying, thank you so much for sticking up for women. We really, and it was literally hundreds of emails, which I've not had anything else I've done on the media, and I've done a lot of media work. So, you know, it was interesting. Oh, yeah, well, the trans issue is something we've discussed a lot on the show.

And the reason I think it's such a hot-button issue is that many women feel that the particular privileges and protections that they've been afforded for very understandable and rational reasons, you know, and they four had to fight for for a long time. are at risk when people who present as female, or as women, rather, but I actually male, you know, go into certain spaces, which are women only spaces and so on. And a lot of women feel very concerned about that issue.

It's very difficult, too, because it's very difficult to legislate effectively for that. And, of course, that's one of the things that courts have had a problem, because, of course, unfortunately, no matter how good a lawyer you are, you can't define sex as you can as a scientist. It's different. Yes. And that's not the fault of the lawyer. it's because actually both are important systems of how we make judgments.

Professor, Lord Sir, Robert Winston, thank you so much for coming on. Our final question, as you know, is always the same, which is what's the one thing we're not talking about that we really should be? Wow. I think maybe political correctness maybe is something we could be looking at. You know, we are a society now increasingly where we're making statements which politically correct, government does that all the time. The new prime minister is doing that all the time.

I hope he doesn't make a mistake in that respect, but that some of the things that are being said at the moment may seem helpful to society, but there may not be. And I think we have to recognize that when we legislate, we legislate for many people who are not necessarily in the same party. Actually, within a party, there will be people with widely differing values. we've become quite tribal in our politics. And I see Parliament more tribal now

than at any time in the past that I've been there, what, 32 years? Too long, probably, of course. But nonetheless, I think that tribal effect of thinking is not always helpful. Of course, there were great differences between Tories and Labour Party and Social Democrats.

But they all have useful values to remember, but often we actually ignore that completely in the arguments we're putting forward. Thank you so much for coming on. Head on over to Trigopod.com.uker, where we continue the conversation with your questions. How soon before AI helps with embryo selection or even editing to optimize human ability, health and longevity?