For Dr. J. Clark Bundren, the draw to the specialty of in vitro fertilization at the time of its infancy was about solving a puzzle.
From the start of the Tulsa physician’s 40-year career in medicine, Bundren sought the underlying reasons for infertility to design the right therapy, often using cutting-edge technology. He co-founded Oklahoma’s first clinic with IVF services and is credited with helping thousands of parents have children.
Last month, this IVF pioneer stopped accepting new patients, and on July 1 he hung up his white medical coat to start retirement.
“My generation of physicians who engineered this work from Australia to England is now moving on,” he said. “It’s been fun.”
Bundren’s interest in IVF began as a 16-year-old Bartlesville student named as a Sir Alexander Fleming Scholar. The program put him in a lab through the Oklahoma Medical Research Foundation, working with cell culture systems for patients with malignancies and chemotherapy and immunotherapy.
People are also reading…
“It was the same kind of technology used to solve the problem of infertility,” Bundren said.
He received an undergraduate degree from Philips University in Enid, attended the University of Oklahoma College of Medicine and completed his training in Tulsa. Graduating from medical school in 1978, his was among the first classes at the Tulsa campus.
IVF technology was emerging in the ‘70s, and Bundren was recruited for his obstetrics and gynecology residency and fellowship in human in-vitro fertilization at Eastern Virginia Medical School. The head of the program was Dr. Howard Jones Jr., considered one of the American trailblazers in assisted reproductive technology. Bundren was the youngest member of the team assembled by Jones.
That high school experience with cell therapy came back to Bundren in problem-solving for fertility. The concept of altering cells for cancer treatment was applied to growing embryos for transplant.
“IVF and embryo transfer was the focus of the work,” Bundren said. “The idea was to get together enough people to figure a solution to make IVF more successful as a treatment for infertility.”
In 1978, the first baby born after conception by IVF was Louise Brown in England. A doctor on that team, physiologist Robert Edwards, won the 2010 Nobel Prize in medicine for the breakthrough IVF technology.
“There was proof this was possible, but how do we make that consistent? We knew we could make it work, but how to do it was our challenge,” Bundren said.
In 1981, the team, including Bundren, delivered the first baby conceived by IVF in the United States — Elizabeth Carr.
But the historical milestone wasn’t without controversy.
The Rev. Jerry Falwell and other leaders of the Moral Majority movement led protests outside the facility, condemning IVF as the “work of the devil” and claiming that the team was “playing God.” Some religious faiths continue to oppose IVF.
“It took me by surprise,” Bundren said. “You have this work, and you’ve got these infertile patients who are truly suffering. They are grateful for what we are doing.”
The opposition didn’t deter Bundren. It also didn’t deter medical institutions desperate to get IVF technology and physicians specializing in the field to offer fertility services there.
Bundren returned to Tulsa in 1982 as an associate professor of obstetrics and gynecology at the OU-Tulsa medical school, bringing a few people from the Norfolk IVF team with him. He and Dr. J.W. Edward Wortham Jr. became co-directors of the Hillcrest Infertility Center — the first clinic of its kind in the region and the fifth in the nation.
In 1983, Bundren and his team delivered twins as the first children in Oklahoma born after IVF conception. The mother had permanently blocked fallopian tubes from complications with a previous birth.
“We never had pushback in Oklahoma,” he said. “I think that is because of the farming culture here. The concept is familiar because it has been done in animal husbandry for a long time.”
In the U.S., about 2% of babies are now born through the use of assisted reproductive therapy, with IVF as the most common, according the U.S. Centers for Disease Control and Prevention.
In Oklahoma, there were 493 pregnancies from assisted reproductive therapy in 2019, with 419 live births, according to the CDC. Nationally, there were 95,030 pregnancies after fertility therapies, resulting in 77,998 births.
In the early days, the chances of a woman getting pregnant through IVF were about 1 in 10. Now it is closer to 50%, Bundren said.
Those improvements came through better cell culture systems, improved drugs to stimulate ovaries and eggs, and a reduction of diseases that affected fertility, particularly sexually transmitted diseases.
The future of the field includes getting more insurance coverage for IVF and infertility therapy, Bundren said. Now 13 states require coverage, but Oklahoma is not among them.
“We need to make this more cost effective for more patients,” he said.
Several hundred former infertility patients, most bringing their children, went to his office recently to bid Bundren and his staff farewell.
“That was very gratifying,” he said.
Bundren retires at a time when women’s reproductive rights are back as a top issue after the U.S. Supreme Court struck down abortion rights. Half of the states, including Oklahoma, have enacted abortion bans.
He says the anti-abortion laws will have consequences for IVF. Asked whether a lawmaker ever asked him how a law would affect his practice, he simply says, “No.”
But particularly in states like Oklahoma, which have declared that legally life begins at fertilization, what to do with unused cells and embryos becomes a quandry.
Some embryos are not considered viable, sometimes through genetic anomalies or other problems that would affect a healthy delivery. Are those still considered lives? Or, if a lab worker drops one of the dishes containing cells, is that murder?
These are issues for the next generation.
Bundren decided to retire after a grueling time working in hospitals during the pandemic, spending a lot of time working with high-risk deliveries at Hillcrest Medical Center.
“The pandemic wore on people more than what I recognized,” he said. “It was hard on hospitals, constantly wearing masks and constantly under threat of the virus. That is stressful.”
In his retirement, Bundren plans to spend more time fishing and farming with his wife, Mary, three children and six grandchildren. As opportunities arise, he plans to continue to work on solutions to the human suffering of infertility.
Featured news video: Navy shipwreck is deepest ever discovered, has ties to Tulsa-area families of sailors