Lord Winston: He made dreams come true. Now he must act to stop IVF turning into a nightmare

The IoS interview: Lord Winston, fertility pioneer

Robert Winston has become one of the great popularisers of science in the last few years. Television programmes about the human body – often allowing us to see rather more of Lord Winston than is strictly necessary – have proved extraordinarily successful, and made Winston's moustachioed face very familiar to viewers. Along with David Attenborough, Richard Dawkins and Steven Pinker, Winston has made science, particularly human biology, fascinating and fun. His latest attempt to do so, Human Instinct, has just started on BBC1.

And yet Winston and his ilk have failed. We still remain astonishingly ignorant about our own bodies, how they work and why they work in the way that they do.

We all know about the mechanics of conception – as Winston puts it: "Of all the human instincts, sex shouts the loudest: we are obsessed" – but those first hours and days after conception are to most people a mystery. They have little clue as to what happens to an embryo and how and why few survive, despite all the publicity given in recent years to the work of people like Robert Winston.

It is, in fact, 20 years since he made his name as a pioneer of in vitro fertilisation (IVF). When I first met him then, his commitment to helping childless people have children, his enthusiasm for the science involved, and his delight in the children born of it (many of them displayed in his office's photographic picture gallery) were infectious. But today, Winston – now professor of fertility studies at Imperial College, London, director of NHS Research and Development at Hammersmith Hospital and a Labour life peer – seems a little more cautious about the benefits of IVF. Last week, it emerged that several studies have shown that test-tube babies are at significantly greater risk of birth defects, and recent research has indicated that longer-term problems have been overlooked.

Winston has been warning for some time that certain assisted conception techniques, such as the use of frozen embryos and the injection of sperm directly into an unfertilised egg, should not be readily used. So serious is this issue that he has made public his foreboding in the starkest of terms in the current edition of the scientific journal Nature Cell Biology: "Reports of a treatment that leaves almost 10 per cent of children handicapped in some way must not be dismissed as a statistical quirk," he wrote. "What's more, this disquieting trend was still apparent when these worrying figures were corrected for multiple births, maternal age and parity [number of children] – even IVF singletons were at considerable risk."

He continued: "Patient desperation, medical hubris and commercial pressures should not be allowed to be the key determining features in this generation of humans ... We cannot ignore the clouds lowering over these valuable therapies."

Desperation, hubris, lowering clouds? You can sense the genes of his rabbi grandfather in this homily. Did you really mean it, Lord Winston, I ask.

"I'm afraid I did," he replies. But he is most critical of the medical establishment.

"There are real concerns here, but not until now has the Medical Research Council and the Human Fertilisation and Embryology authority [the body responsible for regulating this country's work on IVF] said that they want to conduct a study of IVF children. They have been very slow about this. We need a proper authoritative study and to have somebody look at this in depth."

More than 68,000 babies have been born in Britain as a result of IVF, and nearly one million worldwide. The single biggest risk appears to be that of multiple pregnancies. Britain, together with other countries, now places a limit of two on the number of IVF embryos that may be implanted. But what particularly concerns Winston is the use of the frozen embryo technique.

"Put simply, if you freeze food, it tastes different," he explains. "Freezing changes things. A greater proportion of embryos do fail after freezing and we need to ask why this happens. The paramount issue is whether we do any harm."

Around 90 per cent of IVF treatment is done privately, and there is a fear that some doctors will encourage desperate, childless patients to have expensive care even when the prognosis is hopeless.

Winston is trenchant in his criticism of such unscrupulous practices. "There are clinicians who are making huge sums," he agrees, "and it is worrying. When a unit says that it can delay the menopause by storing eggs and yet it has not done any research on this technique, I think that is commercial exploitation of the worst kind."

Treating patients in his NHS clinic no longer plays such a large part in Winston's own working life; he is now 62 and has cut down on the long hours of clinical practice, opting instead for ... well, the lure of fame, via TV shows, and serving as a peer in the House of Lords. But when he does see patients, he continues to tell large numbers that treatment is pointless. For many of them, the reason is age. Female fertility goes into steep decline after 35 and by the age of 42 half of all women are infertile. But many people remain unaware of this.

It is this lack of knowledge about our own bodies that Winston's programmes try to address. His latest TV series on instinct focuses on our behaviour, and the way it is shaped by our evolution on the African savannah millions of years ago. In it, Winston tells us that risk-taking has the purpose of attracting a mate, propagating our genes and so our species. Men do more heroic things, apparently, when watched by an attractive female.

But it's not all sex and competition in the Winston world. Since we evolved in groups, he argues, we have a predilection for co-operation with all the members of a given social circle, as his experiment in Human Instinct with children and chocolates showed.

"They shared them with a degree of fairness," Winston recalls with obvious pleasure. "Human value can travel beyond the cold calculus of evolution."

Professor Robert Winston's series "Human Instinct" is on BBC1 on Wednesdays at 9pm. The book is published by Bantam

Biography

1940 Born in London

1964 Qualifies as a doctor at the London Hospital Medical School after giving up natural sciences at Cambridge

1964-81 Works in London hospitals

1970s Lives off a Surrey smallholding, publishing an account of his experiences, A Little Piece of England

1976-77 Visiting professor, University of Leuven, Belgium

1979-87 Presenter of BBC TV programme Your Life in Their Hands

1980-81 Professor of gynaecology, University of Texas

1982-86 Reader in fertility studies, Royal Postgraduate Medical School, Hammersmith Hospital

1985 J Clyman visiting professor, Mount Sinai Hospital, New York 1985-today Member of Council, Royal Postgraduate Medical School

1992 Chief Rabbinate award for contribution to society

1995 Created a life peer, taking his seat on Labour benches in the House of Lords

1998 The Human Body (BBC)

1999 The Secret Life of Twins (BBC)

2002 Human Instinct (BBC)