Discovering Sex

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Then, in the winter of 1950, Pincus met Margaret Sanger. For nearly forty years she had been fighting hard to spread the gospel of birth control. She asked the scientist if some sort of drug was possible to stop conception. Pincus said yes, and out of that conversation came the first grant from Planned Parenthood. Not long after, Sanger introduced Pincus to Katharine McCormick, heir to the International Harvester fortune and deeply committed to the issue of birth control. She would become an early and crucial financial supporter of Pincus’s work. It was after an early meeting with the two women that Pincus first envisioned the device as a pill and one that would probably use progesterone in some manner to block ovulation. When he arrived home, he was so excited that he told his wife that he had discovered a new device for contraception.

Pincus was the driving figure of the team that made the assault, the leader who kept everyone aligned, whose vision guided the search from the start. Personal politics did not matter to him; only science did. To that end he could be quite cold-blooded. He was capable of secretly undermining the attempts of a valued assistant to get a better position elsewhere. He could cut loose a staffer whom he particularly liked and promote another whom he loathed if he thought it would benefit the project.

He had the ability to remain focused on the central issue, no matter how complicated the problem. He envisioned a pill that would prevent conception by mimicking the hormonal condition of pregnancy, when the body blocked ovulation of its own natural instincts. If you could suppress ovulation, he believed, you could suppress fertilization. Significant earlier studies had suggested that progesterone might be an effective inhibitor of ovulation and that it might be taken orally.

Progesterone was then available in large part because of the work of an eccentric, maverick scientist named Russell Marker, who in 1940 discovered a cheap and plentiful source in the root of a wild yam that grew in the Mexican desert. Previously progesterone had been obtained only in minute amounts from animal sources and, as a result, was fabulously expensive—too expensive, in fact, to be wasted on humans; it was used exclusively to improve fertility in world-class racehorses. But with virtually no support or encouragement from others, Marker set up a primitive lab, and by 1943 he was able to walk into a small wholesale pharmaceutical company in Mexico City carrying two pickle jars filled with powder worth about $150,000 on the open market. Did the owners want some progesterone? he asked.

The first tests on the effect of progesterone on rabbit ovulation were started on April 21, 1951. The actual lab work was carried out by Chang, who was still so poorly paid that he lived in the laboratory, giving rise to persistent rumors among the neighbors that a Chinaman was kept chained in the basement.

Both Sanger and McCormick kept pushing Pincus for quick results; science, he tried to explain, does not necessarily work that way. Even so, the work went surprisingly well. Because of McCormick there was always enough money. Chang was a brilliant lab man, the perfect counterpart to Pincus. He had the patience to endure the seemingly endless laboratory work required in the effort.

From the start Pincus was optimistic. Chang was, he said, equally pessimistic, and he remained so even when test after test succeeded.

By 1952 there was an article in Look that predicted that Pincus would soon discover an oral contraceptive. Searle then passed on to the lab a progesterone steroid called norethynodrel, which, Chang reported back to Pincus, was more powerful than natural progesterone by a factor of at least ten to one. That meant it was time to go on to the next stage.

One thing that Pincus wanted from the start was a medical doctor as a collaborator; eventually the pill would have to be tried out on humans. For a time he considered Alan Guttmacher and Abraham Stone, both doctors and leaders in the birth-control movement. But Pincus worried that this affiliation might diminish their legitimacy for the project; moreover, both were Jewish, which might prove to be a liability, for opposition to birth control came primarily from Catholics and fundamentalist Christians. (For all its freedom from administrative control, the Worcester people maintained caution in publicly discussing what they were doing. The 1955 annual report was more than a little disingenuous; it spoke of unspecified work with animals to control ovulation. The 1956 report detailed the use of steroids to help control painful menstruation.) Finally Pincus turned to an old colleague and friend, Dr. John Rock. Rock was a distinguished physician, the chief of gynecology and obstetrics at Harvard Medical School. He was also a devout Catholic. Rock and Pincus had known each other since the thirties by dint of their common interest in hormones, although for diametrically different reasons: Rock was trying to use them to cure infertility in women. He believed progesterone and estrogen might stimulate the womb, and he sent one of his assistants to work with Pincus to learn from his experience in retrieving mammalian eggs. Gradually their work brought Rock and Pincus closer together.