Many medical therapies, from cancer treatments to the management of infertility, are now so routine that their origins are easily overlooked. Yet each rests on years of painstaking research and discovery to ensure that such treatments are both safe and effective for clinical use. In some cases, scientific breakthroughs required unusual collaborations, not only across scientific disciplines but even with the church, as in the development of the fertility drug Pergonal.
Saint peter's square, Rome, Vatican. Credit: mariananistor35
In the 1940s and 50s, scientists were beginning to understand the role of gonadotropins, a group of hormones that stimulate the ovaries. Of particular interest were two key reproductive hormones—follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Researchers had already observed that certain reproductive hormones could be detected in the urine of pregnant women, a discovery that made early pregnancy testing possible.
Piero Donini, a chemist working for an Italian pharmaceutical named Istituto Farmacologico Serono, discovered that post-menopausal women produced these hormones in abundance. Because their ovaries no longer responded, the body continued to secrete large quantities of these substances in a futile attempt to stimulate them, and the excess hormones were excreted in urine.
Donini succeeded in isolating these hormones from urine and named the extract Pergonal, from the Italian “per gonadi,” or “from the gonads”. He envisioned it as a treatment for infertility. However, there was a daunting practical problem: how could enough of this hormone-rich urine be obtained to produce the drug on a meaningful scale?
A decade later, a young Vienna-born medical student, Bruno Lunenfeld, learned of Donini’s work and contacted him. Convinced of its potential, Lunenfeld urged Serono’s executives to manufacture sufficient quantities of the drug for clinical trials. The idea intrigued them, but his proposal to recruit hundreds of menopausal women and collect their urine was met with open scepticism. After his presentation to the board, the chairman reportedly rose and remarked, “Very nice, but we are a drug factory, not a urinal factory.”
Fortunately, Serono was not an average pharmaceutical company. It was largely owned by the Vatican, and its board of directors included members with deep, ancestral ties to the Papacy. The most crucial figure in this story was Prince Giulio Pacelli, the nephew of the reigning Pope Pius XII. Pacelli took an interest in Lunenfeld’s work, and when he realized they needed thousands of liters of urine, Pacelli turned to his uncle.
With the Pope’s quiet endorsement, the collection of urine for the initial phase began from about a hundred nuns staying in old-age homes. These nuns produced 30,000 litres of piss in a year, which gave about a hundred milligram of the substance, enough to make 9,000 vials of 75 units, sufficient for 450 ovulation induction cycles.
Later, hundreds more and eventually thousands of post-menopausal nuns residing in convents across Italy were recruited. The nuns were instructed to empty their bladders in special tear-drop shaped containers lined with a plastic bag. Serono employees collected the bags of urine and transported them to the Rome laboratory, where technicians emptied them into metal tanks for processing. By the early 1960s, Serono was processing hundreds of thousands of litres of nun urine to produce just a few grams of Pergonal.
There was also a practical advantage to this arrangement. Because contamination from pregnancy hormones would ruin the batches, researchers needed donors who could not be pregnant. Nuns, particularly those in retirement homes, offered near certainty on this point.
The effort paid off. In 1962, a woman treated with Pergonal gave birth to a healthy child, the first successful pregnancy achieved using extracted human gonadotropins. Within a few years, more pregnancies followed, and Pergonal became a cornerstone in the treatment of infertility. It would later play an important role in the development of assisted reproductive technologies, including early work leading to in vitro fertilization (IVF).
As demand for fertility treatments grew, reliance on urine collection from nuns and other donors became impractical. By the 1980s and 1990s, advances in biotechnology allowed scientists to produce these hormones synthetically using recombinant DNA techniques. These lab-produced alternatives eventually replaced urine-derived drugs like Pergonal, bringing consistency, scalability, and independence from human donors.
The ultimate irony of the Pergonal story lies in the Catholic Church’s official stance on reproductive technology. In 1968, Pope Paul VI issued the encyclical Humanae Vitae, which solidified the Church’s opposition to artificial contraception and most forms of assisted reproduction. Years later, in 1987, the Vatican formally condemned IVF. Thus, the very drug that the Pope had helped create, using the biological waste of celibate nuns, had become the primary tool for a procedure the Church considered a sin.
References:
# The strange story of a fertility drug made with the Pope’s blessing and gallons of nun urine. QZ
# The Vatican’s Secret Role in the Science of IVF. Vanity Fair
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