“The main candidates for fertility preservation techniques are young people with cancer”
director of the CMRB Stem-Cell Bank and R&D&i at the Dexeus Institute’s Department of Reproductive Medicine
A pioneer in in vitro fertilization in Spain, doctor Anna Veiga began her research in this field when there were few scientists doing so. Only 26 years old at the time (in 1984), this scientist from Barcelona was on the front page of all the papers with the birth of Victòria Anna, the first test-tube baby in Spain, an experience she recounts in her book El milagro de la vida (The miracle of life).
Since then, she has continued to focus her work on biomedical breakthroughs that have improved quality of life for many people and is currently carrying out stem-cell research to cure diseases, again opening up new avenues towards a more prosperous future in this sense.
Anna Veiga has had a long professional career of excellence closely linked to Catalonia. She holds a PhD in Biological Sciences from the Autonomous University of Barcelona and was head of the in vitro fertilization laboratory at the Dexeus Institute’s Department of Reproductive Medicine from 1982 to 2004. She currently heads up the Stem-Cell Bank at the Center of Regenerative Medicine of Barcelona (CMRB) and R&D&i for the Dexeus University Institute’s Department of Reproductive Medicine.
She is a member of the International Center for Scientific Debate Scientific Committee (a Biocat initiative driven by the “la Caixa” Welfare Projects) and an advocate of this new model of scientific debate being held in Barcelona with experts from around the world. On 6 and 7 June, she will participate in the ICSD workshops entitled Fertility preservation update: consensus meeting, for which she is joint Scientific Director with Pedro Nolasco Barri. Starting in July, she will hold the presidency of the European Society for Human Reproduction and Embryology.
How would you sum up the history of assisted reproduction in Spain?
We started working in this field fairly early, only six years after the first birth —a baby named Victòria Anna Perea Sánchez—, and we are currently in a position on par with most countries in Europe and the world.
In July you will face a new challenge, being the first Catalan scientist to hold the presidency of the European Society for Human Reproduction and Embryology. What does this mean for you and for Catalonia?
This society has a long history and our presence has always been noteworthy, but holding the presidency will surely make us more visible. The ESHRE has already consolidated their system and continuity of actions. Now, what needs to be done? We must foster contact with the European Commission in order to completely consolidate our position as the expert body contacted with any type of doubt in this area, consolidate issues related to training and accrediting professionals, and, afterwards, deal with other aspects that are still up for debate, like reproductive tourism and fertility preservation.
We have reached a moment of maturity regarding in vitro fertilization and it seems that the future lies in less aggressive treatments. What research is being carried out in Catalonia in this line?
In vitro fertilization has been an option for women with fertility problems for more than 30 years now. Over the course of this time, we have incorporated new techniques, and I believe that we have now reached a point where the most we can aim for is to consolidate the results, which is to say positive pregnancy rates among the population we are treating, older women. We must also try to eliminate undesirable effects, like multiple pregnancies and excessive stimulation. In this regard, we’re doing what is being done nearly everywhere; there isn’t much difference between what is happening in a Catalan center and one in Brussels, for example. The techniques we use are the same; we are working in the same line; we attend the same congresses and publish in the same scientific journals.
Some debate workshops, under the framework of the International Center for Scientific Debate, will be held in Barcelona on 6 and 7 June focusing on the emerging discipline of fertility preservation. What is the main aim of these sessions?
We aim to discuss and reach an international consensus on where we are now in this field. The main goal is to draft a document that clearly lays out the instructions for preserving fertility: which methods can be used, the results that can be expected, and where this methodology is now. This is not just for specialists, but also for gynecologists and oncologists that are treating young people with cancer, so they can communicate their possibilities of preserving fertility despite having received aggressive treatment for their disease.
Is this a key moment for defining new strategies and research lines in this field?
This field has some history, which has clearly sped up over the past five years, with some highly consolidated techniques and others that are not so far along. It is important that we strive for this soon and that, as expert specialists in assisted reproduction, those of us at centers around Catalonia and Spain use this opportunity to share what we know with our international colleagues.
Where is fertility preservation headed? Will other scientific disciplines be involved?
In fact, they already are. We aren’t talking about the possibility of curing a reproductive pathology, but of preventing a problem that could appear due to treatment for neoplasia. Thus there is a high degree of transversality. In fact, these sessions we are about to hold will include many different specialists: pediatricians, oncologists, professionals that work in both clinical and laboratory settings, etc.
What type of people are fertility preservation techniques geared towards?
The main candidates are young people, even children, who have had radiotherapy or chemotherapy that will compromise their future fertility. Also patients will autoimmune diseases and cases of premature ovary failure that we can predict ahead of time and therefore believe it is worthwhile to freeze ova or a portion of an ovary. And, on the other hand, social preservation now has a certain degree of demand, which refers to young women who are faced with the undesirability of becoming pregnant at a physiologically appropriate age (between 25 and 35 years old) and decide to freeze their ova for use further down the road, when they are ready to take on the responsibility of having a baby for one reason or another. What we must debate is whether this is something we want to offer and in what cases.
A few weeks ago, you were one of the group who signed a letter, in the wake of an open judicial process in the EU, that warned of the negative effects of limiting stem-cell research. Do you think European research in this field is in danger?
Yes, I was one of those that signed a letter published in the journal Nature in which we expressed our concern that patents involving embrionary stem cells be prohibited in Europe. This process has been open for many years and is led by a German researcher who presented his protest to the European Court of Justice. A preliminary report has recently appeared in which one of the judges declares himself clearly in favor of prohibiting this methodology. It isn’t definitive but the verdict normally ends up being quite similar. We are afraid that this could be the case and that it could end up compromising funding for a lot of research. Biotechnology companies end up committing to sectors with some guarantee of return. If we can’t patent certain methods, we are severely limiting our possibilities.
As a researcher that supports the ICSD, how would you say the Center contributes to the scientific community through selecting and organizing debate workshops?
It is an excellent way to foster progress in our scientific community. Many of us have connections with colleagues on an international level and we must take advantage of these connections to carry out debates to enrich our knowledge. It is a Center that helps us organize workshops with a very different format than what we would find in a normal congress with a lot of people. On the contrary, the formats proposed by the ICSD are more restrictive, with experts that foster exchange and discussion. I am totally convinced that this is the way to move forward.