“In vitro fertilization and assisted reproductive technology have clearly entailed a change in family types”


Anna Veiga (Barcelona, 1956) is a biologist, researcher, and university professor specializing in assisted reproductive technology, clinical embryology, reproductive genetics, and bioethics. She was part of the team that carried out the first in vitro fertilization (IVF) in Spain.

You’re the “mother” of the first Spanish test tube baby. It’s been over 30 years now… How has the technique evolved since then?

It’s changed a lot. And not only from the point of view of the results, which is a really important aspect. What we were getting when Victòria Anna was born 34 years ago and what we’re getting now has changed radically. Now, we’re talking about a 40-50% success rate, while back then it was only around 20%. The methodology has changed, the laboratory has gotten much, much better. The clinical field has also changed a lot, especially because the patients we have are different. Women don’t start having children until they’re over 30 and their ovarian reserve has already run out. They’re not in a reproductive phase of their lives and they want to have children. This makes it extra difficult because the results we get are very closely related to the woman’s age.

How do you remember that day? It was 1984…

It was indeed: July 12, 1984. I remember it with lots of emotion, obviously. It’s something that’s stayed with me throughout my whole professional life. That day was the culmination of a great effort by a group of us, led by Dr. Pere Barri, and we were devoting all of our energy to making this a success. We were all a lot younger [smiles] and the perception of things is different, but in any case, that day marked a turning point in assisted reproductive technology in our country.

Are you in touch with Victòria Anna?

Very much so! She lives in Madrid and I was there just 15 days ago. We had dinner together and went shopping too. We have a very good relationship and we’ve always had one. Whenever I go there, I always try to see her, have dinner with her… We’re in constant contact with each other.

How has IVF influenced the quality of life of people who can’t have children naturally? Do you think it changes their lives?

Of course. When there’s the option to solve a medical problem, the situation changes radically. Before IVF, there were lots of couples who only had two options if they weren’t able to get pregnant spontaneously: either not have children or adopt. Today, most fertility problems are solved using this technology, giving patients a degree of freedom. Just like birth control made it possible, especially for women, to choose when and whether they wanted to have children, in the case of fertility problems, assisted reproductive technology provides the freedom to choose whether they want to have children despite the fact that there’s a problem to address.

In terms of the evolution of fertility, has it decreased among young people?

In principle, no. There might be small changes in some groups that can be exposed to toxins, but there’s not a more significant percentage of fertility problems among young people. The age factor is what’s more decisive.

How many children are in the world thanks to IVF?

Some countries that have very accurate and precise records while others have ones that aren’t as complete. We must have around 8 million children around the world who have been born thanks to IVF.

Has this number been increasing in recent years?

It’s constantly increasing because we’re getting successful pregnancies and more children are being born. It’s increased in a higher proportion than there was before. There are more and more centers for assisted reproduction, the technology is more accessible to anyone who needs it, so there is an exponential increase.

What would you say to people who are totally against this technology?

Luckily there are fewer and fewer of these people. There have always been radical segments that have been opposed to scientific advances, not only with assisted reproductive technology but also with birth control, embryo research, and other matters that are sensitive and delicate from an ethical point of view. For me, a fertility problem is a medical problem that affects part of the population. If the technical means exist and no ethical principle is breached – which I don’t think we’re doing – then I don’t see the problem in being able to use them. These segments see things from a very remote perspective, though; they’re not in touch with the reality it represents.

Where will IVF go?

It’s a very mature field of medicine and biology that’s already evolved a great deal. Not only is it becoming very normal and standard to use in the majority of public and private centers in developed countries, but society has also assimilated it in a very natural way. In the ’80s, patients more or less hid the fact they were having IVF, but today there’s no stigma. On the contrary, people brag about it and are happy to be able to say, “I couldn’t have children, but thanks to IVF I’ve been able to.”

Is one of the aims to get a higher success rate?

We can have more success, especially in favorable cases, with young women, where there aren’t any additional problems. But the fact that we deal with cases that, let’s say, don’t have such a good prognosis because of age, means that it’s likely it may not really be possible to improve the rate in these cases.

Have there been changes in donor legislation in recent years?

No. For egg donors and sperm donors, there are very clear regulations in Spanish legislation that have not changed.

Where will we be 50 years from now? Will there be scenes that seem like science fiction to us right now?

It’s hard to imagine what it will be like in 50 years. In fact, when we started working, we weren’t imagining what would happen 30 years later and where we’d be, either. It’s clear that different techniques and different possibilities will be incorporated into IVF. One of the things that comes to mind, and that will happen, is the possibility of doing gene therapy, in other words, modifying the embryo genome to prevent diseases. At the moment it’s technically feasible, but the results aren’t good. There’s a call for prudence in this field, but it’s likely that all these new methods surrounding IVF, and that have applications in embryos, will end up being used. IVF and assisted reproductive technology have clearly entailed a change in family types. Nowadays, there are many women who don’t have a partner or who decide to be mothers on their own who can do it without any problems. Or for homosexual couples, it’s practically the same, with new options, such as surrogacy, for example. Methods that complement IVF are being incorporated, and in some cases, they aren’t for solving fertility problems. A woman without a partner doesn’t have a fertility problem; basically, what she needs is to receive treatment so she can get pregnant.

What is the status of scientific research right now in our country?

The level is very good, we have very good researchers. And this is demonstrated clearly when you see the publications and the advances being made at the different centers. What is really clear is that we need more resources to be able to move forward. When a country doesn’t dedicate enough resources to research, it’s more difficult for it to advance.

Is there a future for young people who want to dedicate themselves to research?

There is a future, but it’s not an easy path. A scientific career brings a series of obstacles along with it, and you have to have a very clear and strong calling if you want to dedicate yourself to science, because it’s not always smooth sailing.

In your case, what’s the path been like that’s led you to where you are now?

I have no complaints at all. My “reproductive” side, to put it in an understandable way, began at Dexeus in 1979 and, in fact, it still continues there. My more research-oriented side began much later, around 2004, when I joined the Barcelona Centre for Regenerative Medicine (CMR[B]). At Dexeus, what we did, and what we’re still doing, is using technology that was already described and that was already working in other countries. But that’s not research. Research is trying to answer questions that don’t have an answer at a given time. Trying to understand mechanisms for which you don’t have a clear explanation. Although there may be common areas in these two disciplines, in terms of my professional career in the field of assisted reproductive technology, I would say it was a relatively easy path.

You were talking about calling before – is that something essential in research?

Yes, but I think it’s essential in anything. When you do something you love and when you’re passionate about the field you work in, it makes everything a lot easier. The sacrifices you have to make, because the field demands it, become more bearable.

 

A little taste

 

The best time for having a glass of wine.

When the working day is over. You can be more relaxed and carefree and devote time to yourself.

A song for savoring a good wine.

David Bowie’s “Space Oddity.”

Somewhere you’d get lost.

I’d obviously get lost in Cadaqués, where I’ve had a house for many years and where I enjoy my peaceful moments.

What do you do in your spare time?

My spare time is a bit limited, but I like movies and enjoying my friends.

One flaw

Pride bothers me most.

One virtue

I’m very hard working and when there’s something I like, I give it my all and put all of my energy into it.

What did you want to be when you were little?

I think that all children want to be teachers at some point and I did as well, but biology soon caught my eye. A teacher at school piqued my interest in science a little, and it was clear to me from quite early on.

What do you want to be now that you’re grown up?

If I had to start over, I’d do similar things to what I’ve done, but I’d try to avoid the mistakes and do it better. I wouldn’t change too many things.

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