Hanging on the coat rack on the back of her office door, there is a jumper, a lab coat and dozens of lanyards with IDs for congresses and seminars specialising in human reproduction in which Anna Veiga has participated over the last few years. One of the scientific meetings that has taken its place on the Stem Cell Bank director’s coat rack is the annual congress of the European Society of Human Reproduction and Embryology, one of the world’s foremost scientific organisations, which Anna Veiga has chaired since the summer of 2011.
The European Society of Human Reproduction and Embryology’s annual meeting, held in Istanbul in July this year, helped to highlight the fact that since the birth of Louise Brown, in 1978, five million children have come into the world thanks to in vitro fertilisation (IVF)…
This figure demonstrates that in vitro fertilisation is a fully consolidated technique with a standardised methodology that helps to solve many fertility problems. It is a safe technique that yields similar results to births without assisted reproduction.
Is the number of in vitro fertilisation treatments in the world still on the increase? Particularly in industrialised countries due to late motherhood…
It is true that it is one of the reasons for the growth of these techniques. There are no studies that clearly indicate that our society has more infertility problems than a few decades ago. However, it is evident that women are having children later and this brings complications in becoming pregnant. Many of the cases of infertility that we see today are due to the mother’s age.
What is the work area of the European Society of Human Reproduction and Embryology, which you chair?
It is one of the world’s two most important scientific associations in the field of human reproduction; we might say that we are a bit ahead of the North American society. Our objective is to provide scientific support to assisted reproduction activities, furnish scientific evidence on the efficacy of techniques, collect data on the sector’s activity and issue guidelines for the best application of procedures.
What are the future challenges facing IVF? Years ago it was said that the biggest problem is the multiple pregnancies induced by this technique.
Multiple pregnancies are still one of the complications of assisted reproduction techniques, although in recent years twin births have diminished substantially. We have improved the techniques and know a lot more about the cases in which it is justified to transfer more than one embryo, and in which cases we can transfer two embryos, or three at most. In some countries this aspect has even been regulated; in the Spanish state, for example, the law says that no more than three embryos can be transferred in each procedure.
The statistics show that in recent years the number of multiple births has grown considerably, and this is essentially due to assisted reproduction.
You can see this by simply strolling through the streets: there are more twins about. You realise it’s a fact when some advertising campaigns even use the multiple-birth hook.
When Louise Brown was born, in 1978, you were studying biology at the Autonomous University of Barcelona. At that time did you think that one day you might end up working in human reproduction research?
No, the truth is that I didn’t. That piece of news really caught my attention, but at that time I only had a general interest in genetics and cell cultures. There was a lecturer who really inspired me on those topics.
The late Josep Egozcue…
Exactly. I finished university and by chance I read an interview with Dr Pere Barri, of the Clínica Dexeus, which said they were doing inseminations, and I thought: this is an emerging field and it might be good to get involved in it.
So, is it true that it all began when you read an interview in the Ser Padres magazine?
After reading it, I made some enquiries until I managed to talk to Dr Barri to offer him my services. I realised that I did not have a lot to offer: I had just graduated in biology, and was rather short on medical training. He was very kind, but could not initially offer me a great deal because he had no consolidated project. But that was where it all began.
Do you have a family background in the research world?
Not at all. My father was in advertising; he had worked in the automotive industry and in motor journalism. There was no kind of scientific or medical or biological tradition.
What part of Barcelona is your family from?
My grandparents and mother left Gran Via during the Civil War and took refuge in Pedralbes in a house the family had used as a summer residence. I was brought up there and then lived in different neighbourhoods of Barcelona, but after some time I returned to the same house in Pedralbes.
Had the house and the neighbourhood changed a lot?
Obviously the area had changed a little, but the house is the same. I like going back to the neighbourhood where I had always lived, and life is good there.
Scientific Barcelona has undergone some major transformations since your student days…
We have made a lot of progress, we have raised our game. We realised that if a country wants to evolve it has to progress scientifically. It needs all the necessary resources and tools for this to be so. Centres were set up, such as the Barcelona Biomedical Research Park, where the Centre of Regenerative Medicine, where I am employed, is located. At that time science was growing steadily.
And now how do you see the present and the future?
We are a bit apprehensive because the situation is terrible and dramatic. There are cutbacks everywhere, and we have also been hit. The thing with research is that it takes a lot for countries to reach a good level but on the other hand it is very easy to lose that level. It is hard to recover growth. There are many other countries with problems that strive to preserve their research in order to guarantee progress in the medium and long term. Barcelona and Catalonia in general had managed to attract top-level scientists, and not only because of our nice climate – which is true – but also because we have a good scientific level. It is difficult, but we have to make an effort to carry on and keep scientific projects on course.
Going back to your professional career, what is the most memorable part of the birth of Victòria Anna, the first baby born by in vitro fertilisation in the Spanish state, largely thanks to your work?
On the subject of the name and the date, on 12 July – more specifically 1984 –, you say that it was your own personal Victòria, or Victory, Day.
Absolutely. It was a truly exciting day. They were very special moments because everything was new, because we knew that new paths were being opened up to solve fertility problems that affect many people… Moreover, that child’s birth showed that we were on the right track and that the technique worked.
The good memories are always the ones that last, but success did not come easy…
It was hard, but no more so than it was for other groups at the time. Remember that back then it was very difficult to get training in this specialty, to learn how the techniques worked. Now there are master’s programmes and training courses that make things very easy.
Sometimes memory erases negative feelings. In the 1980s there were also groups and people opposed to IVF, albeit a minority.
To tell you the truth, those movements were small and did not really bother us. Most people were delighted with the work we were doing. The real problems were different, such as the times when the technical side of things didn’t work out the way we expected…
Could you elaborate on this specific case you have in mind?
I’m referring to the first pregnancy our team achieved with in vitro fertilisation. The pregnancy test was positive but the ultrasound showed that the embryo had not been implanted in the uterine cavity, but rather in the Fallopian tube, so the pregnancy could not go ahead. It was just one week before Dolors, Victòria’s mother, had a positive pregnancy test.
Did you have the feeling that there were teams competing with you?
It wasn’t a feeling, it was a fact. There was a great deal of competition between two groups: ours and the team led by Dr Marina, also in Barcelona. We knew perfectly well that they were doing exactly the same as us. It really was a race.
Why did you decide to expand your professional career into stem cell research?
Things are sometimes a product of many twists of fate, or a convergence of different circumstances. I was lucky to meet Juan Carlos Izpusúa [director of the Centre of Regenerative Medicine in Barcelona ever since its foundation]; at that time, the law provided for the possibility of doing research with embryonic stem cells, and resources were being invested in this specialty… I found myself on a path that was leading me to get involved in this area, and I didn’t have a moment’s hesitation. It was a privilege to make the leap into this new field, although I have never left behind assisted reproduction, and the proof of that is that I chair the European Society, although it is a non-professional position.
Moreover, you are still linked to the Institut Dexeus…
Yes, I’m the scientific director of the Reproductive Medicine Department at the Institut Dexeus.
What work is being done by the Stem Cell Bank you manage?
We started out with embryonic stem cells. We signed agreements with different assisted reproduction centres that provided us with embryos that couples no longer wanted for reproduction and used them to harvest stem cells. This led us to different cell lines that are duly recorded and can be made available to researchers who request them. The methodology known as IPS [Induced Pluripotent Stem] cells subsequently appeared, which allows us to obtain cells that are very similar to embryonic cells, but without using embryos.
IPS cells were described internationally between 2006 and 2007…
Yes. Our group published a scientific study in 2008 in which we explained a technique for creating IPS cells. In summary, the idea consists of using any cell, from the skin, for example, to make it go backwards in its programming and turn it into an embryo-like cell, with the capacity to become any other body cell.
Are you still working in these fields?
Yes; moreover, we are working to take a direct leap from one cell type to another. We directly convert a skin cell to a neuron. This summer, a major international scientific journal published a study led by a researcher from the Centre de Medicina Regenerativa de Barcelona, which explains how umbilical cord cells have been turned into neurons.
Could this type of work be useful in neurodegenerative diseases such as Parkinson’s or Alzheimer’s?
In the long term, yes. At this moment in time there are only two clinical trials in the world with embryonic stem cells, not with IPS cells, and both projects are related to macular degeneration diseases. For example, in one of the studies, embryonic stem cells are converted into retinal precursors, and these new cells are injected into people with this problem in the retina that is making them go blind.
Wasn’t there another clinical trial being conducted with embryonic cells to restore spinal cord function?
It took many years to get this trial approved, and it eventually got under way. Afterwards, however, when the first phase of the work had begun with two patients, the company in charge decided to stop the project and focus on cancer programmes.
Are the IPS cells an alternative to embryonic stem cells because they avoid the use of embryos?
Most of the people working in this field have a clear understanding of the ethical level of our work. IPS cells are fashionable because use of them it is a new methodology and they are an excellent model for understanding how things work. Perhaps too much attention is being paid to IPS, but we must not forget that the pluripotency standard of cells lies in the embryonic cells.
Victòria’s scientific “mother”
Anna Veiga Lluch was born in Barcelona in 1956 and graduated with a biology degree from the Autonomous University of Barcelona (1979), where she also completed her cum laude PhD (1991). Shortly after finishing her degree she started to collaborate with Dr Pere Barri’s team at the Clínica Dexeus, and in July 1984 she became the scientific mother of Victòria Anna, the first child born in the Spanish state thanks to in vitro fertilisation. She was founder and chairperson (1993 – 2003) of the Spanish Embryologist Society and director of the IVF laboratory at the Institut Universitari Dexeus (1982 – 2004), an organisation she is still linked to as scientific director of the Reproductive Medicine Department (since 2005). Anna Veiga has been an adjunct lecturer in the Department of Experimental and Health Sciences at the Universitat Pompeu Fabra since 2002, and is a coordinator of the Master’s in Reproductive Biology at the Universitat Autònoma de Barcelona. She has received some 20 awards and social and academic distinctions, including the Creu de Sant Jordi (2004) and the Premi Nacional de Pensament i Cultura Científica [National Award for Scientific Thought and Culture] (2006) for her contribution to the dissemination and consolidation of scientific progress, particularly in the sphere of biomedicine. Anna Veiga has been the director of the Stem Cell Bank of the Centre de Medicina Regenerativa de Barcelona since 2005 and chairperson of the European Society of Human Reproduction and Embryology since the summer of 2011.