Introduction
On 25 July 2008, Louise Brown, the world's first person to be born from in vitro fertilization (IVF), turned 30. In January 2007, she had given birth to a healthy son, Cameron Mullider. The original pioneering work of Robert Edwards and Patrick Steptoe 30 years ago started the age of assisted reproduction technology in Europe and the rest of the world. It is now estimated that more than 3 million babies have since been conceived through IVF or intracytoplasmic sperm injection worldwide.
However, IVF does not always work, and, quite often, success is only obtained after several attempts. Moreover, even though the policy of single-embryo transfer seems to be successful in places where it has been implemented (such as Belgium), multiple-embryo transfer is still the rule in many countries, carrying the risk of post-IVF morbidity—intrauterine growth retardation (IUGR) and preterm birth—not to mention the economic costs of multiple IVF cycles and the psychological stress imposed on the mother.
Thus, selection of 'good' embryos and full understanding of the implantation window and uterine preparation for implantation, of uterine-embryo crosstalk and early trophoblast invasion and of the events with which these processes are associated are still important scientific targets, as is the elucidation of the causes of male infertility. For Europe, the importance of these objectives is underscored by the fact that infertility affects approximately one out of six couples there1. Indeed, both female1, 2 and male2 fertility seem to be decaying in Europe and North America.
In addition, reproductive pathology is not limited to infertility—IUGR, premature delivery and low birth weight remain important problems. Furthermore, there is no mechanism-based therapy for preeclampsia, a disease that continues to be a major cause of death of women of reproductive age in developing countries—around 76,000 deaths per year3. Lastly, endometriosis is estimated to affect the lives of 10–15% of women4.
Since the birth of Louise Brown, there has been an explosion of research in the field of reproductive biology. In Europe, for example, if one compares the initial attendance at the first meeting of the European Society for Human Reproduction and Embryology (ESHRE) in Bonn in 1985 (500 researchers) to the attendance at the ESHRE meeting in Barcelona this year (6,532 delegates), it is easy to notice the growth of the field. In addition, the fact that there were 752 exhibitors and 85 journalists at the meeting illustrates that there is a huge market for reproductive research–related products, as well as substantial interest from the media in this topic.
Similarly, research on animal reproduction has made very important progress over the past few years. Aside from evident economic gains (for example, reducing fetal loss and increasing litter size are of marked interest for livestock breeders), research in animals also offers key data that may be of importance for human reproduction.
Because research into both animal and human reproductive biology has such widespread implications, it is pertinent to wonder whether it is adequately funded. Here I argue that in Europe the funds for research in this field are scarce, making it necessary to give it a higher priority than it has so far enjoyed.
Research funds from the European Economic Community (EEC)
As a consequence of the growing social and scientific interest on reproduction, in February 2008 the European Parliament issued a recommendation that research on reproduction should become a priority for the life sciences. Unfortunately, this is far from being the current case, especially when one considers EEC funding.
EEC science funding is budgeted as part of broad Framework Programmes (FPs). FP7, the current program, was launched in 2007 and represents a considerable step forward from its predecessor, with a budget of 
53 billion for its seven-year lifespan—a 40% increase over FP6.
Both FP6 and FP7 have allocated funds mainly through three instruments (Box 1): networks of excellence (NoEs), integrated projects and specific targeted research projects (STREPs). How has research on reproductive biology and medicine fared under each of these instruments? The balance sheet, unfortunately, is quick to draw.
To the best of my knowledge, there is only one fertility-related NoE funded by the EEC—the Embryo Implantation Control (EMBIC) network (http://www.embic.org/), of which I am the coordinator.
The funding for EMBIC is fortunately not negligible: 7.5 million for four years, with an initial membership of 16 laboratories (that has now been extended to 21), one small company and an administrative body. This level of funding has certainly allowed EMBIC partners to markedly increase their productivity and visibility in the discipline—largely, though not exclusively, with work related to the immunology of reproduction. EMBIC has also organized a yearly summer school that has been regularly attended by over 100 students from all over Europe, South America, Asia and other regions, underscoring the interest from young scientists in the field of reproduction.
The key success of EMBIC is that it has brought together for the first time a group of European researchers who previously worked in isolation, often competing with each other, enabling them now to share ideas, techniques, reagents and students in an unprecedented way, thus making European reproductive research more competitive worldwide.
In addition to EMBIC, although it is not focused on reproduction per se, there is a second NoE worth mentioning—Special Non-Invasive Advances in Fetal and Neonatal Evaluation—focused on noninvasive prenatal diagnosis. Also, there exists another important network—Fruitful1—that merits discussion, as it highlights some of the limitations of the funding structures at European level.
When Fruitful was created, it was thought that this network and EMBIC could merge. But one of the major criticisms aimed at many NoEs has been that networks that are too large result in a loss of efficiency5. As a result, Fruitful and EMBIC had to compete to become the single European NoE working on reproductive biology. Given the importance of the field, it is quite unfortunate that only one network had to be selected. It is also a pity that Fruitful was not considered for other integrated projects or STREPs that could provide funds for research on other key aspects of reproductive biology that this network is exploring.
In terms of integrated projects, STREPS and other funding instruments, it is important to mention ReproTect, an integrated project on the toxicology of reproduction. Also, I am aware of only two projects on preeclampsia, a STREP called Pregenesys, aimed at exploring noninvasive diagnostic biomarkers, and (completed) Marie Curie Action. As far as Cooperation in the field of Scientific and Technical Research actions (Box 1) are concerned, there is a project called Gemini (Maternal Interaction With Gametes and Embryos) that will hold its first meeting soon, but I know of no research projects on endometriosis that receive European funds—a search on the website of the European Community Research and Development Information Service (CORDIS; http://cordis.europa.eu) yields zero projects. The few other programs one can find in CORDIS are dedicated to animal reproduction.
At the end of this part of the discussion, private research funds also deserve mention. Support by pharmaceutical industries constitutes a funding opportunity for researchers in the area of reproduction in countries such as Germany and France. These funds are usually available as either an investigator-led trial (under the direction of a principal leading investigator on a given topic) or as part of a clinical study initiated by the sponsor, therefore limiting the freedom of the researchers in terms of what they want to investigate. Even so, because of the recent discovery of a number of potential biomarkers for pre-eclampsia6, there has been an increase in the interest by diagnostic companies in this area, increasing the availability of research funds.
What can be done?
As a whole, it seems that, although solutions are emerging from basic research for problems such as infertility, preeclampsia and endometriosis, and although public interest in reproductive biology is growing, research in the field is not funded at a level commensurate with its economic and social impact. Furthermore, more time is spent in political spheres trying to answer ethical questions about the limitations of stem cell research rather than on supporting research on reproduction.
This is regrettable, as the stakes are high and the success of networks such as EMBIC or centers such as the IVF Unit in Valencia, Spain, show that appropriate funding in reproductive research produces excellent results. There undoubtedly exists a pool of first-rate European scientists working in the clinic and in human and animal research. Without undermining the outstanding and dedicated job performed by the scientific officers who have taken care of EMBIC, it is my opinion that this pool of researchers deserves more attention and support than it currently receives.
Even though reproductive research was listed as a priority of the European Parliament, such a commitment has not yet been translated into research funds. Indeed, there is no specific area of research devoted to reproduction in the life sciences, genomics and biotechnology for health in FP6 or FP7.
In my opinion, this is partly related to the small size of the reproduction field compared to disciplines such as, say, immunology. Moreover, the size of a field tends to be reflected in the impact factors of the journals of that field—the smaller the readers' pool, the less likely it is that a journal will have a large impact factor—and impact continues to be one of the relevant criteria when allocating research funds. But this is a vicious circle. If the field is not properly funded and identified as a priority, it will remain relatively small, and it will be easier for people like me to obtain funds for our work on cytokines in the uterus and placenta through an immunology rather than reproduction grant application.
Through its summer school, EMBIC is trying to enlarge the pool of young scientists in the field of reproduction, but this is far from sufficient. In my view, research on reproduction has to be identified as a priority at both the national and the European levels and should be funded accordingly. Moreover, it must be emphasized to policymakers that research in reproduction has clear potential to pay for itself by reaching the clinic. Imagine, for example, the savings in assisted reproduction costs if it were possible to have a successful IVF cycle transferring a single embryo in a single attempt.
In conclusion, only when the appropriate level of support is reached will the field finally meet the needs of clinicians and the general public. What it needs is to translate public and political interest and awareness into appropriate public and private funding.
