Women's health, including reproductive biology and medicine, is not a research priority on the Belgian agenda, in contrast with health issues such as cancer and in contrast with the US situation, in which a specific US National Institutes of Health branch—the National Institute of Child Health and Development—attends to this topic. This situation is at odds with the fact that infertility affects one in eight couples globally and the recognition that assisted reproductive technologies are a key part of national strategies addressing demographic and reproductive challenges.

Belgian researchers applying for European research funding in reproductive biology are faced with the fact that neither the EU FP6 nor the EU FP7 health research program included a specific call for research projects in their field, making it necessary for them to apply for more highly competitive research categories. Our group, for example, is a partner in the European Network for Endometriosis, supported by the first-ever endometriosis grant provided by the EU Public Health Work Plan in 2006.

Individual research groups can apply for investigator-initiated grants to pharmaceutical companies, but research topics likely to be funded are often limited to the primary interests of these companies. I hold the Merck Serono Chair of Reproductive Medicine at Leuven University (2005–2010) and have received yearly funding (€60,000 per year) from Merck Serono Belgium to do research without any involvement of the company. But this situation is the exception rather than the rule.

Within Belgium, Flanders has recently increased its investment in research and development, but, again, reproductive biology is not a clearly labeled research priority. Moreover, reproductive biology funding from charities is also absent. So, as in the case of European grants, researchers in reproductive biology need to apply in more general categories for research funding (€300,000–500,000 for a four-year research grant and €150,000 over four years as salary stipend for a PhD student) to the two main public funding agencies in Belgium—the Fund for Scientific Research (FWO) and the Institute for Science and Technology.

Even if one is lucky enough to secure national funds, continuity may be a problem. For example, for the past 10 years I have received a FWO grant as principle clinical investigator (€50,000 per year) that has allowed me to devote 50% of my time to research in endometriosis, half-time away from the clinic. However, at the end of the grant period, I may have to go back to clinical medicine full time at the expense of the 12 PhD students working under my supervision.

Finally, in Leuven University and its affiliated hospitals, it is possible for clinical investigators to apply for a variety of grants and awards (four-year research grant for established scientists ranging between €200,000 and €600,000), but the competition is increasingly tough for translational research. And the Flemish Institute for Biotechnology, an excellent but highly selective interuniversity research platform, does not have a research line in reproductive biology and medicine.

In my view, the only way that reproductive medicine and biology can be identified as a high-priority research area on a university level is by creating a large research group on the basis of increased internal collaboration among smaller groups as well as with strong groups in the areas of human genetics, transgenesis and systems biology techniques. Furthermore, active lobbying is needed to give higher priority to women's health and reproductive biology at both the national and European levels.