We interviewed Dr. Dolz and he told us about the current situation of the assisted reproduction. We also talked about the future of the current techniques and other new ones helping to improve the main hindrances of treatments used nowadays.
What has been the trajectory of the assisted reproduction from its beginning until now?
Well, as you know, everything started in the year 1978 when Luis Brown was born; since then, many things have happened making reproduction change and, maybe the most important one is the great amount of children who have been given birth thanks to those techniques. It has changed a lot. It was some time after when I started in this area, and what mainly drew my attention was the existence of a great amount of diagnostic techniques existing but few solutions.
The most important solution was the artificial insemination, and sometimes in vitro fertilisation was carried out as well. It is true that, little by little, assisted reproduction has gradually improved, which has made that virtually less and less diagnostic techniques exist, but there are more and more solutions to the problems. I consider that one as the biggest advance and the biggest change over the last 30 years.
What do you think would be in a future the biggest advance that is still to be made? One step forward in the assisted reproduction.
We still have to progress a lot. There are a number of problems that have to be solved. A very important thing in the field of the pre-implantation genetic diagnosis (PGD) would be having the possibility to study those embryos without hurting them or by optimising those results, because nowadays it is a very efficient technique but not exempt from those mentioned risks.
We have to be aware that what we do is to select an embryo not suffering from the illness, but we are not really treating with such illness. The future would be being able to treat such illness in that embryo.
Other essential advances have come along with the issue of vitrification. Oocyte and embryo vitrification have represented a great improvement. We obtain excellent results and it has opened an essential field to preserve fertility and for patients treated with cancer to have the possibility to keep their eggs for the day they will cure from that illness. This will offer them the possibility to have a baby.
The PGD brings along some ethical and moral problems. What is your opinion about it?
The ideal thing for assisted reproduction not to imply moral problems would be having the possibility to treat that illness with genetic engineering. That would be really the solution accepted by everybody, wouldn’t it?
Currently, that is where we can reach. Now what we can do is to select those embryos not suffering from an illness, and I think that that is a great advance for, at least, that family, because that genetic disorder could be avoided in that moment.
What marked the radical change between past and present of the assisted reproduction? Was it the discovery of any particular technique?
Yes, I think that there has been one technique that has been crucial for the assisted reproduction: the ICSI or intracytoplasmic sperm injection. This technique has allowed the achieving of pregnancies in cases of male severe factor.
Then, we have to think that no longer than 15 years ago, when there were males with sperm under 1 million or 2 millions, the applied treatment was going to an sperm bank to look for a donor, because a baby could not be had by means of in vitro fertilisation. However, nowadays, we have acceptable ranges of pregnancy in very difficult cases where 3, 4 or 5 spermatozoa are obtained.