A Unique Institute
Interview Directors Amsterdam Reproduction & Development – Annual Report 2017
Amsterdam focuses on reproduction and development with its very own institute. An exceptional centre in the Netherlands that ensures cross-pollination, top publications, talent development, and above all: relevant research in its field.
“In 2017 we continued to build on our research institute,” says Christianne de Groot, who forms the managing board of Amsterdam Reproduction & Development (AR&D) together with Sjoerd Repping. “What’s unique about it,” she continues, “is that we pay attention to reproduction and development in its totality: the stage before pregnancy, conception, pregnancy, childbirth, the child as it’s growing up, and the resulting health of the adult stages of life. After a good start of our institute, we’ve already expanded our network. People know each other better, we have achieved a number of top publications, including papers in Science and the New England Journal of Medicine, and were able to award several attractive grants.”
“Our subject is of great social importance,” adds colleague Sjoerd Repping. “All hospitals investigate cancer, infections, and cardiovascular diseases, which are all very significant health problems. In general, the development of a child during its infancy, including the time before birth, is not a priority in most academic hospitals but that’s exactly what we find very important here in Amsterdam. We know there are factors of influence early on in life or even before that, that can have a tremendous impact on a child’s development. That’s why it’s so wonderful that we’ve been able to create an institute with which we also contribute to the current debates in society. How can you guide a pregnant woman through the different choices that exist with all of their advantages and disadvantages? And what are our thoughts on reproduction in general in the Netherlands? How far can you go with genetics? Should you offer a pre-conception test or not? These are all very relevant issues.”
Research into reproduction and development was already being conducted before this institute saw the light of day. What are the advantages of a dedicated institute?
Christianne de Groot: “All people involved in this subject can now find each other more easily. Connections are tightened. People in the lab, people from clinical genetics and gynaecology, pediatricians, and all sub-specialties encounter each other much more often.” AR&D organizes symposia and awards grants to innovative research with a competition model. “We encourage young talent as well, for example by giving them a travel grant,” according to De Groot.
At the start of AR&D, a speed date meeting immediately led to cross-fertilization. “About a hundred researchers, many of whom did not know each other, were able to exchange their ideas in five minutes,” says Repping. “Great ideas for further research came about here. For example, a gynecologist was dealing with a question that could be answered with the help of a model of an anatomist. As a specialist, you’re focused on your own subject. Tunnel vision is lurking. A fresh pair of eyes from someone from another discipline can help in such cases. And it’s important to be receptive. A biologist who is willing to come up with that clinical intervention and a doctor who is willing to understand how it works on a molecular level. That’s what an academic hospital stands for: innovating research and, as a consequence, improving the health of the population as a whole.” The institute focuses on innovation and excellence in fundamental, translational, and clinical evaluation research, as well as research into nursing. Repping: “We want to understand why people are healthy or sick, but also translate this into the healthcare system. So we can improve healthcare as much as possible with research.”
And with education. Developing a 3D atlas of a growing embryo is a great example here. De Groot: “In the atlas of our formal doctoral student and now staff member Bernadette de Bakker, you can see the precise development of each organ of a fetus from day to day. Medics who work with ultrasound images are immensely helped by this. Using the atlas, they can better interpret how organs are developing. This allows them to easily judge whether something is going wrong in the development of an embryo when they’re evaluating ultrasound scans.”
Repping: “Such 3D reconstructions are perfect for educational purposes of course. And this way our research strengthens what we’re here for even more: providing care and educating new talent.”
Much of the research by AR&D has a social impact and this will become increasingly important in our changing society. “Our research into psychosocial counseling of people who become pregnant with donor gametes showed that there is a great need for long-term support, both for parents, child, and donor,” Repping illustrates. “The government picks it up and invests in a national information point for each of them. That’s wonderful.”
AR&D first identifies changes and then conducts research matching those new findings, needs, and questions. “We are now investigating whether we can offer high-tech surrogacy to homosexual male couples,” says Christianne de Groot. “This was not negotiable fifteen years ago. Now we state: the question has arisen, we will not answer it as physicians, but involve policymakers and instigate a public debate.”
Gender dysphoria, the deep sense of discomfort that people experience when birth gender and gender identity do not match, is another such example. Repping: “Interestingly, pediatrics is increasingly involved. This problem used to occur mostly at adult age, while the realization that one is in the wrong body occurs much earlier and is still more open for discussion then. Psychology plays an enormous role here. How do you deal with this situation as a person? And there is also a reproductive aspect. Suppose you are a woman and you want to become a man. Can you still have children and how do you do that? Do you keep the uterus or not, do you freeze your egg cells, and what are your options?” This example confirms the importance of an institute that investigates the circle of life and involves all possible of disciplines.
“We will facilitate more meetings in the coming years so that employees can find each other more and more easily and can truly experience this institute as a single entity,” says De Groot.
Repping: “We aim to present ourselves as an institute to the government, grant providers, and European partners as well. Sharing that we have a discipline-transcending platform here in Amsterdam, where we can study many social issues. With the ultimate goal of contributing to the improvement of reproductive and child health.”