scholarly journals Analysis of costs and results of assisted reproductive technologies in the world and Ukraine

2018 ◽  
pp. 32-40
Author(s):  
Kh.-O. J. Stasiv ◽  
O. M. Zaliska
Keyword(s):  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
State Funding ◽  
Art Programs ◽  
Demographic Situation ◽  
Urgent Task ◽  
The World ◽  
The Usa ◽  
Number Of Cycles ◽  
The Cost

Taking into account the demographic situation in Ukraine, the use of assisted reproductive technologies (ART) is an urgent task for increasing access to modern, expensive methods of infertility treatment. The aim of this study was to summarize the legislative requirements for the implementation of ART, the number of cycles, depending on the type, and the costs for ART in the leading countries of the world and in Ukraine. We showed, that most countries in Europe have budgetary financing for a certain number of cycles, while the medical restrictions and age requirements for parents are included. It was revealed that the highest costs for ART are in the USA, the lowest in Japan and Scandinavian countries. We calculated the rate of provision for IVF and ICSI cycles per 1 million population (Kart) and the countries were ranked into 3 groups. It was shown that Ukraine belongs to countries with a low indicator ‒ less than 500 cycles. Leading countries of Europe, which have government funding for ART (France, Germany, Sweden), are characterized by a high Kart. The need to increase budgetary financing for ART in Ukraine is shown. The cost analysis for ART according to official websites of private clinics was conducted in Ukraine. We established that the average cost per 1 cycle of IVF was 52 584 UAH, for 1 cycle of ICSI was 6 694 UAH. The calculated solvency adequacy ratio for IVF was 703, it indicates a low availability for the population, and for ICSI is 89, which in 7.9 more affordable for families. It was found that in 7 clinics there are no Internet pages, and on the websites of 12 clinics information on the cost of services is shown, without taking into account the use of drugs in the protocols of ART. According to the different approaches to informing on websites of the ART clinics, it is advisable to unify the information providing on the sites about the availability of cycles and the total costs for them to improve provision and access for patients. Therefore, it is important to increase the state funding for ART programs.

scholarly journals Assessment of availability of assisted reproductive technologies in Ukraine and the world

2020 ◽  
pp. 49-59
Author(s):  
O. M. Zaliska ◽  
К.-О. Ya. Stasiv ◽  
N. M. Maksymovych
Keyword(s):  
System Analysis ◽  
Family Income ◽  
Assisted Reproductive Technologies ◽  
Analysis Data ◽  
Reproductive Technologies ◽  
The State ◽  
State Funding ◽  
European Countries ◽  
The World ◽  
The Cost

In Ukraine, in order to achieve the Sustainable Development Goals, the State Strategy for the Implementation of the State Policy for the Provision of the Population with Medicines for the Period until 2025 has been approved, which includes improving the availability of drugs to improve the quality of life. Assisted Reproductive Technologies (ART) are gaining widespread implementation and funding from the budget in the world. Goal – the aim of the work was to analyze the state and dynamics of ART cycles in Ukraine for 1999–2019 and to estimate the cost of ART in Ukraine and to develop a methodology for estimating the availability of ART and comparison with European countries. Materials – international and domestic publications on the assessment of the availability of drugs, the cost of ART. Research methods: system analysis, data synthesis and generalization of information, webometric analysis, statistical analysis of data on the number of ART cycles for 1999-2018, analysis of ART costs. It is determined that the indicator of the number of ART cycles per 1 million population increased 29.9 times for 1999–2018, which is due to the increase in the number of ART centers conducted ART cycles in relation to the decrease in the population of Ukraine. It was found that 85% of ART centers are concentrated in only 4 cities (Kyiv, Lviv, Odessa, Kharkiv), which reduces the accessibility of the population to ART cycles, especially in the conditions of quarantine and pandemic COVID-19. It was found that in 1999–2018 the number of ART centers increased 7.7 times, but only 10.8% of ART centers have state funding, which indicates the low availability of ART for budget funds. It was found that the structure of ART cycles changed significantly. The average costs for the most common ART cycles IVF and ICSI in Ukraine as of the end of 2019 have been determined. It has been shown that only 26% of ART centers provide information on the cost of ART cycles, and web pages need to be filled with information on the cost of ART cycles to ensure that patients are properly informed. It is shown that in Ukraine as of 2020 the costs of ART cycles are 24 425–30 516 UAH (917,25–1 010,57 Euro) depending on the type of cycle from the perspective of the payer. It is estimated that the availability of ART is 1.5–9.98 depending on the type of ART cycle, the cost of ART cycles is 6–10 times higher than the average family income, when in European countries the availability of ART is much lower 1,5–4.2, which showed higher availability of ART in European countries from payer prospect.

Genetic polymorphisms of reproductive hormones and their receptors in assisted reproduction technology for patients with polycystic ovary syndrome

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Yulia A. Koloda ◽  
Yulia V. Denisova ◽  
Natalia M. Podzolkova
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Assisted Reproductive Technologies ◽  
Polycystic Ovary ◽  
Ovarian Response ◽  
Reproductive Technologies ◽  
Reproductive Hormones ◽  
Current Data ◽  
Nucleotide Polymorphisms ◽  
Ovary Syndrome ◽  
Art Programs

Abstract Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women of childbearing, which is defined by the accumulation of multiple, small fluid-filled ovarian cysts without the selection of a single dominant follicle. Most PCOS phenotypes are characterized by the absence of spontaneous ovulation, resistance toward ovulation inductors, the production of a large immature oocytes number, and the high prevalence of ovarian hyperstimulation syndrome, resulting in reduced assisted reproductive technologies (ART) programs effectiveness. The review analyses current data about the relationship between polymorphism genotypes of KISS genes, follicle stimulating hormone (FSH), luteinizing hormone (LH), anti-Müllerian hormone (AMH) and their receptors genes, gonadotropin-releasing hormone (GnRH), estrogen, and progesterone receptors genes, the PCOS risk and the features of ovarian response to stimulation during ART cycles. The use of single nucleotide polymorphisms (SNPs) as prognostic markers of ART programs outcomes would provide a personalized approach to the drugs and doses choice for ovarian stimulation and significantly increase the chance of pregnancy.

The birth of a healthy child in the assisted reproductive technologies program after autologous co-culture of embryo with cumulus cells and a new CAT transfer technology. Case report

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (3) ◽  
pp. 270-274
Author(s):  
Gunai R. Asfarova ◽  
Veronika I. Smol'nikova ◽  
Natalia P. Makarova ◽  
Iuliia S. Drapkina ◽  
Anastasiia P. Sysoeva ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Healthy Child ◽  
Assisted Reproductive Technologies ◽  
Cumulus Cells ◽  
Reproductive Technologies ◽  
Biologically Active ◽  
Human Embryos ◽  
Implantation Failure ◽  
Recurrent Implantation Failure ◽  
Art Programs

Cumulus cells are essential during oocytes growth and development, as well as during their maturation and fertilization. Research results have shown that embryo co-cultivation with autologous cumulus cells increases the frequency of blastocyst formation, and also improves the effectiveness of ART programs. Embryo transfer in such programs is recommended to be carried out using the CAT technology (Cumulus-Aided embryo Transfer), which includes embryo cultivation on a layer of cumulus cells and embryo transfer with a certain amount of diluted cumulus cells. Patient G., 38 years old, came to the department with infertility for 15 years and recurrent implantation failure in history. The patient had ART program with autologous co-cultivation of embryos with cumulus cells and a new CAT transfer technology. The patient fell pregnant and gave birth to a healthy child. Autologous cumulus cells can be a source of biologically active substances and improve embryological parameters and implantation rate in ART programs. Embryo co-cultivation with cumulus cells is especially important for patients with recurrent implantation failure. This technique can become an alternative for optimizing human embryos culturing.

scholarly journals INFLUENCE ON THE OUTCOME OF ART PROGRAMS OF FROZEN-THAWED BLASTOCYSTS EXPANDED ON FIVE OR SIX DAY

2021 ◽  
pp. 68-75
Author(s):  
A.O. Polumiskova ◽  
S.I. Tevkin ◽  
T.M. Jussubaliyeva ◽  
M.S. Shishimorova
Keyword(s):  
Pregnancy Rate ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Miscarriage Rate ◽  
Art Programs ◽  
Group A ◽  
The Difference ◽  
Group B

In order to increase the effectiveness of assisted reproductive technologies (ART) programs, it is essential to improve and develop conditions of embryo culture prior its transfer or cryopreservation of expanded blastocysts on the day 5 or 6. The aim of the study was to assess the effect of human blastocysts’ expansion timing on clinical pregnancy rate (CPR), miscarriage rate (MR) and take-home baby rate (THBR) in frozen-thawed cycles during ART programs. The study involved 2275 frozen embryo transfers (FET) of blastocysts expanded on the day 5 (group A) and 170 FET of blastocysts expanded on the day 6 (group B). The pregnancy rates in both groups were 50.8% and 46.5% respectively. There were no statistically significant differences in clinical pregnancy rate 37.4% and 37.0%, miscarriage rate 26.0% and 21.5% in both groups, respectively. THBR, as the main indicator of efficiency in the programs with transfer of post thawed expanded blastocysts on the day 5 (group A) or 6 (group B) were 36.5% and 35.2%, respectively (the difference is insignificant). In conclusion, in cryoprotocols the day of blastocyst expansion (day 5 or 6 of development) does not statistically affect PR, MR and THBR. In FET programs the quality of blastocyst (excellent and good) should be prioritized regardless of the day of cryopreservation.

Assisted Reproductive Technology in Spain: Considering Women's Interests

2009 ◽  
Vol 18 (3) ◽  
pp. 228-235 ◽  
Author(s):  
INMACULADA DE MELO-MARTÍN
Keyword(s):  
Assisted Reproductive Technology ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Reproductive Technology ◽  
Assisted Conception ◽  
National Healthcare ◽  
The World ◽  
National Healthcare System ◽  
The Subject ◽  
Catholic Tradition

It might come as a surprise to many that Spain, a country with a strong Catholic tradition that officially banned contraceptive technologies until 1978, has some of the most liberal regulations in assisted reproduction in the world. Law No. 35/1988 was one of the first and most detailed acts of legislation undertaken on the subject of assisted-conception procedures. Indeed, not only did the law permit research on nonviable embryos, it made assisted reproductive technologies available to any woman, whether married or not, through the national healthcare system.

scholarly journals Gender Differences in the Experience of Infertility Concerning Polish Couples: Preliminary Research

2019 ◽  
Vol 16 (13) ◽  
pp. 2337 ◽  
Author(s):  
Małgorzata Nagórska ◽  
Anna Bartosiewicz ◽  
Bogdan Obrzut ◽  
Dorota Darmochwał-Kolarz
Keyword(s):  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Clinical Pregnancy ◽  
World Health ◽  
Independence Test ◽  
Chi Square ◽  
Unprotected Sexual Intercourse ◽  
The World ◽  
Preliminary Research ◽  
Health Organization

The World Health Organization (WHO) determines infertility as a disease of the reproductive system defined clinically by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Estimates indicate that the problem of infertility in the world is continuing to grow. The aim of the study was to compare approaches to disease in partners of both sexes diagnosed with infertility. The study was conducted among 61 couples treated for infertility using an original questionnaire developed by the authors. The Chi square independence test was used for statistical analysis. Both men and women responded to the diagnosis of infertility with negative emotions. Regardless of sex, sadness and anxiety were the dominant feelings associated with the diagnosis of infertility. Women believed in the success of the treatment to a greater extent than men. Mainly women attempted to talk openly about the problem of infertility, while men were more restrained in this respect. Women accepted the assisted reproductive technologies (ART) to a greater extent than men, but men would accept childlessness more often than women.

Effectiveness and outcomes of embryo cryopreservation programs in assisted reproductive technologies

2014 ◽  
Vol 63 (4) ◽  
pp. 39-46 ◽  
Author(s):  
Yana Nikolayevna Kravchuk ◽  
Alla Stanislavovna Kalugina ◽  
Olga Vladimirovna Bystrova ◽  
Svetlana Aleksandrovna Shlykova
Keyword(s):  
Embryo Transfer ◽  
Assisted Reproductive Technologies ◽  
Negative Impact ◽  
Perinatal Outcomes ◽  
Reproductive Technologies ◽  
Embryo Cryopreservation ◽  
Control Group ◽  
Fresh Embryo Transfer ◽  
Art Programs ◽  
Thawed Embryo Transfer

Background. Embryo cryopreservation is an essential part of ART programs today. In recent years vitrification method is used increasingly widely. Purposes and tasks. To compare the effectiveness of ART programs using vitrified and fresh embryos, as well as different endometrial preparation regimes for frozen\thawed embryo transfer (modified natural cycle (MNC) and the preparatory hormone therapy(PHT)). To analyze the course of pregnancy and perinatal outcomes after vitrified embryo transfer. Materials and methods. We prospectively assessed the ART programs effectiveness and perinatal outcomes in 153 patients (I group), who underwent vitrified embryo transfer in 2011-2013 year. To prepare the endometrium for thawed embryo transfer in 83 patients PHT (Ia subgroup) and MNC in 70 patients (Ib subgroup) were used. Control group consisted of 70 patients, who underwent fresh embryo transfer. Results. The clinical pregnancy rate, birth rate and “take home baby” rate were not significantly different between the I (47,5 %; 30,9 %; 30,9 %) and II (53,0 %; 34,9 %; 32,5 %) groups, and between Ia (48,3 %; 28,4 %; 28,4 %) and IIb (46,6 %; 34,1 %; 34,1 %) subgroups. Complications during pregnancy and delivery, birthweight, length, Apgar score, congenital malformation rate did not differ significantly after vitrified and fresh embryo transfer. Conclusion. Vitrification is an effective method to achieve clinical results, comparable to native cycles. Application of PHT and MNC results in similar clinical outcomes. Transfer Vitrified embryo transfer does not have a negative impact on obstetric and perinatal outcomes when compared with native cycles.

scholarly journals A comparison of NGS and FISH technologies: comprehensive 24-chromosome screening of embryo

1970 ◽  
Vol 21 ◽  
pp. 311-315
Author(s):  
Yu. V. Gontar ◽  
O. Yu. Verlynskyi ◽  
A. Kyrpyi ◽  
I. E. Ylyn ◽  
A. M. Fedota
Keyword(s):  
Preimplantation Genetic Diagnosis ◽  
Assisted Reproductive Technologies ◽  
Genetic Diagnosis ◽  
Reproductive Technologies ◽  
The Other ◽  
Preimplantation Embryos ◽  
Art Programs ◽  
Chromosomal Aneuploidy ◽  
Investigation Methods

Aim. Optimization of the algorithm of complex 24 chromosomes screening in programs of assisted reproductive technologies. Methods. Research of non-disjunction chromosomes in preimplantation embryos based on the results of trophectoderm nucleus diagnostics using FISH and NGS-based CCS. During the preimplantation genetic diagnosis (PGD) on the nucleus by FISH were used probes for chromosomes 13, 16, 18, 21, 22, X, Y. Results. Among the demonstrated cases of embryo diagnosis there was only one embryo that showed a coincidence in the results obtained by different investigation methods. In the other sample, where was diagnosed non-mosaic 18 and 22 monosomy by FISH, the NGS-based CCS showed only monosomy 18. The other embryo had ploidy mosaicism indicated by FISH, but according to NGS results it was evaluated as euploid. Conclusions. Embryos obtained in ART programs must be screened for chromosomal aneuploidy in the preimplantation period to increase the effectiveness in the programs of assisted reproductive technologies, using combination of FISH and NGS methods. Keywords: preimplantation genetic diagnosis, assisted reproductive technologies, aneuploid embryos, NGS, FISH.

Effectiveness of programs of auxiliary reproductive technologies in patients of late reproductive age

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (1) ◽  
pp. 109-112 ◽  
Author(s):  
E P Beik ◽  
A G Syrkasheva ◽  
N V Dolgushina
Keyword(s):  
Live Birth ◽  
Assisted Reproductive Technologies ◽  
Laboratory Data ◽  
Age Groups ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Art Programs ◽  
Group 2 ◽  
Twofold Decrease ◽  
Group 1

The aim of the study was to study the effectiveness of assisted reproductive technologies (ART) programs in patients of different age groups, taking into account clinical and laboratory data. Materials and methods. A prospective cohort study included 188 patients with infertility of various genesis who were stratified according to age: group 1 (n=87) - patients of late reproductive age - LRA (>35 years), group 2 (n=101) - patients of early reproductive age (≤35 years). Results. In patients with ART compared with patients with LRA, the chances of pregnancy were reduced by 2.2 times (odds ratio - OR 2.2, 95% confidence interval - CI 1.1-4.3), the chances of live birth were 2 times (OR 2.0; 95% CI 1.0-3.9). The only factor affecting the onset of pregnancy in addition to age was the number of embryos received. The threshold age at which and above which the chances of pregnancy and live birth decreased as much as possible were the age of 37 years: the OR of pregnancy 2.6 (95% CI 1.4-5.1, AUC 61.3%), OR live birth 2.6 (95% CI 1.3-5.1, AUC 60.8%). Conclusions. In patients of LRA there is a twofold decrease in the effectiveness of ART programs due to a significant decrease in the number of oocytes obtained, mature oocytes, and, accordingly, embryos.

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