scholarly journals Effect of inclusion of assisted reproductive technologies in the state health insurance programme in Russia

2020 ◽  
Vol 4 (4) ◽  
pp. 19-42
Author(s):  
Alexandra A. Moskaleva

Assisted reproductive technologies (ART) are an infertility treatment tool. In Russia, more than 250 centers implementing infertility treatment with the help of ART have been opened in 67 regions. In 2014, in vitro fertilization (IVF) was included in the programme of state guarantees, and since 2016 the service can be obtained within the Mandatory Health Insurance (MHI) system. Author of this study analyzes how the impact of economic factors on fertility with the use of ART has changed in relation to the inclusion of IVF in the MHI system, and what social factors affect the usage of this technology. The analysis bases on the panel data for the regions of Russia covering the period from 2011 to 2017. The fixed effects method was used to assess the impact of various factors. The study shows that the population income level has a significant positive impact on the proportion of births with the use of ART even after the inclusion of IVF into the MHI programme. At the same time, the inclusion of IVF in the MHI programme has led to an increase in the proportion of births using ART. The positive effect of this inclusion is higher in wealthier regions. Among social factors, a significant impact has the accessibility of information about the procedure, which is measured by the share of population having access to the Internet.

2020 ◽  
Vol 12 (5) ◽  
pp. 104-110
Author(s):  
N. A. Tyuvina ◽  
A. O. Nikolaevskaya

The paper provides a definition of sexual and reproductive health and infertility and also reflects modern ideas about ways to overcome infertility using assisted reproductive technologies, such as in vitro fertilization (IVF) and surrogacy. It shows the specificity of the impact of an IVF procedure on the mental health of a potential mother. The features of the neonatal health status, as well as neuropsychiatric disorders in babies born using the IVF procedure are described. The authors present two types of surrogacy (traditional and gestational ones) and the features of their use in different countries according to governmental legislative regulation, socioeconomic and religious factors, and cultural traditions in society. They unveil the features of a psychological relationship between the mother (surrogate and presumed one) and the fetus. The consequences of surrogacy for a surrogate mother, genetic parents, and a child himself/herself are noted to be little studied. It is shown that the development of assisted reproductive technologies (IVF and surrogacy), on the one hand, helps fight infertility and, on the other hand, entails a number of problems (moral and ethical, legal, cultural and religious, socioeconomic, and neuropsychiatric ones) that need to be solved in order to prevent psychological, neurological, and mental abnormalities in all the participants (a surrogate mother, an unborn child, and potential parents) in the assisted reproductive process:


2020 ◽  
Vol 69 (4) ◽  
pp. 83-88
Author(s):  
Svetlana S. Paskar ◽  
Alla S. Kalugina ◽  
Anna G. Tkachuk

The expansion of indications for assisted reproductive technology has led to significant implications for assisted reproductive technology (ART) programs worldwide. More than 7 million children in the world were born using ART. Modern clinical practice in the field of reproductive sciences is aimed not only at increasing the effectiveness, but also at the safety of treatment. ART, like any other type of therapy, may be combined with negative side effects. Both the correct prediction of the risks associated with treatment and a personalized approach ensure the absolute safety of infertility treatment using in vitro fertilization. In this regard, over the past decade, a number of new research approaches have been noted that use ART methods integrated into clinical practice: cycle segmentation with subsequent embryo transfer and the elective transfer of one embryo. New approaches provide a control in relation to ovarian stimulation and a reduction in the number of transferred embryos, which helps to minimize primarily adverse perinatal outcomes. Predicting the risks and outcomes of treatment using mathematical modeling is the application of good clinical practice.


2021 ◽  
Vol 11 (2) ◽  
pp. 315-328
Author(s):  
Maryna Petrushko ◽  
Volodymyr Piniaiev ◽  
Taisiia Yurchuk

The birth of children after infertility treatment of married couples with the help of assisted reproductive technologies has become a reality after many years of basic research on the physiology of reproductive system, development of oocyte’s in vitro fertilization methods and cultivation of embryos at pre-implantation stages. Given the widespread use of assisted reproductive technologies in modern medical practice and the great interest of society to this problem, the aim of the study was to trace the main stages and key events of assisted reproductive technologies in the world and in Ukraine, as well as to highlight the activities of outstanding scientists of domestic and world science who were at the origins of the development of this area. The paper used historical methods to study and interpret the texts of primary sources and present scientific historical events. In addition, the current trends in assisted reproductive technologies are covered based on the results of our own, more than 30 years of experience in the field of reproductive biology and medicine, and the achievements of world scientists. As a result of the work, it has been shown that despite certain ethical and social biases, the discovery of individual predecessor scientists became the basis for the efforts of Robert Edwards and Patrick Steptoe to ensure birth of the world's first child, whose conception occurred outside the mother's body. There are also historical facts and unique photos from our own archive, which confirm the fact of the first successful oocyte in vitro fertilization and the birth of a child after the use of assisted reproductive technologies in Ukraine. Over the last 20 years, assisted reproductive technologies have continued to grow, addressing many other issues of reproductive potential preservation and infertility treatment. State of the art methods of assisted reproductive technologies include the development of cryopreservation method of gametes and embryos by vitrification, genetic screening of embryos in order to prevent the hereditary diseases transmission and embryo transfer with chromosomal abnormalities, the birth of a child “from three parents” in severe cases of mutations in the mitochondrial genome, etc.


Author(s):  
Svetlana Dragojevic-Dikic ◽  
Saveta Draganic ◽  
Srdjan Dikic ◽  
Vladimir Pilija

One of the main characteristics of the new millennium is the affirmation of human rights in all aspects of human existence, with the intention of turning declarative statements into reality. Development of up-to-date assisted reproductive technologies (ART) and their application in infertility treatment have raised numerous ethical, legal, religious, social and other questions. In vitro fertilization, donation of gametes, embryos and pre-embryos, cryopreservation of gametes, embryos, ovarian and testicular tissues, embryo transfer, genetic reproductive techniques, cloning and other sophisticated methods used in infertility treatment require cooperation between the medical and legal professions. Ethical aspects of human reproduction and assisted fertilization are based on full respect of the life of an individual even before conception, from pre-embryo stage, via embryo stage and fetus stage to a newborn infant. Regarding investigative and clinical projects, this standpoint implies the legalization of all ART procedures, unencumbered exchange of information and consensus about their application, and adherence to the basic ethical principles of autonomy benefit, justice and common welfare. Ethical postulates provide unequivocal directions in the creation of new life and resolve all possible ethical dilemmas, protecting the rights of doctors and participant in relevant procedures alike and reasserting the crucial principle - respect of human dignity.


GYNECOLOGY ◽  
2018 ◽  
Vol 20 (1) ◽  
pp. 113-116
Author(s):  
L A Bagdasaryan ◽  
I E Korneyeva

The aim of the study is to systematically analyze the data available in the modern literature on the relationship between endometrial thickness and the frequency of pregnancy in the program of assisted reproductive technologies (ART). Materials and methods. The review includes data from foreign and domestic articles found in PubMed on this topic. Results. The article presents data on the relationship between the thickness of the endometrium and the frequency of pregnancy in ART programs. The greatest number of studies is devoted to the evaluation of the relationship between the thickness of the endometrium and the frequency of pregnancy on the day of the ovulation trigger. Data are presented on the existence of a correlation between the thickness of the endometrium measured on the day of the ovulation trigger and the frequency of clinical pregnancy, as well as data on the need to evaluate the structure of the endometrium and the state of subendometric blood flow. The importance of multilayered (three-layered) endometrium as a prognostic marker of success in in vitro fertilization/intracytoplasmic sperm injection programs in the ovum is emphasized. The conclusion. The thickness of the endometrium can not be used as an argument for canceling the cycle or abolishing embryo transfer to the uterine cavity. Further studies in this direction are needed with a study of the morphological and molecular genetic characteristics of the endometrium, which in the future will allow us to evaluate the relationship between the thickness of the endometrium and the probability of pregnancy.


Author(s):  
N.A. Altinnik , S.S. Zenin , V.V. Komarova et all

The article discusses the factors that determine the content of the legal limitations of pre-implantation genetic diagnosis in the framework of the in vitro fertilization procedure, taking into account international experience and modern domestic regulatory legal regulation of the field of assisted reproductive technologies. The authors substantiates the conclusion that it is necessary to legislate a list of medical indications for preimplantation genetic diagnosis, as well as the categories of hereditary or other genetic diseases diagnosed in the framework of this procedure.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sandra Monfort ◽  
Carmen Orellana ◽  
Silvestre Oltra ◽  
Mónica Rosello ◽  
Alfonso Caro-Llopis ◽  
...  

AbstractDevelopment of assisted reproductive technologies to address infertility has favored the birth of many children in the last years. The majority of children born with these treatments are healthy, but some concerns remain on the safety of these medical procedures. We have retrospectively analyzed both the fertilization method and the microarray results in all those children born between 2010 and 2019 with multiple congenital anomalies, developmental delay and/or autistic spectrum disorder (n = 486) referred for array study in our center. This analysis showed a significant excess of pathogenic copy number variants among those patients conceived after in vitro fertilization with donor oocyte with respect to those patients conceived by natural fertilization (p = 0.0001). On the other hand, no significant excess of pathogenic copy number variants was observed among patients born by autologous oocyte in vitro fertilization. Further studies are necessary to confirm these results and in order to identify the factors that may contribute to an increased risk of genomic rearrangements, as well as consider the screening for genomic alterations after oocyte donation in prenatal diagnosis.


2021 ◽  
Vol 10 (12) ◽  
pp. 2687
Author(s):  
Kaan Aydos ◽  
Oya Sena Aydos

Retrieving spermatozoa from the testicles has been a great hope for patients with non-obstructive azoospermia (NOA), but relevant methods have not yet been developed to the level necessary to provide resolutions for all cases of NOA. Although performing testicular sperm extraction under microscopic magnification has increased sperm retrieval rates, in vitro selection and processing of quality sperm plays an essential role in the success of in vitro fertilization. Moreover, sperm cryopreservation is widely used in assisted reproductive technologies, whether for therapeutic purposes or for future fertility preservation. In recent years, there have been new developments using advanced technologies to freeze and preserve even very small numbers of sperm for which conventional techniques are inadequate. The present review provides an up-to-date summary of current strategies for maximizing sperm recovery from surgically obtained testicular samples and, as an extension, optimization of in vitro sperm processing techniques in the management of NOA.


2020 ◽  
pp. 13-19
Author(s):  
L. Chalova ◽  
V. Lokshin ◽  
A. Guseva ◽  
A. Kinzhibayev

This world literature review tries to determine the significance of the gamete donation in the field of assisted reproductive technologies as well as the availability of treatment methods using donation in in vitro fertilization programs. Gamete donation is regulated by every country's national legislation system, and quite often the laws vary between the states. There are practically no universal standards and/or rules in this area, which, in turn, leads to an ambivalent reaction towards reproductive practices.


2020 ◽  
Author(s):  
Evelynne Paris-Oller ◽  
Sergio Navarro-Serna ◽  
Cristina Soriano-Úbeda ◽  
Jordana Sena Lopes ◽  
Carmen Matas ◽  
...  

Abstract Background: In vitro embryo production (IVP) and embryo transfer (ET) are two very common assisted reproductive technologies (ART) in human and cattle. However, in pig, the combination of either procedures, or even their use separately, is still considered suboptimal due to the low efficiency of IVP plus the difficulty of performing ET in the long and contorted uterus of the sow. In addition, the potential impact of these two ART on the health of the offspring is unknown. We investigated here if the use of a modified IVP system, with natural reproductive fluids (RF) as supplements to the culture media, combined with a minimally invasive surgery to perform ET, affects the output of the own IVP system as well as the reproductive performance of the mother and placental molecular traits.Results: The blastocyst rates obtained by both in vitro systems, conventional (C-IVP) and modified (RF-IVP), were similar. Pregnancy and farrowing rates were also similar. However, when compared to in vivo control (artificial insemination, AI), litter sizes of both IVP groups were lower, while placental efficiency was higher in AI than in RF-IVP. Gene expression studies revealed aberrant expression levels for PEG3 and LUM in placental tissue for C-IVP group when compared to AI, but not for RF-IVP group.Conclusions: The use of reproductive fluids as additives for the culture media in pig IVP does not improve reproductive performance of recipient mothers but could mitigate the impact of artificial procedures in the offspring.


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