IVF under CHI in 2022

The first in vitro fertilization (IVF) procedure was successfully applied in the UK in 1977. In 1978, the first “test-tube baby” appeared on Earth – the girl Louise Brown. Since then, according to the latest data, more than 4 million children have been born worldwide through IVF (1).

In Our Country, since 2016, this expensive technology has been included in the program of state guarantees and can be provided to citizens as part of the CHI (compulsory medical insurance). That is free for the patient. At the same time, there are a number of important nuances and conditions that must be taken into account.

Under what conditions and where can a couple apply for IVF under CHI

If a couple has problems with the onset of pregnancy, first of all, you need to contact the clinic at the place of residence. There, within the framework of compulsory health insurance, a survey will be conducted to identify the causes of infertility.

If the case requires treatment with IVF, the documents and results of the examination of the couple are transferred to a special commission. If the decision is positive, the couple is given a referral for IVF according to compulsory medical insurance. At the same time, the couple has the right to independently choose a clinic for procedures from the proposed list.

Note. The basis for referral to IVF (in the absence of contraindications) may be infertility that is not treatable for up to 12 months. Also, the basis may be the presence of medical diagnoses, in which the onset of pregnancy is impossible without the use of artificial insemination.

What services are included in the OMS

A number of procedures are carried out free of charge under the CHI policy.

• Stimulation of superovulation, including the necessary drugs prescribed by a doctor.
• Monitoring of follicle and endometrial growth.
• Puncture of follicles, anesthetic manual.
• Fertilization of oocytes, including the ICSI method, and cultivation of embryos.
• Transfer of embryos into the uterine cavity.
• Cryopreservation of embryos.

Keep in mind: storage of cryopreserved embryos (if necessary, this service) is not provided for by the basic CHI program and is paid by the patient additionally.

Stages of pregnancy after IVF

The main limitation for the IVF program, and IVF under CHI in particular, is the identification of the patient’s diseases included in the list of contraindications for the IVF program.

This list is listed in the Order of the Ministry of Health of Our Country dated July 31.07.2020, 803 No. XNUMX-n. The list includes serious diseases, in the presence of which IVF and subsequent pregnancy can adversely affect the patient’s health. Among the contraindications are tuberculosis, in the case of active forms, some mental disorders, oncological diseases.

An important point: the legislation does not limit the age limit of the patient for the IVF program. However, it should be borne in mind that IVF is often technically impossible in patients with egg depletion (2). In this situation, the use of donor eggs is necessary.

Preparation and analyzes

You can contact any antenatal clinic at the place of registration / registration / residence. The doctor will prescribe the necessary tests.

Most analyzes have a certain expiration date. And often women do not have time to collect everything on time. Therefore, it was decided to reduce the list of necessary tests.

Mandatory tests for women:

• a smear for cancer cells from the cervix;
• blood for HIV, syphilis, hepatitis B and C;
• fluorography;
• ECG;
• coagulogram;
• blood for biochemistry, group and Rh factor;
• hormonal background;
• Analysis of urine;
• rubella antibodies;
• smear for trichomonas, gonorrhea, chlamydia, mycoplasma genitalium by PCR.

Mammograms are performed for women over 35 years of age.

Women under 35 years of age undergo an ultrasound examination of the mammary glands. If, according to the results of an ultrasound examination, signs of breast pathology are detected, mammography is performed.

For medical reasons (they are determined by the doctor), additional examinations may be necessary.

In order to receive a quota for IVF in 2022, certain requirements must be met:

• the value of AMH should be above 1,2 (AMH – Anti-Mullerian hormone. This is an accurate marker of ovarian reserve, it shows the reproductive potential of a woman);
• there should be at least 4 antral follicles.

Mandatory tests for men:

• spermogram and MAR test;
• RW, HIV, hepatitis B and C;
• smear for gonorrhea, trichomoniasis, genital mycoplasma, chlamydia by PCR.

For medical reasons:

• determination of blood group and Rh factor;
• ultrasound of the scrotum;
• examination and consultation of an andrologist;
• hormonal examination;
• DNA fragmentation of the spermatozoon by the Tunel method.

It’s important: mandatory examinations are carried out free of charge, within the framework of compulsory medical insurance, but there are a number of specific tests for which you will need to pay out of pocket.

Necessary documents for obtaining a quota for IVF under CHI

To be able to conduct IVF under the MHI policy, spouses must provide:

● certificates on the results of analyzes and surveys;

● an extract with a diagnosis;

● referral for IVF, certified by the head physician of the clinic;

● statement from the patient;

● original and copy of SNILS and spouses’ passports.

After accepting the documents, the patient receives a serial number and code, which can be used to track the position on the website of the Ministry of Health.

How long to wait for approval

The waiting time depends on many factors. It can be from a couple of weeks to several months. The average for 2022 is a year and a half.

Expert Commentary

“According to statistics, approximately 20% of couples have difficulty conceiving, and this figure is growing every year,” notes obstetrician, gynecologist, reproductive specialist Elvira Akhmetova. – Infertility is getting younger. The reason for this is nutrition, ecology, stress, unhealthy lifestyle. All this translates into problems with the endocrine system. It, in turn, is closely related to the reproductive functions of the body. But this is not a sentence. Thanks to the professionalism of doctors, equipment and the IVF program for compulsory medical insurance, couples get the chance to conceive and give birth to a healthy child. All funds for therapy are paid by the CHI Fund. At the same time, there are a number of procedures that are not included in the basic compulsory medical insurance program, for which you need to pay extra.

Not included in the basic CHI program:

– a preliminary examination of the spouses (but can be carried out under compulsory medical insurance in the clinic at the place of residence / antenatal clinic / infertile marriage office);

— donor eggs/sperm/embryos;

— defrosting of previously vitrified oocytes (own or donor);

– biopsy and genetic testing of embryos;

— storage of cryopreserved embryos;

– support drugs after embryo transfer;

– blood tests, including hCG after embryo transfer;

– ICSI (if the direction is not due to the male factor).

Popular questions and answers

The IVF procedure under compulsory medical insurance is increasingly being carried out in Our Country. Naturally, certain questions arise. We, together with an expert, answered the most popular ones.

Sources of

1. Kuzmichev L.N., Shtyrya Yu.A. In vitro fertilization. Only facts. Information for reflection / 2012
2. Svorova M.S., Kravchenko E.N., Makarkina L.G., Krivchik G.V., Koveshnikova T.V. Ovarian reserve in patients included in in vitro fertilization programs / 2018
3. Lysenko O.V., Smirnova I.V. Medical and social characteristics of women aimed at IVF and analysis of unsuccessful attempts / 2010