COMPLETENESS OF EXAMINATION OF MUSCOVITE WOMEN WITH INFERTILITY UNDERGOING IN VITRO FERTILIZATION PROCEDURE
V.V.Borovkova1,2, T.P.Sabgayda2
1. State Budgetary Institution of Healthcare of the City of Moscow, Clinical Diagnostic Center No. 4 of the Moscow Department of Healthcare, Moscow
2. Russian Research Institute of Health, Ministry of Health of the Russian Federation, Moscow
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Summary:
Despite the steady increase in the number of in vitro fertilization cycles included in the compulsory health insurance system, the active development of this technology has not improved its effectiveness.
The purpose of the study: to analyze the completeness of examination of women with infertility undergoing in vitro fertilization procedures in state medical organizations.
Materials and methods. We analyzed treatment information for 1,204 Moscow women who sought treatment at the State Clinical and Diagnostic Center. We determined the effectiveness of IVF for various causes of infertility and the frequency of additional paid examinations.
The completeness of the preliminary screening of women referred for infertility treatment using IVF was assessed based on the results of a survey of 46 experts involved in IVF treatment. Statistical analysis of the data was performed in Excel 2019.
Results. Among the causes of infertility, unexplained infertility accounts for 42.0%, tubal obstruction 8.9%, and male infertility 8.6%. The average duration of treatment for women is 4.0 years, with 5.9% of women receiving treatment for 10 years or more. Pregnancy occurred in an average of 30.7% of women, including 71.4% of women with HIV, 57.7% of women with blocked fallopian tubes, and 10.4% of women with unexplained infertility. Preimplantation genetic diagnosis was performed in 1.8% of women. Major histocompatibility complex (MHC) gene testing was performed in 15% of women, and in 37.4% of cases of unexplained infertility, of which 26.8% were found to be immunologically related. Laparoscopic diagnostic testing was additionally prescribed for 10.7% of women, and was performed in 98.8% of cases. According to experts, only 12.4% of women can immediately begin an IVF program without additional testing and treatment. Additionally, biochemical blood tests and smears for flora and cytology are required in 14.2% of cases, blood hormone tests in 29.5% of cases, and PCR testing for infections in 71.3% of cases. In 39.1% of cases, patients require preliminary treatment. The incidence of complications associated with the absence of certain laboratory or clinical data, according to experts, is 29.1% during IVF and 33.6% during pregnancy.
Conclusion. Currently, women who have received a quota and are referred for infertility treatment under the IVF program are not fully examined, which reduces the effectiveness of the procedure. It is advisable to include HLA typing and determination of vaginal dysbiosis using the PCR method in the list of studies carried out on infertile couples within the framework of the compulsory health insurance program. The program for preparing women diagnosed with infertility for IVF treatment should be optimized.
Keywords infertility causes, HLA typing, unexplained infertility, diagnostic laparoscopy
Bibliographic reference:
V.V.Borovkova, T.P.Sabgayda, COMPLETENESS OF EXAMINATION OF MUSCOVITE WOMEN WITH INFERTILITY UNDERGOING IN VITRO FERTILIZATION PROCEDURE // Scientific journal «Current problems of health care and medical statistics». - 2025. - №4;
URL: http://www.healthproblem.ru/magazines?textEn=1701 (date of access: 05.12.2025).
URL: http://www.healthproblem.ru/magazines?textEn=1701 (date of access: 05.12.2025).
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