The birth of a child is a great happiness for the whole family. It's good when a couple plans conception, and it certainly comes. However, there are men and women who have been running to doctors for years, being treated, using all kinds of methods, following the advice of their grandmothers, and the much-awaited pregnancy never occurs. What is left for such couples to do? As a rule, there is only one way out - IVF (in vitro fertilization), but it is worth saying that this pleasure is not cheap. Someone can afford it without problems, someone takes a loan, and for some it remains a pipe dream. However, today everything has changed - the state gives the opportunity to try to do free IVF under compulsory medical insurance. From January 1, 2013, every person with a compulsory medical insurance policy and special indications has this chance.
How was it before 2013?
It's no secret that the MHI guarantees the appropriate protection of the interests of people living in the territory of the Russian Federation regarding medical care. Citizens were provided with the right not only to receive free treatment, but also suchlong-awaited assistance, as a quota for IVF under compulsory medical insurance. In this case, the state, in order to support those families who, for certain reasons, could not conceive a child, allocated money at a time and free of charge for the described procedure.
How is it happening now?
The demographic situation in the country forced the government to reconsider its attitude to the rules for free IVF. As mentioned above, in 2013 the authorities of the Russian Federation recognized this method as effective not only in the fight against infertility, but also with such an urgent problem as family preservation. That is why IVF under the CHI policy is available to absolutely anyone. In addition, if earlier a woman had only one attempt at a free procedure, today their number is not limited. And rightly so, because only in 30% of cases fertilization occurs the first time.
What else does the law provide regarding IVF under CHI?
Firstly, as already mentioned, this is an unlimited number of attempts. Secondly, the law gives the right to have a child to those couples who are not officially married, and people infected with HIV get a chance, although earlier this was strictly prohibited. Thirdly, even a single woman can do IVF under compulsory medical insurance and take advantage of all the reproductive technologies offered. Fourthly, the patient has every right to independently choose a medical institution for the procedure from all that support the program.
Basic IVF procedure includes: stimulation of superovulation with specialdrugs, monitoring of the growth of the endometrium and follicles, the state of hormones. Also, you will definitely get a puncture of the follicles for free, fertilize the egg, culture the embryo and transfer it to the uterine cavity. However, sometimes there are individual cases when the list of services provided is not enough, and additional costs are required. But they don't compare to the cost of a full IVF procedure.
What are the requirements for insemination?
The IVF procedure under the MHI policy is absolutely free, but that is why the federal program imposes certain requirements on everyone. So, each participant must:
- be a citizen of the Russian Federation;
- have infertility (female or male) confirmed by relevant medical reports;
- provide evidence of treatments performed that were ineffective;
- have a compulsory medical insurance policy, which is issued to every citizen of the Russian Federation from birth;
- be of reproductive age (under 39);
- have no contraindications for the procedure and pregnancy;
- prove that he has no children born in the same marriage;
- don't be an alcoholic or drug addict;
- do not have mental and other diseases.
What should be the indication for a referral?
A referral for IVF under MHI is issued if any of the following occurexpert opinions:
- Female infertility (primary), which is diagnosed due to the absence of ovulation or complete obstruction (absence) of the fallopian tubes.
- Male infertility.
- Previously treated. If the couple went through all the procedures prescribed by the doctor, and pregnancy did not occur within a year after that, then you can count on IVF according to compulsory medical insurance.
- Diseases that preclude pregnancy without IVF.
Restrictions on using the program
Don't count on the procedure:
- Persons with abnormal anti-Müllerian hormone readings (from 0.5 ng/mL to 0.7 ng/mL).
- Couples who have such conditions when IVF under compulsory medical insurance will not be effective, and the use of donor and (and) other types of germ cells, surrogate motherhood is indicated.
- Women who have sex-linked hereditary ailments (Duchenne muscular dystrophy, hemophilia, ichthyosis, etc.)
- Persons suffering from tuberculosis, HIV (during incubation), syphilis, viral hepatitis, chronic blood diseases, the presence of neoplasms requiring surgical intervention.
- Couples diagnosed with certain diseases of the musculoskeletal system and connective tissue, gastrointestinal tract, genitourinary system.
- Men who have a pathological change in sperm.
- To couples who have not passed all the necessary tests for IVF according to MHI and have not passed the appropriate diagnostics.
What tests will be needed for the procedure?
In order to exclude the presence of not only all the above diseases, but also many other ailments, both a man and a woman will have to pass a rather impressive number of tests. Although those couples who are ready to do anything for the birth of a long-awaited baby, this is absolutely not scary.
So, what tests do both partners need? This is a microbiological examination for ureaplasma, mycoplasma, chlamydia, herpes virus, and seeding for aerobic and anaerobic microorganisms, and tests for the determination of antibodies to HIV and viral hepatitis. This is a list of mandatory studies, although in each case it may change (supplement).
The list of tests that a woman will have to take includes: routine and biochemical blood tests, determination of prolactin, vaginal smear, ultrasound of the pelvic organs, cytological examination of the cervix, fluorography, electrocardiogram, ultrasound of the mammary glands (for women under 35, then mammography). As additional studies that may be needed for one reason or another, contrast echohysterosalpingoscopy is often done, consultations with an endocrinologist, genetics, and therapist are prescribed.
It is important for men not to have the contraindications that were described above, and it is necessary to take sperm for analysis.
How do I get a referral for a procedure?
If availableindications for the procedure and the results of examinations, the medical institution prepares a discharge summary, which contains a recommendation for IVF. Next, the woman needs to go to a special commission of the subject of the Russian Federation, which selects patients for the described procedure. This commission reviews the extract, all attached medical documentation, checks what are the indications for IVF, whether there are contraindications and restrictions in accordance with the norms for the use of reproductive technologies, and decides on issuing a referral for IVF at the expense of the state.
If a dream came true, and after long wanderings you are the happy owner of such a "voucher", then the above-mentioned organization should also provide a list of those clinics that participate in this state program, and you just have to choose. Here you should be warned that in case of an unsuccessful attempt to get pregnant, you can again count on receiving another free referral.
What to do next?
As soon as you have received the coveted direction, you must also collect the following documents: an insurance policy (which is issued by the MHI), a passport, all extracts from the medical card. Now you can go to any institution from the list given to you. If all documents are in order, the procedure will be carried out within a month from the date of contacting the clinic.
So you have reached the goal. Yes, the path to it does not promise to be easy and fast. You will have to get aroundmany doctors, pass a huge number of tests, be patient and optimistic. Indeed, in this case, the statement that the end justifies the means fits just perfectly. Believe in yourself, in your strengths, often think that in the end you will have a long-awaited and wonderful baby, and even then you won’t even remember how much you had to endure.
