Real clinical practice of infertility treatment in Russia: a collective opinion of 425 reproductologists

Introduction. Approaches to treatment of infertility have been progressively updated because the field of assisted reproductive technologies (ART) is a science-based symbiosis of the latest knowledge and advances in medicine, biology, and genetics. Today, a real-world clinical practice of a reproduc...

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Main Authors: N. V. Bashmakova, E. N. Novoselova, T. A. Nazarenko, M. M. Ovchinnikova, Yu. A. Fetisova, E. V. Gergert, M. A. Ganikhina, N. G. Valiullina, E. O. Golovina, M. R. Shcherban, A. S. Semikhin, M. A. Polzikov, D. V. Blinov
Format: Article
Language:Russian
Published: IRBIS LLC 2024-01-01
Series:Акушерство, гинекология и репродукция
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Online Access:https://www.gynecology.su/jour/article/view/1868
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author N. V. Bashmakova
E. N. Novoselova
T. A. Nazarenko
M. M. Ovchinnikova
Yu. A. Fetisova
E. V. Gergert
M. A. Ganikhina
N. G. Valiullina
E. O. Golovina
M. R. Shcherban
A. S. Semikhin
M. A. Polzikov
D. V. Blinov
author_facet N. V. Bashmakova
E. N. Novoselova
T. A. Nazarenko
M. M. Ovchinnikova
Yu. A. Fetisova
E. V. Gergert
M. A. Ganikhina
N. G. Valiullina
E. O. Golovina
M. R. Shcherban
A. S. Semikhin
M. A. Polzikov
D. V. Blinov
author_sort N. V. Bashmakova
collection DOAJ
description Introduction. Approaches to treatment of infertility have been progressively updated because the field of assisted reproductive technologies (ART) is a science-based symbiosis of the latest knowledge and advances in medicine, biology, and genetics. Today, a real-world clinical practice of a reproductive specialist needs to be assessed in the Russian Federation (RF) both in terms of a retrospectively analyzed development of RF in vitro fertilization (IVF) technologies and identifying promising approaches for infertility treatment in the future.Aim: analysis of current therapeutic tendencies and promising trends in real clinical practice of infertility in the Russian Federation.Materials and Methods. In 2022–2023 under the auspices of the Institute for Preventive and Social Medicine and the National Alliance for Public Health Advancement, a survey of reproductive doctors practicing at commercial and government ART centers was carried out. The questionnaire contained questions regarding describing a RF female patient’s portrait with an expected ovarian reserve and response to ovarian stimulation to propose a choice of ovarian stimulation protocol as well as basic and concomitant pharmacotherapy.Results. The opinion of 425 fertility doctors from 156 ART centers in 42 cities of the Russian Federation was assessed. A portrait of a female patient with infertility in the Russian Federation was determined in accordance with the ovarian reserve, expected response to gonadotropin-based stimulation (normal response – 40 %, hyporesponse – 40 %, hyperresponse – 20 % of patients). The basic pharmacotherapy in the stimulation protocol in the IVF program based on agonists and antagonists of gonadotropinreleasing hormone (GnRH), various gonadotropin-containing drugs in female patients with expected normal, hypo- and hyperresponse to ovarian stimulation was assessed. The dominant protocol consists of using GnRH antagonist most often observed in patients with hyper- (95 % of cases), normal (75 % of cases) and hypo-response (45.5 %). Preferences in the basic and concomitant pharmacotherapy in IVF programs were identified as well as current trends in embryo transfer in fresh and cryoprotocols (a tendency to freeze all obtained embryos - “freeze-all” strategy), preimplantation genetic testing methods (used in 30 % of protocols in normal responders, 60 % in hyporesponders and 10 % in hyperresponders) were described.Conclusion. Our study provides the most large-scale analysis of the real-world clinical practice of RF reproductive specialists. A portrait of a RF female patient with infertility, expected ovarian reserve and response to ovarian stimulation was described. Contemporary approaches to select stimulation protocol, basic and concomitant pharmacotherapy in real-world clinical practice were identified. The data obtained represent an important significant cross-section for current practical approaches in real-world practice of RF fertility doctors and can serve as the basis for assessing developing ART methods in the Russian Federation as well as be used to create an evidence base for analyzing future clinical and economic effectiveness of IVF programs in the Russian Federation.
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spelling doaj-art-60acf364c22b403e92c6aedd4a42ccf12025-08-20T02:53:55ZrusIRBIS LLCАкушерство, гинекология и репродукция2313-73472500-31942024-01-0117668070610.17749/2313-7347/ob.gyn.rep.2023.468847Real clinical practice of infertility treatment in Russia: a collective opinion of 425 reproductologistsN. V. Bashmakova0E. N. Novoselova1T. A. Nazarenko2M. M. Ovchinnikova3Yu. A. Fetisova4E. V. Gergert5M. A. Ganikhina6N. G. Valiullina7E. O. Golovina8M. R. Shcherban9A. S. Semikhin10M. A. Polzikov11D. V. Blinov12Ural Research Institute of Maternity and Child Care, Health Ministry of Russian FederationLomonosov Moscow State UniversityKulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Health Ministry of Russian FederationThe Lapino medical cluster, MD Medical GroupMD Group Hospital, MD Medical GroupMD Group Hospital, MD Medical GroupMD Tyumen-1 Hospital, MD Medical GroupIVFarma LLCIVFarma LLCKrasnodar Children's City Clinical Hospital, Ministry of Health of the Krasnodar TerritoryGamaleya National Research Center for Epidemiology and Microbiology Health Ministry of Russian FederationIVFarma LLCSechenov University; Institute for Preventive and Social Medicine; Moscow Haass Medical – Social InstituteIntroduction. Approaches to treatment of infertility have been progressively updated because the field of assisted reproductive technologies (ART) is a science-based symbiosis of the latest knowledge and advances in medicine, biology, and genetics. Today, a real-world clinical practice of a reproductive specialist needs to be assessed in the Russian Federation (RF) both in terms of a retrospectively analyzed development of RF in vitro fertilization (IVF) technologies and identifying promising approaches for infertility treatment in the future.Aim: analysis of current therapeutic tendencies and promising trends in real clinical practice of infertility in the Russian Federation.Materials and Methods. In 2022–2023 under the auspices of the Institute for Preventive and Social Medicine and the National Alliance for Public Health Advancement, a survey of reproductive doctors practicing at commercial and government ART centers was carried out. The questionnaire contained questions regarding describing a RF female patient’s portrait with an expected ovarian reserve and response to ovarian stimulation to propose a choice of ovarian stimulation protocol as well as basic and concomitant pharmacotherapy.Results. The opinion of 425 fertility doctors from 156 ART centers in 42 cities of the Russian Federation was assessed. A portrait of a female patient with infertility in the Russian Federation was determined in accordance with the ovarian reserve, expected response to gonadotropin-based stimulation (normal response – 40 %, hyporesponse – 40 %, hyperresponse – 20 % of patients). The basic pharmacotherapy in the stimulation protocol in the IVF program based on agonists and antagonists of gonadotropinreleasing hormone (GnRH), various gonadotropin-containing drugs in female patients with expected normal, hypo- and hyperresponse to ovarian stimulation was assessed. The dominant protocol consists of using GnRH antagonist most often observed in patients with hyper- (95 % of cases), normal (75 % of cases) and hypo-response (45.5 %). Preferences in the basic and concomitant pharmacotherapy in IVF programs were identified as well as current trends in embryo transfer in fresh and cryoprotocols (a tendency to freeze all obtained embryos - “freeze-all” strategy), preimplantation genetic testing methods (used in 30 % of protocols in normal responders, 60 % in hyporesponders and 10 % in hyperresponders) were described.Conclusion. Our study provides the most large-scale analysis of the real-world clinical practice of RF reproductive specialists. A portrait of a RF female patient with infertility, expected ovarian reserve and response to ovarian stimulation was described. Contemporary approaches to select stimulation protocol, basic and concomitant pharmacotherapy in real-world clinical practice were identified. The data obtained represent an important significant cross-section for current practical approaches in real-world practice of RF fertility doctors and can serve as the basis for assessing developing ART methods in the Russian Federation as well as be used to create an evidence base for analyzing future clinical and economic effectiveness of IVF programs in the Russian Federation.https://www.gynecology.su/jour/article/view/1868in vitro fertilizationivfassisted reproductive technologiesartreal clinical practicefollitropin alpharecombinant follicle-stimulating hormonefshgonadotropin
spellingShingle N. V. Bashmakova
E. N. Novoselova
T. A. Nazarenko
M. M. Ovchinnikova
Yu. A. Fetisova
E. V. Gergert
M. A. Ganikhina
N. G. Valiullina
E. O. Golovina
M. R. Shcherban
A. S. Semikhin
M. A. Polzikov
D. V. Blinov
Real clinical practice of infertility treatment in Russia: a collective opinion of 425 reproductologists
Акушерство, гинекология и репродукция
in vitro fertilization
ivf
assisted reproductive technologies
art
real clinical practice
follitropin alpha
recombinant follicle-stimulating hormone
fsh
gonadotropin
title Real clinical practice of infertility treatment in Russia: a collective opinion of 425 reproductologists
title_full Real clinical practice of infertility treatment in Russia: a collective opinion of 425 reproductologists
title_fullStr Real clinical practice of infertility treatment in Russia: a collective opinion of 425 reproductologists
title_full_unstemmed Real clinical practice of infertility treatment in Russia: a collective opinion of 425 reproductologists
title_short Real clinical practice of infertility treatment in Russia: a collective opinion of 425 reproductologists
title_sort real clinical practice of infertility treatment in russia a collective opinion of 425 reproductologists
topic in vitro fertilization
ivf
assisted reproductive technologies
art
real clinical practice
follitropin alpha
recombinant follicle-stimulating hormone
fsh
gonadotropin
url https://www.gynecology.su/jour/article/view/1868
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