Elena Kalinina, obstetrician-gynecologist , MD, laureate of the RF Government Prize for the work "IVF program in the treatment of infertile marriage" Initially, the method of in vitro fertilization (IVF), which involves the connection of a mature egg with spermatozoon outside the woman's body and the following embryo embryo in uterus, was considered the solution of a single problem. It was about situations when, for some reason, the future mother did not have any mother tubes: their absence makes conception impossible, because it is where the egg meets the sperm, for them the fertilized egg moves then to the uterus to attach to its wall and begin to develop. Attempts to circumvent this problem with the help of IVF were undertaken by researchers from different countries, and in November 1977 the efforts of English embryologist physicians became clear that ECO would help overcome various forms of infertility, and the gynecologist from the Born Hall clinic finally succeeded. The next, 601-th attempt to transfer into the womb of an embryo grown outside the body of the woman led to the birth of Louise - the world's first "baby from a test tube".
In Russia, the development of this method began 6 years later: the efforts of Vladimir Ivanovich Kulakov, director of the All-Union Research Center for the Protection of Mother and Child Health (now the SC of Obstetrics, Gynecology and Perinatology), and Boris Vasilievich Leonov, who headed a team of specialists, based on the clinic there was a research laboratory. Here, in the center, Lenochka appeared - despite the absence of her mother's tubes from the mother and the second attempt of IVF. Following the Muscovite Lenochka in December 1986 in Leningrad, in the Research Institute of Obstetrics and Gynecology D. Otto, the first in the history of domestic IVF boy was born. The specialists of the Center for Infertility Treatment at the 1st Grad Hospital, led by Professor VM Zdanovsky, also made remarkable results. So, through the efforts of different groups of researchers, the method of ECO has received the right to life in our country, and since then its development has slowly started gaining momentum.
Happy parents
Over time, we realized that IVF can help overcome various forms of infertility, both female and male. This list now shows problems that were previously thought to be unsolvable: obstruction of the fallopian tubes, which can not be restored by surgery; serious hormonal disorders; infertility caused by unclear causes. In addition, the method has given us the opportunity to develop donor programs, through which patients who for some reason do not have their own eggs, receive them from other women. It is well known now and the opportunity to resort to the services of a surrogate mother who endures and gives birth to a child conceived with the help of an egg and the sperm of "customers".
The method of IVF has become a real breakthrough in the treatment of male infertility . If the number of spermatozoa in the future pope is small or they are unreasonably mobile, we can not only determine the most viable "candidate", but also introduce it directly into the woman's egg, bypassing the natural barriers and ensuring the safety of all its properties. This technique, called ICSI, was developed recently: the first child, conceived with its help, was born in 1993.
According to my observations, the IVF method is now becoming more popular: partly because of the expansion of its capabilities, in part because the causes of infertility is increasing. One of them: women think about the birth of a child at that age, when health problems are added.
Valentin Lukin, Ph.D. , laureate of the RF Government Prize for his work "IVF program in the treatment of infertile marriage" ECO is a method that became the basis for the further development of human reproduction. In the future, it will allow not only to treat infertility in women and men, as it does today, it will give us new opportunities to prevent and cure serious diseases that can be inherited. After all, IVF allows specialists to work with cells that give rise to a person, and, probably, we will have the opportunity to influence these cells. Today it is difficult for us to imagine - the idea of saving human life with the help of blood transfusion seemed to be as incredible at the beginning of the 20th century - but times, as is known, change.
One of the first articles devoted to the new method, which gave life to Lenochka. Journal of Health, March 1986 With a newborn, Elena Kalinina (then a junior research associate at the All-Union Research Center for Mother and Child Health) and Valentin Lukin (then a senior fellow at the Center), February 1986 .
But we will return today. With the advent of IVF, infertility became easier: regardless of the initial data, a woman who turned to us for help has a 30% chance of getting a pregnancy in the first cycle. And now patients no longer spend years, perusing all possible methods of solving their problems, because they can bypass them.
Are there any pros and cons? We have already spoken about the advantages of the method. And yet I would not recommend it to all couples who have problems. It is worthwhile to resort to his help when other possibilities for solving the problem, for example, surgical ones, do not work. Another example: future parents underwent a survey procedure, and the cause of infertility was not found, moreover, their age passed beyond the 40-year mark - in this situation, postpone the visit to the ECO department is not worth it. As for the minuses of the method, you need to remember this: it involves a serious impact on the hormonal background of a woman, which can cause unpleasant complications. In addition, infertility treatment with IVF is an expensive pleasure.
Why after IVF procedure do twins and triplets appear so often?
As already mentioned, it happens that not only one but two or three embryos take root in the uterus. However, everyone knows that it is more difficult to endure such a "company" than a single child (especially if the future mother is under 40). That is why the specialists of IVF all over the world are guided by the "creation" of malnourished pregnancies - in the interests of the woman and the baby. That's why if a married couple wants only one child, in the IVF department they will meet her and will carry a single embryo, as many times as needed. What happens to those eggs that were taken from a woman, connected with spermatozoa, but not transferred to the uterus? With the permission of the "mistress" they are frozen and, if the first attempt fails, do the next, unfreezing those that have remained. If the stock is consumed, the procedure starts from the very beginning.
Are ECO pregnancy and childbirth different from "normal"?
After the efforts of the specialists of the IVF department the woman becomes pregnant, the expectant mother can continue to be observed at any convenient place (for example, in the women's consultation). Such pregnancy requires the attention of doctors, but not because something is different from what has come naturally. It's just that usually women resort to IVF (unfortunately) at the age when they have problems that can prevent a calm course of events. What are they? First of all, the age, secondly, chronic diseases, excess weight. The upcoming birth is also not very different from the usual ones. True, women from the ECO department are more likely to do a planned caesarean section. In this issue, the same nuances as mentioned above are taken into account: age, health problems, multiple pregnancies. By the way, if it comes to triplets, then in any case they appear in the light by surgery, and the age of the mother has nothing to do with it.
Can parents ask a specialist to "plant" an embryo of a certain sex?
They can, but only if they already have three girls or three boys or in the family history there are genetic diseases associated with a certain sex, for example hemophilia. All other situations are covered by the resolution of the World Health Organization, which does not recommend parents to choose the sex of their future child.
Why is IVF so expensive?
In many ways, the price is determined by hormonal drugs. In addition, all the tools that doctors use are disposable and also worth a lot. One such attempt will cost an average of $ 3.5 thousand. To hope for state assistance is not yet necessary: the draft law, according to which the first IVF will be free, is still waiting for its hour.