ECO MHI is one of the services of reproductive medicine, which is provided from the state budget. The program of this kind provides for the behavior of the procedure of in vitro fertilization on a free basis. Consider it in more detail, find out to whom this service is provided, what is needed for this.
Can I do IVF for free?
Free ECO is provided for by the Federal Development Program. Each administrative district determines quotas for such a medical service, painting them for a year. A woman can learn about the possibility of carrying out the procedure directly in her village by contacting a women's consultation at the place of residence. In those cities where there are family planning centers, the queue for manipulation is handled directly by the data of the medical institution. Since 2016 IVF for MHI is carried out for all factors of infertility . The exception is a heavy male factor.
How to make IVF free?
Before making IVF for CHI, a woman must undergo a lengthy procedure for obtaining a quota. First, you need to contact a women's consultation. In this organization, she can get all the information about how many quotas are allocated for the current year, which is necessary in order to get it. Before arriving at the appointed time and day for the procedure, the patient is expected to:
- a comprehensive medical examination with her husband;
- receipt of the opinion of the medical commission;
- the choice of the location of the manipulation;
- write to the queue .
What is included in the IVF program for CHI?
ECO free of charge on the policy can be conducted on several protocols. In this case, the cost of individual stages may vary, and depends on the city, the region in which the woman is going to undergo the procedure. The list of services provided by the clinic is also free. Often, as part of free in vitro fertilization, a woman is provided with the following medical services:
- stimulation of the ovulation process;
- puncture of ripened follicle;
- ICSI ;
- embryo transfer.
Many private clinics that specialize in IVF offer their own services free of charge as part of the program. Among them are:
- freezing of embryos - if necessary, it will be possible to repeat the transplant through time;
- diagnostic studies - determination of the level of hCG , carrying out of ultrasound.
How to start IVF for OMS?
Often, women who want to undergo the procedure for in vitro fertilization for free, do not know what is needed for IVF for IVF. First you need to confirm the diagnosis, to establish the cause of infertility . To do this, you should contact the clinic, which has a license for conducting diagnostic studies in the field of gynecology. As such, you can use the women's consultation at the place of your registration.
The survey involves not only the passage of research by women, but also by their spouses. The average duration of all studies in IVF is free of charge for CHI, until the conclusion in which the diagnosis is displayed - 3-6 months. After all the examinations, a woman gets an extract from her outpatient card. This conclusion is given by the patient to the Commission for the selection of patients for IVF for IVF.
Before you can get an IVF procedure free of charge, according to the MHI, the girl needs to completely go through the prescribed treatment. If 9-12 months after the diagnosis of "infertility", the effects of the treatment - there is no restoration of reproductive function, there are indications for the passage of the IVF program. Only after this there is an opportunity to obtain a quota.
How to get a quota for IVF by MHI?
The free ECO program provides for the implementation of the procedure at the expense of the state budget, in accordance with waiting lists. They are compiled by the Commission on the basis of territorial health authorities. The basis for including the patient in the waiting list is an extract from the conclusion of a recent medical examination.
List of documents for IVF
In order to become a queue for the procedure, you must provide a package of documents. The acceptance of the application and the relevant papers is carried out by district commissions. The list of documents for IVF on the policy of CHI looks like this:
- passports of 2 spouses (partners) with copies;
- health insurance policy and its copy;
- SNILS;
- an extract about the medical procedures that have been passed (2 copies);
- results of the survey;
- referral to IVF from a district gynecologist;
- written consent for the processing of personal data;
- a letter of guarantee from a woman chosen by the clinic, which confirms the possibility of ECO MCH.
Analyzes for IVF
The results of laboratory studies are the basis for the direction of IVF. A full list of spouse surveys is obtained at the consultation stage. The basis of diagnostic activities are:
- Ultrasound of the pelvic organs ;
- blood tests for hormones (AMG, FSH );
- biochemistry of blood;
- Smears from the urethra and vagina;
- tests for ovulation;
- spermogram (in men).
The duration of the analyzes for IVF for MHI is limited. Women planning this procedure should take this fact into account. So, from the moment of receipt of the result of the survey to the submission of data to the Commission, no more than 6 months must elapse. Otherwise, certain types of research will have to be retried. When assessing the possibility of IVF, doctors assess the current state of the woman's reproductive system. The patient provides an extract from the outpatient card, in which the results of the research not only by herself, but also by the partner are displayed.
Indications for IVF
Carrying out in vitro fertilization under the state program is not possible in all cases. The following indications are set for this procedure:
- infertility of tubal origin;
- infertility caused by congenital anomalies in the development of fallopian tubes (obstruction, obstruction, stenosis);
- primary infertility in women associated with anovulatory menstrual cycles;
- the fact of absence of pregnancy within 12 months after the spent treatment;
- presence of the male factor of infertility (disruption of the structure of male sex cells).
Repeated IVF for OMS is possible after a new filing of a package of documents. In addition to these indications, there are also selection criteria, the presence of which is mandatory for obtaining a quota for IVF:
- weight of a woman within 50-100 kg;
- the level of antimulylerovoy hormone (AMG) - 0,5-7 ng / ml;
- concentration of FSH on day 3 of the cycle - 15 IU;
- normospermia in the partner.
Up to what age do IVF for OMS?
It is worth noting that when allocating quotas, doctors pay attention other than the state of health, and the age of the potential patient. There are certain criteria. So the age of a woman for IVF according to CHI should not exceed 39 years. Pregnancy in older ladies is associated with many dangers - difficult births, congenital anomalies of fetal development. Because of this, the centers do not take the procedure for women who at the beginning of the treatment process turned 39 years old.
Contraindications for IVF
Free IVF for OMS is possible if the patient's health meets the criteria. Even with a great desire, in vitro fertilization is not always possible. Contraindications to the procedure are:
- active forms of tuberculosis, regardless of the affected organ;
- viral hepatitis;
- HIV;
- syphilis in a woman or partner;
- neoplasms of malignant nature;
- benign tumors in the reproductive system requiring surgical treatment;
- diseases of the circulatory system;
- endocrine diseases, accompanied by a metabolic disorder;
- prolonged and chronic mental disorders;
- diseases of the nervous system;
- liver failure;
- diseases of the genitourinary system;
- chronic renal failure;
- congenital anomalies of the uterus, in which implantation of the fetal egg is impossible;
- congenital malformations of the cardiovascular system;
- trauma, poisoning.
Procedure for IVF for MHI in stages
Extracorporeal fertilization is preceded by a long period of preparation. The patient must follow all the doctor's prescriptions in order to achieve the ultimate goal. Only after the completion of training, on the appointed day, the IVF procedure is carried out, the stages of which are as follows:
- Stimulation of the ovaries. This stage involves the taking of hormonal drugs that increase the number of simultaneously ovulating eggs. Simultaneously, endometrial monitoring
- Puncture of follicles. At this stage, the collection of mature germ cells is carried out for further fertilization under laboratory conditions. In this case, intravenous anesthesia is used. The manipulation itself is controlled by ultrasound.
- Fertilization of germ cells and cultivation of embryos. The embryologist performs the fertilization of the best egg with sperm, which have the correct structure, correspond to all parameters.
- Transfer of embryos into the uterine cavity.
- Support for the luteal phase for successful implantation of the embryo.
- Diagnostic measures to determine the onset of pregnancy.
How many embryos are transplanted with IVF for OMS?
Embryo transfer during IVF is carried out at different stages of development of the future fetus - from the zygote to the blastocyst stage (most often reproductologists attach the embryo directly at this stage). It is formed on the 5th-6th day after fertilization. In order to achieve the best result, adhering to the practice of leading family planning centers, doctors inject 2-3 embryos at the same time. During the transfer, a special catheter is inserted into the uterine cavity through the cervical canal.
IVF in the natural cycle according to CHI
Preparation for IVF procedure is a long, complex process. At the same time, it is not always possible to use all the procedures of the in vitro fertilization process itself. So stimulation of the ovaries is impossible in women who have problems with the ovaries or have had operations on the sex glands in the past. In such cases, IVF is performed in a natural cycle. Doctors take a single ovulating egg. In this case, the drugs used to maintain the endometrium.
The main principle of this type of IVF is not a violation of the natural cycle. This eliminates the possible risks associated with the use of hormonal drugs. However, there are also disadvantages of IVF in the natural cycle:
- low chances of a positive result;
- if the fertilization procedure is not unsuccessful, it is impossible to repeat it in a short time.
ECO OMS with donor egg
The IVF procedure of this type is used when a woman does not have her own healthy germ cells. In this case, the donor's egg is used. For this purpose, the doctors synchronize the phases of the patient and donor cycle with hormonal drugs. After maturation, doctors take sex cells from a healthy woman, they fertilize their patients with IVF.
Is the sick leave given by IVF for OMS?
Many future mothers are interested in the question as to whether the sick leave sheet is provided for IVF for CHI. At the end of the procedure, an extract from the medical institution, the patient receives a certificate in 2 copies on the passage of IVF. One remains with the future mother, the second - is transferred to a polyclinic at the place of residence. On the basis of this certificate and issued a sick leave, which is provided at the place of work.
With regard to the timing, duration of the action of such a document, it can be provided from the first day of treatment and until the delivery of blood to HCG (evaluation of the result of the procedure). Closed hospital with a negative test for a hormone or after confirmation of the onset of gestation. It is worth remembering that you can get a certificate of incapacity for work at any stage of the IVF program, it is issued according to the patient's application.
How many attempts can IVF be done on compulsory medical insurance?
The fact, how many times you can do IVF for OMS, depends directly on the country of residence. For example, in Western countries (France, Austria) it is permissible to conduct such a procedure up to 4 times. In countries such as Greece and Holland, women can use 3 attempts to conceive a child with IVF for free. As for the CIS countries, in most states there is no strict limit on the implementation of this procedure - the couple submits documents for IVF on MHI unlimited number of times. In practice, for a year a barren couple can use the procedure no more than 2 times.