Uvodnik
NEW STRATEGIES AND RECOMMENDATION EUROPEAN COMMUNITY IN TREATMENT OF INFERTILITY WITH ASSISTED REPRODUCTIVE TECHNOLOGIES
Branko Radaković
; Klinika za ženske bolesti i porode Medicinskog fakulteta i KBC-a u Zagrebu, Zavod za humanu reprodukciju, Petrova 13, Zagreb
Sažetak
Mostly used method of assisted reproductive technology (ART) is conventional or standard in vitro fertilization (cIVF). It is a complex, expensive and aggressive treatment of infertility, very often unpleasant for patient and with substantial risk of complications. The aim of such treatment is to achieve as much as possible pregnancies in initiated cycle. It is necessary to generate many oocytes and embryos for transfer into the uterus to compensate for inefficiencies of laboratory procedures. Ovarian hyperstimulated syndrome (OHSS) and multiple pregnancies are most frequent complications of cIVF. The opinion of most authors is that multiple pregnancies are still the most important problem as well the supreme complication of cIVF because of increased infant mortality and morbidity and higher risk of complications during pregnancy. The costs of multiple pregnancies including costs of IVF and follow up of pregnant woman till delivery are higher than total costs of all the treatments of IVF. That is why we suggest mild, less aggressive treatment of infertility with in vitro fertilization (mIVF) in natural cycle or in cycle with mild protocols of ovarian stimulation with transfer of one or two embryos into the uterus. The aim of such IVF treatment is delivery of a live, healthy and term newborn in determined period of treatment. Such a mild in vitro fertilization is more pleasant for patient, allows more attempts of cIVF in the same period of time, it is not so risky and is equally successful as cIVF. The costs of such attempt of IVF as well as the costs of an infant conceived and delivered by mIVF are significantly lower than those of cIVF.
The decrease of the total fertility rate (TFR) in many European countries, as well as in Croatia has more and more important effect on determining the demographic composition of Europe. Reduced fertility rates will have an impact on the total population number, and will change the age structure of the population that is likely to be the most challenging factor faced by the European Union (EU). Based on evidence suggesting that such demographic structure of population in EU threatens future standards of living and social cohesion, the managing the demographic situation through integrated policy of politicians and experts has become extremely important. The Parliament of EU based on proposals of the European Society of Human Reproduction and Embriology (ESHRE) has decided that ART can have important positive impact upon demographic and economic factors and should be incorporated into population policy of EU countries. The barrier for better use of ART are restrictive legislative or not having legislative on ART. That makes harder access to ART and wrong perception of ART in society. In Croatia we do not have corresponding legislative on ART or Central National Registar on ART, so we have many problems in treating infertility with ART.
Ključne riječi
conventional in vitro fertilization (cIVF); mild in vitro fertilization(mIVF); assisted reproductive technology (ART); demography; infertility
Hrčak ID:
65715
URI
Datum izdavanja:
1.6.2009.
Posjeta: 1.518 *