Saint Petersburg, Founded 1703

Transcription

1 Saint Petersburg, Founded 1703

2 km St. Petersburg Population 146,8 mln Russia Russia

3 Reflections of IVF in Russia: lessons learned Prof. Vladislav Korsak President of the Russian Association of Human Reproduction CEO of ICRM Dakar, Senegal, October 30, 2018

4 Lesson 1

5 Some of the early discoveries in reproductive biology were made in Russia. Karl Ernst von Baer a member of the St. Petersburg Academy of Sciences.. In 1827 he was the first who described the mammalian ovum and established that mammals, including human beings, develop from eggs. Karl Ernst von Baer ( )

6 In 1897, prof. V.S.Gruzdev in Saint-Petersburg published an article about studies on in vitro fertilization of rabbits eggs. He concluded that fertilization deepens on the degree of the egg maturity. V.S. Gruzdev, 1897

7 In 1936 Krasovskaya O.V. the Russian researcher published three articles about a г. О.В. Красовская successful transfer of rabbit embryos after IVF. сообщила об оплодотворении 1959 Chang M.C. reported about an IVF яйцеклеток кролика in vitro. rabbit pregnancy, which worldwide known as a first one

8 Petrov G.N. Abstract "The process of fertilization outside the body in some mammals and human In 1959 Dr. Petrov G.N. a postgraduate student in Crimean State Medical Institute, Russia, defended a Ph.D. thesis named "The process of fertilization outside the body in some mammals and human Women eggs he obtained from ovaries tissue that had been removed due to gynecological diseases. Original Petrov s pictures of women s zygotes and embryo Karl Ernst von Baer 15 h: 2 pronucleus 18 h: pronucleus fusion 26 h: cleavege

9 Moscow, Group of prof. B. Leonovow St. Petersburg: Group of prof. A. Nikitin 1980

10 P. Steptow R. Edwards J. Purdy L. Brown 1978JJul 25, Oldham General Hospital, Oldham, UK

11 Feb Sep This is life story of a first child from test tube in Russia Elena. From embryo to the mother of the boy

12 1986 a group of doctors and embryologists with the mother and the first test tube boy in Russia, Nov 26, St. Petersburg

13 Lesson learned: Iron curtain isolation from the rest of the world resulted in lost of the Russian priority in IVF

14 Lesson 2

15 Russian Association of Human Reproduction founded in 1991 ART Register from 1995 года

16 ANNUAL ART REGISTRY REPORTS OF THE RAHR

17 Number of ART centers ( ) All centers in Russia Register participants

18 Number of ART cycles +10%

19 Assisted Reproductive Technology (ART) in Europe 2015 and development of a strategy of vigilance Preliminary results generated from European registers by ESHRE European IVF Monitoring (EIM), a consortium of representatives from National Registers Christian De Geyter, Switzerland (Chair) Carlos Calhaz-Jorge, Portugal (Past-Chair) Christine Wyns, Belgium (Chair-elect) Markus S. Kupka, Germany (Special Advisor) Edgar Mocanu, Ireland Tatjana Motrenko, Montenegro Giulia Scaravelli, Italy Jesper Smeenk, The Netherlands Snezana Vidakovic (Serbia, ExCo Representative) Veerle Goossens, Science manager, ESHRE COF

20 15 countries with > cycles in Belgium Czech Republic Denmark France Germany Greece Italy Norway Poland Russia Spain Sweden Switzerland The Netherlands Ukraine UK NA

21 2014

22 Pregnancy rates (%) per aspiration IVF Moldova 44.0 Russia 30.9 Norway 26.5 Macedonia 41.9 Sweden 30.7 Germany 26.4 Armenia 40.4 Portugal 29.9 Iceland 26.3 Belarus 39.2 Bulgaria 29.4 Latvia 25.3 Ukraine 36.3 Poland 29.4 Hungary 24.7 Austria 35.5 Spain 28.0 Italy 23.0 Slovenia 34.3 Estonia 27.6 France 22.9 Lithuania 33.8 Greece 27.5 Belgium 22.3 Montenegro 33.3 Switzerland 27.2 Denmark 22.3 Netherlands 30.9 Finland 26.6

23 Lesson learned: A national ART register is of great importance because it shows the effectiveness of ART programs in the country and the country s rating in the professional community

24 Lesson 3

25

26 % pregnancy rate IVF ICSI Pregnancy rates per aspiration IVF ICSI

27 60,0% 50,0% Clomiphene & FSH Pregnancy rates per ET, ICRM yrs FSH analogs 54,4% 53,5% 52,9% 49,3% 49,2% 52,1%49,0% 49,7% 49,9% 47,8% 46,5% 45,5% 43,8% 43,9% 43,8% 44,1% 43,6% 42,0% 40,0% 33,3% 32,8% 36,3% 30,0% Clomiphene 20,0% 20,4% 10,0% 0,0%

28 Lessons learned: The use of gonadotropin analogues significantly raised effectiveness of IVF.

29 Lesson 4

30 Cryopreservation of gamets embryos ovarian tissue

31 Cryopreservation offers: effective prevention of OHSS optimization of gametes donation programs elective single ET (eset) fertility preservation in oncology patients

32 Lesson learned: Cryopreservation is the essential part of ART nowadays

33 Lesson 5

34 Louise Brown with the Incubator in which she was cultured as an embryo! Held at Bourn Hall Clinic Oct 26, 2018 Prof. Anatoly Nikitin with laboratory desiccator which he used fo IVF in , Ott Institute, St. Petersburg, Russia Exhaled air contains 4% carbon dioxide

35 Benchtop incubator Classical incubator Picture from www. fertility.coopersurgical.com Dessicator Picture from INVO Time-lapse incubator Picture from I

36 Intravaginal culture system PR per ET >40% Picture from www. invobioscience.com

37 Lesson learned: Mother is the best and cheapest incubator

38 Louise Brown letter World ART Day sounds like a fantastic idea. Jul 25, my birthday, is the most appropriate date to mark and celebrate the wonderful work of all in the fields of ART and I am happy to support the idea. But the credit must always go to my parents, the pioneering, and those who in ART worldwide. The are millions people I the world grateful for the work you all do. Jul.25,2018 L.Brown 40 yrs

39 July 25 - World ART Day The thanksgiving day Louise Brown Patrick Steptoe Robert Edwards 1978, July 25 Oldham General Hospital, Oldham, UK

40 International Center of Reproductive Medicine Founded 1992 in St. Petersburg Russia by Yary Verlinsky

41 IN VITRO VERITAS

42 Thank you!