One of the most common misconceptions associated with the allocation of quotas for a free in vitro fertilization procedure is that such a referral is supposedly almost impossible to obtain. We will try to dispel your doubts and provide you with the necessary information.
We ask all readers to note that currently quotas for treatment with assisted reproductive technologies (ART) - IVF and ICSI are allocated by both the Federal executive authorities and the Regional budgets.
In this article we will mainly touch on the procedure for obtaining quotas for IVF allocated by the Federal Ministry of Health and Social Development.
However, some documents about regional quotas will also be published in this section of our website. The number of regions funding in vitro fertilization programs is constantly increasing and we will be extremely grateful if you inform us about new regions and new regulatory documents, which we will be happy to publish on the website.
The procedure for providing quotas for free infertility treatment using assisted reproductive technologies, such as IVF and ICSI, is described below:
In vitro fertilization (IVF) and intracytoplasmic (or intracellular) sperm injection (ICSI) are assisted reproductive technologies. These procedures are one of the high-tech types medical care, and its implementation is guaranteed to citizens of the Russian Federation free of charge and the procedure for providing this type of medical care is regulated by relevant legislative and regulatory documents.
When issuing Federal quotas for free infertility treatment using in vitro fertilization and ICSI, representatives of regional authorities are obliged to be guided by the indicators listed in Appendix No. 5 to the ORDER OF THE MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF THE RF DATED 30.12.2009 N 1047n "On the procedure for the formation and approval of the state assignment for the provision of high-tech medical care for citizens Russian Federation at the expense of budgetary allocations from the federal budget"
The order contains the following information:
It is planned to carry out 2,658 IVF procedures at the expense of the federal budget (according to the Ministry of Health, this figure may increase by 30% by the end due to the allocation of additional funds, this happened in 2009);
The cost of one in vitro fertilization procedure at the expense of the federal budget will be 124,600 rubles;
For patients who have received a quota for infertility treatment using assisted reproductive technologies, not only the IVF or ICSI procedure itself will be free, but also the cost of all consumables and medications necessary for the operation.
The above order provides for payment not only for in vitro fertilization, embryo culture and transfer, but also for intracytoplasmic sperm injection (ICSI). Thanks to this change, couples in which the absence of children is due to male factor infertility can become participants in the program. In this case, a woman can be absolutely healthy.
Keep in mind that in 2006-2007, quotas were issued only to patients with tubal infertility. Currently, the state has granted the right to use assisted reproductive technologies at the expense of the budget to all infertile couples, regardless of the cause of infertility.
Who can count on receiving a federal quota for treatment?
1. Age
The Federal Order does not stipulate any age restrictions for those who wish to use assisted reproductive technologies at the expense of the federal treasury. But such frameworks are used in practice when it comes to regional budgets. Thus, in Moscow and St. Petersburg, the free IVF treatment program includes patients aged 22 to 38 years inclusive. In other regions of Russia, other age restrictions may be adopted for infertile couples, for whom assistance is provided at the expense of the regional budget.
At the same time, women applying for a quota should not count on the fact that quotas for in vitro fertilization at the expense of the federal budget are easier to obtain. First of all, the patient’s health condition and the prognosis of the IVF outcome are taken into account. If there is no chance of a positive outcome from in vitro fertilization, then a woman aged 33-35 years may also receive a refusal.
2. Gender
According to the old order, which was in force previously, only women could count on issuing a quota, since it was only about in vitro fertilization. In accordance with the changes made to the new document, in addition to IVF, the ICSI procedure (intracytoplasmic sperm injection) has become possible at the expense of the budget. Thanks to this, those couples in which the woman is absolutely healthy and the reason for the absence of children is male infertility can count on free infertility treatment. If officials refuse to issue you a quota only on the basis that the woman is able to conceive and give birth to a child, and only the man has problems, go to court, since their refusal is unlawful.
The procedure for providing quotas for free infertility treatment using assisted reproductive technologies, such as IVF and ICSI
Once again, please take into account that the described procedure is valid for FEDERAL QUOTAS!! and may differ significantly in the regions when it comes to financing from the regional budget.
If you expect to receive a quota for free infertility treatment using in vitro fertilization, first of all you should contact your local gynecologist (antenatal clinic). He, in turn, must collect the necessary package of documents - an extract from the medical history, results of studies, tests - and first submit it for signature to the chief doctor of the district antenatal clinic, and then to a special commission that reviews all applications for treatment with VTMP.
List of documents to be submitted to the commission:
1. Written statement from the woman. Starting this year, you no longer need to provide a referral from your attending physician!! The gynecologist only has to prepare all the relevant medical documentation;
2. A copy of the patient’s passport or birth certificate;
3. An extract from the medical history, signed by the chief physician of the antenatal clinic. This document must contain data on the woman’s health status, the results of clinical diagnostic examinations, information about what methods of infertility treatment were used previously, as well as the attending physician’s opinion on the need for infertility treatment using assisted reproductive technologies;
4. A copy of the patient’s compulsory pension insurance certificate (if available);
5. A copy of the patient’s compulsory health insurance policy (if available).
After collecting documents and submitting an application for a quota for IVF, your application must be reviewed by the commission within 10 days.
Typically, applications are considered at a commission meeting in the absence of patients. But it is possible that you may be invited to an in-person consultation. If a positive decision is made regarding the patient, his medical documents are sent to the nearest in vitro fertilization department (see. list of Federal IVF centers) to the applicant’s place of residence. In turn, the management of this clinic, after reviewing the documents, decides on the date of the initial appointment to begin the in vitro fertilization procedure.
To the IVF department of the Federal medical institution you must provide the following documents:
Voucher for the provision of high-tech medical care;
Extract from the medical history;
Test results (expiration dates are described in Order No. 67 of the Ministry of Health of the Russian Federation of 2003);
A copy of an identity document;
A conclusion signed by the main staff and freelance specialists in your region (this is done by the commission considering the application for IVF).
If the patient arrives for a consultation at the IVF clinic in person, the decision must be made within 3 days. The processing time for documents sent by mail is up to 10 days.
Representatives of the IVF clinic inform the woman about the decision made through her attending physician. He gives her a referral for free infertility treatment using ART (IVF, ICSI), which indicates the date of the operation.
We have described the ideal algorithm for obtaining a quota and undergoing treatment, but in practical terms, of course, conditions may differ significantly from ideal ones.
Problem one
: low level of preparedness of the lower level of gynecologists in the residential complex. Therefore – DEMAND!!! If you are not pregnant within a year of regular sexual activity, this is sure sign problems. Not necessarily, in vitro fertilization is indicated for you, but this method is one of the most progressive, giving very good results.
Problem two: the number of allocated quotas is clearly not enough for Russia
Problem three: you cannot choose the place of treatment and you will be sent to the nearest federal center (so check with your local department to see if you have regional quotas).
But any problems can be overcome - be persistent and do not forget that officials work for us and for our taxes.
We bring to your attention answers to the most frequently asked questions about IVF funded by the Compulsory Medical Insurance Fund (CHI).
The AltraVita Human Reproduction Clinic (ECO Center LLC, Moscow) provides a unique opportunity for infertile couples to undergo an IVF procedure out of turn at the expense of compulsory medical insurance within the framework of the territorial program in 2017.
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Tests before IVF according to compulsory medical insurance
Answers on questions
The procedure for obtaining a referral to IVF Center LLC (Moscow) for an IVF procedure at the expense of compulsory medical insurance can be found on the website page of the AltraVita clinic - free IVF with compulsory medical insurance.
Recently, it has become possible to do IVF under compulsory medical insurance; this service, which is provided only in some clinics in Russia, including ours at AltraVita, has raised numerous questions among infertile couples. Let's try to answer some of them.
Referral for IVF under compulsory medical insurance
To get it you need:
- Visit your gynecologist at the antenatal clinic and get an extract from the questionnaire from him;
- scan it and send it to our email - [email protected] ;
- We will review it and draw up a conclusion from a consultation of specialists from ECO Center LLC, then send it to you. This conclusion guarantees that the specialists of our center have already become familiar with your pathology and are ready to treat it with the help of assisted reproductive technologies;
- You must submit an extract from the antenatal clinic and a conclusion to your regional Ministry of Health, and they will issue you a referral for IVF with us.
The representative of the Ministry of Health in your district can be a department, committee, or department of the Ministry of Health of the Russian Federation. Where and who to contact, you must be informed in your district housing complex.
What is included in IVF under compulsory medical insurance?
Women are often interested in what manipulations are carried out within the program, since in some cases of infertility, not only in vitro fertilization and embryo transfer may be necessary, but also special sperm processing or donor materials.
IVF under compulsory medical insurance includes:
- the use of various stimulation protocols for superovulation;
- egg retrieval;
- fertilization and cultivation of embryos on nutrient media;
- embryo transfer into the uterus.
Often, in case of infertility associated with male factor, they ask: “Is ICSI included in IVF under compulsory medical insurance?” At our AltraVita clinic, this procedure will be done free of charge as part of compulsory medical insurance.
For what diagnosis can you count on IVF under compulsory medical insurance?
You will be given permission for in vitro fertilization under compulsory medical insurance only if the diagnosis of infertility corresponds to one of the following categories:
- PCOS (No. 28);
- lack of ovulation (No. 97.0);
- pipe (No. 97.1);
- uterine (No. 97.2);
- cervical (No. 97.3);
- associated with the male factor (No. 97.4);
- unknown origin (No. 97.8);
- endometriosis (No. 80).
During the year, a referral can be received no more than two times; within one year, only two free attempts at in vitro fertilization can be made. In addition, a referral will not be issued if there are no objective indications for in vitro fertilization. In our country, as in some other countries, there are no age restrictions for IVF, as well as restrictions on civil status patients. Any unmarried, single woman can, if indicated, undergo IVF under compulsory medical insurance, but the donor material that will be used is not included in the program estimate and must be paid for separately. This also applies to the use of donor eggs.
Contact us at the AltraVita clinic, and our specialists will do everything possible to ensure that in vitro fertilization under compulsory medical insurance is successful. We employ experienced and highly qualified specialists who carefully examine your case and select an individual protocol; if necessary, offer donor sperm or eggs; we have our own cryobank and donor database.
Our embryologists have great experience work on growing embryos on nutrient media, and, if necessary, will carry out additional auxiliary ART methods, such as ICSI.
The treatment of reproductive dysfunction and the implementation of examinations and analyzes require a significant amount of financial resources, and not every married couple diagnosed with infertility can afford such expenses.
A state project aimed at helping childless families “ICSI for free” is being implemented on the territory of the Russian Federation. The federal program involves the implementation of artificial conception procedures using a compulsory medical insurance policy or quotas. In the latter case, financial resources are allocated from federal quotas allocated to eliminate problems of the reproductive system.
The IVF Center clinic in Crimea operates under such a program and offers its services to infertile couples. ICSI is free under the federal program and has certain rules for patients to participate in the selection. It should be taken into account that in different regions of the country there are quotas from the federal and local budgets, and the algorithms for obtaining funds may vary. Treatment under compulsory medical insurance is carried out on a first-come, first-served basis.
IVF ICSI under compulsory medical insurance: features
In the Russian Federation, state support for infertility treatment has been provided since 2013. IVF was included in the list of methods for treating reproductive dysfunction at the expense of the Compulsory Medical Insurance Fund.
To receive financial support when organizing IVF ICSI under compulsory medical insurance, you will need to prepare a package of documents confirming that you have the right to apply for government support.
One of the important nuances that representatives of families with diagnosed reproductive dysfunction should remember is that it is permissible to claim financial compensation for ICSI under compulsory medical insurance if the cause of infertility is the ill health of the male reproductive system. The current regulations provide for separate funding for the treatment of female and male infertility, and in case of detection of reproductive problems mixed type, free ICSI is unacceptable.
This also applies to pathologies of unknown origin. According to some reports, the conditions of the program may be changed, and there is a possibility that the implementation of ICSI under compulsory medical insurance in 2017 will be free for a much larger number of families, as the project is gaining momentum and demonstrating serious progress.
Now more and more couples suffering from reproductive dysfunction can count on the use of modern technologies to solve health problems.
Quota for ICSI in 2017
There is an opportunity to use not only the resources of the compulsory medical insurance fund, but also to undergo the necessary course of treatment thanks to funding from the federal budget and funds provided by the region. Just like in previous years, a married couple can use this method as the 2017 ICSI quota. It does not lose its relevance, but you should be careful when clarifying the conditions for participation in the program for free treatment. The number of quotas is limited, and an impressive number of applications are submitted annually. The distribution system is established by the representative office of the Ministry of Health. You should be careful when collecting documents and submitting them, so as not to miss your chance due to incorrectly formatted paper.
Is ICSI performed under compulsory medical insurance at the IVF Center clinic in Crimea? Yes, our reproductive medicine clinic provides a similar service, and we make every effort to achieve the most effective treatment result.
You can find out the conditions for participation in the program from the clinic administrator or on our website. IVF ICSI is carried out free of charge at the IVF Center clinic in Crimea if you have a compulsory medical insurance policy and if there are indications for assistance of an appropriate nature. Sign up for an initial consultation - and we will be happy to help you!
If just recently in vitro fertilization seemed to be a procedure that was not available to everyone due to its high cost, then since 2013, all infertile couples who have no contraindications have a chance to become parents with the help of reproductive technologies. Thanks to the inclusion of the procedure in the state guarantee program, it is done free of charge - under the federal quota or compulsory medical insurance policy. How to get a quota for IVF? Read about this in the article.
Today you can undergo the artificial insemination procedure for free in two cases:
Quota under the compulsory medical insurance program
You can get a quota for IVF only if there are indications
IN in this case ART is paid for by the territorial health insurance fund. Women whose infertility is caused by one of the following factors can count on receiving it:
- lack of ovulation;
- tubal infertility;
- cervical factors;
- male factor;
- hormonal disorders (excess estrogen);
- ovarian failure;
- PCOS.
The patient has the right to receive the following free services:
- puncture;
- in vitro fertilization;
- embryo culture;
- transfer
The price does not include donor and surrogate mother services, cryopreservation, . It is possible that you will have to pay additionally for some hormonal drugs, necessary for stimulation, although the basic set is included in the range of services provided under the policy.
Quota for the provision of high-tech medical care
In this case, the procedures are paid for from the budget, and the patient is sent for treatment to a federal institution. Patients can count on receiving federal assistance:
- with a complicated medical history;
- mixed type of infertility;
- after long and unsuccessful treatment in regional clinics;
- with confirmed .
The list of services that a patient can receive under the federal quota for medical treatment has been expanded compared to treatment under an insurance policy. For example, if indicated, preimplantation diagnostics and hatching can be done free of charge. Full list manipulations that will be paid for from the budget must be clarified in the selected clinic.
How to get a quota for free IVF?
In addition to having indications, to enter free in vitro fertilization programs, patients must collect a number of documents. What do you need to get a quota for IVF? An approximate procedure will be described below.
- Obtaining a certificate from a therapist.
The certificate is necessary so that the commission that will decide on admission to the program can make sure that the woman has no contraindications to IVF. In order to obtain a certificate, you must first obtain the conclusions of a narcologist and a psychiatrist, as well as undergo examinations based on referrals from a therapist:
- take general urine and blood tests;
- do a blood test for glucose, syphilis and HIV;
- undergo an ECG;
- do fluorography.
- Obtaining an extract from a medical institution where monitoring for infertility is being carried out.
To do this, you need to contact your gynecologist, who will prescribe an additional examination to confirm the diagnosis. The list of analyzes and instrumental studies is quite wide. The basic list looks like this:
At the same time, all medical documentation, including test results, from private clinics and licensed commercial laboratories must be accepted in government institutions. It is important to think through the sequence of tests, taking into account their expiration dates, which the gynecologist will indicate.
When the results of all tests are in the hands of the gynecologist, he must, within three days, prepare an extract from the medical history indicating the diagnosis and results of the examinations. The extract is certified by the chief physician of the institution, after which it is necessary to obtain the consent of the chief specialist of the region (reproductologist or gynecologist). To obtain a quota for IVF in Moscow, you must contact a specialist from the relevant administrative district, who will endorse the clinic’s conclusion.
It is this commission that will make a decision whether to include the patient in the IVF program under compulsory medical insurance, in the federal quota program, or to refuse free IVF. You must provide the following documents (originals and copies):
- passport;
- SNILS;
- compulsory medical insurance policy;
- an extract from the medical history with the results of tests and studies;
- written application (forms will be provided on site);
- consent to work with personal data (filled out on site).
- Conclusion of the commission.
The commission examines the received package of documents ( maximum term its consideration must be specified in the relevant regional law) and makes its decision. If the commission has agreed to IVF, the patient receives a referral within three working days - in person or by email. In case of refusal, she receives a written notification within the same period indicating the reasons for the refusal.
What's next?
What should a woman who has received a quota for IVF do next? First of all, choose the institution where the procedure will take place from those proposed by the commission. A package of patient documents will be sent to this institution for placement on the waiting list.
The sequence of actions may be different. You can first select a clinic, undergo an examination there (or provide the results you have on hand), receive an invitation for treatment, and only then begin collecting documents for the Ministry of Health commission. If there is such an invitation, the woman will be sent for treatment to this particular institution.
After a patient is added to the waiting list, the queue can be monitored on the Ministry of Health website. However, the timing of this wait varies:
- If the patient is accepted into the compulsory medical insurance program, then, according to the Government Decree, the waiting period should not exceed 30 days after receiving the referral for hospitalization.
- If IVF is performed according to the federal quota, the wait can be very long, sometimes at least a year. This is due to the large number of people wishing to get treatment at the leading centers in the country and, accordingly, to long queues.
Features of obtaining a quota for IVF
How many times can I get a quota for IVF? The total number of attempts is not limited by law; the decision on the advisability of further attempts remains with the attending physician, but no more than two attempts per year are allowed. In addition, it is important to keep in mind that each time you will have to go through the procedure of taking tests and collecting documents again.
IVF can be done at the expense of compulsory medical insurance in
This year in Clinic "Mother and Child" Khodynskoye Pole(legal and registry name of the clinic: IVAMED LLC) You can undergo IVF treatment at the expense of the compulsory health insurance fund (CHI) free of charge for the patient. Our clinic is included in the register of medical organizations participating in the implementation basic program Compulsory medical insurance. Our registration number:
in Moscow - 775268.
in the Moscow region - 509687.
What is included in the IVF program funded by compulsory medical insurance?
As part of the implementation of IVF under compulsory medical insurance, next steps:
· Initial examination by a fertility specialist
· Stimulation of controlled superovulation (including all necessary for this medicines)
· Folliculometry (repeated visits to the attending physician to assess the growth of follicles and endometrium, against the background of ovulation stimulation)
· Transvaginal puncture of follicles, performed under general intravenous anesthesia
· Ejaculate processing
· Fertilization of the obtained eggs using IVF and/or ICSI, depending on the indications
· Cultivation of embryos up to 3 or 5 days of development
· Transfer of one to two embryos (ET) (in exceptional, medically justified cases, transfer of more embryos is possible) into the uterine cavity under the control of ultrasound examination
What is not included in the scope of IVF under compulsory medical insurance (paid separately)?Vitrification of remaining embryos good quality
· Thawing and transfer of vitrified embryos
· Donor sperm (if necessary)
· Preimplantation genetic diagnosis (PGD/PGS) to identify chromosomal abnormalities and monogenic diseases
· Assisted hatching
· Repeated consultations with a doctor at the selected health care facility after receiving the hCG results (14th day after PE) and beyond
· Drugs prescribed to maintain pregnancy (if the latter occurs) later than the 14th day after PE
How to get a referral to the Mother and Child Clinic Khodynka Field for IVF under compulsory medical insurance?1. You need to contact the antenatal clinic at your place of residence.
2. The antenatal clinic doctor conducts the necessary examinations, confirms the fact of infertility, makes sure that there are no contraindications to pregnancy and the rationality of using IVF.
Then you will be sent with documents to the district commission to receive a referral to the medical institution of your choice.
Remember! The choice of clinic is up to you! The antenatal clinic doctor and members of the commission can only recommend certain clinics, but the final decision remains yours! In the register of medical organizations of the territorial compulsory health insurance fund, our clinic has a registration number in Moscow - 775268, in the Moscow region - 509687775268 (Ivamed LLC)
3. If the commission’s decision is positive, the next step is to make an appointment with a fertility specialist at our clinic by phone Single Contact Center “Mother and Child” 8 800 700 700 1. After confirming your appointment, you come to the Mother and Child Clinic, Khodynskoye Pole, and at a doctor’s appointment you determine the date of entry into the protocol (the start date of the protocol is determined medical indications). Don’t forget to take the originals of the examination results, the original referral from the territorial commission, an extract from the medical record (original), passport and medical insurance!
Attention! IVF treatment at the Mother and Child Clinic Khodynskoye Pole can citizens of any region of the Russian Federation can pass (regardless of their place of registration and residence)! In some cases, after checking with the doctor in the IVF department, for patients in other regions of Russia, you may need a letter of guarantee from the insurance company that they undertake to pay for your treatment.
Who can use this service?
IVF treatment at the expense of compulsory medical insurance does not provide for restrictions on patients marital status, place of residence and age. The only conditions are Russian citizenship, the presence of a valid compulsory medical insurance policy and a confirmed diagnosis of infertility.
It is important to know! Patients over 43 years of age who have a low ovarian reserve (AMH less than 1) should be informed about the extremely low effectiveness of the IVF program with their own oocytes and the advisability of using donor germ cells. The oocyte donation program in the treatment of infertility at the expense of compulsory medical insurance is not included! Surrogacy is also not included in the IVF program at the expense of compulsory medical insurance.
Both married couples with an officially registered marriage, couples living in a civil marriage, and single women can undergo IVF at the expense of compulsory medical insurance.
Of course, patients who have contraindications to pregnancy or stimulation of superovulation, due to concomitant diseases, require their treatment first and can receive a referral only after eliminating contraindications.
Scroll necessary research for IVF under compulsory medical insurance.
The list of studies required to carry out IVF under compulsory medical insurance is regulated by Order No. 107 of the Ministry of Health of the Russian Federation:
Research, necessary for a woman and their validity period:1. Fluorography (12 months) or x-ray of organs chest(24 months)
2. Therapist’s conclusion about the absence of contraindications to pregnancy (12 months)
3. Clinical blood test (1 month)
4. Hemostasiogram (1 month)
5. Biochemical blood test (total protein, albumin, glucose, creatinine, urea, AST, ALT) (1 month)
6. General analysis urine (1 month)
7. Microscopic examination of smears for flora from 3 points (vagina, urethra, cervix) (1 month)
8. Cervical smear for oncocytology (12 months)
9. Colposcopy (12 months)
10. Ultrasound of the thyroid gland (12 months)
11. Ultrasound of the mammary glands (up to 35 years) or mammography (after 35 years), mammologist’s report (12 months)
12. Microbiological examination (culture) from cervical canal for mycoplasma and ureaplasma with determination of sensitivity to antibacterial drugs (6 months)
13. Smear (PCR) for chlamydia, herpes simplex virus types I and II, CMV and human papillomavirus types 16 and 18 (6 months)
14. Blood test for RW, AgHBS, ntiHBcor, antiHCV, HIV (3 months)
15. Blood on TORCH infections– complex (rubella, CMV, toxoplasma, HSV 1 and 2) (1 year)
16. Blood type and Rh factor (indefinitely)
17. ECG (1 month)
Examination of husband/partner1. Spermogram + MAR-test (3 months)
2. Microbiological examination (culture) from the urethra for mycoplasma and ureaplasma with determination of sensitivity to antibacterial drugs (6 months)
3. Smear (PCR) for chlamydia, herpes simplex virus types I and II, CMV and human papillomavirus types 16 and 18 (6 months)
4. Blood test for RW, HBSAg, antiHBcor, antiHCV, HIV (3 months)
5. Antibodies to HSV types 1 and 2 by ELISA (6 months)
6. Microscopic examination of smears from the urethra for flora (3 months)
7. Blood type and Rh factor (indefinite).
8. An andrologist’s conclusion regarding male factor infertility about the treatment performed and its effectiveness.
The number of quotas allocated for this year is limited!
You can find out more information about the remaining quotas at the Clinic by making an appointment for a free initial appointment with a fertility specialist.
