Demography and social economy, 2018, 2(33):82-93
doi: https://doi.org/10.15407/dse2018.02.082
UDC 314.3:618 (477)
JEL CLASSIFICATION: J13

V.P. Dumanska
PhD (Еcon.), Senior researcher
Ptоukha Institute for Demography and Social Studies
of the National Academy of Sciences of Ukraine
01032, Ukraine, Kyiv, blvd Taras Shevchenko, 60
E-mail: vita.dumanska@gmail.com

CONTRIBUTION OF ASSISTED REPRODUCTIVE TECHNOLOGIES TO FERTILITY IN UKRAINE
Section: DEMOGRAPHIC PROCESSES
Language: Ukrainian
Abstract: The paper aims to provide a comprehensive analysis of the use of assisted reproductive technologies in Ukraine, assess their availability and determine possible contribution to fertility. According to statistics, about 1.6 % of children each year are conceived using assisted reproductive technologies, and this indicator is rapidly increasing. Rapid spreading of reproductive treatment can have a number of demographic implications, among them postponement of first birth, increasing number of multiple deliveries, changes in population sexual structure due to selection of the embryo sex. The author compares the structure, scale, and effectiveness of the assisted reproductive technologies application in Ukraine and European countries. In Ukraine, the number of implemented reproductive cycles is 6–8 times less than in developed European countries, while the structure of the use of reproductive methods is quite progressive and similar to the structure in European countries. However, in Ukraine, the effectiveness of reproductive cycles is 15–20 % lower (depending on the type of reproductive technology). The peculiarities of the use of reproductive technologies for different age groups are outlined. A significant problem for European reproductive medicine is that citizens turn to reproductive clinics after 35 years, and that age is close to the end of fertility. In Ukraine, 52 % of reproductive cycles occur for women under the age of 35. This can be a significant reserve for increasing the efficiency of the use of assisted reproductive technologies. Based on the detected scale of female and male infertility, high demand for the use of assisted reproductive technologies has been identified. The author evaluates the availability of assisted reproductive technologies in Ukraine on the basis of the calculation of the average cost of birth (for ICSI and IVF methods). The calculations include primary medical diagnostic, the cost of fertilization services and associated medical services, as well as the cost of delivering. The calculations are based on data from the private reproductive clinics of Kyiv (as of 01.03.2018).
Key words: fertility, infertility, assisted reproductive technologies, order of births, cohort fertility, abortion.
References:
1. Statystychnyj biuleten’. Tablytsi narodzhuvanosti, smertnosti ta seredn’oi ochikuvanoi tryvalosti zhyttia [Statistical bulletin. Birth rates, mortality and average lite expectancy]. (2017) Derzhavnyj komitet statystyky [State Statistics Service of Ukraine]. database.ukrcensus.gov.ua. Retrieved from http://database. ukrcensus.gov.ua/PXWEB2007/ukr/publ_new1/2017/BL1001_2017_02_born.pdf [in Ukrainian].
2. Mul’tyindykatorne klasterne obstezhennia domohospodarstv [Multiindicator Cluster Survey of Households]. (2012). State Statistics Service of Ukraine. Kyiv : K.I.S., 2013 [in Ukrainian].
3. Informatsijno-statystychnyj dovidnyk pro dopomizhni reproduktyvni tekhnolohii v Ukraini [Information and Statistical Directory on Assisted Reproductive Technologies in Ukraine]. (2017). Center of medical statistics of Ministry of Health [in Ukrainian].
4. Chamber, G. (2014). The impact of consumer affordability on access to assisted reproductive technologies and embryo transfer practices: An international analysis. Fertility and Sterility,101(1), 191-198. doi: https://doi.org/10.1016/j.fertnstert.2013.09.005
5. Bromer, J., Ata, B., Meltemc, S., Charles, L., & Emrea, S. (2011). Preterm deliveries that result from multiple pregnancies associated with assisted reproductive technologies in the USA: A cost analysis. Current Opinion in Obstetrics and Gynecology, 23(3), 168-173. doi: https://doi.org/10.1097/GCO.0b013e32834551cd
6. Leridon, H. (2004). Can Assisted Reproduction Technology Compensate for the Natural Decline in Fertility with Age? A Model Assessment. Human Reproduction, 1548-1553. doi: https://doi.org/10.1093/humrep/deh304
7. Singh, S., Remez, L., & Sedgh, G. (2018). Abortion Worldwide 2017: Uneven Progress and Unequal Access. Guttmacher Institute. guttmacher.org. Retrieved from https://www.guttmacher.org/report/ abortion-worldwide-2017.
8. Ferraretti, F. (2017). Trends over 15 years in ART in Europe: an analysis of 6 million cycles. Human Reproduction, 2, 1-10. doi: https://doi.org/10.1093/hropen/hox012
9. Sorokolat, Yu. (2014). Stan zdorov’ia ditej, narodzhenykh pry zastosuvanni dopomizhnykh reproduktyvnykh tekhnolohij (ohliad literatury) [The state of health of children born with application of assisted reproductive technologies (literature review)]. Sovremennaia pedyatryia - Modern Pediatrics. Retrieved from http://nbuv.gov.ua/UJRN/Sped_2014_1_10 [in Ukrainian].
10. Zegers-Hochschild, F., Adamson, G., & De Mouzon, J. (2009). Revised glossary of ART terminology. Fertil Steril: International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO), 92, 1520-1524. doi:https://doi.org/10.1016/j.fertnstert.2009.09.009
11. Povorozniuk, M.V. (2015). Prychyny porushen’ reproduktyvnoho zdorov’ia u cholovikiv iz bezpliddiam u shliubi [Causes of reproductive health disorders in men with infertility in marriage] Zdorov’e muzhchyny - Menth Health, 2, 162-165. Retrived from http://nbuv.gov.ua/UJRN/Zdmu_2015_2_40 [in Ukrainian].
12. Ziebe, S., & Devroey, P. (2008). Assisted reproductive technologies are an integrated part of national strategies addressing demographic and reproductive challenges. On Behalf of the State of the ART 2007 Workshop Group. Human Reproduction Update, 14(6). doi: https://doi.org/10.1093/humupd/dmn038
13. Leridon, H. (2017). Biological Effects of First Birth Postponement and Assisted Reproductive Technology on Completed Fertility. Population, 72, 445-472.
14. Connolly, M.P., Hoorens, S. & Chambers, G.M. (2010). The costs and consequences of assisted reproductive technology an economic perspective. Human Reproduction Update, 16 (6). Retrived from doi: https://doi.org/10.1093/humupd/dmq013
15. Serednia zarobitna plata za vydamy ekonomichnoi diial’nosti za misiats’ [Average wages by type of economic activity per month]. (2018). State Statistics Service of Ukraine. ukrstat.gov.ua. Retrived from http://www.ukrstat.gov.ua/
16. Imaz, E. (2017). Same-sex parenting, assisted reproduction and gender asymmetry: Reflecting on the differential effects of legislation on gay and lesbian family formation in Spain. Reproductive Biomedicine & Society Online, 4, 5-12. doi: https://doi.org/10.1016/j.rbms.2017.01.002

» pdf