Translation. Region: Russian Federal
Source: Moscow Government – Government of Moscow –
Blood analysis to assess reproductive potential, freezing eggs in a cryobank, genetic research in embryo laboratories – this is not a fantasy story, but the reality of Moscow medicine. Free program “I’ll become a mother” helps women plan their pregnancy and give birth to a healthy baby. More than 200 thousand residents of the capital have already become its participants.
On the eve of International Women’s Health Day, celebrated on May 28, a mos.ru correspondent spoke with doctors and patients about a unique project. We tell you at what age the supply of eggs begins to run out, how to maintain the ability to get pregnant, and what diseases, thanks to modern technology, are no longer a death sentence for happy motherhood.
Women’s Health Under Control. What is the Benefit of Anti-Müllerian Hormone Analysis?
The “I’ll Become a Mom” program was launched in September 2024. It is primarily aimed at Muscovites aged 25 to 39. To participate in the program, you need a Moscow compulsory medical insurance policy and an attachment to a city women’s clinic or women’s health center (opened on the basis of multidisciplinary hospitals).
Women often postpone pregnancy for personal or medical reasons. The goal of the project is to tell people that the supply of eggs is exhaustible, to help assess this reserve, maintain reproductive health and realize the dream of becoming a mother. The first test within the program is an analysis of the anti-Müllerian hormone (AMH). It shows the quantity and quality of eggs. Usually, it peaks at 25 years, then it begins to gradually decrease. From 32–34 years, and sometimes earlier, the rate of decrease in the AMH level increases. You can take the test even if you do not plan to get pregnant in the coming years. The test does not oblige you to do anything, it only allows you to keep the situation under control. Some are afraid to take the test: what if the level is too low? You should not bury your head in the sand. Today, doctors have options for solving the problem. Vera Korennaya, chief freelance gynecologist of the capital’s Department of Health
Patients aged 25–39 are referred to donate blood automatically. The exception is pregnant women and mothers with newborns. The test is available in the electronic medical record. If it is not available, you need to contact an obstetrician-gynecologist. Girls aged 18–24 for medical reasons, and women aged 40 and older can also receive a referral from a doctor.
You can donate blood on a convenient day at a women’s clinic or women’s health center. The result and decoding will appear in the electronic medical record. A reading of 1.5 or higher indicates that the egg supply is normal. 1.49 or lower indicates that it is running low. This number opens up additional program options. Such a patient is invited to an appointment with an obstetrician-gynecologist, who talks to her about future motherhood. The doctor will also suggest that she take steps to preserve eggs or embryos so that she can become a mother in the future. If the woman is interested in this, she will be examined: for example, the patency of the fallopian tubes and the number of follicles in the ovaries will be assessed. This will assess the ability to conceive on her own and exclude contraindications to further procedures. After that, the doctor will issue a referral to a reproductive specialist. Nadezhda Sokolova, Head of the Women’s Health Center, City Clinical Hospital No. 15 named after O.M. Filatov
Muscovite Ksenia Gonchar became interested in the project when she saw a referral for an AMG test in her medical record. She is 29 years old, and she and her husband have two children. They wanted to have a third, but kept putting it off.
“It seemed like there was time. Despite my experience, I didn’t know what an AMH test was, and I didn’t think about the fact that there was a time limit set by nature. The hormone level turned out to be high – 4.4. My husband and I were inspired and decided to use this chance. Now we are expecting our third baby,” she admitted.
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Pregnancy on schedule, or freezing eggs in a cryobank
Becoming a mother in the future may not just be an idea, but a well-thought-out plan. Women with low AMH levels are given a unique opportunity to cryopreserve their eggs or embryos. The procedure is carried out in Family Planning and Reproduction Center of the S.S. Yudin Hospital, National Medical Research Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov and other clinics — partners of the project. After collecting the eggs, the laboratory will determine the best quality ones and either place them in a cryostorage facility or fertilize them and obtain embryos, which can also be preserved for a long time.
The eggs and embryos are frozen in liquid nitrogen at a temperature of minus 196 degrees Celsius. As part of the project, they will be stored in a cryobank for free for two years (the service is available to residents with permanent registration in Moscow or the Moscow region).
“If the patient decides that she is ready to get pregnant, the egg or embryo will be defrosted and, using assisted reproductive technologies, the procedure necessary for pregnancy will be carried out. Cryopreservation not only increases the chance of having a child in the future, but also provides psychological support. A woman is often worried if she has not yet met a life partner, and the body’s resources are exhausted. But she calmly continues the search – confident that in a couple of years she will be able to become a mother. Cryopreservation is also indicated for serious diseases, such as oncology. All efforts are spent on fighting the tumor, but the patient is motivated by the fact that in remission she will use the preserved eggs. This is the mission of doctors – to help find the happiness of motherhood, no matter what the obstacles and life circumstances are,” shared Nadezhda Sokolova.
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Geneticists to help future mothers
It is important not only to plan your pregnancy wisely, but also to take care of the health of your future baby. Before freezing the embryo, you can do preimplantation genetic diagnostics. The study is conducted in embryo laboratories. Thanks to it, doctors identify possible pathologies and choose the healthiest embryo. Today, this is the most accurate and safe method for excluding deviations in the early stages of fetal development, the reliability of the results is close to 100 percent. It is prescribed for medical reasons: for example, if a woman has had miscarriages or unsuccessful IVF attempts, if one or both parents have hereditary pathologies. The condition for participation is permanent registration in Moscow or the Moscow region.
“Diagnostics are also offered to women aged 35 and older. The fact is that the probability of having a child with chromosomal abnormalities increases with age. The study allows you to carry and give birth to a healthy child. First, specialists take material: from a woman – eggs, from a man – sperm – and carry out an artificial insemination procedure. After it, the embryo begins to grow due to cell division. Several of them are safely taken to check for common pathologies. In the future, a woman will be able to do the IVF procedure under the compulsory medical insurance policy,” Nadezhda Sokolova emphasized.
Yulia Mikhailova is 34 years old. She dreams of a second child, but in the coming years she plans to build a career, and the AMH level is decreasing. She and her husband decided to freeze the embryo.
“I was amazed by the empathy of the doctors at the Family Planning and Reproduction Center of the S.S. Yudin Hospital. They treat their patients with all their heart. And this is not my last chance to give birth. What kind of concern they must show for women whose chance of becoming a mother is one in a thousand! We conducted a genetic study, during which it turned out that the resulting embryo cannot be transplanted: there is a high probability of miscarriage. The doctors calmed me down, inspired me, prescribed therapy, and then we will try again. I am convinced that the second time we will get a healthy embryo, and we will freeze it. I will have a reserve that I will be able to use later. Today, the obstetric and gynecological service is so developed that women give birth to healthy children even at 40 years old,” says Yulia Mikhailova.
“An annual medical examination – and you are in the safety zone”
Moscow is introducing a new standard of obstetric and gynecological care. Five women’s health centers have already opened — clinics where you can undergo examinations, prepare for pregnancy, and see a doctor after the birth of your child. Modern perinatal centers have been built, and maternity hospitals have been equipped with cutting-edge equipment. All this allows us to successfully manage even the most difficult cases of pregnancy, care for newborns with extremely low body weight, and diagnose and treat diseases in children at the stage of intrauterine development.
“Even 40 years ago, some diagnoses were a death sentence. Oncology, blocked fallopian tubes, kidney transplant, systemic diseases such as lupus – and they put a cross on having children. Modern Moscow medicine helps to become a mother in different situations. But regular examinations are important. Infertility can be overcome when the signs and causes that lead to it are identified in time. Cancer is curable when it is detected in time. An annual medical examination – and you are in the safety zone. You can undergo it in the capital’s clinics – quickly and comfortably,” concluded Vera Korennaya.
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