Russian Association of Human Reproduction:
25 years of the struggle against infertility and prejudice
How it all began

A giant leap in assisted reproductive technology (ART) occurred at the beginning of the XXI century. Today, society believes in ART and understands the significance of methods of artificial insemination in the fight against infertility. However, such a breakthrough would not have been possible without the many years of hard work by the originators of ART who conducted the first tentative attempts, sometimes without any funding or support from colleagues and the state. Through the efforts of enthusiasts, the human reproduction industry in Russia, although it has not become an official medical specialty, has been recognized and is continuing to develop at an accelerated pace.

The isolation of the Soviet Union from the world scientific community hampered the development of assisted reproductive technology: international congresses and foreign literature were banned; nevertheless Soviet doctors managed to find information, conduct their own research, and in 1986 the first successful results of IVF were obtained in Moscow and Leningrad (now Saint-Petersburg).

The Russian reproductive technology industry was started by leaders of the first centers of infertility treatment: Anatoly Illarionovich Nikitin in St. Petersburg, Fyodor Vlasovich Dakhno and Viktor Ivanovich Grishchenko in Kharkov, and Valery Mstislavovich Zdanovsky in Moscow. They pioneered many areas of ART.
We were the first in the USSR to conduct the GIFT and ZIFT procedures (transfer of embryos not into the uterus, but into the fallopian tube), to apply the IVM method (obtaining immature eggs that would become mature outside the body, then fertilizing them and transferring them to the uterus).
In our center the first ICSI was made and the first child was born here by a 57-year-old menopausal woman. All this happened in the 1990s
Says Valery Mstislavovich Zdanovsky
The First Conference in Dagomys (Sochi)

This success encouraged the leaders of the emerging direction of human reproduction to arrange in the USSR a conference on problems of infertility treatment. The historic event took place on October 1, 1991 in Dagomys. About 300 specialists attended the conference – those who either directly or indirectly confronted the issues of overcoming infertility.
It was a significant event, the first experience of organizing a conference for gynecologists on such a narrow topic as infertility treatment
Margarita Beniaminovna Anshina, the RAHR founder
The first historical event was held
on October 1, 1991 in Dagomys

Today, the conference would seem primitive: there were no electronic presentations, and rather routine methods were discussed. Laparoscopy that enables the restoration of the tubal patency was the only modern subject. However everything went well. It was obvious that reproduction had a future. We have great prospects." IVF was also for the first time discussed in Dagomys: the program has assisted for the first children to have already been born.

To unite efforts to combat infertility, to develop the ART and to hold regular professional meetings, it was decided at the conference that a Reproduction Association should be established. It appeared in the Soviet Union, and two months later, in December 1991, it was transformed into the Russian Association of Human Reproduction.
Visionaries of the ART development in Russia

The idea of creating the RAHR came from Margarita Beniaminovna Anshina. Having studied the experience of international associations, the founders realized that an official professional association could unite all specialists, direct joint efforts to solve paramount problems and participate in legislative processes. At the turn of the XXI century Russian reproductive technologies were in need of such support. The Council of the Association was established and a Charter was prepared.

Valery Mstislavovich Zdanovsky was elected the first president of the Human Reproduction Association.
He was also engaged in the legal registration of the Association, which took 2 years. It was necessary to solve many formal questions, to find representatives in the regions. Because this required concentrated effort, in the early years the RAHR did little in science and medicine.
But experts from all over Russia and the former Union Republics as regularly discussed in Sochi the problems of overcoming infertility. The level of the conference has been increasing year by year.
The outstanding geneticist Yury Semenovich Verlinsky and his associates were informal leaders of the ART development in Russia in those years. In the early 1990s, the scientist lived in the United States where he was the head of the Chicago Institute of Reproductive Genetics. He also supported the development of IVF in Russia by creating centers and training Russian specialists. Vladislav Stanislavovich Korsak was appointed as the head of one of the centers created by Verlinsky (a branch of the Chicago Institute of Reproductive Genetics in St. Petersburg). In a short time he proved himself to be a talented doctor and competent organizer, and at the next conference of the RAHR in Adler he was elected the President of the Association.
The primary objectives of the RAHR at that stage were not confined to the organizational and scientific development of reproductive medicine in Russia. The association had to inform doctors and patients of methods of artificial insemination, and had to overcome public distrust and the skepticism of colleagues. Then no one had reliable information. Many obstetrician-gynecologists themselves persuaded patients that IVF was a dubious and inefficient technology. The task of spreading information set by the RAHR was assisted by the mass media always drawn to the subject of IVF, which was rich in beautiful stories, contradictory, mysterious and vital.
State support

Nowadays, it is not necessary to explain what IVF is. The technology is known and has been widely used, and many Russian women using the ART have given birth to a long-awaited child. Now in almost every region of Russia there are about 200 IVF centers.

The technology importance in the fight against infertility has been recognized by the State. In 2007, in vitro fertilization was included in the program of high-tech care, and by now 520 patients have undergone IVF at the expense of the State. Since 2013, IVF has been partly, and since 2016, fully covered by the program of mandatory medical insurance.
Support for the IVF only as part of high-tech medical care limited the number of the medical organizations involved. As a rule, high-tech medical care is provided only by federal institutions. The availability of ART for the population was restricted both by geography and by long waiting lists. The introduction of IVF in Compulsory Health Insurance (CHI) contributed to the expansion of the range of organizations. Now more than 120 medical (state, municipal, private and departmental) centers perform IVF within the CHI program
Oleg Semenovich Filippov, Deputy Director of the Department of Development of Medical Care for Children and the Service of Obstetrics in the Ministry of Health and Social Development of the Russian Federation
Today, queues to have a CHI covered IVF are eliminated within a year. There are commissions at health departments that review each case and include it in the waiting list and a number is assigned to the patient. The woman can choose the organization from the list of the Federal Compulsory Medical Insurance Fund (FCMIF), which is formed every year, and uses the website of the regional Ministry of Health to monitor the queue movement.

Based on an interview with M.B. Anshina

The RAHR today

Today, the RAHR unites human reproduction specialists across Russia – from Kaliningrad to Vladivostok. The Association's subdivisions function in the regions.
For 20 years the VRT Register of the RAHR has been collecting, analyzing and publishing reports on the cycles of ART in Russia. Since 1995 the Association has been publishing the Journal Problems of Reproduction, where translations of foreign articles are published. In addition, the RAHR as a public organization is involved in the development of regulatory documents. Special surveys are conducted to find the opinions of every member in order to form a common position.
Annual conferences of the RAHR are attended by thousands of participants, dozens of Russian and foreign experts. In addition to the general event, regional events are held.
Most of them are educational in nature: the Association has been actively involved in the introduction of the system of continuous medical education, which is especially important, because there is no "reproductology" (fertility science) specialty in Russia. The only way to master knowledge and skills is to learn from colleagues.
The RAHR has also been successful in international activities. It is a part of the European Society of Human Reproduction and Embryology (ESHRE), and Russian specialists annually attend the ESHRE conferences, and provide data for the European Register of ART. The president and scientific secretary of the RAHR, Vladislav Stanislavovich Korsak and Anna Anatolievna Smirnova, belong to the management of the International Federation of Fertility Societies (IFFS). Connection has also been maintained with the Associations of Human Reproduction of Armenia, Belarus, Kazakhstan, Latvia and Ukraine. This all contributes to the awareness of advanced medical experience, to leading foreign experts attending Russian conferences, and participation in international events, programs and research. Many Russian reproduction specialists are trained in western centers and adopt the best technologies.
It is worth emphasizing that ART includes many aspects as the success is dependent on the efforts of different specialists. That is why the Association unites both obstetricians and gynecologists, and ultrasound specialists, urologists, andrologists, pediatricians and psychologists. All of them meet not only at the official events, but also at informal gatherings: once a year the doctors go on a kayak tour along the Siberian rivers.
Today the RAHR is not just a formal association, but a solid team of doctors, where the contribution of each individual specialist is of great value. This attitude has provided for the Russian Association for Human Reproduction to celebrate its 25th anniversary as a strong prosperous organization with a rich past, a successful present and a confident view of the future.