Problems of organizing the preparatory stage of medical care with the use of assisted reproductive technologies in men

Abstract

Introduction. The demographic crisis that has taken shape in recent years in the Russian Federation has multifactorial causes. The leading place among the most significant factors of its development is taken by the growing number of infertile couples, including those caused by reproductive limitations in men. The aim of the study was to identify the main problems in the organization of medical care using assisted reproductive technologies (ART) by interviewing patients. Materials and methods. An anonymous survey of 297 men (husbands, partners) participating in ART in medical institutions in St. Petersburg in 2021 was conducted using a specially designed questionnaire. Results. Only 14.2 % of patients had a preliminary examination completed within a time frame of less than six months. One in ten respondents (10.7 %) was diagnosed between 6 months and 1 year. Preliminary examination for more than 1 year was completed by 68.0 % of the men who participated in the survey. The average duration of examination of men when receiving medical care free of charge was significantly longer than that for paid medical services: 13.4 ± 1.2 months and 10.3 ± 0.9 months respectively (t = 4.7, p = 0.02). The main reasons for men to seek medical care for a fee were the following: long waiting period for urologist's consultation and diagnostic examination in the outpatient clinic at the place of residence (31,4 per 100 respondents); lack of possibility to perform all the necessary examinations and consultations at the place of residence for free (26,3 per 100 respondents); queues in the state medical organizations (16,8 per 100 respondents). Only 23.1 % of men did not experience psychological discomfort while receiving medical care. Discussion. Restrictions on the availability of medical care for the examination of men participating in the ART procedure are expressed in the failure to comply with the principles of its free-of-charge nature, the established waiting periods, and the lack of the possibility in some cases to perform the necessary analysis or examination in the medical organization of one's place of residence. Conclusion. The conducted research allowed us to form an idea of the main problems in the organization of medical care faced by men undergoing examination in preparation for IVF procedures.