Infertility and reproductive technologies: contradictory Russian development and possible population impact
Olga G. Isupova, Institute of Demography of the Higher School of Economics, Moscow
Nina E. Rusanova, Russian Academy of Sciences
Infertility incidence - figures according to various evaluations, as well as sociological and (regional) epidemiological research are present in the paper, followed by discussion of social meaning of infertility with its still stigmatizing nature, which probably results in lower than real incidence figures in some surveys, based on self-evaluation. Especially striking is the difference between male infertility rate in the surveys and in medical epidemiological research. In addition, surveys and census data cannot provide with proper account of secondary infertility. There also is data provided on infertility reasons which are the most widely spread. Hormonal disorders are the most frequent both in rural and urban areas of one case study region. However, they are more severe in the city, where endometriosis also much more often causes infertility than in the village. Abortion complications, contrary to what some Russian officials believe, become infertility reason only in the minority of cases. Assisted reproductive technologies already have a story of successful development in Russia, however mostly limited to Moscow and Saint-Petersburg. Although now geography of IVF clinics is much more extensive and diverse than it was in the 1990-s, concentration in two largest cities prevails as before. Data on success rate of ART in Russia is presented, as well as percentage of ART-related births in overall fertility, in comparison to the countries where this percentage is maximal (in Russia, only 0.45% in the 2007, but there is a potential for development, considering growing number of clinics and thus ART availability). Given growing average mother age at birth, the potential for future ART demographic impact is even higher. Some analysis of ART-related and not ART-related TFR components is present. It demonstrates that not ART-related fertility is almost stable while ART-related fertility grows steadily.