Chances for the future: Russia forms a new strategy to combat infertility
There is a contradictory situation in Russia: according to official data, the number of cases of male infertility has decreased by more than 25%, however, regional monitoring records serious health problems among young people and as many as half of men in some regions of the federation. Experts emphasize that only an integrated approach and the urgent active participation of the state will be able to change demographic dynamics and improve the reproductive health of the country's residents. All the details are in the Izvestia article.
The reproductive mirror of the country
According to the Ministry of Health, from the beginning of last year to the summer of this year, over 12.5 million Russians underwent a reproductive system examination, and 12.9% of women and 2.1% of men were diagnosed with diseases that make it difficult to conceive a child. At the same time, 9% of adolescents aged 15-17 also showed various reproductive abnormalities. The Russian Association of Human Reproduction (RARCH) has already called on the specialists of the Ministry of Health to urgently adjust the clinical recommendations on male infertility: among other things, it was proposed to include the term "Male infertility factors" in the clinical recommendations, including not only "absolute male infertility", but also the concept of "male reproductive function deficiency".
Karina Sagamonova, Chairman of the RARCH Council, points out that, according to Rosstat, about 11 thousand men and 66 thousand women diagnosed with infertility are registered annually in the country. In addition, women are increasingly delaying the birth of children. The expert points out that every 10th Russian woman does not become a mother by the age of 45.
—Issues of protecting and promoting reproductive health are among the priorities of state policy,— says Sagamonova. — In 2024, 97% of teenagers aged 15-17 underwent a preventive examination, which is significantly higher than the planned figure. This is an important result, because early diagnosis helps to prevent future fertility problems.
Analysts have identified the level of final childlessness in Russia, estimating the proportion of women in each generation who have not given birth to a single child by the end of the reproductive period. The study showed that approximately 10% of Russian women did not become mothers by the age of 45-49. In the 35-39 age group, 14% of women remain childless, with about 5-6% of first births occurring in women over 35, and their share has been steadily growing over the past 20 years, the expert notes.
At the same time, according to the Federal Compulsory Health Insurance Fund, in January –December 2024, about 6.7 million people underwent medical examinations to assess reproductive health, including 2.6 million men and 4.1 million women. And one in 10 had diseases of the reproductive system and risk factors that negatively affect reproductive health.
The importance of updating and improving systemic measures to improve demography is also pointed out by the NF expert.Analytics", President of the Society of Specialists in Reproductive and Sexual Medicine Roman Aliyev. He emphasizes that the level of pathology among the surveyed Russians has already acquired demographic significance and requires special attention.
"Violations have been identified among teenagers and adults, indicating a national problem," he notes. — The President instructed to ensure the availability of assisted reproductive technologies and expand the possibilities of medical examinations. Therefore, today it is not just a medical task, but a strategic one.
Izvestia sent inquiries to the press service of the Ministry of Health, Roszdravnadzor and the office of Deputy Prime Minister Tatyana Golikova regarding the government's plans to implement the instructions of the head of state, but no clarifications had been received at the time of publication.
Important analyses
It's not just about annual surveys. Experts demand to update the clinical standards of the Ministry of Health themselves. The focus is on the precise definition of male infertility factors.
Karina Sagamonova believes that the current recommendations require revision: in the current version, they do not reflect real statistics and create distortions in medical reporting.
The same position is supported by Sergey Borovets, a urologist and a leading researcher at the Scientific Research Center of Urology at the Pavlov Moscow State Medical University Institute of Surgery and Emergency Medicine.
"In half of the cases, the male factor becomes the cause of infertility," he says. — Even with a normal spermogram, we see hidden violations. We need a more comprehensive approach to diagnosis and new terminology that reflects the real clinical capabilities of medicine.
The Russian Society of Urology (ROE) stands in solidarity with him. They add that interdisciplinary approaches and a new standard for diagnosis have appeared in the recommendations updated in 2025.
"Reproductive failure is not a private problem of a man, but a common problem of a couple," the ROE emphasizes. — Only the joint work of medical specialists will be able to increase the effectiveness of treatment and prevention.
The demographic frontier
The role of the state in changing the situation is becoming key. Sagamonova notes that the medical examination of reproductive health is a unique measure that has no analogues. Since 2024, it has been included in the program of state guarantees of free medical care and has become an early diagnosis tool.
— We proposed to include in the program a mandatory study of the level of anti—Muller hormone in women, - Sagamonova explained. — This indicator is able to identify the reproductive resource of the body long before the loss of fertility. If detected in a timely manner, the patient can be referred to a reproductologist.
Such measures are linked to the national goals outlined by the Russian president: by 2030, the total fertility rate should rise to 1.6, and by 2036 to 1.8.
Roman Aliyev adds that the Ministry of Health's order No. 211n came into force in September 2025, according to which preventive examinations to assess reproductive health now begin at the age of six.
"This is a radical change," he notes. — It is important to identify violations at the earliest stages and correct them immediately. In addition, the government is expanding quotas for free IVF programs — in 2025, more than 103,000 women will be able to use them.
Early diagnosis of varicocele in boys
The problem of male infertility has finally been recognized as systemic. Professor Borovets draws attention to the fact that the medical examination of adolescents helps to identify varicocele in time — the most common cause of fertility loss.
—Early diagnosis of varicocele in boys allows us to preserve their reproductive potential," the professor notes. — This is a simple measure, but it directly affects the future demography of the country.
State Duma deputy, Honored Doctor of Russia Tatyana Kusayko believes that the second wave of medical examinations for men has become an important step.
"Now men undergo a comprehensive examination, including semen and microflora analysis," she says. — This will allow you to diagnose problems long before they become an obstacle to conception.
Her colleague, State Duma deputy and doctor Tatiana Butskaya, urges to work with the motivation of citizens.
"People need to realize that health is not a one—time event, but a lifestyle," she notes. — Especially men often ignore prevention, and this is what prevents them from solving fertility problems in a timely manner.
How to reduce the risk of a frozen pregnancy and increase the chances of conception
Russian modern medicine already offers innovative methods of treatment. For example, low-energy laser therapy has already been introduced at Pavlov St. Petersburg State Medical University, Professor Sergey Borovets told our publication. He notes that this method significantly reduces the risk of a frozen pregnancy and increases the chances of natural conception.
Alexander Lapshikhin, a reproductologist and head of the ART department at the Remedi Clinic, adds that Russia is one of the leading countries in terms of coping with infertility.
"We have advanced treatment methods and government programs to preserve fertility," he says. — It's more likely that other countries should adopt Russia's experience. But the main prevention remains the health of the person himself: proper nutrition, rejection of bad habits and physical activity.
Taras Shatylko, a urologist from the Department of Andrology and Urology at the Kulakov National Research Medical Center of Obstetrics, Gynecology and Perinatology of the Russian Ministry of Health, confirms that the number of infertility diagnoses has stabilized, but constant prevention is needed, especially among young people.
"Early diagnosis in adolescents helps to identify hormonal and anatomical abnormalities," he notes. — The earlier the treatment begins, the higher the chance of maintaining the ability to procreate.
Fertility Care
In fact, for the first time, government agencies consider reproductive health not only as a medical but also as a social task.
Roman Aliyev directly emphasizes: New regional initiatives, such as the Men's Health Project in the Altai Territory and the I'll Become a Mom program in Moscow, should become federal.
"These projects are shaping a culture of fertility care," he says. — Only comprehensive diagnostics, medical examination and education will ensure a steady increase in the birth rate.
Karina Sagamonova concludes that it is the systemic interaction of education, medicine and the state that will help correct the demographic trajectory.
— Promoting a healthy lifestyle, involving young people, supporting families and the availability of modern technologies — these are what determine the future of Russia's reproductive potential today, — summarizes the head of the Council of the RARCH.
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