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0CHARACTERISTICS OF THE HEALTH OF CHILDREN BORN THROUGH EXTRACORPORAL FERTILIZATION
Usmonova Kh.E.
Scientific researcher, National University of Uzbekistan named after Mirzo Ulugbek https://doi. org/10.5281/zenodo. 13883598
Abstract. It is known that in recent years, the demand for assisted reproductive technologies in the treatment of infertility, including the practice of in vitro fertilization, has increased, indicating the importance of studying the health and psychological development of children born through in vitro fertilization.
In this article, the process of in vitro fertilization practice, various prenatal and perinatal period changes, and some specific characteristics of the health of children born through in vitro fertilization are highlighted.
Keywords: infertility, assisted reproductive technologies (ART), vitro fertilization (VF), embryo, neonatal period, children's health, psychomotor development, prenatal period, perinatal period, spermatozoid.
In recent years, the rate of infertility is increasing among the population of the whole world, which has undergone epidemiological diseases and environmental changes. According to the latest data from the World Health Organization (December 2023), 17.5% of the world's adult population, that is, every sixth person of the population, suffers from infertility. For this reason, the demand for the use of assisted reproductive technologies (ART) in the fields of reproductive medicine, gynecology, andrology has increased significantly.
In what situations is ART recommended for couples? After a woman and a man undergo infertility tests, if the treatment does not give a positive result, IVF from ART is recommended. Almost any type of male or female infertility can be treated with the help of assisted reproductive technologies. (females up to 49 years old, men up to 55 years old) VF practice now has technically advanced generations, including IVF, IKSI, IMSI, PIXI, ZEYMOT, MARS. It should be noted that the selection of types of infertility treatment using ART is a process dependent on male spermatozoa.
As a result of improvements in reproductive technology, the percentage of successful embryo transfer is increasing every year, resulting in the occurrence of a fetus and the birth of a live child from the fetus.
In recent years, the number of children born with the help of IVF is increasing rapidly, one of them is In vitro fertilization (IVF). The problem of IVF and embryo transfer is not only a medical problem, but also has socio-demographic, economic and moral significance.
This, in turn, is not only the improvement of RNs or the improvement of childbirth, but also the need to study the health of children in the early neonatal period along with the specificity of postnatal development, to compare the structure of the disease, the determined results and the quality of life of single and multiple pregnancy children. [2;32]
LITERATURE ANALYSIS
In the process of studying the health of children born with the help of ART, world scientists have identified the unique characteristics of these children. In particular, A.I. Volkina came to the following conclusions from the results of her research.
The specific aspects of the clinical and anamnestic characteristics of the group of children born with the help of ART are adverse fetal development, various degrees of early labor, low birth weight, long-term hospitalization, sometimes complications of being in intensive care units.
Pathology of the central nervous system as a result of perinatal ischemic-hemorrhagic injury takes the lead in the first-year morbidity structure, neonatal disadaptation, breastfeeding difficulties, and genital pathology are found. [1]
N.A. Maslyaniuk's research and the results of a comparative analysis of IVF children's health showed the following differences. During the period of fetal development delay and perinatal pathology observed, IVF children born from multiple pregnancies differ in the fact that their physical development lags behind, that is, the frequency of development of rickets, anemia, ORVI, gastrointestinal diseases and respiratory diseases is high.
Children of this group showed delayed psychomotor development. [5;123] The results of observation of IVF children born from multiple pregnancies at term showed that physical, psychomotor development and in the first year and 2-3 years of life they did not differ from children born from multiple pregnancies in a natural way. Children born with a delay in fetal development lag behind their peers in physical and psychomotor development up to the age of 36 months. [5;115]
On the one hand, couples have had the opportunity to have their own children at a level that was undreamed of in the recent past, that is, society, through highly effective infertility treatment, but on the other hand, research shows that this method cannot be called absolutely "virtuous". There are different views in the literature.
Some scientists claim that as a result of IVF, the physical development of children born from multiple pregnancies is retarded. In turn, other indicators show that the condition and further development of children born through IVF do not differ from other peers. Children's development is greatly influenced by their social situation, especially family relationships.
But this question has not yet received attention. Therefore, these aspects of the problem are not fully explored. Many studies have focused on the assessment of neuropsychological status in children's development. This problem is the main and leading one, although it is also important in the formation of other functional systems. [5:30]
V.O. Mansimova emphasizes that the quality of life of early-born IVF children is characterized primarily by the aspect of social well-being related to the patients' family characteristics, compared to that of children born naturally. [4]
N.Dj. Gadzhimuradova's research, as a result of a comprehensive assessment of the differences in the health status of children with IVF in the first year of their life compared to children born naturally, the following were more often found in IVF children: diseases of the respiratory, digestive, urinary tract and endocrine systems, metabolic disorders, blood-forming (former) in the form of iron deficiency anemia, organ disorders, skin and subcutaneous diseases in the form of atopic dermatitis.
At the same time, no statistical difference was found in their physical and neuro-psychic development, resistance level of the organism. [2;66]
DISCUSSION
The results of the research mentioned above show that the health of children born through IVF differs from that of children born naturally. In particular, various levels of preterm birth, low birth weight, pathology of the central nervous system, neonatal maladaptation, difficulties in
feeding with breast milk, pathology of genital organs, retardation of physical development of IVF children born from multiple pregnancies, including rickets, anemia, ORVI, gastrointestinal diseases and pathology of respiratory organs, retardation of psychomotor development, respiratory, digestive, urinary tract and endocrine system diseases, metabolic disorders, disorders of blood-forming organs in the form of iron deficiency anemia, skin and subcutaneous diseases in the form of atopic dermatitis are observed. If children born with a delay in fetal development lag behind their peers in physical and psychomotor development up to the period of 3 -6 months, in the first year and 2-3 years of life, they do not differ from children born from multiple pregnancies in a natural way. From this, it can be seen that in the treatment of various diseases encountered in IVF children, it is required to take into account the specific features of their mother's health and the birth process of children.
The quality of life of IVF children in infancy is characterized by the aspect of social well-being related to the family characteristics of the patients, compared to that of children born naturally.
This means that medical diseases of children born through IVF during infancy, infancy (up to 0-1 years) and early childhood (1 year) can be equaled by a healthy family environment and an individual approach to the health of such children when they reach the age of 4-5 years.
Scientists themselves note that there are different points of view in the literature, and some scientists claim that as a result of IVF, the physical development of children born from multiple pregnancies is retarded. In turn, other indicators show that the condition and further development of children born through IVF do not differ from other peers.
CONCLUSION
In conclusion, it can be said that today, as the demand for the use of reproductive technologies in the treatment of infertility increases, so does the demand to know their effectiveness and results. In particular, it is the demand of the time to study the specific health characteristics of children born through IVF and their psychological development.
The process of IVF practice of children born by IVF shows that as a result of various prenatal and perinatal period changes, medical diseases can cause changes in children's psychological development during infancy, infancy (up to 0-1 years) and early childhood (1 year).
The need for a system of measures to improve the health of young families aimed at having children naturally will lead to a reduction in the number of pregnancy complications related to the IVF cycle and mother and child. The need to prepare married couples for the use of artificial reproductive technologies on the basis of a deep choice leads to a reduction in negative complications and an increase in positive results.
At the same time, the literature analysis showed that the psychomotor and neuro-psychic development of IVF children by the age of 2-3 years does not differ from that of naturally born children. It is reasonable to conclude that the reduction of differences by the age of 2-3 is the result of children's socialization and parents' special attention to the health and psychological development of IVF children, as well as family attitudes towards expected children.
The importance of medical workers, psychologists, pedagogues and the family environment in monitoring the physical and psychological development of IVF children is incomparable. This showed the importance of studying the health and psychological development of IVF children in the scope of these areas.
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