Vladimir Ivanovich Kulakov
Authors: Boleslav Lichterman
Journal: BMJ (2007)

Vladimir Ivanovich Kulakov helped to introduce in vitro fertilisation (IVF) to the former Soviet Union in 1986 and performed the first laparoscopic hysterectomy in Russia in 1993. He was director of the All-Union Research Centre on the Protection of Mother and Child (currently Scientific Centre for Obstetrics, Gynaecology, and Perinatology) in Moscow for more than two decades. He was editor in chief of Akusherstvo I Ginekologija (Obstetrics and Gynaecology)—a leading Russian periodical—and president of three national associations—Russian Association of Family Planning, Russian Association of Obstetricians and Gynaecologists, and National Association of Endoscopic Gynaecologists of Russia.

Kulakov was born in 1937 in Meshcherskoe village in the Moscow region to a military officer and a school teacher. He studied at the paediatric faculty of the Pirogov Moscow Medical Institute N2 (now Russian State Medical University) but on graduating decided to specialise in obstetrics and gynaecology at Moscow Regional Research Institute for Obstetrics and Gynaecology. In 1967 he defended his kandidatskaya dissertation (PhD thesis) on pregnancy and the blood coagulating system in women with varicose veins followed by his doctorskaya dissertation (a second thesis required for professorship similar to the habilitation thesis in Germany) on a similar topic 10 years later. In 1975, at the age of 38, he was appointed a director of the institute where he had started his residency 14 years before. In 1982 he became a professor of obstetrics and gynaecology.

In 1985 Kulakov headed the All-Union Research Centre on Protection of Mother and Child—the largest Russian institution in the field. In 1974 he was a consultant gynaecologist at the Fourth Main Department of the Ministry of Health of USSR (a special department which took care of Soviet nomenklatura, high ranking officials and their families). In 2001 he was appointed a chief obstetrician and gynaecologist of the Ministry of Health of the Russian Federation. He also worked part time as a chair of obstetrics, gynaecology and perinatology at the Faculty of Postgraduate Training of the Sechenov Moscow Medical Academy.

For many years Kulakov was head of the department of human reproduction in the institution that he directed. The first Soviet test tube baby was born in 1986 at the laboratory of Boris Leonov at Kulakov's institution, and was delivered by Kulakov by caesarean section. Kulakov was convinced that IVF centres should be established throughout the country to help infertile women, which he estimated to number 6 million in the country. He further estimated that thanks to IVF the number of healthy newborn infants might be as high as 100 000-200 000 annually. However, only 10 000 test tube babies were born in Russia from 1986 to 2001, and half of them at his centre. The number of centres is insufficient and the procedure expensive. It is not covered by state insurance and many couples are unable to pay 100 000 roubles (Â£2000) for one attempt.

Being a president of the Russian Association of Family Planning, Kulakov supported a programme on sexual education of youngsters, including centralised state purchase of contraceptives for teenagers at risk. With 1.6m abortions in Russia and only 1.2m births yearly, the programme aimed at reducing the number of artificially terminated pregnancies and sexually transmitted diseases. However, the Russian parliament stopped financing it, declaring it immoral propaganda of free sex.

In the early 1990s Kulakov started to develop methods of laparoscopic surgery in gynaecology. By the early 2000s more than 70% of all interventions were performed at his centre laparoscopically, including more than 1000 hysterectomies.

He authored and coauthored about 600 scientific publications, including many monographs dedicated to surgical treatment of inflammatory diseases of uterine appendages, IVF for treatment of female and male infertility, endoscopy in gynaecology, clinical use of haemopheresis, etc.

In 1988 Kulakov was elected a corresponding member of the Soviet (since 1992, Russian) Academy of Medical Sciences and in 1994 gained full membership. During 2001-6 he was vice president, but in 2006 he brought his institution under the aegis of the Federal Agency for High Technology Medical Care which promised better financing and participation in federal health programmes. Kulakov was a laureate of the Government of Russian Federation prize three times. He was also awarded the Demidov prize, one of the oldest and most prestigious scientific awards in Russia won by only two other medical doctors before, one being Nikolai Pirogov. Kulakov was a member of many international societies of obstetrics and gynaecology and an expert for the World Health Organization.

Vladimir Kulakov was gentle and trustful, and sometimes people around him betrayed his confidence. Even when having to fire an employee he first tried to find him or her another place of work. During his last months he suffered from cancer but continued to work. He leaves a stepsister; a wife, Tatiana Evgenievna Samoilova; and two daughters, one from each of his two marriages.

Vladimir Ivanovich Kulakov, former professor of obstetrics and gynaecology Moscow (b 1937; q Moscow 1961; MD), died from arterial thrombosis on 10 February 2007.