- Basic information
- How to order
- Counseling
- Donor program
- Egg donation
- Sperm donation
- Information for the recipient of the egg
- Frequently Asked Questions
- Glossary
- Documents to download
- Price list of services
- Annual reports
- Our team - contacts
The Center for Reproductive Genetics is a part of Centers of Reproductive Medicine and Reproductive Genetics of the Motole Faculty of Medicine and the 2nd Faculty of Medicine of the UK, which was established in 1995. Our "Center" is an integrated workplace of the Institute of Biology and Medical Genetics (embryology and reproductive genetics) and the Department of Gynecology and Obstetrics (Reproductive Medicine), which provide long-term cooperation, professional, personnel, methodological and unique equipment. comprehensive services for couples with reproductive disorders based on the latest advances in medical genetics and clinical medicine.
Within the Center for Reproductive Medicine and Reproductive Genetics, patients receive the best and most modern medical and genetic care. The gynecologists of the integrated "Center" are developing ultrasound and endoscopic methods, which are the basis for determining the correct diagnosis and for proposing further treatment.
Detailed sperm examinations (sperm concentration and motility, morphological evaluation of spermatozoa, molecular cytogenetic examination of aneuploidies in spermatozoa) and cooperation with the Urological Clinic of the University Hospital in Motol enable comprehensive diagnostics and therapeutic care, including surgeries on the epididymis and testes (where sterility is conditioned by azoospermia). - absence of sperm in the ejaculate).
Reproductive genetics focuses on specialized genetic counseling for couples with reproductive disorders and develops in direct contact with improving methods of assisted reproduction.
We focus on improving preconception genetic diagnostics using methods of molecular genetics, molecular cytogenetics and classical cytogenetics (in cooperation with ÚBLG departments), and preimplantation genetic diagnostics in cooperation with colleagues from the cooperating center of assisted reproduction Repromeda.
In the embryology laboratory, thanks to experience and state-of-the-art technical equipment, all the procedures and procedures of assisted reproduction known at present are performed at a high level.
The center also provides treatment with donated gametes and embryos where necessary. Cryopreservation of sperm, possibly, is also standard. testicular tissue in cancer patients before starting oncotherapy, which can lead to fertility problems. Methods leading to successful cryopreservation of oocytes and ovarian tissue are being developed. In cooperation with the Department of Gynecology and Obstetrics, its perinatology center and our biochemical laboratory within the ÚBLG, subsequent comprehensive care in pregnancy after successful conception of assisted reproduction methods, including childbirth and the puerperium, is also guaranteed.
The Center for Reproductive Genetics has the approval of the Ministry of Health within the Center for Reproductive Medicine and Reproductive Genetics for the implementation of procedures and methods of assisted reproduction (Ref. No. 25751/2006, date of issue: 7 September 9).
The Tissue Facility and its cooperating diagnostic laboratories were the State Institute for Drug Control (SÚKL), based on inspections performed within the scope of authorization pursuant to Act No. 296/2008 Coll., On ensuring the quality and safety of human tissues and cells intended for human use and on change related acts (Act on Human Tissues and Cells) and pursuant to Act No. 552/1991 Coll., on state control, a decision on permitting the operation of a tissue facility and diagnostic laboratory was submitted on 15 November 11.
The permit was issued to the University Hospital in Motol to the extent specified in this decision.
The Center for Reproductive Medicine and Reproductive Genetics has been granted accreditation by a training facility for assisted reproduction methods. At the same time, it operates as a training facility for pre- and postgraduate teaching (also within the IPVZ Prague).
First visit
Ask your gynecologist for advice in advance and bring this document with you. You can order on weekdays from 10.00 pm to 15.00 pm on the nurse's telephone number 224 434 215. Order a spermiogram at the telephone number 224 433 578 on working days from 8.00 to 14.30. When visiting, present:
- identity card or other document necessary for identification,
- insurance company card,
- documentation of previous relevant examinations and treatment (it is appropriate that the patient has a cytological examination result not older than 1 year).
The presence of both partners is very suitable and welcome.
Ambulance location
The reproductive medicine center's outpatient clinic is located in the outpatient section of the GP clinic, on the 5th floor of node A of the adult hospital.
The outpatient clinic of the Center for Reproductive Genetics - Spermiogram is located on the 3rd floor of Node D of the Adult Hospital.
Office hours of the Center for Reproductive Medicine
Ultrasound | Consultation | |
Monday | 8.00 - 10.00 | 10.00 - 14.00 |
Tuesday | 8.00 - 10.00 | 10.00 - 14.00 |
Wednesday | 8.00 - 10.00 | 10.00 - 14.00 |
Thursday | 8.00 - 10.00 | 10.00 - 14.00 |
Friday | 8.00 - 10.00 | 10.00 - 14.00 |
Blood samples are taken daily from 7.00 to 8.00.
Office hours of the Center for Reproductive Genetics
Sisterna | Ambulance | |
Monday | 7.00 - 15.00 | 8.00 - 9.30 MUDr. Locksmith 9.30 - 13.00 MUDr. Bc. Cernikova 13.00 - 15.00 RNDr. Paulas, PhD. |
Tuesday | 7.00 - 15.00 | 8.00 - 13.00 MUDr. Bc. Černíková 13.00 - 15.00 RNDr. Paulas, PhD. |
Wednesday | 7.00 - 15.00 | 8.00 - 15.00 RNDr. Paulas, PhD. |
Thursday | 7.00 - 15.00 | 8.00 - 12.00 MUDr. Locksmith 13.00 - 15.00 RNDr. Paulas, PhD. |
Friday | 7.00 - 15.00 | 8.00 - 12.00 RNDr. Paulas, PhD. 12.00 - 13.00 MUDr. Toothless |
Are you postponing motherhood?
Test your AMH (Anti-Müllerian hormone)
Do you want to have a child, but not before three years? Do you want to finish your studies first and start your career? Unfortunately, time sometimes runs faster than we would like, so it may not be easy when you really want a baby. The good news is that concerns about the possible risks of late pregnancy can be eliminated to some extent today. Thanks to the AMH test, you can easily find out how much time you have left to get pregnant.
What you need to know about AMH
- The supply of follicles in the ovary can be determined according to the AMH value. If the level of AMH is seriously low and a woman still needs to postpone her pregnancy, it is possible to prevent her egg cells from vitrifying, ie freezing, and use them later. Otherwise, she would have no choice but to use the donor's eggs in the future.
- AMH measurements are made from blood. It can occur at any time because the AMH level does not change during the menstrual cycle.
What do AMH doctors say
MUDr. Roman Chmel, Head of the Department of Gynecology and Obstetrics, University Hospital in Motol: "Women with polycystic ovaries, for example, have a high AMH value, but this does not automatically mean a positive disposition to get pregnant quickly, but this information can be used to optimize hormonal stimulation."
MUDr. Eva Uhrová, chief physician of the gynecology department of the Center for Reproductive Medicine and Reproductive Genetics, University Hospital in Motol: "For the best usability of the AMH test, it is good to test FSH (follicle-stimulating hormone, which is measured 3. day of the cycle) and ultrasound examination of the ovaries. "
We want a child, not a psychologist!
Why is psychological support needed in infertility treatment?
The diagnosis of sterility means permanent psychological pressure for most partners, especially when they both know in advance that they will not be able to have common offspring in the future due to infertility or other serious illnesses. However, in cases where the partners naturally counted on the birth of their own children, but the planned pregnancy does not occur for a long time, and their desire to have their own child is not fulfilled, the problem often comes to the fore dramatically and a stressful situation arises, which often develops into a crisis. Therefore, psychological support of the couple is now considered an important part of infertility treatment.
Unlike many centers, where care is still largely focused on physical health, our modern center considers the need for specialized care in this area to be topical, and therefore included counseling and psychotherapeutic interventions in its treatment procedures. Unfortunately, although, like more than half of specialist reproductive center physicians, we consider psychological care of parents planning for parenthood with the help of reproductive medicine to be an excellent support for a common goal, in practice we encounter the problem that only about a third of couples ask for psychologist support. Why? Are the partners ashamed to stand in front of a psychologist as people with whom something is wrong? Are they worried that the couple's psychological care will increase their mental strain? - We assure you it's all a myth. Everyone who has tried it will confirm to you that specific professional procedures can significantly reduce the stress of a couple and especially a woman.
How do we work with clients?
The way we work in this area is based on current world trends and is based on an active interest in the psychosocial and especially emotional needs of our clients. The main purpose of such activities is to inform our clients about the possibilities of psychological support during medical care and then integrate special counseling as needed directly into the ongoing treatment day after day. Our goal is to support and help during treatment, which in turn affects not only the mental but also the overall health of clients, in terms of improving both personal and partner life satisfaction. In particular, we want to reduce negative psychosocial reactions and also help patients to better understand and address the current situation in infertility treatment.
Take your wish to have the child in your own hands. With the help of a psychologist, you can significantly increase your chances of fulfilling it. Ask your doctor from the Center for Reproductive Medicine and Reproductive Genetics at the University Hospital in Motol.
The pictures were drawn by children in the therapeutic workshop of the pediatric clinic of the Motol University Hospital.
Not everyone is lucky enough to have a child in a completely natural way. An increasing part of the population today suffers from infertility. The egg and sperm donation program is intended for all infertile couples who want a child and are looking for a suitable solution to their problem.
The donor program also benefits those who decide to become a donor - they will receive detailed information about their health and reproductive health, undergo tests for sexually transmitted diseases and will be acquainted with the results of genetic testing, eg they will find out if they are carriers of serious genetic defects.
Egg and sperm donation in the Czech Republic is legal, voluntary, safe and is based on the principle of an anonymous relationship between the donor (recipients) and the recipients of the donated germ cells and between the donor (donor) and the child born from the donated germ cells.
Act No. 373/2011 Coll., On specific health services, states that germ cells donated by an anonymous donor - an anonymous donor - can be used for artificial insemination of a woman. Only a woman who has reached the age of 18 and has not exceeded the age of 35 can be an anonymous donor. An anonymous donor must not be a person deprived of legal capacity or a person with limited legal capacity.
The provider, who is authorized to perform the methods and procedures of assisted reproduction, is obliged to ensure that the mutual anonymity of the donor and the infertile couple and the anonymity of the donor and the child born from assisted reproduction are maintained. The provider who performed the medical fitness assessment of the anonymous donor is obliged to keep the donor's health status for 30 years from the artificial insemination and to provide the infertile couple or adult born from assisted reproduction with health information upon written request. anonymous donor.
The donor or donor is not entitled to financial or other compensation for the collection of reproductive cells. The Provider reimburses anonymous donors or donors only for purposefully, economically and demonstrably incurred expenses associated with germ cell donation.
There are a number of situations that lead a woman to accept donated oocytes (eggs). The cause of female infertility is, for example, a congenital malformation, a genetic defect, an injury, a chronic illness or the intervention of doctors due to a cancer. In the following interview, MUDr. Jelena Černíková from the Center for Reproductive Medicine and Reproductive Genetics.
What are the criteria for donor status?
Examination of reproductive cell donors is mandatory by law. Act No. 296/2008 Coll., On tissues and cells, stipulates that a donor may be a healthy woman from eighteen to thirty-five years of age with normal results of genetic and serological examination. Antibodies to HBV, HCV, HIV1 and HIV2 and syphilis are tested. Negative tests for sexually transmitted diseases must be reported repeatedly by potential donors. The donor must be insured in the Czech Republic, her appearance and intelligence should not deviate in a negative direction from the population norm and significant overweight is not suitable - BMI up to 29 is recommended. at least one healthy child, but this is not a condition. It is possible to donate eggs repeatedly, for donors who donated oocytes at another workplace, we accept donations a total of six times, at our workplace a total of four times.
What does egg donation entail for a donor?
Every woman who decides to donate eggs must undergo a genetic test to rule out the transmission of genetic diseases. He also undergoes gynecological examinations, blood tests for sexually transmitted infections and urine examinations. If all examinations are negative, the donor is approved as a suitable donor and undergoes hormonal stimulation to support egg growth. Hormonal stimulation is controlled by a gynecologist and effectiveness is checked by ultrasound. The injection of hormones takes about 10 to 12 days and the donor can inject them subcutaneously. At present, so-called depot preparations are being used for stimulation, which are applied once, so there is no need for annoying daily injections for some.
Egg collection takes place under short-term general anesthesia. Eggs are collected under ultrasound puncture through the vaginal wall. About two hours after the outpatient procedure, the donor goes home. The risks do exist, but fortunately they are not great. It is mainly a hyperstimulation syndrome, where the body responds to previous hormonal stimulation, which aims at excessive egg production. Other (rather theoretical) risks include injury during egg collection or subsequent inflammation. Donors are carefully checked by a doctor during and after the donation. Of course, there is also a risk of unwanted pregnancy, so it is recommended for donors during the cycle of sexual abstinence.
Are donors afraid of hormones?
Many women considering egg donation are concerned about the negative effects of hormonal stimulation, fearing weight gain, breast cancer, uterine cancer, or other adverse side effects. These problems may be related to elevated estrogen levels, with markedly elevated levels over a long period of time. However, this does not occur during ovarian stimulation. Hormonal stimulation is provided by injections with follicle-stimulating hormone (FSH), which acts directly on the ovarian tissue and under the influence of which eggs grow. This pituitary hormone works in the same way during the normal menstrual cycle. Thus, the main difference in stimulation is the higher level of FSH, which will allow more eggs to mature. A higher number of collected eggs increases the probability of developing a quality embryo, which is a basic prerequisite for the emergence of pregnancy and the birth of a healthy fetus.
Estrogens, specifically the hormone estradiol, are produced in growing follicles (vesicles surrounding a maturing egg). As more eggs mature, the production of estrogen increases accordingly. However, a more significant increase appears only at the end of stimulation. After the eggs are aspirated, the follicles collapse and estrogen production decreases very sharply. Thus, elevated estrogen levels usually persist for only about 7 days when donating eggs. Compared to pregnancy, when significantly increased estrogen levels are detectable even after more than 6 months of pregnancy, the amount of total estradiol produced during stimulation is practically negligible. Thus, such a brief increase in estrogen levels does not lead to weight gain or increase the risk of breast or uterine cancer. Extensive and long-term studies show that only women who take estrogens in the form of hormone replacement during menopause are at increased risk if the duration of use exceeds 5 years.
The donor is entitled to a so-called financial compensation. What does it mean?
Reproductive cell donation in the Czech Republic is voluntary, anonymous and free of charge. According to the law, all donors are entitled to financial compensation as compensation for lost profits and purposefully incurred costs. The compensation provided at our workplace amounts to CZK 22.
Egg donation is strictly anonymous. What information can the couple still share?
We select a donor for a specific couple on the basis of a questionnaire filled out by the couple. We strive for agreement in blood group and Rh factor and for the highest possible agreement in phenotypic parameters (eye color, hair color, height, weight). Other information that the couple will receive is the age, education, nature and interests of the donor.
How long does the whole process of egg donation take, from the first consultation at the Center for Reproductive Medicine and Reproductive Genetics to the actual collection of oocytes?
Ideally 4 to 6 months. If the woman has already donated eggs at our place or at another workplace, and therefore has finished genetic tests, the whole process will be speeded up and the donation can take place within 3 months of the first visit.
What would you say to those women who decide whether to donate their reproductive cells and are afraid?
Egg donation is more demanding than sperm donation, so egg donors are relatively few. We value their cooperation very much, we carefully investigate donors to minimize possible risks. A woman who decides to donate her eggs will bring hope to couples who have been trying to become parents for many years. This will not only give you a good feeling, but also information about your fertility, the results of tests for sexually transmitted infections and the results of genetic tests. We thank all the women who decide to donate their eggs for infertility treatment.
A common cause of infertility in many couples today is the poor quality of the partner's sperm. it does not no sperm capable of fertilizing an egg. Such an infertile couple is then reliant on the use of sperm from an anonymous donor. How can such sperm be obtained? Maybe you can give. Join our program and become an anonymous sperm donor. You will help others and at the same time find out something about your health condition.
Meeting the criteria for donor status - a condition for inclusion in the program
The donor must be between the ages of 18 and 40 (preferably under the age of 39) and have at least a high school education and be in good health. Those interested in sperm donation must first undergo an examination on a spermiogram (you can order from us on the phone number 224 433 578). If the values of the spermiogram meet the requirements of the donor, the future donor will undergo a genetic consultation, during which the doctor will discuss in detail his personal and family history and compile a pedigree. This is followed by examinations at the urology department and specific genetic examinations stipulated by law. Once all examinations have been performed and evaluated, the date of sperm donation is determined.
Frequency of donations and legal compensation of the donor
Urine and blood are examined for sexually transmitted diseases (HIV, syphilis, jaundice, chlamydia trachomatis) during each cryopreservation of sperm. The number of cryopreservations depends on the quality of the dose, usually 2-3 visits are enough. A final examination of sexually transmitted infections will take place 180 days after the last cryopreservation of sperm. Donations are mutually anonymous, voluntary and free of charge. Financial compensation for sperm donors is CZK 10 at our workplace and is payable from the date of release of donated cryopreserved sperm (this is the so-called release of a package of reproductive cells for use in the treatment of an infertile couple).
The Center for Reproductive Medicine and Reproductive Genetics, which offers a comprehensive egg (oocyte) donation program, has an extensive database of donors, which allows you to select a suitable donor. A specialized team of physicians and embryologists has many years of experience in the oocyte donation program and achieves high success in terms of pregnancy per treatment cycle. The examination and selection of the donor is carried out in accordance with Act No. 296/2008 on Human Tissues and Cells, Implementing Decree No. 422/2008 Coll., The quality and safety of human tissues and cells intended for human use, as amended and with strict American Association for Reproductive Medicine - ASRM criteria.
Egg and sperm donation in the Czech Republic is legal, voluntary, safe and is based on the principle of an anonymous relationship between the donor (recipients) and the recipients of the donated germ cells and between the donor (donor) and the child born from the donated germ cells.
The use of donated eggs is one of the most successful methods of infertility treatment. Eggs obtained from an anonymous healthy donor are fertilized in the laboratory by the sperm of the recipient's partner (future mother) and the resulting embryos are then transferred to her uterus. Infertility treatment with this method is very psychologically demanding for the treated couples (it represents a great emotional burden), but it gives a real chance to have children even for those couples who would otherwise have no hope. Compared to adoption, the method brings, in addition to a clear (50%) genetic contribution of the father, also benefits for the mother, especially the possibility to influence the nutrition and satisfaction of the fetus before birth. Also, the experience of one's own pregnancy from the very beginning, childbirth and the immediate possibility of breastfeeding is a clear benefit for the child, the mother and the whole family.
Risk
As with pregnancies caused by sexual intercourse or the IVF method, 12 to 15% of cases end in abortion with the method of using donated eggs. About 20% of such pregnancies in the Czech Republic are multiple, depending on the number of embryos transferred. However, in our Center for Reproductive Medicine and Reproductive Genetics, we mostly transfer only one embyo.
Donor selection
Egg donation in the Czech Republic is anonymous, voluntary and free of charge. Our donors are young women under the age of 34 who meet the requirements set by the legislation of the Czech Republic and the European Tissue Directive and the strict guidelines for finding egg donors set by experts (Guidelines for oocyte donation of The American Society of Reproductive Medicine, published in Fertility and Sterility, Vol. 77, No. 6, Suppl. 5, June 2002).
Gynecological, endocrinological and genetic examinations are performed in advance on all donors and all of them are repeatedly tested for sexually transmitted diseases (HIV, syphilis, jaundice, chlamydia). Only donors who pass all these tests with negative results are included in the donation program.
Treatment cycle
Indications for oocyte donation:
- absence of ovaries as a birth defect or as a result of surgery,
- premature ovarian failure (for unknown reasons, ie idiopathic, or after chemotherapy or radiotherapy for cancer, etc.),
- ovarian factor (repeatedly very low number of obtained oocytes, low quality of oocytes, repeated failure of fertilization, wrinkling, implantation using own oocytes),
- severe forms of ovarian endometriosis,
- genetic indication not yet solvable by preimplantation genetic diagnostics.
Due to the fact that most women who require inclusion in the donor program have an extinct ovarian function, it is necessary to initiate stimulation of mucosal growth in the uterine estrogen in tablets or patches after previous synchronization with the donor, by monitoring endometrial growth dynamics with ultrasound. On the day of oocyte collection at the donor, we add progestogens to the estrogens and transfer one embryo on about the fifth day. The remaining quality embryos can be frozen in a cryopreservation program.
If the recipient ovulates, we perform embryo transfer in the natural cycle with only mild luteal supplementation. After the embryos have been transferred, the recipient continues to take estrogens and progestogens for 10 to 14 days, during which we perform a blood test (hCG). Due to its positivity, the recipient continues to use hormones until approximately the 10th to 12th week of pregnancy. If the pregnancy test is negative, the patient will stop taking the medication and consult a doctor about the next steps.
Decision making process
Recipients of donated eggs usually face many concerns and are bothered by many questions to which they would like to know the answer. Don't hesitate to ask for help - only then will you get the support you want and need. A consultation with an expert who understands the egg donation program and could support you in your decision-making could be of great help to you. If you are interested in infertility treatment with donated eggs, contact us by phone.
Reimbursement by insurance company vs. patient payment?
1. Until how many years of a woman is IVF covered by an insurance company? How many cycles does the insurance company pay for IVF?
Medical care provided in connection with artificial insemination is reimbursed
from public health insurance for women with bilateral oviduct obstruction aged 18 to 40, other women aged 22 to 40. The insurance company pays for the care at most three times in a lifetime, or four times in a lifetime, if only one embryo was transferred in the first two cycles.
2. Is the insemination covered by the insurance company? How many times is it performed (if the spermiogram is OK) before proceeding with other assisted reproduction methods?
Intrauterine insemination (IUI) is performed with patent fallopian tubes. IUI is covered by public health insurance funds, and has a frequency limit of 6 times during the patient's lifetime. At our workplace, after three unsuccessful attempts, we will invite the patient for an interview and consider the next treatment procedure, whether to continue with IUI or whether to include the couple in an IVF program.
3. Are all artificial insemination medicines covered by the insurance company, or do I have to pay extra?
According to the decree, there is now a greater or lesser surcharge for most medicines.
4. Which services are covered by the insurance company and which by the patient?
Ultrasound and blood tests, oocyte collection under general anesthesia and embryo transfer after two days of embryo cultivation are fully covered by public health insurance funds. Supplements for stimulating drugs are in different amounts, above-standard laboratory methods (ISCI, PICSI, extended embryo cultivation, TESA, MESE, AH) are not covered at all.
5. When does sperm / oocyte freezing be covered by the insurance company and when is the patient?
Cryopreservation of reproductive cells can be performed from a medical indication, then the procedure is charged to the patient's health insurance company, or at his own request, then it is paid for by the patient according to the currently valid price list. Indication criteria:
- before oncological or other treatment with drugs that interfere with spermiogenesis (corticoids, cimetidine),
- prior to planned treatment with IVF methods for findings other than normospermia,
- before treatment with AR methods, when the partner will not be available,
- before treatment with donated oocytes.
6. Does the insurance company pay for the examination of the ovarian reserve for patients?
Ovarian reserve testing can take several forms. Examination of AFC (number of antral follicles) using ultrasound is covered by the insurance company, as well as examination of the basal level of gonadotropins, estrogens and AMH (anti-Mullerian hormone)
7. How will I pay for the treatment? When will I find out the final amount?
Services not covered by health insurance are paid at our workplace at the reception of the Department of self-pay care. The final amount to be paid will be determined by the couple based on the addition of the prices for all performed above-standard services.
Which tests are performed before treatment is started?
8. Do I need a recommendation from my gynecologist?
Yes. Health care provided in connection with artificial insemination is covered by public health insurance for women with bilateral fallopian tube obstruction aged 18 to 39 years, other women aged 22 to 39 years. According to Act No. 48/1997 Coll., Assisted reproduction services are reimbursed by the public health insurance on the basis of the recommendation of the registering female doctor.
9. Do I have to have any examinations with my gynecologist in advance or will the gynecologist send me straight to the assisted reproduction center and all the necessary examinations will be performed in the hospital?
The patient must bring the result of the latest oncological cytology.
10. Which examinations are performed first?
As part of the initial examination, the anamnesis of both partners is first ascertained. This is followed by specific gynecological and genetic examinations. During the first visit to the clinic for infertile couples, the gynecologist determines a suitable individual examination plan and performs a basic initial examination (spermiogram for men, gynecological examination for women, pelvic ultrasound, hormonal profile, ultrasound folliculometry, fallopian tube patency). Other examinations may follow - hysteroscopy, laparoscopy, examination by a reproductive immunologist, clinical psychologist, sexologist and clinical geneticist. In the field of genetics, personal anamnesis, family anamnesis - genealogy, cytogenetic examinations, molecular genetic examinations are determined.
11. Is it possible to have sperm tested preventively? What is the price?
Examination of sperm at his own request (execution of a spermiogram) is possible, payment is according to the current one price list.
12. Is the examination of the patency of the fallopian tubes always performed at the same time as the examination of the sperm, or only after the spermiogram?
Given the fact that we try not to prolong the examination, as part of the basic initial examination, we usually indicate both examinations at the same time before the second consultation, where we evaluate the findings and propose further diagnostic and therapeutic procedures.
13. Does a woman always have to be hormonally stimulated?
No, it depends on what performance. Hormonal stimulation is required especially when the woman does not mature eggs.
14. When is the native IVF cycle used and when is the woman hormonally stimulated?
The native IVF cycle is used in women who are afraid of hormonal stimulation before IVF, or in women who have exhausted all cycles covered by public health insurance.
15. When is it appropriate to perform an AMH hormone test?
In all women over the age of 35 and in women with an irregular menstrual cycle.
16. When is a genetic test done?
General indications for genetic testing:
a) examination of a child with a congenital malformation or mental retardation,
b) hereditary diseases in the family, congenital malformations in the family, repeated abortions, sterility of partners, cancer in the family.
Indications for genetic testing in pregnancy:
c) pregnant age higher than 35 years,
d) positive pregnancy screening,
e) suspicion of a congenital malformation in the fetus,
f) hereditary disease in family history,
g) the birth of a child with a congenital malformation in a previous pregnancy,
h) the presence of a structural chromosomal defect in one of the parents,
i) pregnancy after IVF (artificial insemination),
j) oncological disease in one of the parents before pregnancy,
k) use of drugs during pregnancy or the effect of other teratogens.
Cryopreservation or vitrification?
17. What is cryopreservation of sperm, eggs and testicular tissue
The procedure is based on freezing sperm or eggs in the presence of a cryoprotective medium - storage in liquid nitrogen. The medium used prevents the formation of crystals and thus allows the vitality of the reproductive cells to be maintained. The purpose of this procedure is the long-term preservation of cells for use by assisted reproduction methods.
18. What are the advantages of rapid freezing (vitrification)?
There are two methods of freezing, cryopreservation: Slow freezing is an older method of cryopreservation of embryos. Currently, a very fast freezing method, so-called vitrification, is used, which gives significantly better results in terms of survival of embryos after thawing.
19. Are there any risks when freezing / thawing embryos?
Embryo damage during cryopreservation can occur due to the formation of ice crystals. However, the vitrification method, when performed correctly, minimizes this risk. A necessary condition, however, is to select only quality embryos for cryopreservation.
20. How long can eggs be frozen? How long can sperm be frozen?
A temperature of -136 ° C is considered the moment when all biological processes stop. The temperature of the liquid nitrogen at which the reproductive cells are stored is even 60 ° C lower (-197 ° C) and should safely guarantee storage for a virtually unlimited period of time. In practice, however, the reproductive cells are stored for a period of 10-20 years, at the request of patients it is possible to extend this period in justified cases.
Possibility to choose an egg donor, possibility to choose a sperm donor
21. What data are recorded about egg donors and sperm donors?
The following data on reproductive cell donors are recorded: results of genetic examinations, results of examinations for sexually transmitted diseases, results of gynecological examinations, pedigree analysis, blood group and phenotypic traits.
22. How are reproductive cell donors assigned to pairs?
The selection is made on the basis of a questionnaire, which is filled in by a couple. It is done in such a way that there is agreement in blood group, RH-factor and as much agreement in phenotypic traits as possible.
The course of procedures and which procedures are performed under anesthesia
23. Is oocyte collection performed under general anesthesia? Is hospitalization necessary?
Hospitalization is not necessary, it is a procedure under short-term intravenous anesthesia, where the patient leaves home after 2 hours in the dormitory.
24. When is it good to have eggs frozen?
At a time when a woman's "biological clock" is ticking and a child's potential father is not in sight. In the case of a couple who rationally plan the family for a later period, it is a good idea to freeze embryos up to the age of 40 that tolerate cryopreservation better than eggs.
25. How is the length of embryo cultivation determined? What effect does the length of cultivation have on embryo nesting?
At the end of the third day, the embryo has eight cells and is still in the fallopian tube under physiological conditions. Embryos are introduced into the uterus, and it is preferable to cultivate the embryos for at least another 48 hours so that they can be transferred to the uterus at the appropriate developmental stage. In addition, during the eight-cell stage, control is transferred from the maternal to the embryonic genome, and prolonged cultivation can eliminate embryos that have failed due to inactivation of the entire signaling cascade.
to stop development. In other words, if more than one embryo is available on the third day, prolonged cultivation until the fifth day is a very good way to select the most viable and avoid embryo transfer of the embryo to a site that does not fully match its developmental stage.
26. Will I already know the date when the embryo will be transferred to the uterus when oocytes are collected?
The term embryo transfer is specified during cultivation according to how and how many embryos develop accordingly. They are usually transferred on the third or fifth day, or all embryos are frozen and transferred successively in subsequent cycles.
27. How does embryo transfer work? Do I have to be calm then?
The transfer takes place without anesthesia, it is a painless procedure - usually 1 embryo is transferred to the uterine cavity through a plastic catheter. Absolute rest is not necessary, but movement to the maximum aerobic capacity (spinning, heats, aerobics) is not suitable.
28. How many embryos are normally transferred?
In the first two cycles, we prefer SET - single embryo transfer in younger patients, ie transfer of 1 embryo.
Another transfer, another IVF
29. How long after an unsuccessful attempt is it possible to undergo another transfer of frozen embryos?
It is advisable to use the first menstrual cycle after a failed IVF cycle.
30. How long does it take to take another egg?
At the earliest in 3 months.
Risk
31. What are the risks of IVF?
The patient's burden and health problems should be minimized. Nevertheless, occasional complications may occur
- as with any other procedure. Possible complications associated with each pregnancy (miscarriage, premature labor, etc.) cannot be ruled out. In this respect, post-IVF pregnancies are no different from "normal" pregnancies. Of course, there is an increased likelihood of multiple pregnancies. When two or more embryos are transferred, a good 20% of pregnancies occur
with twins.
Purely theoretically, there is a risk of pregnancy in the abdominal cavity, resp. in the fallopian tube. Under normal circumstances, if pregnancy occurs without medical help, the incidence of pregnancy in the fallopian tube is about 2%. After embryo transfer, if parts of the fallopian tube are preserved, this risk rises to about 3%. A typical complication of hormonal treatment is the so-called hyperstimulation or OHSS. The ovaries enlarge, ovarian cysts form, there is pressure in the lower abdomen, less often the accumulation of body fluid in the abdomen, sometimes even in the lungs. Therefore, in rare cases, especially when pregnancy has occurred, the need for short-term hospitalization may arise. Hyperstimulation resolves spontaneously.
The pictures were drawn by children in the therapeutic workshop of the pediatric clinic of the Motol University Hospital.
AFC antral follicle count - evaluation of the number of small follicles in the resting phase within the ovarian reserve testing
AH assisted hatching, mechanical disruption of the embryo's shell for easier nesting of the embryo into the uterine lining
AMH Anti-Müllerian hormone - a hormone produced by the smallest spinal cords in the ovary. Determining its serum level is a very good prediction of biological aging of the ovaries. AMH levels are related to the number of eggs that are present in the ovary and whose number is only declining throughout a woman's life. In women, this hormone is produced by the cells that surround the egg (called granulosa cells) and regulates their maturation. Its level decreases with age and is proportional to the supply of eggs. Women with low AMH have a small ovarian reserve, which is manifested by ovulation disorders and pregnancy problems. Women with high levels of this hormone have a higher risk of a violent reaction to ovarian stimulation and the development of hyperstimulation syndrome. The service is not covered by health insurance.
ASSISTED REPRODUCTION methods involving human germ cell manipulation
ASTENOSPERMIA low sperm motility (sperm are thus unable to reach the egg and fertilize it)
BLASTOCYST embryonic developmental stage, 4. -5. day of development
CONCEPING OPTIM TIMING determination of the most suitable time for conception using ultrasound folliciometry
EMBRYO embryo, is formed by the division of the zygote
ET embryo transfer - embryo transfer 3rd - 5th day with a plastic catheter into the uterine cavity without the need for anesthesia
FERTILIZATION fertilization - fusion of sperm and egg
PHOLICULOMETRY measuring egg growth using ultrasound
GAMETES germ cells, female gamete - egg, male gamete - sperm
HORMONAL PROFILE blood sampling at the beginning and end of the menstrual cycle to assess current levels of female sex hormones and thyroid hormone levels
HYSTEROSCOPY view of the uterine cavity under brief general anesthesia using thin optics
ICSI microscopic injection of sperm into the oocyte using pipettes of a micromanipulation device, from English Intra Cytoplasmic Sperm Injection
OVULATION INDUCTION induction of ovulation by tablets or injections containing hormones in women without spontaneously maturing eggs
IUI intrauterine insemination - insertion of washed sperm into the uterine cavity in a woman with patchy fallopian tubes - shortening the path that sperm must cross into the fallopian tube to the egg
IVF In vitro fertilization is the process by which an egg is fertilized by sperm outside the body: in vitro. It is one of the methods of assisted reproduction used in the treatment of infertility, a method originally developed for women who do not have clear fallopian tubes. After hormonal stimulation, eggs are aspirated under short ultrasound control under ultrasound control, which are transferred to the laboratory either to classic IVF Adding sperm to the dish to the egg or to ICSI - when sperm is injected into the egg using a microneedle.
KET thawed embryo transfer (cryoembryotransfer)
SPERM CONCENTRATION number of sperm in 1 ml of ejaculate. A sperm concentration of 15 mil / 1 ml ejaculate or more is considered normal
CONTINUOUS MONITORING OF EMBRYOS continuous monitoring of embryo development on a monitor without the need to transfer embryos outside the culture area under a microscope. It allows you to monitor the progress of embryonic cell division, select the most suitable embryo to transfer to the uterus and thus increase the chances of a successful pregnancy.
CRYON CONCERVATION freezing and subsequent storage of reproductive cells for later use - cryopreservation
LAPAROSCOPY operations from the group of minimally invasive surgery - under general anesthesia penetration of three punctures into the abdominal cavity and evaluation of the condition of intra-abdominal organs and organs in the small pelvis with the possibility of surgical procedures
SPERMIUM MOTILITY sperm motility
NATURAL CYCLE is a natural cycle of a woman, where usually one egg is taken, which has matured without the influence of hormones
NATURAL CYCLE WITH ET is a cycle where the woman is not hormonally stimulated or undergoes only minimal hormonal preparation, without general anesthesia the eggs are collected and after cultivation in the embryological laboratory they are transferred back to the uterine cavity
NATURAL CYCLE WITHOUT ET is a cycle where we do not get any egg (the follicle was empty), or that the egg does not fertilize the sperm, or the embryo does not grow further, so there is no transfer of the uterine cavity.
OLIGOSPERMIA low sperm count in ejaculate (reduced sperm production)
OPU ovum pick-up (OPU - ovum pick-up) takes place under short general anesthesia (anesthesia). In the laboratory, the eggs are fertilized by sperm (so-called "in-test tube" fertilization). An embryo develops into an embryo, which is then transferred to the uterus. The name "in a test tube" is misleading because in vitro fertilization usually takes place in a petri dish.
SPERM male germ cell, gamete
SPERMIOGRAM evaluation of the number and quality of sperm after three days of sexual abstinence in a man, which testifies to fertility
THESIS (Testicular Sperm Extraction), extraction of sperm directly from testicular tissue
Mesa Microsurgical Epididymal Sperm Aspiration - Microsurgical aspiration of epididymal contents
OOCYT female gamete - germ cell, egg, ovum, egg cell
PICSI Preselected IntraCytoplasmic Sperm Injection - an intracytoplasmic injection of pre-selected sperm that uses only mature sperm that have been shown to have a lower incidence of chromosomal abnormalities.
POSTKOITAL TEST Orientation immunological examination of whether the partners "biologically" fit together "consists in the examination of mucus from the cervix of a woman a few hours after sexual intercourse
EXTENDED CULTIVATION prolonged embryo culture in laboratory conditions
X-ray HSC X-ray hysterosalpingography - non-invasive outpatient examination of the patency of the fallopian tubes under X-ray control without the need for anesthesia
SMALL PAN ULTRASONIC EXAMINATION non-invasive examination with a vaginal probe
EGG female gamete - germ cell, egg, ovum, egg cell, oocyte
INPUT INTERVIEW client's interview with a doctor - includes a history of both partners
ZYGOT fertilized egg
Prices are understood in CZK without VAT (if it is a procedure with a medical goal, the procedure is exempt from VAT).
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Our team - contacts
Enter the four-digit line after the name after the telephone number (+420) 22443 ****
Doctors of the reproductive medicine team
MUDr. Miloš Čekal - Chief Physician of Reproductive Medicine, line 4274
MUDr. Vladimir Cerny
doc. MUDr. Tomáš Fait Ph.D - prescribes on Friday
MUDr. Karel Hynek, line 4274 - prescribes on Thursday
MUDr. Eva Uhrová, route 4274
MD Jan Sulc
Sisters
Marie Keilová, route 4215
Tatana Sahulkova, route 4215
Bc. Lenka Uhlíková, line 4215
Doctors of the reproductive genetics team
MD Bc. Jelena Černíková - physician of reproductive genetics, geneticist, line 3578
MD Marína Zámečníková - physician of reproductive genetics, geneticist, line 3578
Sister
Ivana Vnoučková, route 3578
Hana Mendlová, route 3578
Laboratory team
RNDr. Petra Paulasová, Ph.D. - Head of the Center for Reproductive Genetics, andrologist, geneticist, embryologist
Ing. Monika Adamečková - embryologist
M.Sc. Monika Vlčková - embryologist
Ing. Jakub Beránek - andrologist
Kateřina Indrová - laboratory assistant
contact: ivfmotol@fnmotol.cz