Prague Fertility Centre: Infertility treatment in Czech Republic, Prague

Specialist infertility treatment in Prague, Czech Republic offering IVF: in-vitro fertilisation, ICSI: intracytoplasmic sperm injection, PICSI technique, permanent embryo monitoring, PGD/PGS, extended embryo culture, assisted hatching, embryo freezing, sperm freezing, egg donation, sperm donation, and embryo donation. 

News: Prague fertility centre offers package of 3 full IVF cycles for the price of 2. 

Results worldwide show without doubt that the 'cumulative‘ success rate is always higher than that from one cycle. Their aim of keeping costs down is to encourage the idea of IVF as a multiple cycle treatment. Success is more likely to be achieved if couples accept IVF as a course of treatment rather than a one cycle attempt.

Prague Fertility Centre (PFC) is a world-class fertility centre in Czech Republic. PFC is co-led by the widely respected embryologist Dr. Daniel Hlinka PhD., who was the first to introduce permanent monitoring of embryo development, which is why PFC is the only fertility centre in the Czech Republic (and amongst the very few in the world) that performs this new and effective method in infertility treatments.

Your treatment in their centre is absolutely transparent - you receive a video report of your embryo development recorded by newly introduced permanent embryo monitoring. Specialists at PFC take care of you in a friendly and relaxed way. They put a great emphasis on the psychological aspect of your treatment and provide you with faith and certainty.

Prague Fertility Centre guarantee system

In one egg/embryo donation cycle PFC always guarantee:

• one embryotransfer (ET) of fresh embryos

• one ET of cryopreserved (vitrified) embryos

In their guarantee system PFC would like to minimize the biologically based variations in the process of donor stimulations. Accordingly, there are several situations which are calculated and solved as follows:

1. if there is no one embryo for embryo transfer: - they prepare a new egg donor (this is a very rare case but they cannot exclude such a situation);

2. there are 4 and more good quality embryos: 2-3 embryos are transferred (according to the age and history of every woman) and the rest ones are vitrified for future use;

3. there are just 2 or 3 good quality embryos: - these embryos are used for ET. If no pregnancy is established after ET (or when after successful pregnancy and delivery of the baby a new attempt is planed) they prepare a new egg donor to produce embryos for guaranteed  ET of cryopreserved (vitrified) embryos.

Moreover, in their egg/embryo donation they assure your pregnancy in the two following donation cycles - otherwise the third cycle is free (provided the normal i.e. at least 50% fertilization rate was obtained using your partner's sper­matozoa -  in egg donation).

Please see more at http://www.pragueivf.com/en/donation-program/guaranties/.

The Prague Fertility Centre approach to infertility treatment

To provide comprehensive, innovative, evidence-based fertility and gynaecology treatment focused on individual problems and needs.

1. PICSI for the best spermatozoa selection
2. Monitoring of embryo development:
    a. to select the best embryo and to avoid early miscarriages
    b. to make infertility treatment absolutely transparent (following the progress of embryo development on-line and exact analysis of developmental processes)

• Prague Fertility Centre specialises in infertility treatment for people over 40

• Prague Fertility Centre is the first accredited centre working with human tissue in the Czech Republic compliant with the Directive of the European Parliament and Council 2004/23/ES and Law no. 296/2008 from the collection of laws and legal directives no. 422/2008. It has a permit issued by the National Institute for Medication Control (SUKL).

• There is no waiting list for egg donation with Prague Fertility Centre

Sonja Lazarovska MD.

Dr Sonja Lazarovska MD. is a gynecologist-obstetrician with Prague Fertility Centre: specialised in reproductive medicine.

Sonja has more than 20 years of practice in the field with specialisation in gynecology and obstetrics:

1. 13 years with the Institute for Obstetric and Pediatric Care, Podoli, Prague, where she was mostly dedicated to prenatal diagnostics including invasive diagnostic intervention

2. Over 8 years with the Sanatorium Pronatal, Prague in the field of reproductive medicine

During this time she has been involved in complex diagnostics, sterility treatment with all methods of assisted reproduction available, endoscopic surgery, and reproductive endocrinology.

Daniel Hlinka MVD., PhD.

Dr Daniel Hlinka MVD., PhD. ESHRE certified Senior Clinical Embryologist: one of the most experienced Czech and Slovak embryologists:

1. He was the first to apply the ICSI method successfully in the Slovak Republic, resulting in the birth of the first such child in 1994.

2. He contributed substantially to the introduction of preimplantation genetic diagnosis/screening (PGD/PGS) in the clinical practice.

Previously he has led embryological laboratories in:

• II. gyn.-obst. clinic Košice – Slovakia;

• KRM Zlín, Repromeda Brno, Pronatal Prague – Czech rep.

PFC offers the newest ART treatments for successful infertility treatment

Production of healthy and viable embryos is a crucial step in achieving successful infertility treatment.

Prague Fertility Centre (PFC) provides highly personalised care, support, and treatment options. They aim to do everything they can to maximise your chances of having a healthy baby.

PFC has highly qualified and experienced staff which will help you through your treatment.

Their efforts are supported through PFC research programs and their association with other research programs.

The Prague Fertility Centre specialises in infertility treatment for people over 40.

There is no waiting list for egg donation at PFC in Czech Republic

Prague Fertility Centre only uses eggs from healthy young donors and they never use surplus eggs from their patients. The donors undergo hormone screening, an ultrasound examination, psychological screening, and repeated tests for sexually transmitted diseases (HIV, HBsAg, HCV, syphilis). They also undergo karyotype screening and genetic screening to reveal the presence of CFTR gene mutations which cause cystic fibrosis. Their donors are usually university students or young mothers on maternity leave. None of them are treated for infertility and egg donation is their free choice. Czech law states that egg donation is anonymous: It is not possible for the donor to know the identity of the recipient or vice versa. It is however possible to choose a donor with certain specific characteristics – height, weight, hair and eye color. It is also possible to choose a donor with the same blood group like the recipient.

If you are interested in egg donation or require further information about donation, please don’t hesitate to contact Prague Fertility Centre.

Sperm donation at Prague Fertility Centre

Sperm donation involves using semen from an appropriately screened man (donor). The semen is used to fertilise eggs during assisted reproductive treatment.

Embryo donation

In their embryo donation program Prague Fertility Centre can offer just embryos that have been created using donated eggs and donated spermatozoa.

Prague Fertility Centre do not use already existing cryopreserved surplus embryos that have been created using IVF techniques and are in excess to the needs of the couple who created them.

If you are interested in embryo donation or require further information about donation, please don’t hesitate to contact Prague Fertility Centre.

IVF: in-vitro fertilisation

During IVF eggs are placed together with washed spermatozoa and fertilisation occurs spontaneously, as in the oviducts of the mother. A disadvantage of this method is the low fertilisation rate, mainly in cases when the partner’s sperm is low-quality. Often fertilisation is unsuccessful even though sperm is assessed as good quality in semen analysis. Sometimes polyspermy occurs, when more than one sperm fertilise an egg; the resulting embryos are abnormal (have more chromosomes than normal) and so are rejected.

ICSI: intracytoplasmic sperm injection

During ICSI one sperm is injected directly into the egg cytoplasm using an apparatus that transforms imperfect hand movements into fine and precise movements of micromanipulation tools. This method is used in the following cases:

1. Abnormal semen analysis findings. I.e. low sperm concentration or a high level of abnormal sperm with low motility

2. Fertilisation using sperm surgically extracted from testicles or the epididymis (using MESA/TESE techniques)

3. Failure to spontaneously fertilise in the previous cycle even though semen analysis results are positive

PICSI technique improves pregnancy rates and reduces the number of IVF miscarriages

In the ICSI procedure, an individual sperm is selected and injected into an oocyte. Until now, the only technique available to embryologists to select the sperm has been visual observation. Using the PICSI procedure Prague Fertility Centre is able to determine sperm selection in much the same way it happens in human biology.

Sperms are placed in a PICSI dish containing samples of hyaluronan hydrogel. Hyaluronan is a naturally occurring biopolymer found in all human cells, including the gel layer surrounding the oocyte.

Mature, biochemically competent sperm bind to the hyaluronan where they can be isolated by the embryologist and used for ICSI. This procedure mimics a key step in the natural fertilisation process; the binding of mature sperm to the oocyte complex. As a result, the selected sperm is essentially the same as one that would be successful in the natural reproductive process.

Research has proved that hyaluronan-bound PICSI-selected sperm are, in the vast majority of cases, more mature, exhibit less DNA damage, and have fewer chromosomal aneuploidies.

Click here to view a video of PICSI mature spermatozoa selection.

Click here to view a video of PICSI human egg fertilisation by selected spermatozoon.

Non-invasive embryo imaging with detection of abnormal divisions leading to aneuploidy

Objective and non-invasive imaging of embryo characteristics allows detection of abnormal cleavages leading to the occurence of chromosomal malsegregation which are a major cause of spontaneous miscarriage or birth defects PFC offers a noninvasive aneuploidy prediction as an alternative to invasive genetic aneuploidy screening (requires biopsy procedure for 1-2 embryonic cells removal).

Non-invasive aleuploidy prediction examples

• Mosaic embryo

• Mosaic embryo

• Entirely aneuploid embryo

Monitoring of early embryonic cleavages allows reliable aneuploidy prediction

The evalutaion of embryonic developmental abilities according to the static microscopic observation is negatively influenced by a great subjectivity in the assessment and by questionable relevance of the measured morphological parameters. On the other side the new imaging technologies allow continous embryo monitoring and subsequent picture analysis. Using non-invasive embryo imaging Prague Fertility Centre can reveal mosaic embryos consisting of aneupliod/euploid cells frequently leading to early abortions

Click here to view more about embryo monitoring.

PGD/PGS: reimplantation genetic diagnosis/ preimplantation genetic screening

Genetic evaluation of embryos before transfer: the embryo's development does not always reflect its genetic constitution.

After in-vitro fertilisation was introduced into clinical practice, preimplantation genetic diagnosis (PGD) was put forward as an alternative to prenatal diagnosis of genetically transmitted diseases.

In the first place it was supposed to solve the dilemma as to whether a pregnancy should be terminated if the embryo was found to be carrying a genetic defect.

Gradually genetic screening of embryos became used more and more in practice to detect de novo emerging anomalies (chromosomal anomalies emerging in the course of gametogenesis and during early embryo development); preimplantation genetic screening (PGS).

Click here to view a video of PGD/PGS biopsy of a human embryo.

Click here to view a video of PGD/PGS aneuploid embryo detection using permanent monitoring.

Extended embryo culture

Extended embryo culture is a term used to describe the embryo remaining in a culture medium from the third day after fertilisation. Its advantage is that it allows one to judge the embryo’s development and morphological characteristics.

Permanent monitoring of the embryo’s development provides Prague Fertilty Centre with much more information about the dynamics of cell division and very often the healthiest embryos suitable for transfer are already known at day 2 of culturing.

Culture duration is also influenced by the following factors:
1) Endometrial development (growth of uterine lining)
2) Possible occurrence of hyperstimulation syndrome
3) Time necessary for genetic screening of biopsy cells during PGD/PGS

Assisted hatching (AH)

Disruption of the outer embryo layer: this helps implantation of the embryo in the uterus. On the 5th or 6th day of its development, the embryo leaves its protective outer layer (zona pellucida), which among other things has protected it till now from extracorporeal manipulation. This process of breaking out or “hatching” is necessary for the embryo to establish contact with uterus cells become implanted. Some embryos are not able to undergo this process and they remain lodged in the zona pellucida. This is why scientists have come up with the assisted hatching (AH) technique. Using this technique the zona pellucida is breached in one place using micromanipulation tools which helps the embryo hatch out of its layer. Although today there are many varying opinions about AH, it is generally believed that healthy embryos are not affected by this technique. Patients should not overrate the effectiveness of AH.

Click here to view a video of assisted hatching.

Freezing surplus embryos

Preserving embryos for use at a later time: there are many reasons why a patient may want to freeze embryos when undergoing infertility treatment, the most common ones are:

• To preserve surplus embryos (not used for embryo transfer) in the given cycle

• Freezing all embryos in these cases:

1. Risk of hyperstimulation syndrome

2. Inadequate growth of uterine lining

3. Medical finding on the reproductive organs which prevents the creation of conditions necessary for embryo implantation

4. Other acute diseases that are incompatible with pregnancy
   

Freezing of the spermatozoa in advance

In the egg donation program it is considered appropriate to freeze sperm before oocytes are retrieved.