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Planning the treatment

IVF/ICSI using own oocytes

Scheme of the treatment procedure:

Consultation

After the first initial interview and initial examinations, the physician will evaluate the patients’ health condition and analyse the current results. As a matter of course, a consultation with patients will be held to discuss the treatment options and to determine a suitable treatment strategy. The initial examinations include gynaecological, ultrasound, hormonal examinations and also a spermiogram examination of the husband/partner.

If you are interested, a short Skype consultation can be arranged before the actual visit to the clinic.

However, the introductory interview and examination in the centre is a prerequisite for starting the therapy.

Hormonal stimulation

The principle of the IVF/ICSI cycle is a controlled hormonal stimulation of the patient’s ovaries, which will allow us to obtain a higher number of fertile eggs from both ovaries, compared to the natural cycle when only one oocyte matures.

Ovarian stimulation is carried out according to a determined stimulation protocol, which is explained to the patient by the physician, and also later in detail by the nurse. In the case of any questions, our information centre can be reached by telephone or e-mail.

Stimulation medication is administered by patients daily mostly in a form of subcutaneous (under the skin) injections. After approximately 5 days of stimulation, the first ultrasound examination follows, and the number and size of follicles are evaluated.

During the stimulation, ovarian response and follicular growth are checked by scheduled ultrasound examinations (twice or three times during the stimulation in most cases).
If the follicles are of adequate size and oocytes are mature, the physician will determine the timing of ovulation induction and the application of the medication necessary for inducing the final stage of egg maturation. Generally, egg retrieval is then conducted about 34-36 hours later.

Oocyte retrieval

Oocyte retrieval is done without hospitalisation under analgosedation or a brief general anaesthesia by transvaginal puncture (vaginal route) of the ovaries under ultrasound control.

Following the oocyte retrieval, the patient will stay under the supervision of the medical staff in the monitoring room. The presence of the patient’s partner is a matter of course. The patient leaves the clinic accompanied by her partner usually 2 hours after the procedure.

Oocyte fertilisation

Intracytoplasmic sperm injection (ICSI) is the most widely used technique of “artificial insemination”, during which an egg is fertilised by inserting/microinjecting sperm directly into its cytoplasm.

The technique was originally developed for couples with deteriorated spermiogram parameters, where the conventional fertilisation by adding sperm to eggs have failed, but thanks to the high success rate, this technique has now entirely replaced the conventional IVF method.

Cultivation of embryos

After the fertilisation of eggs, we cultivate embryos for five days to the blastocyst stage before the eggs are inserted in the mother’s uterus during embryo transfer. Obviously, it is possible to transfer an embryo at an earlier stage of development, but since the male factor does not start to influence the embryo development considerably until the third/fourth day, this is one of the many reasons why our centre applies the extended culture method for each cycle as default.

Similarly, the endometrium is physically ready for insertion of an embryo only about six/seven days after fertilisation, the transfer of a blastocyst is therefore synchronically tuned with its preparedness. The extended cultivation thus offers a better opportunity for selection of the morphologically most suitable embryo and an enhanced chance of successful nidation of the embryo in the uterus.

Embryo transfer (EmbryoGlue option)

Embryo transfer is understood as the transfer of an embryo back into the uterine cavity after laboratory culture. In the vast majority of cases, we transfer embryos in the blastocyst stage after the preceding extended cultivation (fresh transfer – ET)

All remaining embryos of good quality are cryopreserved by vitrification.

These embryos can be transferred to the uterus in the following treatment cycle – cryo-embryo transfer (CET).

Our data as well as data from specialised literature indicate at least the same or even higher success rate of cryo-cycles – this is thanks to the solid option of preparation of the endometrium to accept the embryo.

In both ET and CET techniques, we prefer to transfer one embryo. The average number of transferred embryos per transfer was 1.1 embryo per transfer in our IVF centre in 2022.
The chance of pregnancy after one transfer at our clinic is approximately 53%.

Cryo-conservation

Vitrification is a reliable process for the fast and gentle freezing of tissues and cells, which are then preserved at very low temperatures (liquid nitrogen) for later use.

In the IVF/ICSI cycle, the most common vitrification is of the “remaining” quality blastocysts that are primarily not transferred. We are pleased to have the renowned Belgian embryologist Dr Pierre Vanderzwalm as our long-term collaborator and colleague, as he is one of the pioneers of research and development in cryo-conservation, and a pioneer in the intracytoplasmic sperm injection method (ICSI). In addition to cryo-conservation of blastocysts/embryos, the cryo-conservation of sperms and oocytes is naturally also possible in our clinic.

The method of “in vitro fertilisation” or “extracorporeal insemination” is understood as joining the egg and sperm outside the mother’s body. For this purpose, after prior stimulation of the ovaries, one or more eggs are removed from both ovaries, then transferred into a test tube (= in vitro) and combined with the male sperm. The embryo thus created is developed in laboratory conditions for three to five days and then returned to uterus (= embryo transfer). 

Since the procedure described above can be challenging for some parenting couples, the approach should be as personal as possible, and the therapy should take place in a confidential atmosphere. This is precisely the reason why we strive for an individual approach by enabling every couple treated to have one permanent physician, as far as possible. The treatment begins with details of health history, comprehensive advice and information on all aspects of the therapy, including potential risks.

After the analysis of all previous and current findings, thorough gynaecological examination and after checking the spermiogram, an individual therapeutic plan is prepared. 

It has emerged from many cases that psychological counselling might prove beneficial before the in vitro fertilisation as such.  A precise overview of the course of the planned therapy, individual examinations and the detailed description of medication will be given to each couple as part of the individual therapeutic plan.

Price list

from 2 500 EUR

The price includes special laboratory methods, which make the success rate of the treatment higher.

The price does not include a surcharge for medication.

In our IVF clinic we approach infertility treatment very individually. Thanks to this we achieve a high success rate. The total cost of the therapy depends on methods and procedures used, which have been chosen based on the needs of the treated couple. You will find out all specific information during your initial interview.

IVF/ICSI with donated oocytes

Our efforts are always aimed at the most possible match in phenotypic characteristics, including blood group and Rhesus factor between the recipient and the donor.

Treatment with donated eggs (oocytes) has a long tradition in our clinic and has been conducted at a high-quality level since the establishment of our clinic.

In the case of therapy using donated oocytes, the eggs used have been obtained from anonymous healthy donors, whose eggs are then fertilised with the partner’s sperms by the ICSI/IMSI methods.

Donors undergo a careful selection. Only young healthy women (18-34 years of age) are included in the oocyte donation programme and must comply with the strict criteria based on legislation and internal requirements of our clinic.

Examination of donors

Gynaecologic examination (detailed medical history, ultrasound examination)

Evaluation by a clinical geneticist Hormonal screening blood test

Genetic examination (karyotype, CFTR, SMA, GBJ2)

Toxicological examination from blood and urine

Regular screening for sexually transmitted diseases (HIV, hepatitis, lues)

Testing of blood group and Rhesus factor

Price list

from 5 900 EUR

Treatment with donated oocytes give a chance to couples who cannot conceive using their own eggs.

The price includes special laboratory methods, which make the success rate of the treatment higher.

The price does not include a surcharge for medication.

In our IVF clinic we approach infertility treatment very individually. Thanks to this we achieve a high success rate. The total cost of the therapy depends on methods and procedures used, which have been chosen based on the needs of the treated couple. You will find out all specific information during your initial interview.

Other treatment options

HyFoSy

HyFoSy (hysterosalpingo-foam-sonography) is an ultrasound screening examination conducted on an outpatient basis.
Its objective is to determine the patency of fallopian tubes and to obtain information about the uterine cavity.
Reliability of the above information is reported to be approximately 70-80%. On the plus side, this is a non-invasive procedure, without the need of anaesthesia, surgery or X-ray.

Planned sexual intercourse

Monitoring a woman’s natural cycle (or a cycle with a minor hormonal support) to determine or induce ovulation and to plan the optimum time for intercourse with the aim of achieving fertilisation.

Artificial insemination

Monitoring a woman’s natural cycle (or a cycle with a minor hormonal support) to determine or induce ovulation and to plan the optimum time for intercourse with the aim of achieving fertilisation.

This is a non-invasive procedure, carried out on an outpatient basis, improving the chance of successful conception.

However, this method does not replace the IVF/ICSI cycle, and the success rate mostly does not exceed 15%.

These methods do not replace IVF/ICSI and their success rate is lower.


Preservation of eggs and sperm

The whole process involves several days of hormonal stimulation, retrieval of eggs in a short total anaesthesia and their subsequent freezing (vitrification). Eggs are then preserved in our clinic in liquid nitrogen until the woman decides to use them. 

Social freezing offers women the option to preserve and freeze their own eggs because they might plan parenting later, for various factors (e.g. since they might prioritise their careers, studies, search for a suitable partner, work in a harmful environment or there are serious health reasons, such as a scheduled oncological treatment, surgery of ovaries, etc.).

The options offered by our clinic provide time and space to make dreams come true or to overcome difficult periods in life. To have your own eggs frozen, you just need to visit our clinic Next Fertility IVF Prof. Zech Plzeň, consult our physician and undergo the initial examination (gynaecological, ultrasound and hormonal profile examination). Based on results of the examination and by mutual agreement, a treatment plan will be developed shortly, and your treatment can begin within a few days. 

Price list

from 2 750 EUR

The possibility of freezing good quality eggs and their subsequent use for a treatment in the future.

Genetic testing

Genetic testing performed in cooperation with MUDr. Petr Lošan of the genetics institute Genetika Plzeň s.r.o.

As part of infertility treatment, the purpose of genetic analysis is to examine unfertilised or fertilised eggs for potential genetic defects before inserting the eggs to mother’s uterus.  

All detailed information regarding the examination process and possible risks as well as medical indications and legislation will be provided to you during the medical consultation.

Genetic testing in infertility treatment is recommended in the following cases in particular:

  •  Individual and/or familial genetic burden
  • Repeated miscarriages
  • Several unsuccessful treatment cycles during IVF therapy

Price list

from 480 EUR

PGT-A examination of 24 Chromosomes by NGS

PGT-SR for familial chromosomal aberration by NGS

PGT-M for monogenic disease by Karyomapping

Laser-Trofectoderm-Biopsy

Methods that increase the success rate

IMSI

Intracytoplasmic injection of morphologically selected sperm: thanks to this technique, sperm is selected for injection into the oocyte (ICSI) after a thorough evaluation of morphology (appearance). A detailed morphological analysis is made possible by the special adjustment of the microscope, with the magnification of up to 6600x.

Studies conducted by our team have revealed that the probability of isolating one normal sperm without defects in the sperm head for fertilisation of the egg considerably increases compared to the ICSI method. Sperm with defects in the head may have damaged DNA, which in turn may have an adverse impact on the further development of the embryo. Accordingly, we offer and perform the IMSI technique as the standard for oocyte fertilisation.

Microfluidic chip

The purpose of this method is to select high quality sperm for fertilisation. The method relies on the selection of sperm through a microfluidic membrane, which simulates the natural in vivo environment.

In this procedure, a sperm population is obtained with better quality parameters (optimal morphology, lower DNA fragmentation, better motility) in comparison with the original sample.

This method is suitable for couples who have undergone repeated failures in the previous treatment or several miscarriages. The advantage of this method over the conventional separation method is its simplicity and gentleness to the sperm processed.

PICSI

Pre-selective intracytoplasmic sperm injection: This technique imitates a natural selection of mature sperm. In natural fertilisation, an egg is fertilised successfully only by mature sperm which is able to bond to hyaluronan, a substance present on the egg surface. Accordingly, the principle of the PICSI method is to bind mature sperm on a special dish, on which a gel containing hyaluronan is applied. The selected sperm is then used for micromanipulation fertilisation.

Continuous monitoring of embryo development

Continuous monitoring of the embryo development makes it possible to observe the development of embryos in the incubator throughout their cultivation in laboratory. This system enables us to observe the dynamics of embryo development in real time, without disturbing the ideal culture conditions, directly in the closed incubator.

Based on the recorded embryo development, we are able to assess, in particular, the regularity of cell division of the embryo, and thus determine the developmental potential and dynamics of morphological changes of embryos.

Assisted hatching

In this micromanipulation method, the zona pellucida (glycoprotein envelope of the egg) is opened with the help of laser. This will facilitate the hatching process, i.e. the release of the inner cellular part of the embryo through the zona pellucida, which is necessary for the successful nidation/implantation of the embryo in the woman’s uterus.

EmbryoGlue

This medium contains a high proportion of hyaluronan, a substance important for the embryo to settle in the woman’s uterus. A transferred embryo is cultured in this media for several hours before the embryo transfer and it is subsequently transferred into the uterus.

The objective of the use of this special transfer media is to provide the utmost support for the embryo to nest /implant successfully.

Donated sperm

The indication for the use of donated sperm is the absence of production of own sperm (non-obstructive azoospermia) or a serious risk of a possible transmission of a genetic defect to the child. With the consent of the couple treated, we can use sperm from an anonymous donor for treatment.

Our clinic Next Fertility IVF Prof. Zech has its own sperm bank. The donor is at all times selected according to the phenotypic criteria of the couple treated.

Make an appointment

Use the on-line contact form or call us directly.

Call daily from 8:00 to 16:00 hours on 
+420 377 279 350

Address

Next Fertility
IVF Prof. Zech Pilsen s.r.o.
Bedřicha Smetany 167/2,
301 00 Plzeň - Vnitřní Město

Contact

Telephone
+420 377 279 350

E-mail
office.pilsen@next-fertility.cz

Surgery hours

Monday08:00 - 16:00
Tuesday08:00 - 16:00
Wednesday08:00 - 16:00
Thursday08:00 - 16:00
Friday08:00 - 16:00