Methods of assisted reproduction

Ovulation induction

This technique has traditionally been used for women with an ovulation or oligo-ovulation. More recently it has been used to improve a woman’s chances of conceiving using any method of assisted procreation by increasing the number of eggs which will grow.

Before intrauterine insemination or timed intercourse antiestrogens can be used.

Before IVF more sophisticated methods are used. For direct stimulation of ovaries we use recombinant FSH in personal doses. Premature luteinization can be avoided by agonists or antagonists

The short agonist protocol starts at the beginning of the period with the application of agonists and the 2nd day by FSH application. Ovulation induction is triggered by HCG.

The long agonist protocol starts with 10 days of agonist application and after proper suppression FSH application begins with ovulation triggered by HCG.

The antagonist protocol starts with FSH application. Antagonists are added from day 5 or 6. Ovulation triggering can be done by HCG or agonists.

Intra Uterine Insemination (IUI)

This procedure is often called artificial insemination. The procedure involves placing sperm in the uterus with a small catheter through the cervix. In this way, the sperm is brought past the cervical barrier and movement into the fallopian tubes is made easier. Variations in the procedure involve taking medication to produce multiple follicles and the release of more than one egg (superovulation) in order to improve the chances of fertilization. This procedure is simple but the success rate is several times lower than with IVF.

In Vitro Fertilization (IVF)

The female patient is given medicine, usually by injection, to stimulate the maturing process of her eggs (ova). These eggs are then retrieved and combined with sperm outside the woman’s body. The resulting embryos are nourished in an incubator before being placed in the woman’s womb (uterus) to continue their normal fetal development.

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intracytoplasmic Sperm Injection (ICSI)

ICSI is an advanced method for treating male infertility. Using this technique a single sperm is inserted into a mature egg obtained from an ovary of a woman undergoing in vitro fertilization. ICSI is the treatment of choice for couples who have experienced previous IVF failures or low sperm quality. The fertilized egg then develops into a normal embryo. The number of high quality embryos is slightly higher than with standard IVF. Embryos for transfer can be expected in 95 - 97% of ICSI cycles. Babies born after intracytoplasmic sperm injection are just as healthy as babies conceived spontaneously.

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PISCI

This is the ICSI procedure in which sperm are selected by the process of binding mature sperm to the hyaluronic acid layer on egg shell surface. Such sperm are of higher quality and, in a higher percentage, contain good genetic information.

Blastocyst cultivation

Czech law allows the cultivation of all embryos until blastocyst. In this way we have a very good opportunity to select the best quality embryos.

Embryo viewing

Our camera can “watch” your embryos for 24 hours. On the computer we can calculate the “growing” curve in time as the best indicator of embryo quality and select the best embryos for embryo transfer.

Testicular sperm extraction and Epididymal Sperm Aspiration

TESE, MESA

The sperm of men who suffer from a blockage or any other abnormality which prevents the passage of sperm through ejaculation can be retrieved through minor surgery. The sperm is taken from the epididymis or the testicle tissue and injected using intracytoplasmic sperm injection into mature eggs obtained from a woman by means of in vitro fertilization. Sperm obtained this way can be cryopreserved for later use.

Assisted Embryo Hatching (AH)

Woman’s eggs are surrounded by a shell-like substance. Once an egg is fertilized, the resulting embryo in its earliest stages develops within the confines of the shell. When the embryo reaches the uterus it must break out of the shell in order to make contact with the lining of the womb (endometrium). Assisted embryo hatching is a technique which helps to open the shell surrounding the egg just prior to its being placed in the woman’s uterus following in vitro fertilization. In some women helping the embryo to break through its shell may improve the chances of an IVF pregnancy.

Cytoplasmic transfer

Cytoplasmic transfer can be recommended to women with low quality eggs. Using the same procedure as ICSI, donor cytoplasm (without genetic information, but full of unknown cytoplasmic factors like enzymes, mitochondria and energy sources) can be aspirated from donor eggs and transferred to the recipient’s egg. This way the cytoplasm can be improved and we can ensure proper chromosomal distribution and contact. This method is not as successful as egg donation, but it uses the woman's own genetic material.

Cryopreservation

Using an advanced scientific technique gametes, testicular tissue or embryos are frozen (cryo) and stored (preserved) to be used later by the same couple. The embryo is returned to the woman’s body with very little need for medication. Babies born after embryo cryopreservation are just as healthy as babies conceived spontaneously.

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