After initial examinations have identified causes that prevent natural pregnancy or do not allow for simpler methods of assisted reproduction, the IVF (in vitro fertilization) procedure is recommended in consultation with an IVF specialist.
We do not prolong your journey to the desired goal with inefficient methods. From the very beginning, we have been trying to find the most effective solution for you.
1. Hormonal treatment that stimulates the maturation of more eggs
Based on the results of the hormonal profile, AMH and age of the woman, a long or short stimulation protocol and a suitable combination of stimulation preparating drugs are chosen. The patient then applies these stimulating drugs according to precise instructions and goes for regular check-ups during stimulation.
2. Monitoring the course of stimulation
During regular check-ups (usually on the 5th, 8th, 11th day of stimulation), the number and size of follicles are measured by ultrasound and at the same time the level of the hormones FSH, LH and E2 in the blood is checked. In the afternoon of the same day, the blood results and the ultrasound findings are evaluated together by the chief physician and the patient is informed by the coordinator about the next procedure – adjustment of dosage (if necessary), date of further control, termination of stimulation, etc.
3. Embryological interview
During stimulation, each patient (possibly with a partner) undergoes an interview with an embryologist. At this interview everything is explained again with the help of illustrative pictures, for example the choice of egg fertilization method is clarified (if the results of further examinations were awaited), patients are instructed on the need to fill in informed consents, which they will take home to read and fill. Patients then bring these informed consents before egg collection.
4. Egg collection (puncture, OPU)
Stimulation usually lasts at least 11-12 days, so egg collection is performed no earlier than the 13th, more often the 14th day. If necessary, eg uneven or slow follicle growth, the stimulation should be extended. On the last day of stimulation, the patient receives a final injection in the evening according to the instructions. Then the day is a break and the next day he comes with his partner in the morning to collect eggs. Egg collection is performed under general anesthesia 34-36 hours after the final injection, it is a short procedure, after which the patient goes home with an accompanying person after 2 hours.
5. Sperm collection
Sperm collection is performed in the morning on the same day as egg collection. Semen collection can also be performed outside our workplace, for which it is necessary to pick up a sterile container in the laboratory and observe the conditions for transport.
Sperm can also be used pre-frozen, in the absence of sperm in the ejaculate (azoospermia) it is possible to try to obtain sperm from testicular tissue (TESE).
6. Preparation of reproductive cells for fertilization
After puncture of the follicles, the eggs are stored in an incubator and fertilization takes place approximately 3-4 hours after collection. After collection, sperm are processed according to a pre-selected fertilization method (classical gamete coincubation, ICSI, PICSI), sperm processing can be supplemented by the MACS method.
7. Fertilization of eggs
If the so-called classical fertilization is selected on the basis of the results of the spermiogram and functional tests, after a certain time from collection, the processed sperm are added to the eggs for spontaneous fertilization in a culture dish (“in a test tube”).
If the micromanipulation technique (ICSI, PICSI) is approached, then the eggs are depleted of cumulus cells, their maturity is evaluated and the mature eggs are then fertilized by inserting sperm into the egg using a micromanipulator needle.
8. Fertilization check
No matter how the eggs were fertilized, their fertilization is evaluated the day after the eggs are collected. The patient then calls the embryology laboratory at 10:15, where she receives information about the number of mature and fertilized eggs.
9. Monitoring of embryo development
Patients will receive further information about the ongoing development of embryos on the 3rd day, when they call at 10:15.
10. Transfer, freezing, PGT
On the 5th and 6th day of embryo development, the patient calls at 8:00 to agree with the embryologist on the use of quality embryos. If a fresh transfer is planned, it is done on the 5th day. On day 6, all quality embryos are frozen (vitrified). On the morning of the 5th day, the embryologist agrees with the patient on the time of the fresh transfer. It is usually planned for the morning.
If a PGT-M / PGT-A examination is planned, a biopsy of embryos at the stage of hatching blastocysts (HB) and fully hatched blastocysts (FHB) is performed – day 5 or 6 (more often) of embryo culture. Embryos are frozen after biopsy (cell collection) and transferred in one of the next cycles.
The results of the PGT examination are available within a maximum of 4 weeks after the biopsy, but usually the transfer of the examined embryo in the next cycle can be completed. The results are communicated to the patient by telephone by a clinical geneticist.
If no fresh transfer has taken place and the embryos have been vitrified, then KET is usually planned in one of the next cycles. Based on the doctor’s instructions, the patient agrees with the coordinator on the check up and preparation before KET. To schedule a check up before KET, the patient calls the coordinator at the beginning of the cycle – please consider working hours 7-15: 30. The inspection is then scheduled for 11-14. day of the cycle, two checks are performed as needed.
12. Pregnancy test
We recommend performing a pregnancy test 10.-12. day after embryo transfer. If the pregnancy test is clearly positive, there is no need to take a blood test. All you have to do is to book an ultrasound examination about a week after the positive test.
Our care for you does not end with a successful embryo transfer, we will be happy to take care of you even during pregnancy. We offer all pregnancy examinations, prenatal ultrasound diagnostics and a counseling center for high-risk pregnancies.