- The obstruction of the tubes can be caused by inflammation, previous surgery, endometriosis, or congenital malformations – In this case, the passage of the oocyte through the fallopian tubes is compromised or impossible.
- Cervical mucus is insufficient, or hostile to sperm that cannot penetrate
- Thyroid disorders, hyperprolactinemia, etc.
The most common causes of infertility in men are:
- Disruption of spermatogenesis
- Reduction of sperm motility
- Sperm transport disturbances
- Diseases that affect the whole body (diabetes, thyroid diseases, etc.).
Sexual dysfunction (caused by a paralysis, etc.)
Donors remain anonymous in the Czech Republic. Our clinic has its own sperm bank, the screened frozen sperm in our bank are used for fertilizing oocytes. Hence there is no waiting time for finding a sperm donor. On the other hand, ovum donations include fertilization of the ova on the same day as they were retrieved. To donate to our clinic donors need to undergo several consultations with our physicians. They need to pass a battery of exams before they can be entered into our registry. The screening criteria are very accurate and thorough according to the Czech legislation. At the minimum all our donors are high school graduates and our sperm donors are men between the ages of 18 and 35. They are also perfectly healthy as they undergo specific medical examinations before donating. Our strength lies in our ability to match the donor’s phenotypes with those of the recipient (blood type, hair color and eye color, height, weight, skin type). It is critical for us to please our patients and cater to their preferences so that it results in the birth of a healthy baby.
Before coming to the clinic
All our patients are required to provide us with a recent PAP smear test and hormonal profile blood FSH, LH, PRL, E2, progesterone, fT3, fT4, TSH) before the first interview. These results will be discussed with our physician in an individual consultation session. On the beginning of a woman’s period, the blood work for hormonal values will be performed, between the 2nd and the 4th day of the menstrual cycle. The results should not be older than six months. Patients should make sure that the physician has the results before the first interview; they can also send their results by email or fax. The most important test for men is the semen-seminal fluid analysis which is done to assess the quality of the sperm. Semen collection is performed in our clinic; the report will indicate the most efficient laboratory method. Patients who are collecting a semen specimen for analysis should abstain from sexual practices for at least 2-4 days. This sample will also be stored in case it is needed in the future (due to illness, accident, etc.) for treatment.
During your consultation (Skype or personal) with the physician you can ask any questions that you have, the session will last approximately one hour. The doctor will study your results and may require more analyses and controls to be made. He will inform the couple about the treatment options and laboratory procedures required once he has made the diagnosis of the situation. If you decide to proceed with the treatment, we will immediately provide you with all the needed medications as well as instructions on how to use them.
During the natural menstrual cycle, many oocytes are developed in a woman’s ovaries. However, only one oocyte matures and is released. The pituitary hormones control the development, maturation, and release of the oocyte from the ovaries (ovulation). A physician carefully monitors a hormonal stimulation so that several oocytes are developed and mature. This increases the success rate of the treatment.
The kind of stimulation that is best suited for the woman to achieve the desired results will be decided on during the consultation. After the first consultation, the physician will prepare the treatment plan and provide the patient with the medications required for the treatment. An ultrasound examination of the ovaries will be performed to assess the follicular development, which is the number and sizes of the follicles in which eggs mature, during the stimulation. An ultrasound examination of the endometrium will also be performed to measure the mucus thickness. The patient has the option to have these examinations done by her gynecologist. However, it is preferred that the examinations are done at our clinical because the retrieval of the oocytes should coincide with maturations which happen within a few days of being carried out, and these tests will indicate this. The pharmacological stimulation of the ovaries can be achieved using injections. These doses may be administered in the patient’s home by a physician, gynecologist or by the patient herself (under the skin) or her partner/husband.
Once the ovarian follicles have reached a certain degree of development, oocyte maturation is induced, and the oocytes are retrieved (OPU – Ovum pick up). The retrieved oocytes are fertilized with the partner’s sperm on the same day. Fertilization can be done either by a fresh sperm of frozen sperms from the previous consultation in our clinic. Sperm donors need to practice sexual abstinence for at least 2-4 days.
CSI (Intracytoplasmic sperm injection) is an in vitro fertilization procedure in which a single sperm is injected directly into an egg using a fine, micropipette. In cases where the sperm quality is poor or there are infertility problems this procedure is most suitable. Based on the best appearance and motility, a healthy sperm is selected to be injected into an ovum. ICSI allows numerous oocytes to be fertilized. The PICSI sperms to be tested for their ability to feed and function.
Three days after the eggs are fertilized (or up to 5 days for a prolonged cultivation), the best quality embryos that have reached an appropriate stage of development, are selected to be transferred to your womb. Implantation of multiple embryos increases the percentage of success but also increases the risks for both mother and fetuses. You should discuss the number of embryos you are willing to have implanted with your doctor and embryologist. We do our best to eliminate these risks and make the decision with each couple individually.
You will be able to leave our clinic and travel one hour after the transfer of the embryo. You can take a pregnancy test (urine) 14 days later for a positive result, taking the test early may give a false negative. A more accurate test would be measuring the value of hCG in the blood (the Beta-hCG).