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Alternative B
IVF CYCLE IN COOPERATION WITH YOUR GYNAECOLOGIST

This alternative requires two visits to Prague; the first may be managed in a single day. Subsequently, in an arbitrary further cycle, the stimulation treatment itself with checkups by a cooperating gynaecologist at home, arrival 2 - 3 days prior to egg retrieval, woman leaves approx. 5-9 days afterwards.

When arranging your 1st appointment (1st visit to Prague), please bear in mind it must be outside of your menstruation period.

First visit
The participation of both partners is required.
We will explain the issue of extracorporeal fertilization in detail – stimulation, egg retrieval, embryo transfer. We explain the significance of individual special procedures such as ICSI, PICSI, assisted hatching, extended cultivation, embryo freezing, or PGS, if applicable. You shall be issued consent forms for the treatment to study through. They shall be endorsed and the identity shall be verified during the next visit.
A part of the 1st visit is also a gynaecological examination and blood investigation for
sexually transmitted diseases in both partners. If these tests were performed earlier, the investigations will not be necessary. A negative result is a prerequisite for further treatment at our facility. If you wish to minimize the partner’s necessary period of stay, freezing of his sperm may be immediately arranged. The partner must also sign a consent form in front of the practitioner for treatment with verification of the partner’s identity.
We shall prepare a stimulation treatment schedule.
Payment without performing tests 120 EUR
Payment when performing tests of both partners 360 EUR
Payment for performing tests only in the man or only in the woman 240 EUR
(This payment shall be deducted from the IVF cycle price during the final billing).
Sperm freezing – if agreed 128 EUR
The couple will then be provided the medication necessary for the entire stimulation. We shall provide instruction on their use.
Reimbursement of medication package (the price may fluctuate according to the present
situation) 1000 EUR
Departure is possible the same day.

Stimulation of the ovaries
The treatment itself may begin in any following cycle. The patient must have planned checkups by a gynaecologist, who is experienced in evaluating the reaction of ovaries to stimulation treatment.
We ask that you inform us by telephone, when the stimulation begins. On the basis of that, we shall decide how further mutual communication shall proceed.
The first check-up should be performed directly before the period or ideally before initiating stimulation, regardless of bleeding. The goal is discover any potential pathological findings, for example cysts. We must be notified about the presence of any pathological finding. We shall decide on how to proceed further.
The stimulation treatment begins on the 2nd day of the cycle. The first day is considered to be the day when full intensity bleeding presented by 9 a.m. If the bleeding occurred later, we designate this day as day "0".
Administration of the stimulation medication then follows according to the schedule.
The next check-up follows between the 6th—8th day of the cycle. The result must again be consulted by telephone. An additional stimulation schedule and a further check-up follow.
During stimulation, the woman must undergo a general health status examination. Minimal extent: full blood count, liver tests, microscopic urine examination, ECG, evaluation, whether the woman is capable of undergoing a short procedure in total anaesthesia.

A check-up is gradually planned at our clinic, usually between the 9th-11th day of the cycle (during a slow ovarian reaction, sometimes even later).

The second stay in the Czech Republic should be planned for 5 to 9 nights.

2nd visit to our clinic
Based on the prior arrangement, between the 9th and 11th day of the cycle (sometimes even later during a slow reaction of the ovary).

Both partners endorse their consent with treatment with a verification of identity based on a passport. (The presence of both partners is not necessary, if the sperm was frozen and the consent form was signated during the first visit). An ultrasound examination follows to determine the condition of ovaries and usually to schedule the end of stimulation and the eggs retrieval itself. It is necessary to draw blood from both partners (if the sperm was not frozen) a second time to test for sexually transmitted diseases.
Reimbursement:
Payment for IVF cycle 1980 EUR
(the amount paid during the first visit and the initial deposit shall be deducted, reimbursement for sperm freezing, if performed, shall not be deducted)
All else occurs similarly to the cycle, which occurred entirely at our clinic.
Reimbursement is also the same.

We always plan further check-ups according to the current finding

Egg retrieval (follicle puncture)
Occurs between 8 a.m. and 10 a.m. This procedure is performed under general anaesthesia. This means that prior fasting is necessary, i.e. no eating after dinner, no drinking after midnight. We also recommend avoiding smoking prior to the procedure. After the follicle puncture, the woman remains lying for approximately 2 hours at our clinic. Afterwards, we notify the client(s) of how everything went and what the next step will be. We explain how to administer medication for luteal support. Leaving our clinic is thereafter possible. An escort is necessary.
Reimbursement:
ICSI method 352 EUR or PICSI method 640 EUR
General Anaesthesia 132 EUR

Embryo Transfer
The transfer itself always takes place in the early afternoon, or on Saturday before the midday.
Starting with the second day after the egg collection, we will inform you about the progress of the embryo cultivation and we will tell you in time which afternoon the transfer will take place.
The transfer itself is a painless procedure. Before the transfer you will be thoroughly informed about the result, i.e. how many and what embryos will be transferred and how many of them were possibly frozen for further use.
You will leave our institute after 1 to 2 hours after the transfer. We recommend that the woman limits all activities that are not absolutely essential for approximately the next 3 days.
The best date for leaving the Czech Republic is after 3 or 4 days following the embryo
transfer. A sooner departure is also possible.
Reimbursement:
extended cultivation above 48 hours - 140 EUR
assisted hatching – 1 embryo - 132 EUR
further as negotiated
freezing of excessive embryos and storage for 1 year - 148 EUR
embryo glue – 66 EUR

Pregnancy test
A Pregnancy test should be performed after 16 to 18 days following the transfer. If the test is positive, luteal hormonal support must still be maintained. If the test is negative, you shall discontinue this medication. Menstrual bleeding usually appears after the termination of luteal support therapy. Should bleeding appear earlier, we recommend that you discuss the further procedure with us.
Please notify us of the pregnancy test result by telephone or by mail.
If the treatment is successful, please inform us as well on the course of the pregnancy and on the delivery.

Subsequent cycles with embryo cryopreservation
In case the pregnancy did not appear and other embryos are available in their frozen state, another transfer should be arranged.
We recommend a minimal interval of 1 month.
We recommend using a combination of drugs for managing the cycle – oestrogens and progestins. You will administer the medication with the micronized oestradiol on day 1 in dosage 3 x 2mg daily. We can sell you this medication ourselves (delivery via post possible + 60 Eur) or your gynaecologist may prescribe it for you.
A condition for transfer is a uterine mucosal height of at least 7 mm. The finding may be verified by your gynaecologist. After the required endometrial height has been achieved (usually between the 12th and 14th day), we add the micronized progesterone medication in a dosage of 3 x 200 mg per day.
The transfer will follow after 2 to 5 days depending on the stage of the frozen embryos.
The transfer date may be arrange by telephone and arrival in the Czech Republic on the day of transfer is usually sufficient. All specifics will be provided based on the actual situation. It is possible and even better, to arrive in the Czech Republic around the 12thday of the cycle.
Check-ups before the transfer are then performed at our clinic.
Residency in the Czech Republic for 3 days after the transfer is sufficient.
The partner’s attendance is not necessary. But we need a signed Application for an embryo transfer procedure (the document will be sent to you in advance).
The transfer is performed in an identical manner as in the first cycle.
The price is 484 EUR + possibly 132 EUR for assisted hatching/ 1 embryo + possibly 66 EUR for embryo glue