{"id":879,"date":"2020-03-14T16:48:08","date_gmt":"2020-03-14T15:48:08","guid":{"rendered":"https:\/\/fertilityport.vesmirnekure.cz\/?page_id=879"},"modified":"2020-11-12T12:15:02","modified_gmt":"2020-11-12T11:15:02","slug":"prubeh","status":"publish","type":"page","link":"https:\/\/fertilityport.com\/cs\/lecba-neplodnosti\/prubeh\/","title":{"rendered":"Pr\u016fb\u011bh"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8220;1&#8243; _builder_version=&#8220;4.4.0&#8243; background_image=&#8220;https:\/\/fertilityport.com\/wp-content\/uploads\/2020\/03\/lecba_neplodnosti_head.jpg&#8220;][et_pb_row column_structure=&#8220;2_3,1_3&#8243; _builder_version=&#8220;4.4.0&#8243;][et_pb_column type=&#8220;2_3&#8243; _builder_version=&#8220;4.4.0&#8243;][et_pb_text module_class=&#8220;c_blurb&#8220; _builder_version=&#8220;4.4.1&#8243;]<\/p>\n<h1>Bli\u017e\u0161\u00ed informace o pr\u016fb\u011bhu jednotliv\u00fdch terapi\u00ed<\/h1>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8220;1_3&#8243; _builder_version=&#8220;4.4.0&#8243;][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8220;1&#8243; _builder_version=&#8220;4.4.0&#8243; custom_padding=&#8220;||0px|||&#8220;][et_pb_row _builder_version=&#8220;4.4.0&#8243;][et_pb_column type=&#8220;4_4&#8243; _builder_version=&#8220;4.4.0&#8243;][et_pb_text module_class=&#8220;c_blurb&#8220; _builder_version=&#8220;4.4.0&#8243;]<\/p>\n<h2>Pr\u016fb\u011bh inseminace (IUI) a jej\u00ed \u010dasov\u00fd harmonogram<\/h2>\n<p>[\/et_pb_text][et_pb_text module_class=&#8220;textv textv&#8211;rose&#8220; _builder_version=&#8220;4.6.1&#8243; animation_direction=&#8220;bottom&#8220; hover_enabled=&#8220;0&#8243; sticky_enabled=&#8220;0&#8243;]<\/p>\n<p>Inseminace se pl\u00e1nuje v ovula\u010dn\u00edm cyklu. To znamen\u00e1 v cyklu kdy p\u0159edpokl\u00e1d\u00e1me uvoln\u011bn\u00ed vaj\u00ed\u010dka, kter\u00e9 \u010dek\u00e1 na oplodn\u011bn\u00ed spermi\u00ed. U \u017een, kter\u00e9 maj\u00ed menstrua\u010dn\u00ed cyklus pravideln\u00fd, nej\u010dast\u011bji kolem 28 dn\u00ed, bude v\u011bt\u0161inou sta\u010dit jedno ultrazvukov\u00e9 vy\u0161et\u0159en\u00ed, po kter\u00e9m bychom m\u011bli b\u00fdt schopni podle velikosti nejv\u011bt\u0161\u00edho folikulu napl\u00e1novat IUI v n\u00e1sleduj\u00edc\u00edch dnech. N\u011bkdy je pot\u0159eba ultrazvukov\u00e9 vy\u0161et\u0159en\u00ed opakovat, zejm\u00e9na u \u017een s nepravideln\u00fdm \u010di del\u0161\u00edm menstrua\u010dn\u00edm cyklem. Pokud se ovula\u010dn\u00ed cyklus nepotvrd\u00ed, je bohu\u017eel nutn\u00e9 pl\u00e1nov\u00e1n\u00ed IUI odlo\u017eit do dal\u0161\u00edho menstrua\u010dn\u00edho cyklu.<\/p>\n<p>P\u0159i potvrzen\u00ed ovula\u010dn\u00edho cyklu v\u00e1s, spole\u010dn\u011b s partnerem, pozveme k proveden\u00ed intrauterinn\u00ed inseminace. Po zpracov\u00e1n\u00ed ejakul\u00e1tu v Andrologick\u00e9 laborato\u0159i, co\u017e trv\u00e1 cca hodinu, v\u00e1s pou\u010d\u00edme o aktu\u00e1ln\u00ed kvalit\u011b spermiogramu a o n\u00e1sledn\u00e9m re\u017eimu po proveden\u00e9m v\u00fdkonu. Samotn\u00fd z\u00e1krok je velmi rychl\u00fd a nebolestiv\u00fd, zpracovan\u00e9 spermie v\u00e1m m\u011bkk\u00fdm katetrem (tenk\u00e1 hadi\u010dka) vprav\u00edme p\u0159es d\u011blo\u017en\u00ed hrdlo do d\u011blo\u017en\u00ed dutiny. T\u011bhotensk\u00fd test bude n\u00e1sledn\u011b napl\u00e1nov\u00e1n za 2-3 t\u00fddny po proveden\u00e9m v\u00fdkonu nebo se zpo\u017ed\u011bn\u00edm menstruace.<\/p>\n<p>[\/et_pb_text][et_pb_text module_class=&#8220;textv textv&#8211;grey&#8220; _builder_version=&#8220;4.6.1&#8243; animation_direction=&#8220;bottom&#8220; hover_enabled=&#8220;0&#8243; sticky_enabled=&#8220;0&#8243;]<\/p>\n<p><strong>Dal\u0161\u00ed informace:<\/strong><\/p>\n<ul>\n<li>intrauterinn\u00ed inseminace je do dne 39. narozenin hrazena Va\u0161\u00ed zdravotn\u00ed poji\u0161\u0165ovnou<\/li>\n<li>zdravotn\u00ed poji\u0161\u0165ovnou je d\u00e1n limit na maxim\u00e1ln\u011b 6 inseminac\u00ed za rok, doporu\u010dujeme v\u0161ak pokus opakovat maxim\u00e1ln\u011b 3-6x, pot\u00e9 je dobr\u00e9 znovu prodiskutovat dal\u0161\u00ed mo\u017enosti \u2013 z\u00e1le\u017e\u00ed na mnoha faktorech a bude v\u00e1m doporu\u010deno individu\u00e1ln\u011b<\/li>\n<li>\u0161ance na ot\u011bhotn\u011bn\u00ed pomoc\u00ed IUI je kolem 10% (s ohledem na hlavn\u00ed faktor \u00fasp\u011b\u0161nosti \u2013 v\u011bk \u017eeny a kvalit\u011b spermi\u00ed jej\u00edho partnera)<\/li>\n<\/ul>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8220;1&#8243; module_id=&#8220;tab2&#8243; _builder_version=&#8220;4.4.0&#8243; custom_padding=&#8220;||0px|||&#8220;][et_pb_row _builder_version=&#8220;4.4.0&#8243;][et_pb_column type=&#8220;4_4&#8243; _builder_version=&#8220;4.4.0&#8243;][et_pb_text module_class=&#8220;c_blurb&#8220; _builder_version=&#8220;4.4.0&#8243;]<\/p>\n<h2>Pr\u016fb\u011bh cyklu stimulace s vlastn\u00edmi vaj\u00ed\u010dky a spermiemi a jeho \u010dasov\u00fd harmonogram<\/h2>\n<p>[\/et_pb_text][et_pb_text module_class=&#8220;textv textv&#8211;rose&#8220; _builder_version=&#8220;4.6.1&#8243; animation_direction=&#8220;bottom&#8220; hover_enabled=&#8220;0&#8243; sticky_enabled=&#8220;0&#8243;]<\/p>\n<p>N\u011bkdy je indikace k cyklu um\u011bl\u00e9ho oplodn\u011bn\u00ed (cyklu IVF, cyklu stimulace) jednozna\u010dn\u00e1 a bez na\u0161\u00ed pomoci by p\u00e1r m\u011bl zcela minim\u00e1ln\u00ed nebo \u017e\u00e1dnou, \u0161anci d\u00edt\u011b po\u010d\u00edt p\u0159irozenou cestou (nap\u0159. odstran\u011bn\u00e9 oba vejcovody u \u017eeny), jindy je to sp\u00ed\u0161e d\u00e9lka snahy o koncepci \u010di opakovan\u011b ne\u00fasp\u011b\u0161n\u00e9 intrauterinn\u00ed inseminace co p\u0159im\u011bje p\u00e1r k dal\u0161\u00edmu kroku, cyklu stimulace. Je pot\u0159eba si uv\u011bdomit, \u017ee p\u00e1r po dvou a\u017e t\u0159\u00edlet\u00e9 snaze o po\u010det\u00ed m\u00e1 minim\u00e1ln\u00ed \u0161anci na ot\u011bhotn\u011bn\u00ed a je pot\u0159eba se sv\u011b\u0159it do p\u00e9\u010de centra asistovan\u00e9 reprodukce.<\/p>\n<p>V\u0161emu mus\u00ed v\u017edy p\u0159edch\u00e1zet konzultace s l\u00e9ka\u0159em, v\u017edy s ob\u011bma z p\u00e1ru, kdy v\u00e1m budou podrobn\u011b vysv\u011btleny aspekty cyklu stimulace a jej\u00ed mo\u017en\u00e1 rizika, komplikace event.n\u00e1sledky. Je nutn\u00e9 doplnit hormon\u00e1ln\u00ed vy\u0161et\u0159en\u00ed, ultrazvukov\u00e9 vy\u0161et\u0159en\u00ed \u010di kontroln\u00ed spermiogram, pokud nebudou aktu\u00e1ln\u00ed hodnoty zn\u00e1my \u010di bude doporu\u010dena jejich kontrola. Podle mnoha faktor\u016f (v\u00e1\u0161 v\u011bk, anamn\u00e9za p\u0159edchoz\u00edch IVF cykl\u016f stimulace, ovari\u00e1ln\u00ed z\u00e1soba dle ultrazvukov\u00e9ho vy\u0161et\u0159en\u00ed a v\u00fdsledky hormon\u00e1ln\u00edch vy\u0161et\u0159en\u00ed) v\u00e1m na va\u0161i \u017e\u00e1dost bude p\u0159ipraven l\u00e9\u010debn\u00fd pl\u00e1n, v\u010detn\u011b optim\u00e1ln\u00edho stimula\u010dn\u00edho protokolu.<\/p>\n<p>V tuto dobu budete spole\u010dn\u011b s partnerem podepisovat informovan\u00e9 souhlasy s v\u00fdkonem a budete m\u00edt dostatek prostoru a \u010dasu na to kl\u00e1st eventu\u00e1ln\u00ed dopl\u0148uj\u00edc\u00ed ot\u00e1zky. \u017d\u00e1dost na zdravotn\u00ed poji\u0161\u0165ovnu (pokud st\u00e1le budete m\u00edt n\u00e1rok na \u00fahradu od zdravotn\u00ed poji\u0161\u0165ovny) pod\u00e1v\u00e1 FertilityPort Prague. \u017d\u00e1danka je schv\u00e1lena nej\u010dast\u011bji do 2-3 t\u00fddn\u016f, nejpozd\u011bji do 30-ti pracovn\u00edch dn\u016f. Pot\u00e9 byste se, ide\u00e1ln\u011b spole\u010dn\u011b s partnerem, dostavila pro l\u00e9\u010debn\u00fd pl\u00e1n. Pl\u00e1n v\u00e1m bude podrobn\u011b vysv\u011btlen a z\u00e1rove\u0148 v\u00e1m bude vysv\u011btlena injek\u010dn\u00ed aplikace hormon\u016f. Platnost \u017e\u00e1danky do vyd\u00e1n\u00ed pl\u00e1nu a recept\u016f na stimula\u010dn\u00ed l\u00e9ky je 3-6 m\u011bs\u00edc\u016f dle typu zdravotn\u00ed poji\u0161\u0165ovny. N\u00e1sledn\u011b za\u010d\u00edn\u00e1te se stimulac\u00ed \u2013 aplikac\u00ed l\u00e9k\u016f, dle nastaven\u00e9ho pl\u00e1nu, v\u011bt\u0161inou 2.-3.den menstrua\u010dn\u00edho cyklu nebo n\u011bkolik dn\u00ed p\u0159ed o\u010dek\u00e1vanou menstruac\u00ed.<\/p>\n<p>Aplikace hormon\u016f se v\u016fbec nemus\u00edte ob\u00e1vat, jedn\u00e1 se podko\u017en\u00ed aplikaci drobnou jehli\u010dkou do vytvo\u0159en\u00e9 ko\u017en\u00ed \u0159asy, nej\u010dast\u011bji do okol\u00ed pupku. R\u016fst folikul\u016f, tedy efektivitu hormon\u00e1ln\u00ed l\u00e9\u010dby, je nutn\u00e9 v pravideln\u00fdch intervalech kontrolovat. Prvn\u00ed ultrazvukov\u00e1 kontrola se prov\u00e1d\u00ed cca 5.-6.den stimulace, kdy se zhodnot\u00ed mno\u017estv\u00ed a velikost rostouc\u00edch folikul\u016f, zda je dosta\u010duj\u00edc\u00ed d\u00e1vka hormon\u016f, kterou si \u017eena aplikuje. Druh\u00e9 a eventu\u00e1ln\u00ed n\u00e1sleduj\u00edc\u00ed kontroln\u00ed ultrazvukov\u00e9 vy\u0161et\u0159en\u00ed je v\u011bt\u0161inou napl\u00e1nov\u00e1no s odstupem n\u011bkolika dn\u00ed (2-3) a pokud je r\u016fst folikul\u016f optim\u00e1ln\u00ed, b\u00fdv\u00e1 ji\u017e rozhodnuto o term\u00ednu ovari\u00e1ln\u00ed punkce folikul\u016f.<\/p>\n<p>Punkce folikul\u016f se prov\u00e1d\u00ed v kr\u00e1tk\u00e9 celkov\u00e9 anestezii, v\u00fdjime\u010dn\u011b v analgosedaci \u010di bez anestezie dle po\u010dtu punktovan\u00fdch folikul\u016f. V jednom folikulu by m\u011blo dozr\u00e1vat jedno vaj\u00ed\u010dko. O fin\u00e1ln\u00edm po\u010dtu z\u00edskan\u00fdch vaj\u00ed\u010dek se dozv\u00edte p\u0159ed va\u0161\u00edm propu\u0161t\u011bn\u00edm z na\u0161eho centra. V ten sam\u00fd den budou pot\u0159eba spermie partnera, va\u0161e vaj\u00ed\u010dka budou oplodn\u011bna spermiemi metodou IVF nebo ICSI (k oplodn\u011bn\u00ed se daj\u00ed pou\u017e\u00edt \u010derstv\u00e9 nebo mrazen\u00e9 spermie). V den punkce folikul\u016f mus\u00edte v\u017edy odej\u00edt v doprovodu dosp\u011bl\u00e9 osoby.<\/p>\n<p>V n\u00e1sleduj\u00edc\u00edch dnech budete informov\u00e1ni o po\u010dtu \u00fasp\u011b\u0161n\u011b oplodn\u011bn\u00fdch vaj\u00ed\u010dek a po\u010dtu vyv\u00edjej\u00edc\u00edch se embry\u00ed. Samotn\u00fd embryotransfer, tedy zaveden\u00ed embry\u00ed zp\u011bt do d\u011blohy, bude proveden v z\u00e1vislosti na po\u010dtu a kvalit\u011b embry\u00ed v den 3 a\u017e den 6 v\u00fdvoje embry\u00ed (den odb\u011bru vaj\u00ed\u010dek je den 0), nej\u010dast\u011bji v den 5 v\u00fdvoje, tedy ve f\u00e1zi blastocysty. P\u0159ed zaveden\u00edm embry\u00ed budete pou\u010deni o kvalit\u011b embry\u00ed, n\u00e1sledn\u00e9m re\u017eimu a budou v\u00e1m zodpov\u011bzeny ve\u0161ker\u00e9 va\u0161e dotazy souvisej\u00edc\u00ed s terapi\u00ed. Samotn\u00fd embryotransfer se prov\u00e1d\u00ed v naprost\u00e9 v\u011bt\u0161in\u011b p\u0159\u00edpad\u016f bez nutnosti celkov\u00e9 anestezie. T\u011bhotensk\u00fd test bude napl\u00e1nov\u00e1n za 14 dn\u00ed a\u017e 3 t\u00fddny po mbryotransferu.<\/p>\n<p>Zbyl\u00e1 embrya, spl\u0148uj\u00edc\u00ed kvalitativn\u00ed krit\u00e9ria, budou n\u00e1sledn\u011b dle va\u0161eho p\u0159\u00e1n\u00ed zamra\u017eena k dal\u0161\u00edmu pou\u017eit\u00ed bez nutnosti dal\u0161\u00ed hormon\u00e1ln\u00ed stimulace. Tento embryotransfer se naz\u00fdv\u00e1 kryoembryotransfer, embrya jsou rozmrazena v den embryotransferu a pokud jsou po rozmrazen\u00ed v optim\u00e1ln\u00ed kvalit\u011b, jsou transferov\u00e1na do d\u011blohy stejn\u011b jako v cyklu \u201e\u010derstv\u00e9m\u201c (\u0161ance na \u201ep\u0159e\u017eit\u00ed\u201c po vitrifikaci maj\u00ed embrya cca 95%). Kryoembryotransferu se nen\u00ed t\u0159eba ob\u00e1vat, \u0161ance po \u00fasp\u011b\u0161n\u00e9m rozmrazen\u00ed jsou srovnateln\u00e9 \u010di zcela identick\u00e9 ve srovn\u00e1n\u00ed s transferem \u201e\u010derstv\u00fdm\u201c.<\/p>\n<p>[\/et_pb_text][et_pb_text module_class=&#8220;textv textv&#8211;grey&#8220; _builder_version=&#8220;4.6.1&#8243; animation_direction=&#8220;bottom&#8220; hover_enabled=&#8220;0&#8243; sticky_enabled=&#8220;0&#8243;]<\/p>\n<p class=\"h3\"><strong>Dal\u0161\u00ed informace:<\/strong><\/p>\n<ul>\n<li>zdravotn\u00ed poji\u0161\u0165ovna hrad\u00ed \u017een\u011b do dne 39.narozenin 3-4 cykly IVF stimulace. Z\u00e1le\u017e\u00ed na tom, kolik si nech\u00e1 \u017eena zav\u00e9st embry\u00ed v prvn\u00edch dvou cyklech IVF. Pokud si \u017eena nech\u00e1 p\u0159i prvn\u00ed a\/nebo druh\u00e9 stimulaci (cyklu um\u011bl\u00e9ho oplodn\u011bn\u00ed) zav\u00e9st embrya dv\u011b, m\u00e1 n\u00e1rok na spolu\u00fa\u010dast zdravotn\u00ed poji\u0161\u0165ovny pouze na 3 cykly. Pokud je p\u0159i prvn\u00ed i druh\u00e9 stimulaci zavedeno pouze jedno embryo, m\u00e1 \u017eena do dne 39.narozenin n\u00e1rok celkem na 4 cykly stimulace.<\/li>\n<li>po\u010det kryoembryotransfer\u016f a po\u010det embry\u00ed zaveden\u00fdch p\u0159i kryoembryotransferech nem\u00e1 vliv na po\u010det spolu\u00fa\u010dast\u00ed zdravotn\u00ed poji\u0161\u0165ovny. V\u00fdjimku tvo\u0159i situace, kdy je z r\u016fzn\u00fdch d\u016fvod\u016f nutn\u00e9 v aktu\u00e1ln\u00edm cyklu stimulace embrya zamrazit a kryoembryotransfer pl\u00e1novat n\u00e1sledn\u011b (jedn\u00e1 se nap\u0159\u00edklad o situaci, kdy hroz\u00ed riziko hyperstimula\u010dn\u00edho syndromu). V t\u011bchto situac\u00edch je po\u010det embry\u00ed transferovan\u00fdch v kryoembryotransferu rozhoduj\u00edc\u00ed pro dal\u0161\u00ed spolu\u00fa\u010dast zdravotn\u00ed poji\u0161\u0165ovny.<\/li>\n<li>\u0161ance na graviditu p\u0159i cyklu stimulace z\u00e1le\u017e\u00ed na mnoha faktorech, p\u0159edev\u0161\u00edm na v\u011bku \u017eeny a po\u010dtu transferovan\u00fdch embry\u00ed, do 36 let se \u0161ance uv\u00e1d\u00ed cca 55 %, mezi 36-40lety cca 40%, po 40. roce v\u011bku cca 10-15%, po 43. roce v\u011bku maxim\u00e1ln\u011b cca 5%<\/li>\n<li>doporu\u010dujeme v naprost\u00e9 v\u011bt\u0161in\u011b p\u0159\u00edpad\u016f k transferu jedno, v\u00fdjime\u010dn\u011b 2 embrya<\/li>\n<\/ul>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8220;1&#8243; module_id=&#8220;tab3&#8243; _builder_version=&#8220;4.4.0&#8243; custom_padding=&#8220;||0px|||&#8220;][et_pb_row _builder_version=&#8220;4.4.0&#8243;][et_pb_column type=&#8220;4_4&#8243; _builder_version=&#8220;4.4.0&#8243;][et_pb_text module_class=&#8220;c_blurb&#8220; _builder_version=&#8220;4.4.0&#8243;]<\/p>\n<h2>Pr\u016fb\u011bh cyklu s darovan\u00fdmi vaj\u00ed\u010dky\/vlastn\u00edmi spermiemi a jeho \u010dasov\u00fd harmonogram<\/h2>\n<p>[\/et_pb_text][et_pb_text module_class=&#8220;textv textv&#8211;rose&#8220; _builder_version=&#8220;4.6.1&#8243; animation_direction=&#8220;bottom&#8220; hover_enabled=&#8220;0&#8243; sticky_enabled=&#8220;0&#8243;]<\/p>\n<p>V p\u0159\u00edpad\u011b, \u017ee ji\u017e \u017eena nedisponuje dostate\u010dn\u00fdm mno\u017estv\u00edm kvalitn\u00edch vaj\u00ed\u010dek, vaje\u010dn\u00edky jsou pro odb\u011br anatomick\u00fd nep\u0159\u00edstupn\u00e9, v p\u0159edchoz\u00edch cyklech stimulace opakovan\u011b prok\u00e1\u017eeme \u0161patnou kvalitu vaj\u00ed\u010dek nebo pacientka trp\u00ed n\u011bjakou genetickou poruchou (kter\u00e1 by v\u00fdrazn\u011b zvy\u0161ovala riziko posti\u017een\u00ed d\u00edt\u011bte), bude p\u00e1ru z medic\u00ednsk\u00e9ho hlediska doporu\u010dena mo\u017enost vyu\u017eit\u00ed vaj\u00ed\u010dek darovan\u00fdch. Darovan\u00e1 vaj\u00ed\u010dka jsou vaj\u00ed\u010dka z\u00edskan\u00e1 od mlad\u00e9 zdrav\u00e9 \u017eeny, anonymn\u00ed d\u00e1rkyn\u011b. Kvalita jej\u00edch vaj\u00ed\u010dek by tedy m\u011bla b\u00fdt optim\u00e1ln\u00ed. Uv\u011bdomujeme si, \u017ee toto rozhodnut\u00ed mus\u00ed b\u00fdt pro v\u011bt\u0161inu \u017een\/p\u00e1r\u016f velk\u00fdm kompromisem a budeme se sna\u017eit V\u00e1m b\u00fdt v tomto rozhodnut\u00ed co nejv\u00edce n\u00e1pomocni. D\u016fvody pro tento typ terapie a cel\u00fd pr\u016fb\u011bh v\u00e1m podrobn\u011b vysv\u011btl\u00edme. Budete m\u00edt dostatek \u010dasu si v\u0161e promyslet a kl\u00e1st dopl\u0148uj\u00edc\u00ed dotazy.<\/p>\n<p>Dle v\u00e1mi vybran\u00fdch po\u017eadavk\u016f v\u00e1m bude vybr\u00e1na d\u00e1rkyn\u011b, kter\u00e1 t\u011bmto po\u017eadavk\u016f co nejv\u00edce odpov\u00edd\u00e1. Proces darov\u00e1n\u00ed je pln\u011b anonymn\u00ed a zachov\u00e1n\u00ed anonymity d\u00e1rkyn\u011b\/p\u0159\u00edjemkyn\u011b je na\u0161\u00ed hlavn\u00ed povinnost\u00ed a prioritou. Dle za\u010d\u00e1tku stimulace (za\u010d\u00e1tku menstruace) va\u0161\u00ed d\u00e1rkyn\u011b v\u00e1m bude sestaven optim\u00e1ln\u00ed terapeutick\u00fd pl\u00e1n. V n\u011bkter\u00fdch p\u0159\u00edpadech je nutn\u00e9 k synchronizaci va\u0161eho cyklu s cyklem d\u00e1rkyn\u011b nasadit hormon\u00e1ln\u00ed l\u00e9\u010dbu k posunut\u00ed menstrua\u010dn\u00edho cyklu nebo zah\u00e1jit tzv.downregulaci \u2013 kdy se pomoc\u00ed injekce nebo injekc\u00ed \u201evy\u0159ad\u00ed\u201c v\u00e1\u0161 p\u0159irozen\u00fd cyklus. Tento postup n\u00e1m d\u00e1v\u00e1 dostate\u010dn\u00fd prostor pro napl\u00e1nov\u00e1n\u00ed cel\u00e9 terapie bez ohledu na v\u00e1\u0161 p\u0159irozen\u00fd cyklus. K zaji\u0161t\u011bn\u00ed kvalitn\u00edho r\u016fstu endometria (sliznice dutiny d\u011blo\u017en\u00ed) bude nasazena estrogenn\u00ed terapie ve form\u011b tablet, n\u00e1plasti nebo transderm\u00e1ln\u00edho spreje. Po p\u0159ibli\u017en\u011b 10-12 dnech u\u017e\u00edv\u00e1n\u00ed estrogen\u016f je nutn\u00e9 zkontrolovat v\u00fd\u0161ku a kvalitu endometria pomoc\u00ed vagin\u00e1ln\u00edho ultrazvukov\u00e9ho vy\u0161et\u0159en\u00ed. Proto\u017ee d\u00e9lka stimulace \u017eeny\/anonymn\u00ed d\u00e1rkyn\u011b je v\u017edy individu\u00e1ln\u00ed, nebudeme v\u00e1m v\u011bt\u0161inou schopni v den ultrazvukov\u00e9 kontroly zat\u00edm sd\u011blit p\u0159edb\u011b\u017en\u00fd term\u00edn odb\u011bru \u010derstv\u00e9ho vzorku spermi\u00ed a term\u00edn n\u00e1sledn\u00e9ho embryotransferu. O definitivn\u00edch term\u00ednech v\u00e1s budeme s dostate\u010dn\u00fdm p\u0159edstihem informovat telefonicky nebo emailem. Obdr\u017e\u00edte tak\u00e9 p\u0159ehledn\u00fd aktualizovan\u00fd terapeutick\u00fd pl\u00e1n.<\/p>\n<p>V p\u0159\u00edpad\u011b pou\u017eit\u00ed vlastn\u00edch spermi\u00ed mus\u00ed b\u00fdt nejpozd\u011bji v den punkce d\u00e1rkyn\u011b k dispozici vzorek od partnera. S ohledem na v\u00e1\u0161 komfort je mo\u017eno spermie k terapii zamrazit s p\u0159edstihem (pokud kvalita spermi\u00ed odpov\u00edd\u00e1) V\u0161echna z\u00edskan\u00e1 vaj\u00ed\u010dka od anonymn\u00ed d\u00e1rkyn\u011b jsou pot\u00e9 oplodn\u011bna metodou ICSI.<\/p>\n<p>V n\u00e1sleduj\u00edc\u00edch dnech budete informov\u00e1n\u00ed o po\u010dtu \u00fasp\u011b\u0161n\u011b oplodn\u011bn\u00fdch vaj\u00ed\u010dek\/a po\u010dtu vyv\u00edjej\u00edc\u00edch se embry\u00ed. Samotn\u00fd embryotransfer, tedy zaveden\u00ed embry\u00ed zp\u011bt do d\u011blohy, bude proveden v z\u00e1vislosti na jejich po\u010dtu a kvalit\u011b, nej\u010dast\u011bji den 5 v\u00fdvoje embry\u00ed \u2013 ve f\u00e1zi blastocysty (den odb\u011bru vaj\u00ed\u010dek je den 0). P\u0159ed zaveden\u00edm embry\u00ed budete pou\u010deni o kvalit\u011b embry\u00ed, n\u00e1sledn\u00e9m re\u017eimu a budou v\u00e1m zodpov\u011bzeny ve\u0161ker\u00e9 va\u0161e dotazy souvisej\u00edc\u00ed s terapi\u00ed. Samotn\u00fd embryotransfer se prov\u00e1d\u00ed v naprost\u00e9 v\u011bt\u0161in\u011b p\u0159\u00edpad\u016f bez nutnosti celkov\u00e9 anestezie. T\u011bhotensk\u00fd test bude napl\u00e1nov\u00e1n za 14 dn\u00ed a\u017e 3 t\u00fddny po embryotransferu.<\/p>\n<p>Zbyl\u00e1 embrya, spl\u0148uj\u00edc\u00ed kvalitativn\u00ed krit\u00e9ria, budou n\u00e1sledn\u011b dle va\u0161eho p\u0159\u00e1n\u00ed zamrazena k dal\u0161\u00edmu pou\u017eit\u00ed bez nutnosti dal\u0161\u00ed hormon\u00e1ln\u00ed stimulace. Tento embryotransfer se naz\u00fdv\u00e1 kryoembryotransfer, embrya jsou rozmrazena v den embryotransferu a pokud jsou po rozmrazen\u00ed v optim\u00e1ln\u00ed kvalit\u011b, jsou transferov\u00e1na do d\u011blohy stejn\u011b jako v cyklu \u201e\u010derstv\u00e9m\u201c (\u0161ance na \u201ep\u0159e\u017eit\u00ed\u201c po vitrifikaci maj\u00ed embrya cca 95%). Kryoembryotransferu se nen\u00ed t\u0159eba ob\u00e1vat, \u0161ance po \u00fasp\u011b\u0161n\u00e9m rozmrazen\u00ed jsou srovnateln\u00e9 \u010di zcela identick\u00e9 ve srovn\u00e1n\u00ed s transferem \u201e\u010derstv\u00fdm\u201c.<\/p>\n<p>[\/et_pb_text][et_pb_text module_class=&#8220;textv textv&#8211;grey&#8220; _builder_version=&#8220;4.6.1&#8243; animation_direction=&#8220;bottom&#8220; hover_enabled=&#8220;0&#8243; sticky_enabled=&#8220;0&#8243;]<\/p>\n<p class=\"h3\"><strong>Dal\u0161\u00ed informace:<\/strong><\/p>\n<ul>\n<li>obecn\u011b je \u00fasp\u011b\u0161nost programu s darovan\u00fdmi vaj\u00ed\u010dky velmi vysok\u00e1, \u0161ance na \u00fasp\u011bch se pohybuj\u00ed kolem 50-55% p\u0159i transferu jednoho embrya a 70-75% p\u0159i transferu dvou embry\u00ed<\/li>\n<li>riziko dvoj\u010dat p\u0159i transferu dvou embry\u00ed optim\u00e1ln\u00ed kvality je kolem 20%<\/li>\n<li>c\u00edlem terapie je fyziologick\u00fd pr\u016fb\u011bh gravidity a porodu, doporu\u010dujeme proto ve v\u011bt\u0161in\u011b p\u0159\u00edpad\u016f transfer jednoho embrya<\/li>\n<\/ul>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8220;1&#8243; module_id=&#8220;tab4&#8243; _builder_version=&#8220;4.4.0&#8243; custom_padding=&#8220;||||false|false&#8220;][et_pb_row _builder_version=&#8220;4.4.0&#8243;][et_pb_column type=&#8220;4_4&#8243; _builder_version=&#8220;4.4.0&#8243;][et_pb_text module_class=&#8220;c_blurb&#8220; _builder_version=&#8220;4.4.0&#8243;]<\/p>\n<h2>Pr\u016fb\u011bh cyklu s darovan\u00fdmi vaj\u00ed\u010dky\/spermiemi (Darovan\u00e1 embrya) a jeho harmonogram<\/h2>\n<p>[\/et_pb_text][et_pb_text module_class=&#8220;textv textv&#8211;rose&#8220; _builder_version=&#8220;4.6.1&#8243; animation_direction=&#8220;bottom&#8220; hover_enabled=&#8220;0&#8243; sticky_enabled=&#8220;0&#8243;]<\/p>\n<p>V p\u0159\u00edpad\u011b, \u017ee ji\u017e \u017eena nedisponuje dostate\u010dn\u00fdm mno\u017estv\u00edm kvalitn\u00edch vaj\u00ed\u010dek, vaje\u010dn\u00edky jsou pro odb\u011br anatomick\u00fd nep\u0159\u00edstupn\u00e9, v p\u0159edchoz\u00edch cyklech stimulace opakovan\u011b prok\u00e1\u017eeme \u0161patnou kvalitu vaj\u00ed\u010dek nebo pacientka trp\u00ed n\u011bjakou genetickou poruchou (kter\u00e1 by v\u00fdrazn\u011b zvy\u0161ovala riziko posti\u017een\u00ed d\u00edt\u011bte), bude p\u00e1ru z medic\u00ednsk\u00e9ho hlediska doporu\u010dena mo\u017enost vyu\u017eit\u00ed vaj\u00ed\u010dek darovan\u00fdch i spermi\u00ed darovan\u00fdch. Darovan\u00e1 vaj\u00ed\u010dka i spermie jsou z\u00edskan\u00e1 od mlad\u00e9 zdrav\u00e9 \u017eeny a mlad\u00e9ho zdrav\u00e9ho mu\u017ee, anonymn\u00edch d\u00e1rc\u016f. Kvalita jej\u00edch vaj\u00ed\u010dek\/spermi\u00ed by tedy m\u011bla b\u00fdt optim\u00e1ln\u00ed. Uv\u011bdomujeme si, \u017ee toto rozhodnut\u00ed mus\u00ed b\u00fdt pro v\u011bt\u0161inu \u017een\/p\u00e1r\u016f velk\u00fdm kompromisem a budeme se sna\u017eit v\u00e1m b\u00fdt v tomto rozhodnut\u00ed co nejv\u00edce n\u00e1pomocni . D\u016fvody pro tento typ terapie a cel\u00fd pr\u016fb\u011bh v\u00e1m podrobn\u011b vysv\u011btl\u00edme. Budete m\u00edt dostatek \u010dasu si v\u0161e promyslet a kl\u00e1st dopl\u0148uj\u00edc\u00ed dotazy.<\/p>\n<p>Dle v\u00e1mi vybran\u00fdch po\u017eadavk\u016f v\u00e1m bude vybr\u00e1na d\u00e1rkyn\u011b, kter\u00e1 t\u011bmto po\u017eadavk\u016f co nejv\u00edce odpov\u00edd\u00e1. Proces darov\u00e1n\u00ed je pln\u011b anonymn\u00ed a zachov\u00e1n\u00ed anonymity d\u00e1rkyn\u011b\/p\u0159\u00edjemkyn\u011b je na\u0161\u00ed hlavn\u00ed povinnost\u00ed a prioritou. Dle za\u010d\u00e1tku stimulace (za\u010d\u00e1tku menstruace) va\u0161\u00ed d\u00e1rkyn\u011b v\u00e1m bude sestaven optim\u00e1ln\u00ed terapeutick\u00fd pl\u00e1n. V n\u011bkter\u00fdch p\u0159\u00edpadech je nutn\u00e9 k synchronizaci va\u0161eho cyklu s cyklem d\u00e1rkyn\u011b nasadit hormon\u00e1ln\u00ed l\u00e9\u010dbu k posunut\u00ed menstrua\u010dn\u00edho cyklu nebo zah\u00e1jit tzv.downregulaci \u2013 kdy se pomoc\u00ed injekce nebo injekc\u00ed \u201evy\u0159ad\u00ed\u201c v\u00e1\u0161 p\u0159irozen\u00fd cyklus. Tento postup n\u00e1m d\u00e1v\u00e1 dostate\u010dn\u00fd prostor pro napl\u00e1nov\u00e1n\u00ed cel\u00e9 terapie bez ohledu na v\u00e1\u0161 p\u0159irozen\u00fd cyklus. K zaji\u0161t\u011bn\u00ed kvalitn\u00edho r\u016fstu endometria (sliznice dutiny d\u011blo\u017en\u00ed) bude nasazena estrogenn\u00ed terapie ve form\u011b tablet, n\u00e1plasti nebo transderm\u00e1ln\u00edho spreje. Po p\u0159ibli\u017en\u011b 10-12 dnech u\u017e\u00edv\u00e1n\u00ed estrogen\u016f je nutn\u00e9 zkontrolovat v\u00fd\u0161ku a kvalitu endometria pomoc\u00ed vagin\u00e1ln\u00edho ultrazvukov\u00e9ho vy\u0161et\u0159en\u00ed. Proto\u017ee d\u00e9lka stimulace \u017eeny\/anonymn\u00ed d\u00e1rkyn\u011b je v\u017edy individu\u00e1ln\u00ed, nebudeme v\u00e1m v\u011bt\u0161inou schopni v den ultrazvukov\u00e9 kontroly zat\u00edm sd\u011blit p\u0159edb\u011b\u017en\u00fd term\u00edn odb\u011bru \u010derstv\u00e9ho vzorku spermi\u00ed a term\u00edn n\u00e1sledn\u00e9ho embryotransferu. O definitivn\u00edch term\u00ednech v\u00e1s budeme s dostate\u010dn\u00fdm p\u0159edstihem informovat telefonicky nebo emailem. Obdr\u017e\u00edte tak\u00e9 p\u0159ehledn\u00fd aktualizovan\u00fd terapeutick\u00fd pl\u00e1n.<\/p>\n<p>Jakmile je u d\u00e1rkyn\u011b stanoven term\u00edn odb\u011bru jej\u00edch vaj\u00ed\u010dek, informujeme pacientku o p\u0159esn\u00e9m term\u00ednu embryotransferu. V\u0161echna z\u00edskan\u00e1 vaj\u00ed\u010dka jsou pot\u00e9 oplodn\u011bna darovan\u00fdmi spermiemi metodou ICSI.<\/p>\n<p>V n\u00e1sleduj\u00edc\u00edch dnech budete informov\u00e1n\u00ed o po\u010dtu \u00fasp\u011b\u0161n\u011b oplodn\u011bn\u00fdch vaj\u00ed\u010dek\/a po\u010dtu vyv\u00edjej\u00edc\u00edch se embry\u00ed. Samotn\u00fd embryotransfer, tedy zaveden\u00ed embry\u00ed zp\u011bt do d\u011blohy, bude proveden v z\u00e1vislosti na jejich po\u010dtu a kvalit\u011b, nej\u010dast\u011bji den 5 v\u00fdvoje embry\u00ed \u2013 ve f\u00e1zi blastocysty (den odb\u011bru vaj\u00ed\u010dek je den 0). P\u0159ed zaveden\u00edm embry\u00ed budete pou\u010deni o kvalit\u011b embry\u00ed, n\u00e1sledn\u00e9m re\u017eimu a budou v\u00e1m zodpov\u011bzeny ve\u0161ker\u00e9 va\u0161e dotazy souvisej\u00edc\u00ed s terapi\u00ed. Samotn\u00fd embryotransfer se prov\u00e1n\u00ed v naprost\u00e9 v\u011bt\u0161in\u011b p\u0159\u00edpad\u016f bez nutnosti celkov\u00e9 anestezie. T\u011bhotensk\u00fd test bude napl\u00e1nov\u00e1n za 14 dn\u00ed a\u017e 3 t\u00fddny po embryotransferu.<\/p>\n<p>Zbyl\u00e1 embrya, spl\u0148uj\u00edc\u00ed kvalitativn\u00ed krit\u00e9ria, budou n\u00e1sledn\u011b dle va\u0161eho p\u0159\u00e1n\u00ed zamra\u017eena k dal\u0161\u00edmu pou\u017eit\u00ed bez nutnosti dal\u0161\u00ed hormon\u00e1ln\u00ed stimulace. Tento embryotransfer se naz\u00fdv\u00e1 kryoembryotransfer, embrya jsou rozmrazena v den embryotransferu a pokud jsou po rozmrazen\u00ed v optim\u00e1ln\u00ed kvalit\u011b, jsou transferov\u00e1na do d\u011blohy stejn\u011b jako v cyklu \u201e\u010derstv\u00e9m\u201c (\u0161ance na \u201ep\u0159e\u017eit\u00ed\u201c po vitrifikaci maj\u00ed embrya cca 95%). Kryoembryotransferu se nen\u00ed t\u0159eba ob\u00e1vat, \u0161ance po \u00fasp\u011b\u0161n\u00e9m rozmrazen\u00ed jsou srovnateln\u00e9 \u010di zcela identick\u00e9 ve srovn\u00e1n\u00ed s transferem \u201e\u010derstv\u00fdm\u201c.<\/p>\n<p>[\/et_pb_text][et_pb_text module_class=&#8220;textv textv&#8211;grey&#8220; _builder_version=&#8220;4.6.1&#8243; animation_direction=&#8220;bottom&#8220; hover_enabled=&#8220;0&#8243; sticky_enabled=&#8220;0&#8243;]<\/p>\n<p class=\"h3\"><strong>Dal\u0161\u00ed informace:<\/strong><\/p>\n<ul>\n<li>obecn\u011b je \u00fasp\u011b\u0161nost programu s darovan\u00fdmi embryi velmi vysok\u00e1, \u0161ance na \u00fasp\u011bch se pohybuj\u00ed kolem 50% p\u0159i transferu jednoho embrya a 70% p\u0159i transferu dvou embry\u00ed<\/li>\n<li>riziko dvoj\u010dat p\u0159i transferu dvou embry\u00ed optim\u00e1ln\u00ed kvality je kolem 20%<\/li>\n<\/ul>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Bli\u017e\u0161\u00ed informace o pr\u016fb\u011bhu jednotliv\u00fdch terapi\u00edPr\u016fb\u011bh inseminace (IUI) a jej\u00ed \u010dasov\u00fd harmonogramInseminace se pl\u00e1nuje v ovula\u010dn\u00edm cyklu. To znamen\u00e1 v cyklu kdy p\u0159edpokl\u00e1d\u00e1me uvoln\u011bn\u00ed vaj\u00ed\u010dka, kter\u00e9 \u010dek\u00e1 na oplodn\u011bn\u00ed spermi\u00ed. U \u017een, kter\u00e9 maj\u00ed menstrua\u010dn\u00ed cyklus pravideln\u00fd, nej\u010dast\u011bji kolem 28 dn\u00ed, bude v\u011bt\u0161inou sta\u010dit jedno ultrazvukov\u00e9 vy\u0161et\u0159en\u00ed, po kter\u00e9m bychom m\u011bli b\u00fdt schopni podle velikosti [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":873,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_et_pb_use_builder":"on","_et_pb_old_content":"<p>[et_pb_section fb_built=\"1\" _builder_version=\"4.4.0\" background_image=\"https:\/\/fertilityport.com\/wp-content\/uploads\/2020\/03\/lecba_neplodnosti_head.jpg\"][et_pb_row column_structure=\"2_3,1_3\" _builder_version=\"4.4.0\"][et_pb_column type=\"2_3\" _builder_version=\"4.4.0\"][et_pb_text module_class=\"c_blurb\" _builder_version=\"4.4.0\"]<\/p><h1>How it works?<\/h1><p>[\/et_pb_text][\/et_pb_column][et_pb_column type=\"1_3\" _builder_version=\"4.4.0\"][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=\"1\" _builder_version=\"4.4.0\" custom_padding=\"||0px|||\"][et_pb_row _builder_version=\"4.4.0\"][et_pb_column type=\"4_4\" _builder_version=\"4.4.0\"][et_pb_text module_class=\"c_blurb\" _builder_version=\"4.4.0\"]<\/p><h2>The course of the insemination (IUI) and its time schedule<\/h2><p>[\/et_pb_text][et_pb_text module_class=\"textv textv--rose\" _builder_version=\"4.4.0\" animation_style=\"slide\" animation_direction=\"bottom\" animation_intensity_slide=\"10%\"]Insemination is planned within the ovulation cycle. This means the cycle during which the egg, which awaits the fertilisation by a sperm, is released. In women whose menstrual cycle is regular, most usually around 28 days, one ultrasound examination is enough, after which it should be possible to determine the IUI in the following days. Sometimes the ultrasound examination needs to be repeated, especially in women with an irregular or longer menstrual cycle. If the ovulation cycle is not confirmed it is, unfortunately, necessary to postpone the IUI until the next menstrual cycle.<\/p><p>In case of the confirmed ovulation cycle you will be, together with your partner, invited to perform intrauterine insemination. After processing of the ejaculate in the Andrological Laboratory, which takes approx. an hour, you will be informed about the current quality of your spermiogram and the steps following the treatment. The treatment itself is very quick and painless and the processed sperm is introduced by the means of a soft catheter (a thin tube) through the cervix into the uterine cavity. The pregnancy test will then be scheduled 2-3 weeks after the treatment or after the delayed menstruation.[\/et_pb_text][et_pb_text module_class=\"textv textv--grey\" _builder_version=\"4.4.0\" animation_style=\"slide\" animation_direction=\"bottom\" animation_intensity_slide=\"10%\"]<\/p><p><strong>Further information:<\/strong><\/p><ul><li>intrauterine insemination is covered by your health insurance company until your 39th birthday\u00a0<\/li><li>the health insurance company defined limit of inseminations is 6 per year, however, we recommend repeating the attempt at maximum 3-6 times, after which it is advised to revisit other possibilities \u2013 many factors can be at play and you will receive individualised advice<\/li><li>the chances of pregnancy using IUI is about 10% (regarding the main success factor \u2013 the female partner\u2019s age and the sperm quality of her partner)<\/li><\/ul><p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=\"1\" _builder_version=\"4.4.0\" custom_padding=\"||0px|||\" hover_enabled=\"0\" module_id=\"tab2\"][et_pb_row _builder_version=\"4.4.0\"][et_pb_column type=\"4_4\" _builder_version=\"4.4.0\"][et_pb_text module_class=\"c_blurb\" _builder_version=\"4.4.0\"]<\/p><h2>Course of the stimulation cycle with own eggs and sperm and the time schedule<\/h2><p>[\/et_pb_text][et_pb_text module_class=\"textv textv--rose\" _builder_version=\"4.4.0\" animation_style=\"slide\" animation_direction=\"bottom\" animation_intensity_slide=\"10%\"]<\/p><p>Sometimes the indication to perform an artificial fertilisation cycle (IVF cycle, stimulation cycle) is unanimous and without our help the couple would have a minimal, or zero, chance of conceiving a child naturally (e.g. removal of Fallopian tubes in the female partner), while at other times it is more the length of the attempts at conception or repeated intrauterine insemination. Both reasons can force the couple to take the next step, namely the stimulation cycle. What must be taken into account is that after two to three years of unfruitful attempts at pregnancy the couple has only a minimum chance at successful pregnancy and it is necessary to contact an assisted reproduction centre.<\/p><p>\u00a0All must start with consulting the doctor, always by both the male and female partner, when both of you will receive detailed information on the aspects of the stimulation cycle and the potential consequences. Hormone examination must be performed or its results submitted, together with an ultrasound examination or a control spermiogram, should the current values not be known or in case there is the recommendation to check them. Based on many factors (your age, the case history of previous IVF stimulation cycles, ovarian supply based on the ultrasound examination and the results of the hormonal examination) you will be given, on your request, a pre-formulated treatment plan including the optimal stimulation protocol.<\/p><p>\u00a0At that moment you will, together with your male partner, sign informed consents with the treatment, and you will have ample space and time to ask any further questions you might find necessary. FertilityPort then sends the request to the health insurance company (if you are eligible for coverage of the treatment by the health insurance company). The request form is typically approved within 2-3 weeks, 30 days by the latest. Then you can, ideally with your male partner, schedule a meeting to discuss your treatment plan. This plan will be explained to you in detail, as will the injection-applied administration of hormones. The request form validity until the production of the plan and prescriptions for the stimulation medicine is 3-6 months depending on the health insurance company type. Then you begin administering the stimulants \u2013 application of the medicine based on the pre-defined plan, usually the second or third day of the menstrual cycle or several days before expected menstruation.<\/p><p>\u00a0Hormone application is nothing to be feared, only a hypodermic injection by a tiny needle into a skin fold, typically somewhere around the belly. Follicle growth, or in other words the effect of the hormone treatment, must be checked at regular intervals. The first ultrasound check-up is performed on day 5-6 of the stimulation, when the number and size of the growing follicles is assessed, and whether the hormone dosage applied by the woman is adequate. The second and potentially further ultrasound examination is typically scheduled within a couple of days (2-3) and if the follicle growth is optimal, the decision is made regarding the term of the ovarian puncture of the follicles.<\/p><p>\u00a0<b>In case of foreign patients the ultrasound examination can be done by your local gynaecologist and so it is not necessary to travel to Prague to perform these. All that is needed is the respective report and ultrasound scans if possible.\u00a0<\/b><\/p><p>\u00a0Follicle puncture is performed during a short period of total anaesthesia, in rare cases under analgosedation or without anaesthesia based on the number of follicles punctured. One egg should mature in one follicle. You will be informed about the total number of the eggs obtained before you are released from our centre. We will require the sperm of our male partner on that same day. Your eggs will be fertilised using IVF or ICSI methods (either fresh or frozen sperm may be used in the fertilisation process). You have to leave accompanied by another adult person on the day of the follicle puncture.<\/p><p>In the following days you will be informed on the number of the successfully fertilised eggs and the number of developing embryos. The embryotransfer itself, or, in other words, the introduction of the embryos back into the uterus, will be performed, depending on the number and quality of the embryos, on day 3 to 6 of the embryotic development (the day of the egg collection is day 0), most typically on day 5 of the development, or in the blastocyst phase. Before the introduction of the embryos you will be informed on their quality, and any questions you might have regarding the therapy will be answered. The embryotransfer itself is most commonly performed without any need of total anaesthesia. A pregnancy test is scheduled for 14 to 21 days after the embryotransfer.<\/p><p>The remaining embryos, which fulfil the qualitative criteria, will then be, based on your wish, frozen for further use without any need of additional hormone stimulation. Such embryotransfer is called an cryoembryotransfer, the embryos are unfrozen on the day of the embryotransfer, and if they are in optimum quality after the defrost procedure they are transferred into the uterus the same way they would be in the \u201cfresh\u201d cycle (the embryo\u2019s \u201csurvival\u201d chance after vitrification is approx. 95%). Cryoembryotransfer is nothing to be feared because after successful thawing the chances are comparable or identical to those of a \u201cfresh\u201d transfer.<\/p><p>[\/et_pb_text][et_pb_text module_class=\"textv textv--grey\" _builder_version=\"4.4.0\" animation_style=\"slide\" animation_direction=\"bottom\" animation_intensity_slide=\"10%\"]<\/p><p class=\"h3\"><strong>Further information:<\/strong><\/p><ul><li>number of cryoembryotransfers and the number of embryos introduced during cryoembryotransfers does not affect contribution plan of the health insurance company. There is an exception when due to various reasons it is necessary to freeze the embryos during the current stimulation cycle and plan the cryotransfer later on (e.g. when hyperstimulation syndrome is a risk). In such situations the number of embryos transferred during cryotransfer determines the health insurance company\u2019s participation.<\/li><li>the chance of achieving gravidity during a stimulation cycle depends mainly on the female partner\u2019s age and the number of embryos transferred; the defined chance until 36 years of age is approx. 55%, 36-40 of age approx. 40%, aged 40+ 10-15% and aged 43+ only approx. 5%<\/li><li>it is recommended to transfer 1, or 2 embryos in special cases<\/li><\/ul><p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=\"1\" _builder_version=\"4.4.0\" custom_padding=\"||0px|||\" hover_enabled=\"0\" module_id=\"tab3\"][et_pb_row _builder_version=\"4.4.0\"][et_pb_column type=\"4_4\" _builder_version=\"4.4.0\"][et_pb_text module_class=\"c_blurb\" _builder_version=\"4.4.0\"]<\/p><h2>Course of the cycle with donated eggs\/own sperm and the time schedule<\/h2><p>[\/et_pb_text][et_pb_text module_class=\"textv textv--rose\" _builder_version=\"4.4.0\" animation_style=\"slide\" animation_direction=\"bottom\" animation_intensity_slide=\"10%\"]<\/p><p>In case that the female partner does not possess a sufficient number of quality eggs, the ovaries are anatomically inaccessible for extraction, the previous stimulation cycles showed repeatedly insufficient quality of the eggs, or the patient suffers from a genetic defect (which would significantly increase the chance of the affliction of the child), the couple will be advised, based on medical reasons, to use donated eggs. These are eggs obtained from a young and healthy woman who is an anonymous donor. The quality of her eggs should be optimal. We realise that such a decision has to be a bit compromise for all couples\/women and we will assist you during this decision-making process as much as possible. We will explain the reasons and the whole course of the treatment to you. You will have enough time to think everything through and ask questions.<\/p><p>A donor will be selected as the closest fit to your requirements. The donation process is fully anonymous and keeping the donor\u2019s\/receiver\u2019s anonymity is our main duty and priority. The optimum therapy plan will be compiled based on the stimulation start (start of menstruation) of your donor. In certain cases it is necessary to synchronise your cycle with the donor\u2019s cycle using hormone treatment to shift your menstrual cycle or begin the so-called downregulation \u2013 using an injection or multiple injections your natural cycle is \u201cswitched off\u201d. This method gives us sufficient time to plan the whole therapy without having to align it to your natural cycle. To ensure quality growth of the endometrium (the mucous membrane of the uterine cavity) an estrogenic therapy will be administered in the form of pills, plaster or transdermal spray. After approx. 10-12 days of oestrogen use the height and quality of the endometrium must be checked by the means of vaginal ultrasound examination. Due to the fact that the length of the female partner\u2019s\/anonymous donor\u2019s stimulation is always individualised, we will probably not be able to tell you on the day of the ultrasound check-up the preliminary term of the sampling of fresh sperm and the term of the later embryotransfer. You will be informed on the final terms well in advance by phone or email. You will also get an updated therapeutic plan.<\/p><p><b>In case of foreign patients the ultrasound examination can be done by your local gynaecologist and so it is not necessary to travel to Prague to perform these. All that is needed is the respective report and ultrasound scans if possible.\u00a0<\/b><\/p><p>\u00a0In case of using your own sperm a sample from the male partner must be available on the day of the puncture of the donor by the latest. To ensure maximum comfort it is possible to freeze sperm in advance (provided that its quality is sufficient). All eggs from the anonymous donor are then fertilised using the ICSI method.<\/p><p>In the following days you will be informed on the number of the fertilised eggs and\/or the number the developing embryos. The embryotransfer itself, or the introduction of the embryos back into the uterus, will be performed based on their number and quality, most typically on day 5 of the embryotic development \u2013 at the blastocyst phase (egg collection day is 0). Before the introduction of the embryos you will be informed on the embryo quality, the following situation, and any questions regarding the therapy will be answered. The embryotransfer itself is most typically performed without total anaesthesia. The pregnancy test is scheduled 14 to 21 days after the embryotransfer.<\/p><p>The remaining embryos, which fulfil the qualitative criteria, will then be, based on your wish, frozen for further use without any need of additional hormone stimulation. Such embryotransfer is called an cryoembryotransfer, the embryos are unfrozen on the day of the embryotransfer, and if they are in optimum quality after the defrost procedure they are transferred into the uterus the same way they would be in the \u201cfresh\u201d cycle (the embryo\u2019s \u201csurvival\u201d chance after vitrification is approx. 95%). Cryoembryotransfer is nothing to be feared because after successful thawing the chances are comparable or identical to those of a \u201cfresh\u201d transfer.<\/p><p>[\/et_pb_text][et_pb_text module_class=\"textv textv--grey\" _builder_version=\"4.4.0\" animation_style=\"slide\" animation_direction=\"bottom\" animation_intensity_slide=\"10%\"]<\/p><p class=\"h3\"><strong>Further information:<\/strong><\/p><ul><li>generally the donated eggs programme is very successful, the success rate is somewhere between 50-55% in case of a single embryo transfer and 70-75% in case of two embryos<\/li><li>the risk of having twins in case of two embryos of optimum quality is approx. 20%<\/li><li>it is the aim of the therapy to facilitate a physiological course of gravidity and pregnancy and so we recommend in most cases the transfer of a single embryo<\/li><\/ul><p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=\"1\" _builder_version=\"4.4.0\" custom_padding=\"||||false|false\" hover_enabled=\"0\" module_id=\"tab4\"][et_pb_row _builder_version=\"4.4.0\"][et_pb_column type=\"4_4\" _builder_version=\"4.4.0\"][et_pb_text module_class=\"c_blurb\" _builder_version=\"4.4.0\"]<\/p><h2>Course of the cycle with donated eggs\/donated sperm and the time schedule<\/h2><p>[\/et_pb_text][et_pb_text module_class=\"textv textv--rose\" _builder_version=\"4.4.0\" animation_style=\"slide\" animation_direction=\"bottom\" animation_intensity_slide=\"10%\"]<\/p><p>Should the case be that the female partner no longer has a sufficient number of quality eggs, her ovaries are inaccessible, previous stimulation cycles showed repeatedly low egg quality, or the patient suffers from a genetic disorder (which would significantly increase the chances of the affliction of the child), the couple will be, based on medical reasons, recommended the usage of donated eggs as well as sperm. Donated eggs and sperm will be obtained from a young and healthy woman and man, both anonymous donors. The quality of their eggs\/sperm should therefore be optimal. We realise that this decision has to be a great compromise to most women\/couples, and so we will be there to assist you during the decision making as much as possible. The reasons to choose this therapy and its whole course will be explained to you. You will be given ample time to decide and ask any questions you want.<\/p><p>A donor will be selected as the closest fit to your requirements. The donation process is fully anonymous and keeping the donor\u2019s\/receiver\u2019s anonymity is our main duty and priority. The optimum therapy plan will be compiled based on the stimulation start (start of menstruation) of your donor. In certain cases it is necessary to synchronise your cycle with the donor\u2019s cycle using hormone treatment to shift your menstrual cycle or begin the so-called downregulation \u2013 using an injection or multiple injections your natural cycle is \u201cswitched off\u201d. This method gives us sufficient time to plan the whole therapy without having to align it to your natural cycle. To ensure quality growth of the endometrium (the mucous membrane of the uterine cavity) an estrogenic therapy will be administered in the form of pills, plaster or transdermal spray. After approx. 10-12 days of oestrogen use the height and quality of the endometrium must be checked by the means of vaginal ultrasound examination. Due to the fact that the length of the female partner\u2019s\/anonymous donor\u2019s stimulation is always individualised, we will probably not be able to tell you on the day of the ultrasound check-up the preliminary term of the sampling of fresh sperm and the term of the later embryotransfer. You will be informed on the final terms well in advance by phone or email. You will also get an updated therapeutic plan.<\/p><p><b>In case of foreign patients the ultrasound examination can be done by your local gynaecologist and so it is not necessary to travel to Prague to perform these. All that is needed is the respective report and ultrasound scans if possible.<\/b><\/p><p>As soon as it is possible to determine the donor\u2019s term of egg collection we inform the patient about the exact date of the embryotransfer. All eggs obtained are then fertilised using sperm donated through the ICSI method.<\/p><p>In the following days you will be informed on the number of the fertilised eggs and\/or the number the developing embryos. The embryotransfer itself, or the introduction of the embryos back into the uterus, will be performed based on their number and quality, most typically on day 5 of the embryotic development \u2013 at the blastocyst phase (egg collection day is 0). Before the introduction of the embryos you will be informed on the embryo quality, the following situation, and any questions regarding the therapy will be answered. The embryotransfer itself is most typically performed without total anaesthesia. The pregnancy test is scheduled 14 to 21 days after the embryotransfer.<\/p><p>The remaining embryos, which fulfil the qualitative criteria, will then be, based on your wish, frozen for further use without any need of additional hormone stimulation. Such embryotransfer is called an cryoembryotransfer, the embryos are unfrozen on the day of the embryotransfer, and if they are in optimum quality after the defrost procedure they are transferred into the uterus the same way they would be in the \u201cfresh\u201d cycle (the embryo\u2019s \u201csurvival\u201d chance after vitrification is approx. 95%). Cryoembryotransfer is nothing to be feared because after successful thawing the chances are comparable or identical to those of a \u201cfresh\u201d transfer.<\/p><p>[\/et_pb_text][et_pb_text module_class=\"textv textv--grey\" _builder_version=\"4.4.0\" animation_style=\"slide\" animation_direction=\"bottom\" animation_intensity_slide=\"10%\"]<\/p><p class=\"h3\"><strong>Further information:<\/strong><\/p><ul><li>generally the donated embryo programme is very successful, the success rate is about 50% in case of a single embryo transfer and 70% in case of two embryos<\/li><li>the risk of having twins in case of a two-embryo transfer of optimum quality is approx. 20%<\/li><\/ul><p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>","_et_gb_content_width":"","footnotes":""},"class_list":["post-879","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Pr\u016fb\u011bh le\u010dby neplodnosti | FertilityPort Prague - tady za\u010d\u00edn\u00e1 \u017eivot<\/title>\n<meta name=\"description\" content=\"P\u0159e\u010dt\u011bte si v\u00edce informac\u00ed o pr\u016fb\u011bhu jednotliv\u00fdh typ\u016f terapi\u00ed, kter\u00e9 u n\u00e1s nab\u00edz\u00edme\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/fertilityport.com\/cs\/lecba-neplodnosti\/prubeh\/\" \/>\n<meta property=\"og:locale\" content=\"cs_CZ\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Pr\u016fb\u011bh le\u010dby neplodnosti | FertilityPort Prague - tady za\u010d\u00edn\u00e1 \u017eivot\" \/>\n<meta property=\"og:description\" content=\"P\u0159e\u010dt\u011bte si v\u00edce informac\u00ed o pr\u016fb\u011bhu jednotliv\u00fdh typ\u016f terapi\u00ed, kter\u00e9 u n\u00e1s nab\u00edz\u00edme\" \/>\n<meta property=\"og:url\" content=\"https:\/\/fertilityport.com\/cs\/lecba-neplodnosti\/prubeh\/\" \/>\n<meta property=\"og:site_name\" content=\"FertilityPort Prague\" \/>\n<meta property=\"article:modified_time\" content=\"2020-11-12T11:15:02+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Odhadovan\u00e1 doba \u010dten\u00ed\" \/>\n\t<meta name=\"twitter:data1\" content=\"17 minut\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/fertilityport.com\\\/cs\\\/lecba-neplodnosti\\\/prubeh\\\/\",\"url\":\"https:\\\/\\\/fertilityport.com\\\/cs\\\/lecba-neplodnosti\\\/prubeh\\\/\",\"name\":\"Pr\u016fb\u011bh le\u010dby neplodnosti | FertilityPort Prague - tady za\u010d\u00edn\u00e1 \u017eivot\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/fertilityport.com\\\/#website\"},\"datePublished\":\"2020-03-14T15:48:08+00:00\",\"dateModified\":\"2020-11-12T11:15:02+00:00\",\"description\":\"P\u0159e\u010dt\u011bte si v\u00edce informac\u00ed o pr\u016fb\u011bhu jednotliv\u00fdh typ\u016f terapi\u00ed, kter\u00e9 u n\u00e1s nab\u00edz\u00edme\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/fertilityport.com\\\/cs\\\/lecba-neplodnosti\\\/prubeh\\\/#breadcrumb\"},\"inLanguage\":\"cs\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/fertilityport.com\\\/cs\\\/lecba-neplodnosti\\\/prubeh\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/fertilityport.com\\\/cs\\\/lecba-neplodnosti\\\/prubeh\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/fertilityport.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"L\u00e9\u010dba neplodnosti\",\"item\":\"https:\\\/\\\/fertilityport.com\\\/cs\\\/lecba-neplodnosti\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Pr\u016fb\u011bh\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/fertilityport.com\\\/#website\",\"url\":\"https:\\\/\\\/fertilityport.com\\\/\",\"name\":\"FertilityPort Prague\",\"description\":\"\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/fertilityport.com\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"cs\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Pr\u016fb\u011bh le\u010dby neplodnosti | FertilityPort Prague - tady za\u010d\u00edn\u00e1 \u017eivot","description":"P\u0159e\u010dt\u011bte si v\u00edce informac\u00ed o pr\u016fb\u011bhu jednotliv\u00fdh typ\u016f terapi\u00ed, kter\u00e9 u n\u00e1s nab\u00edz\u00edme","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/fertilityport.com\/cs\/lecba-neplodnosti\/prubeh\/","og_locale":"cs_CZ","og_type":"article","og_title":"Pr\u016fb\u011bh le\u010dby neplodnosti | FertilityPort Prague - tady za\u010d\u00edn\u00e1 \u017eivot","og_description":"P\u0159e\u010dt\u011bte si v\u00edce informac\u00ed o pr\u016fb\u011bhu jednotliv\u00fdh typ\u016f terapi\u00ed, kter\u00e9 u n\u00e1s nab\u00edz\u00edme","og_url":"https:\/\/fertilityport.com\/cs\/lecba-neplodnosti\/prubeh\/","og_site_name":"FertilityPort Prague","article_modified_time":"2020-11-12T11:15:02+00:00","twitter_card":"summary_large_image","twitter_misc":{"Odhadovan\u00e1 doba \u010dten\u00ed":"17 minut"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/fertilityport.com\/cs\/lecba-neplodnosti\/prubeh\/","url":"https:\/\/fertilityport.com\/cs\/lecba-neplodnosti\/prubeh\/","name":"Pr\u016fb\u011bh le\u010dby neplodnosti | FertilityPort Prague - tady za\u010d\u00edn\u00e1 \u017eivot","isPartOf":{"@id":"https:\/\/fertilityport.com\/#website"},"datePublished":"2020-03-14T15:48:08+00:00","dateModified":"2020-11-12T11:15:02+00:00","description":"P\u0159e\u010dt\u011bte si v\u00edce informac\u00ed o pr\u016fb\u011bhu jednotliv\u00fdh typ\u016f terapi\u00ed, kter\u00e9 u n\u00e1s nab\u00edz\u00edme","breadcrumb":{"@id":"https:\/\/fertilityport.com\/cs\/lecba-neplodnosti\/prubeh\/#breadcrumb"},"inLanguage":"cs","potentialAction":[{"@type":"ReadAction","target":["https:\/\/fertilityport.com\/cs\/lecba-neplodnosti\/prubeh\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/fertilityport.com\/cs\/lecba-neplodnosti\/prubeh\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/fertilityport.com\/"},{"@type":"ListItem","position":2,"name":"L\u00e9\u010dba neplodnosti","item":"https:\/\/fertilityport.com\/cs\/lecba-neplodnosti\/"},{"@type":"ListItem","position":3,"name":"Pr\u016fb\u011bh"}]},{"@type":"WebSite","@id":"https:\/\/fertilityport.com\/#website","url":"https:\/\/fertilityport.com\/","name":"FertilityPort Prague","description":"","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/fertilityport.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"cs"}]}},"_links":{"self":[{"href":"https:\/\/fertilityport.com\/cs\/wp-json\/wp\/v2\/pages\/879","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/fertilityport.com\/cs\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/fertilityport.com\/cs\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/fertilityport.com\/cs\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/fertilityport.com\/cs\/wp-json\/wp\/v2\/comments?post=879"}],"version-history":[{"count":7,"href":"https:\/\/fertilityport.com\/cs\/wp-json\/wp\/v2\/pages\/879\/revisions"}],"predecessor-version":[{"id":3269,"href":"https:\/\/fertilityport.com\/cs\/wp-json\/wp\/v2\/pages\/879\/revisions\/3269"}],"up":[{"embeddable":true,"href":"https:\/\/fertilityport.com\/cs\/wp-json\/wp\/v2\/pages\/873"}],"wp:attachment":[{"href":"https:\/\/fertilityport.com\/cs\/wp-json\/wp\/v2\/media?parent=879"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}