Frequently asked questions
What is infertility?
In approx. 40% of the cases the cause is in the female partner. It is most commonly a low or very high supply of eggs, eggs’ failure to mature (anovulation) or ovarian obstruction. The same ratio – 40% – is constituted by the causes in the male partner. 20% of the infertility causes are a combination of both factors – male and female.
Is infertility a common problem?
10-15% of women of fertile age suffer from inability to conceive a child. Infertility is therefore unfortunately becoming a common problem of the today’s society and there is no need to feel ashamed because of it.
Who is there to blame?
About 40% of the cases show that the cause is on the side of the man while another 40% show an issue on behalf of the woman. Men most commonly suffer from a low concentration of sperm or low agility. The women may suffer from a very low or high supply of eggs, immature eggs (anovulation) or tubal obstruction of the Fallopian tube. Approx. 20% of couples see causes with both partners. 10% of the couples cannot be successfully diagnosed using the methods available.
How long should we try to conceive before we visit a doctor/specialist?
The general recommendation is to visit an IVF centre to perform at minimum a basic examination of both partners after approx. one year of unprotected sexual intercourse. As the woman’s age increases her chances of a spontaneous pregnancy as well as chances of success of any IVF method decrease. Therefore, it is recommended for women of 35 years of age or more to seek help sooner, preferably after 6 months of unsuccessful attempts.
Is it possible to visit a private gynaecologist?
Again, it is mainly a matter of the woman’s age and the results of the examinations performed so far, e.g. the spermiogram of your partner. Your private gynaecologist can, however, inform you about your ovarian reserve and can observe your ovulation on a monthly basis using sonography.
What kind of examinations regarding infertility can I expect?
The basic examination of the woman includes sonography examination of the ovaries – determining the count of the so-called antral follicles, the size and shape of the uterus, endotermial thickness related to the phase of the woman’s cycle, potentially a test of the patency of Fallopian tubes. There is also a blood sample taken in order to ascertain the so-called hormonal profile including the determination of the AMH hormone, which is used to assess the egg supply in the woman’s ovaries.
The man has to undergo the determination of the sperm concentration in one millilitre of the ejaculate, their agility and morphology.
How should I understand the term “IVF”?
IVF (In Vitro Fertilisation) is the basic method of assisted reproduction. It is in essence a method of fertilising the egg during which sperm is poured over an egg in a dish and then left for one day to fertilise the egg. This method is used today only in marginal amount of cases, the eggs are most commonly fertilised using the ICSI (IntraCytoplasmic Sperm Injection) method, which is based on introducing a single sperm into the cytoplasm of the oocyte in a microscope under strong magnification using a microneedle. The success rate of the fertilisation using ICSI method is many times higher compared to IVF, namely 70-80%. IVF is, however, a term so common that it is used in connection when talking about cycle stimulation in general, despite the fact that the IVF method is rarely used nowadays.
Who can be the receiver of the treatment in the Czech Republic?
The treatment in the area of assisted reproduction may only be administered to a couple of a man and a woman according to Czech legislation. However, they do not have to be married.
How is the stimulation cycle performed within the IVF cycle?
The usual situation is that during one ovulation cycle (approx.once per month) one egg is released. To obtain a larger quantity of eggs hormonal stimulation is necessary, lasting usually for about 10 days. The woman gives herself stimulating hormones using a small intradermal injection on a daily basis. The injection of the hormones is very easy and there is no need to fear it. During the hormonal stimulation the growth of the follicles in your ovaries is checked. One follicle typically contains one egg. After a short operation performed in general anaesthesia usually between 8 and 14 eggs are obtained, the specific number depending on the age and ovarian reserve of the woman. On the day of the operation you will be accompanied to the clinic by your partner who will submit his sperm, which shall be used on the same day to fertilise your eggs collected. The fertilised eggs, or embryos, undergo further growth in an incubator and their development is observed by an embryologist. One or two best embryos are introduced back into the woman’s uterus between the third and fifth day after the operation. This operation – embryotransfer – is usually easy and quick. The rest of the embryos will be frozen and stored in liquid nitrogen. The length of the storage has no impact on their quality during their further usage and the embryos may be stored for many years. After the embryotransfer you will use medication to support the nesting of the egg, which shall be applied intravaginally. Two weeks later you will learn from the pregnancy test whether the given cycle was successful or not.
What is the success rate of the IVF treatments?
In general the IVF therapy success rate is stated between 40-60%. It depends on many factors and circumstances, the most prominent of which is undoubtedly the woman’s age. Younger women, aged 37 and less, have a larger chance to get pregnant, namely around 60%. On the other hand the chances of a woman aged 42 and more are 5-10%. It is therefore clear that the sooner, the better.
What to do when the woman does not have a sufficient amount of quality eggs?
Especially in older women usage of donated eggs is often the only chance to achieve the desired pregnancy. These eggs are obtained from young women, so their quality should therefore be optimal. We understand that the usage of donated eggs is a significant compromise for most women and couples and an abundance of time is necessary to reach the final decision.
What is the age limit for performance of IVF treatment in the Czech Republic?
The current legislation states that the embryotransfer may be performed no later than on the woman’s 49th birthday.
What is the difference between donated eggs and surrogacy?
Donated eggs may be used by women who no longer produce their own but her internal genitalia – the uterus – is in good condition and capable of receiving the embryo. Simply put surrogacy is the opposite – the woman produced enough eggs – her ovaries are all right, but for a reason she is not able to carry the embryo in her uterus and therefore has to seek help of another woman, who carries her embryo in her own uterus.