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Examination procedures

Here is a general description of infertility examinations which may vary in individual cases.

For men, the most important examination is the semen analysis – spermiogram. The analysis always needs to be done after several days of sexual abstinence (minimum of 2, maximum of 7 days). Semen is obtained by masturbation in a special room designated for this purpose near our laboratory. It is also possible to analyse a sample which you bring with you; however, we do not recommend it because there might not be optimal conditions during the transport.

A definite conclusion cannot be reached after one negative finding; the test needs to be repeated after a time (4 - 6 weeks). In serious cases it is necessary to determine the levels of sex hormones in blood; in extreme cases the testicle biopsy may be needed. The microscopic analysis can reveal whether the production of sperm takes place or what development forms of sperm are present (TESE). Using micromanipulation methods (ICSI) it is then possible to use even the thus-obtained sperm for assisted reproduction. Severe cases of male fertility disorders require genetic tests to exclude some inherited diseases.

Part of the semen analysis is the examination of a large number of parameters, most important of which is the count of sperm, its motility and morphology (i.e. the correct form). The reference values are standardized by the World Health Organization (WHO) and listed in the table below. Part of the examination is also determination of white blood cells. In case of their increased occurrence a culture test that may detect infection should be carried out.

Beyond the normal testing, we also offer optional examination including DNA fragmentation of sperm. This examination gives us more information about the quality of sperm, which can be used to plan the next treatment steps. After previous phone call, we also offer the sperm analysis to the patients who are not treated in our clinic.

Semen analysis (spermiogram)

The reference values of sperm analysis according to the current WHO Manual (2010). As a matter of interest, they are compared to the values from 1999.

Semen parameters Low reference limit (WHO 2010 - current) Low reference limit (WHO 1999)
Volume of ejaculate [ml] 1,5 ml 2 ml

Sperm count [mil/ml]

15 mil/ml 20 mil/ml
Sperm motility (progressive movement) [%] 32% 50%
Sperm morphology (normal forms) [%] 4% 15%

For women, the emphasis is on proving the ovulation. The most accurate method is repeated ultrasound examination - folliculometry, which enables us to monitor the growth and bursting of a follicle. Sometimes, we need to assess the results in connection with the analysis of hormone levels in blood. It should be emphasized that calculation of ovulation by measuring the basal temperature is very inaccurate. Femal hormonal profile test together with determining the ovarian reserve, in particular by AMH (antimullerian hormone) is really important. We test the right thyroid function. Fallopian tube patency is diagnosed with the ultrasound test during which the uterus and fallopian tubes are filled with a contrast agent - HyCoSy. This testing is the least intrusive of all possible tubal patency examinations. In case of suspection of a uterine polyp or other atypical findings in the uterine cavity we perform hysteroscopy. It is a surgery under general anaesthesia, during which the abdominal cavity is monitored by thin optics inserted into the cervix uteri. The most accurate information about the condition of inner genitals, including evidence of potential endometriosis, adhesions of the uters, etc., is provided by laparoscopy. The immunological cause of infertility can be found by the presence of antibodies in sperm or blood of one or both partners. In some cases, genetic test or, possibly, testing for thrombophilia is needed. After repeated IVF failures we can do the ERA test (endometrial receptivity array) to be able to examine whether the endometrium is receptive on the day of embryotransfer, i.e. able to receive the embryo.

We also care for women with recurrent miscarriage, because as reproductive gynaecologists we have rich experience in this field.

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Poděkování

Poděkování
04.03.2020

Vážený pane doktore Šulci,

Chtěli bychom se touto cestou vrátit zpátky k péči, které se nám dostávalo od Vás a Vašich kolegů z GESTu od cca května loňského roku a které se nám dostává stále v průběhu prozatím dobře se vyvíjejícího těhotenství.

Vám bychom chtěli moc poděkovat mj. také za Váš přístup k nám, díky kterému jsme se i v ne vždy pozitivně vyhlížející situaci cítili tak, že je o nás postaráno a že je tady někdo, na koho se můžeme obrátit pro pomoc a radu. Moc si toho vážíme, protože nám to jednak pomohlo a také jsme si vědomi toho, že to v dnešní době bohužel stále není standard.

 Ještě jednou moc děkujeme

Michalka

Michalka
26.02.2020

Finaly even me can boast with joyfull news. On 10th February 2020 was born gorgeous girl Michalka (3650 g, 51 cm). She arrived 10 days after predicted date of birth. We, happy parents, want to thank to the whole Gest team for the longwished happiness. Markéta and Lukáš

Michal

Michal
07.01.2020

Finally can we show off our babyboy Michal. He was born on 24.12.2019, his weight was 2720g and was 48 cm long. Michal came into this world little bit earlier - at 37th week. 
Thanks a lot to the whole team - finally we have our little treasure. 
Happy parents Jaroslava and Luboš 

Zuzanka

Zuzanka
11.12.2019

We would like to thank the whole GEST team for the birth of our babygirl Zuzanka. She was born on 13. 7. 2018. Her weight was just 1120g - she was early born (28+6 week). She became a healthy, beautifull girl.
Grretings and thanks a lot again. 
Milena Wágnerová  

 

Jakoubek

Jakoubek
25.11.2019

We would like to thank to the whole GEST team for their care, namely Dr. Šulc, his colleagues, which we also met - Dr. Poláková, Dr. Černý and Dr. Alexandr. 
On 28th October was born our healthy babyboy Jakoubek. 
Thank you very much!
Jana and Martin 

Babyboy

Babyboy
04.11.2019

We want to thank to the whole GEST team for their excellent care and kindliness. Because of them is our family bigger. On 30th September 2019 was our babyboy (4270g) born. 

Tomáš and Klára 

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Address

NL - CLINIC Gest IVF s.r.o.
Nádražní Str. 762/32
(entrance from Rozkošného Str. 1058/3)
150 00 Praha 5 - Smíchov

Surgery hours:

Mon - Fri

8 - 19 On Fridays is open only until 5pm 
Sat 8 - 13  

Contact

Phone.: +420 257 212 516 - 518
Mobile: +420 602 328 346
E-mail: info@gest.cz
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