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The Centre

of Reproductive Medicine 

& Gynaecology

20 years of tradition and more than 8,000 children

The Centre

of Reproductive Medicine 

& Gynaecology

20 years of tradition and more than 8,000 children

Glossary

AFC (antral follicle count)

An ultrasound examination of the ovaries used to estimate the ovarian reserve in the patient according to the number of immature follicles.

AID (arteficial insemination by donor)

Intrauterine insemination using donor sperm.

AMH (anti-Müllerian hormone)

A hormone whose value determines the ovarian reserve - "the quantity of eggs in the ovary".

Assisted hatching (AH)

The oocyte, later the embryo, is surrounded by a layer called zona pellucida. The embryo must leave this layer in order to attach to the uterus. This process is called hatching. Sometimes, the layer is too thick or stiff and thus the embryo cannot leave it. It is supposed that, in some cases, this might be the reason for infertility. This condition can be improved by an embryologist who creates a small opening in the layer so that the embryo can leave the layer easily.

Asthenospermia

The result of semen analysis where the percentage of motile sperm is below standard lower limit, i.e. below 40%.

Azoospermia

It is a medical condition when the ejaculate contains no sperm.

Blastocyst

Usually a 5-day old embryo, when some cells already differentiate to form a placenta (trophoblast) and some cells form a fetus (embryoblast).

Clinical pregnancy

It is a pregnancy visible in the uterus by ultrasound. Biochemical pregnancy is the phase of pregnancy when there is a positive finding of HCG hormone either in blood or urine in the pregnancy test.

Corpus luteum

A structure on the ovary formed by remaining cells of the follicle after ovulation. It is hormonally active and it produces oestrogens and mainly progesterone preparing the endometrium to accept the embryo and ensuring its successful development until this function is taken over by the placenta in about the 12th week of pregnancy.

Donor

A person who gives sperm, eggs or embryos.

Embryo

A germ resulting from the fertilization of the egg by the sperm.

EmbryoGen

It is a new culture medium, which contains an important cytokine (GM-CSF) that creates an ideal environment for proper embryonal division and development of embryos. It is used to culture embryos within 72 hours. It is suitable for patients with recurrent reproductive failure and for patients with a history of recurrent miscarriage.

EmbryoGlue

This medium is specially developed so that there is a perfect communication between the endometrium and embryo after embryotransfer. The medium is enriched in particular with hyaluronan, thereby creating a suitable environment for embryo implantation. EmbryoGlue is particularly suitable for women over 35 years.

Embryotransfer (ET)

It is transcervical placement of embryos into the uterus by a thin catheter.

Endometriosis

A disease when endometrial cells implant outside the uterine cavity. The cause of the disease is not entirely clear. These cells may be found on the ovary and form typical endometroid cysts which are sometimes associated with infertility. If found elsewhere in the pelvis, they may cause pain or create adhesions that restrict fallopian tube patency.

Endometrium

A mucous membrane: it is a lining of the uterine cavity whose quality changes during a menstrual cycle. In certain phase of the cycle it can receive an embryo so that it can further develop.

ERA (endometrial receptivity array)

A test designed to show whether the endometrium can receive the embryo on the day of embryotransfer. If not, it can determine when to perform embryotransfer, i.e. whether sooner or later. It is made after repeated failure in assisted reproduction.

Extended embryo culture

Culturing embryos in the laboratory for longer than 48 hours, but at a maximum of 144 hours. The extended embryo culture is used to select the most suitable embryos for embryotransfer. If embryos are cultured for more than 48 hours, the quality of their development and their viability can be better assessed.

Fertile days

It is a time period in the female menstrual cycle when it is possible to conceive. It is in a period of ovulation, with a maximum span of up to 7 days before ovulation and 3 days after ovulation. If the cycle is 28 days, then the ovulation comes on the 14th day of the cycle. If the cycle is shorter, the ovulation occurs earlier, e.g. in a 25-day cycle it is on the 11th day of the cycle. If the cycle is longer, the ovulation occurs later e.g. in a 35-day cycle it is on the 21th day of the cycle.

Follicle

A small sac in the ovary filled with fluid where the egg develops. Its size in resting state is up to 8 mm. It gradually grows to a diameter of 18-24 mm when it bursts and the egg is released (see Ovulation).

Folliculometry

Measurement of the follicle size by ultrasound. It is performed repeatedly over several days to monitor the follicular growth and to predict or evidence ovulation.

Freezing (cryopreservation)

Sperms, eggs and embryos can be freezed in liquid nitrogen theoretically for unlimited period of time. In this state, no processes are ongoing in the cells, everything stops and the activity renews after thawing.

Frozenembryotransfer (FET)

Transfer of frozen-thawed embryos into the uterus.

Genetic testing

Genetic testing is based on the interview of both partners with a clinical counsellor. Nowadays, the importance of genetic tests is often overestimated. If the woman has a regular menstrual cycle with ovulation and the man has normal results of semen analysis, the probability of finding a genetic abnormality is the same as in the general population.

GTH (gonadotrophic hormones)

Hormones that are naturally produced in the pituitary gland (an endocrine gland in the brain) and regulate ovarian function. They are also produced as medication which can "force" the ovary to grow more than one follicle. We call the process “controlled hormonal stimulation”. They are only in the form of injections.

Hormonal stimulation

The process which we start IVF treatment with. It takes place in the first half of the cycle for about 10-15 days. Using hormonal drugs, we stimulate ovarian activity so that more than one egg matures at the same time.

HyCoSy (hysterosalpingo contrast sonography)

A method to examine the patency of fallopian tubes. The principle of the method is the insertion of a contrast solution into the uterus; ideally, this solution then penetrates into the fallopian tubes and abdominal cavity where it is absorbed. We monitor the process by ultrasound. This method is the most gentle of the possible examinations. The patients describe their feelings during the examination as the same as during menstruation, which then fade away. If necessary, we perform this test in a short general anaesthesia.

Hysteroscopy

A minor gynaecological performance when optical technology is inserted into the uterine cavity through the vagina and cervix to examine the shape of the uterine cavity and the quality of the endometrium and to see the mouth of the fallopian tubes. The method is used to detect polyps and other pathologies. Surgical hysteroscopy is called resectoscopy when some pathological formations can be removed from the uterus by using instruments. It can be combined with a biopsy of the endometrium or HyCoSy. This all is performed in our clinic.

ICSI (intracytoplasmic sperm injection into the oocyte)

A type of fertilization when the embryologist selects a sperm according to its appearance and motility and inserts it directly into the egg.

Implantation

Implantation of the embryo in the endometrium.

Implantation window

A short period of about 2 days when the endometrium is ready to receive an embryo for "implantation". It is 6-7 days after ovulation.

IUI (intrauterine insemination)

Cleaned sperms are inserted by a thin catheter directly into the uterine cavity.

IVF (in vitro fertilization)

Fertilization which takes place outside the body.

Laparoscopy

A minimally invasive surgical method of abdominal surgery when operations on the organs of the abdominal cavity or small pelvis are performed while using long thin instruments under the control of cameras. It is performed under general anaesthesia and requires brief hospitalization.

Low responder

A patient who is less responsive to hormonal stimulation in IVF process. These are usually patients with low ovarian reserve.

Menstrual cycle

The cycle begins on the first day of bleeding and ends on the first day of further bleeding. It is therefore calculated from the beginning to the beginning of menstruation. If bleeding comes by 10 o'clock in the morning (not just blood spotting), we count it as the first day of the cycle. However, if bleeding occurs after 10 o'clock in the morning, it is a zero day and the first day of the cycle is the following day.

MESA (microsurgical epididymal sperm aspiration)

It is used in patients with obstructive azoospermia. It is a microsurgical aspiration of sperm from the epididymis.

Minimal stimulation IVF cycle

An IVF cycle when lower than usual amount of stimulation drugs is administered. Then we expect the growth of fewer follicles, sometimes only one.

Myoma

A frequently occurring benign "tumor" in the uterus. It occurs in the muscle of the uterus (myometrium) where it creates defined "balls" that distort the uterus. According to whether they occur closer to the uterine cavity, in the middle of the myometrium or on the surface of the uterus, they are divided into submucosal, intramural and subserosal. They might be associated with the inability to conceive or recurrent miscarriage, but there might not be the connection. It depends on their size and location in the uterus. Sometimes they are removed, sometimes they are left there. There is already conservative treatment, too.

Natural IVF cycle

The IVF cycle where no hormonal drugs are administered to stimulate egg production.

Normospermia

Normal values of sperm analysis in all parameters.

OHSS (ovarian hyperstimulation syndrome)

Excessive ovarian response to hormonal stimulation in IVF process. It is a set of symptoms, such as enlarged ovaries, lower abdominal pressure or pain, nausea, vomiting, reduced urination, etc.

Oligospermia

Abnormal result of sperm analysis when the sperm concentration in the ejaculate is less than the standard lower limit, i.e. 15 mil./ml.

Oocyte

Egg. It is the biggest cell in the human body with a diameter of 0.1 mm.

Oocyte puncture

Transvaginal aspiration of follicular fluid containing the eggs from the ovary to obtain the eggs for IVF process to fertilize them in the laboratory. It is performed in short general anaesthesia through a thin needle.

Ovarian reserve

In simple terms, it is a "number of eggs in the ovary". Women have the highest values of ovarian reserve after puberty and these values decrease with growing age. The value of ovarian reserve as well as the rate of its decline is very individual. The ovarian reserve is estimated from the level of FSH (follicle-stimulating hormone) or rather level of AMH (anti-Müllerian hormone), but also by ultrasound ovarian examination – AFC (antral follicle count).

Ovarium

A female reproductive organ in a lesser pelvis which produces oocytes and is hormonally active.

Ovulation

The burst of a growing follicle and the release of an egg from a follicle in the ovary.

PGD/PGS (preimplantation genetic diagnosis/preimplantation genetic screening)

A method in the IVF process where an embryo is genetically tested whether it is healthy. The number of some or all chromosomes can be tested in the embryo, i.e. whether any chromosomes are missing or present abundantly, to exclude the Down’s syndrome or testing for hereditary diseases where there is a real risk of inheriting the disease.

PICSI (preselected intracytoplasmic sperm injection)

It is a modified ICSI method where based on the functional assay a sperm is selected and then injected into the egg. The method is suitable for couples with recurrent poor quality of embryos or repeated failure. It can be used as soon as the first IVF cycle when the couple wants to maximize their treatment in that cycle. The PICSI method can not be used if a semen analysis shows significantly pathological results, with low sperm count or completely immotile sperm.

Polyp

Also a „villus” or a „mucosal pouch”. In gynaecology, we can find endometrial polyps in the uterine cavity or cervix. If a woman who wants to conceive has a uterine polyp, it must be removed. Sometimes such a polyp acts like an IUD and thus prevents pregnancy. Histological examination of the polyp can exclude a possible malignant polyp which is, however, rare in women of reproductive age.

Reproductive period of a woman

A time period when the woman can become pregnant. This reproductive period may vary for each woman within several years. The female’s ability to conceive ends many years before the last menstrual bleeding in life. The female’s inability to conceive after the age of 40 is not seen as a disease, but a physiological process of reproductive aging.

Sactosalpinx

A dilated fallopian tube with inflammation where both tubular ends stick together and the tube is filled with fluid. Such filled fallopian tube can be seen by ultrasound examination. Sometimes, we distinguish hydrosalphinx where the fallopian tube is filled for a long time, its walls are thinned and the inflammation is healed, and pyosalphinx which is an ongoing acute inflammation and the fallopian tube contains pus. In its acute phase, it is treated with antibiotics. Such fallopian tube is often irreversibly damaged and sometimes it is better to remove it.

Semen analysis (spermiogram)

Examination of the ejaculate (sperm), based on which male fertility is assessed. Several days of sexual abstinence are recommended before undergoing this examination.

Social freezing

Freezing of oocytes at the age when the woman is young and still has quality oocytes. For well known reasons, many women now decide to have a baby in their 40s. It is generally known that the ability to conceive decreases with age. In order to give the older woman a chance to have her biological child, the eggs freezed in her “reproductive youth” can be thawed and used in the IVF+ET programme. It is necessary to freeze eggs by the age of 35 for this method to be successful.

Sperm DNA fragmentation

A high standard test for testing the quality of sperm. The result is the percentage of sperm with damaged DNA in the sperm head. This test gives us more information about the quality of sperm that can be used to plan the next treatment procedure.

Teratospermia

The abnormal test result of semen analysis when the ejaculate contains an increased percentage of sperms with abnormal shape. The standard is very liberal. We speak about teratospermia if the percentage is higher than 96%.

TESE (testicular sperm extraction)

A surgery that is performed under general anaesthesia in patients with azoospermia. The purpose is to obtain sperms directly from the male gonad. The testicle cover is cut open to obtain testicular seminiferous tubules and find sperms under the microscope. The sperm can be freezed or used directly for fertilization using the ICSI method. This surgery can be synchronized with the stimulation of the woman when TESE is performed on the day of the egg retrieval (OPU). At our clinic we perform both of these options. The TESE is performed on an outpatient basis and is not covered by public health insurance.

Time-lapse embryo monitoring system

A method allowing continuous monitoring of the embryo development under unchanging environmental conditions. Using this method, we have a complete overview of the development of each individual embryo. Based on the dynamics of differentiation and other parameters, an embryologist has the option to choose the best quality embryos for embryotransfer and decide which embryos are suitable for freezing. This method must be combined with ICSI/PICSI methods.

Vitrification

Fast freezing used for freezing the embryos and oocytes. This method is more expensive than previous slow freezing, but ensures better survival of embryos or oocytes after thawing. Embryos/oocytes can be freezed in liquid nitrogen theoretically for an unlimited period of time

Client ranking

Two very positive experiences

Two very positive experiences
30.06.2018

My husband and I have and will continue to recommend the clinic to any couple requiring fertility treatment based on our excellent experiences with the team there. We had ICSI in 2015, led by Dr. Alexander. Despite our fertility problems (high FSH/LH and low AMH, and cryptospermia), we were successful.

Our little boy was born in 2016 and is a beautiful and healthy two year-old now! We returned a few weeks ago, for our second ICSI cycle and are currently in the two-week-wait period and feeling optimistic. We were treated by Dr. Alexander again. Thank you Dr. Alexander and the embryologists at the clinic for making our dreams come true. We will definitely be returning to the clinic in the near future with the hope of having more children.

Michelle H., UK

Our baby twins are with us now :)

Our baby twins are with us now :)
18.06.2018

Amazing experience! Our baby twins are with us now :-)

The IVF Team took us on a wonderful experience with our treatment, everything was planned perfectly, taking into consideration the details of our particular case.Our treatment consisted of two visits to Prague where all the steps where explained by Dr. Daniel Alexander. We had a great time in Prague on these two visits and thank you to all the team, now we have our wonderful babies with us. ❤

Omar Virguez, United Arab Emirates

1st April baby girl

1st April baby girl
09.05.2018

On 1 April, we had a healthy, beautiful baby girl!!! She is the joy of our lives and we couldn’t be happier. ❤

Lada

Lada
16.03.2018

I too would like to express great thanks to GEST. I could not get pregnant for four years, I ran around countless doctors and, finally, somebody recommended me the GEST, so I came here. The senior physician Mr. Černý helped me not only with my problem, but also mentally. He is an amazing man whom I seriously swear by. I cannot complain a bit of other staff, either; they were always very nice and helpful. After the second IUI, I got pregnant and I already have a two-year old boy. Now we are thinking about the second baby and again I have turned to the senior physician with great confidence; I have received a warm welcome again and he tries to help me now. I really cannot say a bad word; on the contrary, I only recommend and praise.

Václav, Marcela, Barborka and Terezka

Václav, Marcela, Barborka and Terezka
09.02.2018

We came to GEST on the recommendation of our friends and after the first info meeting me and my wife left with various feelings. We got a lot of information about what to expect, but mainly we were amazed by the professional approach, kindness and helpfulness of all the staff, not to mention a great homelike environment. We were just a bit afraid of what this all would cost. Nobody ever talked to us about money, nobody forced us to do anything; they just kept explaining and giving their recommendations and, except for a couple of thousand, it really didn’t cost anything. After the third IUI they recommended us IVF and after excellent results we succeeded in the first attempt. The twins Barborka and Terezka were born. We would like to hereby thank the GEST and recommend them to everybody. And that someone is dissatisfied? Not even this great staff can do miracles. Whenever we think of Dr. Čekal and his dry humour, we have a good laugh.

David, Zuzana and Zuzanka

David, Zuzana and Zuzanka
09.02.2018

We are happy to inform you that on 30 July 2016 a beautiful baby girl (3,200 kg/49 cm) was born to us. This is thanks to your care when you performed insemination. Me and my husband thank you very much and wish the entire GEST team every personal and professional success.

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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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