In this webinar, Klára Havelková, Medical Patient Coordinator at UNICA Clinic, Prague, has discussed IVF and egg donation laws and regulations in the Czech Republic.
Klára Havelková is a medical coordinator at the clinic in Prague, and she has been doing this for several years now. She’s more focused on the medical part of the treatment, so if you got in touch you would deal with her colleagues first, and then she would take over whether for the consultation or afterwards for the treatment itself. Klára would be the connection between the patient, doctor, and nurses.
Unica is an IVF clinic based in Prague, Brno, and in the Czech Republic. They serve patients from both the Czech Republic and abroad. The clinic employs coordinators who speak various languages to accommodate their diverse patient base. Klara focuses on English-speaking patients, while other coordinators speak German, French, Italian, and Polish, ensuring that patients feel comfortable and welcomed by communicating in their native languages, which helps them understand everything more easily.
Unica offers a program with donated eggs, supported by a large database of over 1200 active donors. One of the clinic’s significant advantages is that there is no waiting list, and the donor database remains robust, even during the pandemic, which has not negatively impacted this aspect of their services.
Additionally, Unica emphasizes a Holistic Fertility Program, focusing on an individualized approach during consultations with doctors. These consultations consider the patient’s medical history and personal preferences, with doctors suggesting various techniques or holistic methods to reduce stress and help patients feel more relaxed during treatment.
The clinic was awarded last year for its exceptional IVF treatment experience and for having the best fertility blog, an achievement they are very proud of.
Two legislations need to be followed, and various laws apply, especially regarding the egg donation program.
The doctors always highly recommend a single embryo transfer, however we do transfer 2 if that’s what the patient wishes.
The clinic is not permitted to treat single women, single men, or same-sex couples.
Unica provides genetic testing, such as PGT-A and PGT-M. 
PGT-A, or Pre-implantation Genetic Screening, is essentially a biopsy of the embryos. After combining the eggs and sperm, the embryologists perform a biopsy on the embryos, and the sample is sent to an external lab within the Czech Republic. The results typically take two to three months, and the outcome indicates whether the embryo is suitable for transfer or not. This is a general genetic test.
PGT-M focuses on specific genetic diseases. If patients already know that either one of them carries a specific genetic disease, embryos can be tested for that issue. Once the results are received, the embryo that is not a carrier is selected for transfer.
The clinic is not allowed to share the sex of the embryos unless it’s related to a specific genetic disease that may pose a risk. In such cases, this information can be shared. However, gender selection is not allowed, meaning patients cannot choose the gender of the embryo.
The egg donation program is strictly anonymous, as required by law. No pictures or family background information of the donor can be shared. However, basic information such as height, weight, eye colour, hair colour, blood type, hobbies, and education may be provided if the patient is interested.
Unica has a very large donor database, ensuring there is no waiting list. The matching process depends on the patient’s preferences. Donor profiles are selected by a colleague responsible for the donor program, and the profiles are then forwarded to the patients. Patients can decide from one donor profile or a selection of three to five profiles, depending on the chosen package, so they feel involved in the process.
Donors under 35 are required by Czech law to undergo genetic testing, gynaecological exams, psychological assessments, and testing for STDs. Most donors at Unica are under 30, and they are thoroughly tested for health and genetic suitability to ensure a successful and healthy pregnancy outcome.
The sperm donation legislation is similar to that for egg donation. It is anonymous, and the clinic has a large database of male donors. The matching process is identical to the one used for egg donation. The maximum age for male donors is 35, though most are under 30.
Embryo donation follows similar legislation as egg and sperm donation. It is anonymous, and embryos are created using sperm and egg samples from donors.
We cannot use embryos that were embryos of our patients… even if the patients agree with it.
If a couple has a successful pregnancy but no longer wishes to use their embryos, the clinic is prohibited from providing those embryos to other couples.
Embryos created from the highest quality sperm and eggs are frozen at Unica and can be used by patients who wish to receive them. All testing required for this process is included.
Unica also incorporates holistic fertility methods, which are tailored to each patient. Some patients are interested in these methods, while others wait for recommendations from their doctors.
A psychologist is available for patients, as IVF treatment can be emotionally challenging. If patients encounter difficulties during the process, they are encouraged to seek emotional support from the psychologist.
Acupuncture is commonly used before and after the transfer to help patients relax and prepare for the procedure, as well as to get into a positive mood afterwards. Other holistic treatments include meditation and fertility yoga, allowing patients to choose what makes them feel most comfortable. These methods are integrated into the fertility journey to support both the body and mind.
This is a common question. We do have patients coming in every day, it differs from country to country. My colleagues who deal with German-speaking patients, know exactly how it works with Germany, and French-speaking coordinators know exactly how it works with France, but we’re trying to kind of keep up as much as we can.
In different countries, the patients have to quarantine as they go back. I know, for example, in the UK, as they come to the Czech Republic, before their departure, they have to have a PCR test that is ideally not older than 48 hours, but it could be up to 72 hours. Then, as they come to the Czech Republic, they should repeat the test. We provide COVID-19 tests and PCR tests at our clinic, so that’s at least something that the patients can rely on. They’ll have a place where we can do the PCR and COVID-19 tests, usually, we have the results within the same day, in the evening or 24 hours.
When it comes to the restrictions in the Czech Republic, a lot of them have been lifted; it’s getting a lot better. Right now, the restaurants are open, and we only wear masks, at the clinic, we have to wear masks in public transportation, but so far, for the past couple of weeks, a lot of the restrictions have been lifted. The gyms are open, the restaurants, bars, places where you can get coffee, stuff like that, those are open. Hopefully, they’re going to stay open for a while.
That’s really something that I cannot predict. I also kind of feel it’s not going to change anytime soon. I don’t think so. If it ever will, I don’t know, but I don’t think it’s going to change anytime soon.
In the Czech Republic, yes, egg freezing is possible. The process is the same. We can treat couples, but in this case, for egg freezing, it could be just women. They don’t have to have a husband or a partner as long as they’re not going to use the eggs, but the process is the same. They will go through a consultation with the doctor, and they will be given a therapy plan, they will be stimulated, and then the egg collection will happen. Then, the eggs would get frozen, and they would be stored in our lab for further usage, but once they get used again since we can only treat couples, we have to have a partner.
The therapies are similar, but being stimulated means that the couple is using their own eggs and their own sperm sample, it’s a lot more difficult for the woman because they have to use injections every day, and then they have to go through anaesthesia, and they have to get the eggs collected, but when it comes to timing it would be pretty much the same, it’s about three weeks altogether. The treatments start with the first or second day of the woman’s period, and then with therapy with their own eggs, they go through multiple ultrasounds because we have to check the follicles where the eggs would be hidden, later on, we can see them under the microscope after egg collection. So, we can see on the ultrasounds there are follicles. Those have to be checked more often.
Then, the egg collection happens and, according to the doctor and also the embryologist, three to five days after the egg collection the transfer would happen. The eggs get fertilized on the very same day as they’re collected, so they get collected, and they get fertilized with a sperm sample.
With the therapy with donated eggs, when it comes to the medication, it’s usually a lot easier because they only use medication orally, and then later on, they apply medication vaginally. Typically, 80% of the patients only need one ultrasound. We then coordinate the donor and the patient, and then the egg collection happens. We require the sperm sample the same day, so the eggs can get fertilized, and then 5 days later, it would be the transfer, but time-wise, it’s very similar, it’s about three weeks altogether.
That depends on the patients. Some patients wish to have all the ultrasounds at the clinic, which is possible, and that way, they would have to come over for at least two, maybe three weeks, if they wanted to come for the whole treatment. If not, especially with my patients from abroad, it’s not possible to have a holiday for three weeks, which we completely understand then the ultrasounds can be done abroad with the local gynaecologist, they just send us the results, they send us pictures, I forward these to our doctor, and they can give them feedback.
This is how this works mostly, the only thing when it comes to the therapy with their own eggs, we do prefer to have the second or third ultrasound at the clinic because the doctors want to do the ultrasound themselves because then it’s going to be them collecting the eggs. They want to see the final situation before the egg retrieval.
Regarding the therapy with donated eggs, I do have patients who come for a week, which means for the fertilization and then for the transfer. Sometimes, the female partner comes in for the fertilization only, and then it would just be one day for each partner, and then they can go home.
This is very individual. Some patients feel more comfortable being at the clinic or being available for us anytime, so they come over for the treatment, and some patients who live further away could just come for a couple of days or a week max.
Yeah, definitely. I can tell them the options, and then they choose whatever they’re most comfortable with, and I also tell them what the doctor recommends. So, I can tell them what we would prefer as a clinic because the doctors do have their own recommendations, but especially with my patients who live far away, even in the United States, they cannot simply just come over anytime, it has to be planned, so in these cases of course we look deeper into it, and we try to schedule it as much as possible, even though it’s still dealing with human bodies, and we cannot predict everything 100%.
On top of that, you have the COVID-19 restrictions in general, and that makes it even harder. We do have patients coming every day to the clinic; we kind of got good at it, we learned h how to deal with the COVID-19 restrictions, so the more time passes, the better we get at it. I mean, as coordinators, we follow a lot of the rules and read all the embassy articles and stuff so we can help out, and it’s been working well, especially the fact that they can do the PCR tests at the clinic. That helps the process.
It’s individual, but most of what we do is ask the patients if they’re willing to share pictures with us so they can share their pictures, or they can even tell us what their requirements are. We ask for the most recent pictures. If they would like the donor to have, for example, blond hair. If the patient is blonde, then it would be something we would focus on. The pictures help, but if the patients don’t feel comfortable sharing pictures, they can just tell us their height, weight, eye colour, and hair colour, as much as we can get that makes the matching easier for us.
As coordinators, we don’t do the matching, our colleagues take care of the whole donor program, so we would forward these pictures and requirements to my colleague, and she does the matching. She would then forward the profiles to me and I translated everything for the patients, and I forward the profiles again only profiles to the patients.
Sometimes, I do have patients who are more interested in hobbies or education, so that’s something we can share, but no more than that.
That depends, we do have different packages, so the standard one would be that the clinic simply finds the best match for the couple and that’s the one that’s given to them. With an exclusive package, we do the three profiles that match them the most, and they can choose from those.
There’s an exclusive plus which is five donor profiles, so it’s still donors or profiles of donors that match them the most, but the patients have the option or the opportunity to pick themselves to have more of a selection.
