FAQ CLINIC AND DOCTORS. What is the name and address of your clinic?

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1 CLINIC AND DOCTORS What is the name and address of your clinic? The clinic is called GYNEM Fertility Clinic and and the address is Ledčická 1, Prague 8, Czech Republic. How is your organisation regulated? What accreditations or registrations does the clinic have? GYNEM clinic is regulated by SÚKL (the State Institute for Drug Control) and must meet strict criteria in order to have the certification to treat infertile couples. The Czech Republic s reproduction legislation is one of the toughest and most regulated in Europe. SÚKL is responsible for regulating all cell donation procedures, laboratory conditions, including air quality, laboratory materials and documentation procedures. They also regulate blood samples and certify laboratories. We offer one of the highest standards in Europe. What equipment does the fertility clinic have to help my treatment? We offer you the latest modern technologies. Our laboratory is equipped according to Czech law with special air conditioning and small particle filtering systems to keep the laboratory clean without any contamination or bacteria in the air. We offer the latest methods, like PICSI, Primovision Embryo Monitoring, PGD/PGS, CGH among others. How long has the clinic been operating and how many cycles of treatment does it perform each year? The GYNEM IVF Clinic has been in operations since September 2013 and is one of the only buildings in Prague which was designed specifically for IVF treatment. We have the capacity to perform 1500 cycles per year. 1

2 CLINIC AND DOCTORS What qualifications do your doctors have? All of our physicians hold their doctor s degree from the Czech education system, which is honored as one of the toughest in the world with 6 years of studying. And after having completed university, they must train for 5 additional years in order to be a specialist. Our physicians have many years of experience and have also worked abroad. Does the Doctor speak English and how experienced is he? MUDr. Milan Mrazek, Ph.D. has been trained by some of the world s top specialists and has the highest possible specialist qualifications. He has participated in a number of specialized trainings and visits abroad. He is a member of the Czech Medical chamber, European Society of Human Reproduction and Embryology as well as the Committee of National Representatives of ESHRE. He speaks English fluently and hold a First Certificate in English. He has more than 17 years of experience in assisted reproduction and 32 years in obstetrics and gynecology. COSTS If we decide to go with your program, how are payments made? Is there a deposit payment? A deposit of 1,500 EUR is paid beforehand via bank transfer, credit card or cash once you have decided for an confirmed the treatment. This payment covers the cost of the stimulation medication and compensation for the donor. The remaining sum must be paid prior to or on the date of the embryo-transfer. We accept cash, credit cards or direct bank transfer into our account. Does the fertility clinic offer some discounts? We do offer some discounts on an individual basis, so discounts in further cycles or treatment can be discussed with the doctor and management. 2

3 COSTS Are the drugs that both I and the donor take included in the price? How do I receive the medications? Yes, the medicaments for you until the pregnancy test and also for your donor are included in the price of the program. We will ship the required medications worldwide through an internationally recognized shipping company to have an extra assurance that they have been delivered on time and in good condition. Does the clinic charge for the initial consultation? Yes, it is included in the price of the program, which means that you will pay for the consultation and if you decide to go ahead with the program, we will deduct this amount from the price of the program. If you decide not to go ahead with the program, you will only pay for the price of the consultation. PRE-TREATMENT What are the pre-treatment requirements and can it be done at your clinic? Results for pre-treatment tests can be done in your home country and sent to us via . From these tests, you will receive a free evaluation and professional opinion by our doctors and specialists. You may also undergo these tests here in Prague at our clinic during your initial consultation. Compulsory tests for women: blood group and Rh factor blood tests for infectious diseases (Hepatitis B and C, HIV and Syphilis) ultrasound scan of uterus and ovaries looking at the endometrium lining Recommended tests for women: Cervical cultures (ureaplasma, mycoplasma and chlamydia, smear tests) Mammography for women older 40 years Compulsory tests for men: blood group and Rh factor 3 spermiogram and infectious diseases (Hepatitis B and C, HIV and Syphilis)

4 PRE-TREATMENT I have already undergone some of the pre-treatment tests. Do I need to do them again? If you ve taken the tests previously and the results aren t older than 2 years, you do not need to take these tests again. You can send your results via . Is there a waiting list to be seen at the clinic? There is a short waiting time for finding the right donor (1-3 months). We can search our donor database within 24 hours from your inquiry and see if we have a match for you already. DURATION OF STAY How many days do I have to stay in Prague? We recommend that you stay in Prague for approximately 7 days, arriving one day before the egg retrieval and staying until the embryo transfer, which takes place 3-5 days of embryo cultivation. If you stay for 7 days, you will need to schedule an ultrasound on the 10th day of your stimulation back home and send us the results via . The second option is to stay in Prague for approximately 3 days, only for the embryo transfer, using frozen sperm from your initial visit. You will arrive one day before the embryo transfer and will need to schedule an ultrasound for the 10th day of stimulation back home and send us the results via . There is another option for you to stay in Prague for approximately 10 days, where you will undergo the ultrasound scan on the 10th day of your stimulation here at the clinic. The male partner s stay can be reduced to only 1-2 days. 4

5 EGG RETRIEVAL How many eggs are normally retrieved? We retrieve approximately 8-12 eggs from a donor. As our program is based on a sole match principle, you don t share the eggs with other recipients. All retrieved eggs are fertilized and healthy ones transferred to you or frozen for next attempts. Will you keep us informed after egg pick up as to the number of eggs collected and in regards to the quality of the cells? Yes, your personal coordinator will be in touch with you on a daily basis with updates from the embryologist so you will know how the embryos are evolving. The embryologist also speaks English fluently. On what day will the male partner need to go in for sperm collection? Is it the same day that you collect the eggs from the donor? The male partner needs to be at the clinic the day of the egg pick up to donate sperm and also to sign an agreement (which both partners need to sign). If his sperm is frozen during the initial visit, it is not necessary for him to come to Prague again. EMBRYO TRANSFER When are embryos transferred? How long are they cultivated? In most cases, the clinic transfers embryos on day 5. The clinic prefers to do prolonged cultivation of embryos as it increases the success rate. There is no charge for prolonged cultivation to the blastocyst stage. 5

6 EMBRYO TRANSFER When are embryos transferred? How long are they cultivated? In most cases, the clinic transfers embryos on day 5. The clinic prefers to do prolonged cultivation of embryos as it increases the success rate. There is no charge for prolonged cultivation to the blastocyst stage. Is the embryo transfer performed under general/local anaesthesia? How long does it take? The embryo transfer is performed under local anesthesia and takes 3-5 minutes. After less than an hour of rest in the recovery room you can leave the clinic. How many embryos are transferred? We transfer one or two embryos, depending on what the doctor and you decide together. We recommend freezing the remaining high-quality embryos. Do you offer embryo monitoring for how much? How many days are the embryos monitored? Yes, we do offer embryo monitoring via PrimoVision for a charge of 120 EUR/ day. The embryos are monitored from fertilization until the third day. Thanks to this method, embryologists can choose the best and strongest embryo(s) for transfer, which may increase the chance of a successful pregnancy. DONORS Is sperm and egg donation legal in your country? What are the rules about donor anonymity in your country? Yes, it s legal to donate sperm, oocytes and embryos in the Czech Republic. This is an anonymous process and recipients or future children born from donation can t know the identity of their donor. 6

7 DONORS What information can you provide about sperm and egg donors for the selection of my donor? The process is completely anonymous, however, you can select a donor according to the following characteristics: eye color, hair color, weight, blood type, education, and hobbies. Our program is based on a sole match principle, meaning that each recipient is assigned one donor and all eggs from the donor are available only to one recipient. Can I see photo of donor either as an adult or as a baby? We can find a suitable donor for you matching provided physical characteristics but unfortunately we can t send you any photos of the donor, not even from childhood. However, you may send us your photo and we can use it to find a donor who most precisely matches your needs. Who qualifies for being an egg donor? What are donors screened for? Egg donors must pass mental and health examinations, be aged between years and have completed at least 12 years of schooling. They must be from normal social environments, with no abnormal physical features and with no preexisting genetic conditions. All egg and sperm donors must undergo blood tests for sexually transmitted diseases and genetic defects. The following tests are performed on all donors: Infectious hepatitis B and C, HIV, TPHA, genetic testing + chromosome analysis, determination of blood group, ultrasound scans and psychological interviews with a doctor. Donors are citizens of the Czech Republic. Can I request a donor who has donated before and been successful? Yes, you can make a request for a successful donor as we have many donors who have been successful with donating eggs in the past. 7

8 GUARANTEES What guarantees do you have? We will select a suitable donor for the recipient according to requirements based on height, weight, colour of eyes, colour of hair and blood type. We guarantee the harvesting of 6 eggs and 2 healthy embryos for transfer if the sperm quality is good. If the donor doesn t produce enough eggs, we will provide you with a new donor for no extra charge. If your first and second cycle is not successful (meaning that you are not pregnant), we will provide the third cycle free of charge. What happens, if the procedure is unsuccessful? If you have some embryos left which are kept frozen, we can use them for KET (Kryo Embryo Transfer) after three months. The cost of the procedure is 400 EUR + cost of medication (It may be possible to use what you have left from the previous attempt as well). EXTRA SERVICES FOR INTERNATIONAL PATIENTS Who deals with flights & accommodation? Our patient coordinator will be more than happy to recommend affordable flight connections to and from Prague and fully equipped apartments in a lovely Prague neighborhood or hotels nearby the clinic. Do you provide apartment accommodation which is close to the clinic? We cooperate with Prague Apartments, a company with fully equipped flats at V zahradách 802/23, Praha, Czech Republic. There is a tram connection directly to the GYNEM clinic or it only takes about 10 minutes by car. 8

9 EXTRA SERVICES FOR INTERNATIONAL PATIENTS Do the staff speak my language or provide interpreters? All of our staff members, doctors and embryologist speak English fluently. We have patient coordinators who can speak German, Russian, Serbian and French fluently. We can provide language interpreters for other languages at no additional cost. Do we need to travel to Prague for initial consultation? We recommend for you to see our facility, meet the doctor and go through the initial consultation with us, but if you prefer to do this by skype and send us pretreatment test results via , this is also an option. Would we get any assistance with airport transfers and travel to/from clinic for appointments? Yes, airport pick up and the first transfer to the clinic with our representative is included in the price of the egg donation programme. Can we choose a particular treatment date as we would need to arrange times of work in advance? Yes, if you let us know in advance, we are able to choose a particular treatment date according to your needs. Does the clinic offer an all-inclusive package with travel and accommodation? You can choose from a list of hotels or apartments which are nearby the clinic and we will help you with flights and booking. We do not offer all-inclusive packages unless specifically requested, as we focus on providing medical services. 9

10 EXTRA SERVICES FOR INTERNATIONAL PATIENTS Do you offer other services such as counselling? Yes, we offer counselling services. Do you offer any other services to enhance my stay? We can arrange for a sightseeing tour for you and your companion. We will be more than happy to discuss with you how to use a public transport which works really well in Prague. We can offer you a broad range of cultural activities. There is an exceptionally broad range of sports activities you can do in Prague as well. GENERAL What medication will I take during the stimulation? Estrofem / Estradiol / Progynova / 3 tablets a day Prednison 1 tablet a day Anopyrin / Aspirin 1 tablet a day Synarel / Norethisterone / Orgametril in case your period isn t regular Utrogestan 6 tablets a day You will receive a detailed stimulation protocol, according to which you will take the medication. What are your success rates? Our success rate is 65% of clinical pregnancies throughout all age groups. Is there an age limit for woman? We will provide egg donation programmes for women that are not older than 50 on the day of the embryo transfer. 10

11 GENERAL Are there any restrictions for relationship status? We do not require a marriage certificate, however you and your partner will need to come together to the clinic to sign an agreement which is certified by a lawyer. Unfortunately we can not offer this treatment to single women as it is not legal in the Czech Republic. What day is the first day of the cycle? The first day of the menstrual cycle is the first day of bleeding. If you start to bleed after 18:00 in the evening, the first day is the next day. When should I do the pregnancy test? The pregnancy test can be done 2 weeks after the embryo transfer. Is there any advice for men before sperm collection? It is recommended that a man be abstinent 2-3 days before donating sperm. Is there a recommended weight range for a female prior to embarking on treatment? There is no weight limit for egg donation treatment in the Czech Republic. Is the procedure that I require legal in your country? Yes, all procedures what we offer are legal in the Czech Republic. Will you help me to choose the right treatment? We certainly will! Every inquiry is evaluated by our top experts, by doctors with highest level of education and with many years of practical experience in assisted reproduction. We will always come up with the most suitable treatment for you based on the data you provide. The evaluation is always done free of charge. 11