The Czech Republic consistently ranks amongst the most popular countries for IVF and other fertility-related medical tourism. But what makes it such a sought-after destination, and how can expats benefit from the same procedures outsiders visit the country to receive? We spoke with Mirna Turčinovič, Patient Relationship Manager at Prague’s Clayo Clinic, to get the basics on fertility treatment for resident and non-resident foreigners in the Czech Republic.
A lot of people come to the Czech Republic for fertility treatments. Why is it such an attractive destination for people seeking out IVF, for example, or for someone who wants to freeze their eggs?
We have a lot of patients coming from abroad mainly due to the Czech legislation, which is relatively liberal, and because donation programs are anonymous. In nearby countries like Germany and Poland, the legislation is much more restrictive. In practice, that means that doctors and embryologists don’t have the option to practice some fertility treatment methods like genetic analysis of embryos or biopsy of embryos.
Cost is also a motivating factor. For American patients, the cost is the biggest motivator because they pay $30,000 to $40,000 in the U.S. for some treatments that we do here for EUR 4,000 to 5,000. So for them, it's often a vacation. They stay in Prague because Prague is a beautiful city, so it’s like a little honeymoon getaway, plus the treatment, and they still save money. British patients mostly choose to come here because of the waiting time and accessibility. So the motives why people travel vary from saving money to legislation to methods to success rates.
What are the unique concerns of expats who come to a clinic like yours?
For me, being an expat here and listening to my friends and going through my thirties and early forties, it can be really difficult for an expat woman to arrange her life abroad. Maybe in her home country it would be easier because there would be more family, more support. But here she needs to have a reliable partner, she needs to have financial stability somehow, she needs to be supported by the government to receive some maternity rights. Those things need to be in place for women to say, “Okay, I'm ready.” And the partner has to be ready, too.
The clinic's owner, Dr. Daniel Hlinka, was at one point an IVF patient: he and his wife Zuzana underwent an IVF ICSI [intracytoplasmic sperm injection] procedure, which resulted in the successful birth of two healthy children, twins. Now, 17 years later, you can see the whole family in the clinic, breaking the taboos on IVF and infertility.
For some people it happens easily. For others, they have to struggle. But we are here to help. Many of us here, including myself, went through some kind of either IVF treatment or fertility preservation just to remove this stress.
Which standard fertility treatments are covered by Czech public health insurance?
Women who live here and are insured can have three or four rounds of IVF, depending on the number of embryos transferred, until the age of 40. After 40, insurance stops covering it. Insurance can continue covering basic procedures like blood tests or consultations, but not IVF procedures.
But even before the age of 40, insurance still doesn't cover everything. The basic package covers methods like egg collection, fertilization, embryo transfer and medication to a certain extent. Our clinic is run by Dr. Daniel Hlinka, the most famous embryologist in the Czech Republic, and the methods he has introduced to Czech clinics and Czech markets are quite unique. These additional methods, like OPTIM-ICSI [a variation of intracytoplasmic sperm injection developed by Dr. Hlinka], time-lapse monitoring, ASET [Asynchronous Embryo Transfer], and assisted hatching, are not covered by insurance.
For someone living in Prague and realizing they may need fertility support, what are the most important things to look for when choosing a fertility clinic?
It's important to do your homework and learn about who the doctors are, and who the embryologists are. After researching online or asking around, it’s normal to visit two, or maybe three clinics and see where you feel the most comfortable. You need to find a clinic where you feel the most comfortable because trust is a major factor. You have to be relaxed, you have to have all your questions answered, and you have to trust the team and the doctor.
Patients often choose our clinic because it's a family-owned clinic. They say, 'We don't feel like a number here' or 'We don't feel like a statistic here.'
It’s very important to choose one clinic and stay with one clinic. It’s human psychology to think, “If I'm not successful, I will try another clinic.” But from my 17 years of clinical IVF experience, it’s best to stay at one clinic until a pregnancy is achieved. The more we know you, the more we can assist you. The more we learn about your body and your embryos, the more we can adapt.
When you make that decision and you choose a clinic, you're entering into what's not just a clinical relationship, but an emotional one as well. What might a patient consider to know that they're in good hands psychologically, not just physically?
When a patient comes in, you can see if they are ready or not and we help them to understand which phase they are in. Are they looking for information? Are they ready to become parents? We try to help them be as prepared as possible. We have a team of coordinators that are in contact with the patient throughout the whole process.
IVF is not an impulsive decision—you have to take some time off, be ready mentally to focus, to inject hormones, to go for egg collection—so it needs to match your schedule. So, in addition to the doctors that will tell you which medication to take and how to optimize your body, you have a coordinator that helps you navigate this. Life can be messy, but we help them decide when the best time to start is.
In my experience, from the first contact until the treatment—we are talking about at least three months’ time—we are communicating with the couple as they are slowly preparing for this. We focus on the medical treatment, but sometimes they might need support on the side as well, like a coach or an acupuncturist.
It must be emotional work for you, too!
We go through everything with our patients. To work in an IVF clinic, you need to have some kind of empathy, and that’s why most of our employees are female. I'm not saying men don't have empathy—they do, and they're good professionals—but we talk about the female body, the menstrual cycle and how to prepare yourself. We’re mostly speaking with women. Men are there as well, of course, and we need them equally—but we need a female touch.
For us, the difficult part is the two-week wait after the embryo transfer and before the pregnancy test. And the first trimester is very emotional for them and for us. We absorb half of their anticipation and excitement and, in the case it's not successful, sometimes disappointment. When we have a positive heartbeat and the first trimester is over, they relax more and begin to tell their family and friends. When we have positive tests, of course we are happy, too. It gives us the energy to go on.
We only see cells here; we see embryos in the stage of cells. But after you have a delivery, you see the baby pictures and stay in contact with the couples and some of them even send pictures throughout the years. Then you just see the future, you know? You see new generations. When a baby is born, it brings joy to the whole family. It's a great moment for everybody in the circle of life and it really gives us a lot of meaning to what we do.
What is one thing you wish patients knew when they walked in the door?
It's important that patients see us as their partners. We want to be with them until their pregnancy is achieved.
Sometimes if a patient reads too much on Google, it can be confusing because what worked for one person won’t necessarily work for another person. Nothing that we plan is written in stone, and anything can change during the treatment. Flexibility is important because we will do what’s best for them, and that often isn’t one set method. They need to entrust their body, their time and their finances into the hands of our experts.
Trust and partnership is most important in terms of success. Everything we went through as parents and when we wanted to be parents, we want to apply to our patients. Luckily, Czech legislation and Dr. Hlinka have given us methods to do so. By coming with an open mind and heart and trusting their reproductive cells in the hands of our IVF experts, we can help them achieve pregnancy.
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