Infertility treatment

Klinika Galena offers complex medical care and individual approach to those who have been trying to conceive. We perform all necessary tests as well as hormonal, microbiological, biochemical and ultrasonographic diagnostic tests. We specialise in using endoscopy for diagnostic and surgical purposes. We use minimally invasive hysteroscopic and laparoscopic techniques, also using a diode laser or a CO2 laser, where necessary. We are the only medical centre in Poland which laparoscopically removes endometriosis foci with the use of the CO2 laser. This method allows the surgeon to operate with great precision and thus be able to remove even those foci of endometriosis which normally cannot be accessed without making a damage to healthy tissues of the reproductive organ if a classic method is used.

 

During hysteroscopic procedures we use the precise and minimally invasive thin optical fibre of a diode laser to remove pathological lesions in the area of the uterus (congenital defects, fibroids polyps or adhesions). Since the cervix is not expanded during the surgery, the procedure does not reduce woman’s reproductive potential.

 

The use of lasers translates directly into faster recovery of the patient. Removal of the foci of endometriosis, fibroids, polyps, adhesions or other uterine pathological lesions often restores the woman’s ability to get pregnant.

 

Respecting our patients’ outlook on life, we do not deny the techniques of assisted reproduction and the so-called NaProTechnology. Our fundamental purpose is to provide couples with comprehensive treatment based on all available tests, examinations and methods of treatment. We cooperate for example with the Infertility Treatment Centre “Parens” in Kraków which implements the In vitro Fertilization Infertility Treatment Programme and therefore we can offer a therapy at that Centre to the couples which qualify for the IVF.

Causes of infertility

By definition infertility is the inability of a sexually active, non-contracepting couple to achieve pregnancy in one year. The problem affects approximately 20% of the population of reproductive age. In Poland there are approximately 1.5 million such couples. Klinika Galena has specialised in infertility treatment for many years. The starting point of therapy is diagnostics. The doctors at Klinika Galena, after a comprehensive analysis of the reproductive potential of both partners and a thorough assessment of their health, decide on the appropriate, individual infertility treatment program.

 

Infertility is a problem that affects both the female and the male partner equally. In 35% of cases the cause of infertility is attributable to the woman. Identical percentage of infertility cases is due to “male factor” infertility. In order for a woman to conceive and, ultimately, give birth to a child, several conditions must be met. The woman’s body must produce an egg whilst the man’s body – the sperm. In order for the sperm to fuse with the egg appropriate favourable conditions must be met. The embryo created in such a way must successfully implant into the uterus. Favourable conditions include appropriate construction and condition of the woman’s reproductive system as well as man’s health and potential of his seminal fluid. The environment is another factor which impacts fertility. In the case of humans many years pass since infancy to the moment when a person becomes capable of sexual reproduction. During that period plenty of environmental factors have an impact on the human body. Recently the period over which the environmental factors impact our reproductive capabilities has extended due to frequent postponement of the decision to have a baby. Environmental pollution and diet rich in hormone mimicks contribute to deterioration of the quality of reproductive cells, especially male ones. That results in a reduced number of sperm cells and their limited ability to accomplish fertilisation.

 

Female infertility is in approximately 1/3 of cases a result of hormonal imbalance and ovulation disorders which may have a form of the absence of ovulation, maturation of an empty follicle without an egg or abnormal release of the egg from the follicle during ovulation, e.g. in the case of PCOS. Other causes of female infertility include: tubal obliteration, inflammation in the small pelvis, endometriosis, uterine fibroids, polyps, adhesions in the uterine cavity and in the small pelvis, defects of the uterus and the cervix, e.g. cervical mucus hostility. Hormonal disorders associated with the pituitary gland, adrenal glands, thyroid gland and pancreas as well as sexually transmitted diseases form a separate group.

 

Male infertility may be the effect of the infectious diseases or surgeries e.g. of undescended testicles, inguinal hernia, etc. in childhood. The factors which have an impact on the fertility of a mature man include past urological disorders, e.g.: varicocele, sexually transmitted diseases, systemic diseases such as hypertension, diabetes, obesity, neurological and endocrynological disorders, neoplastic and other diseases, testicle injuries and lifestyle (e.g. stress, stimulants, lack of exercise and diet based on highly-processed foods).

 

Taking into consideration all the above-mentioned factors, in the case of couples with infertility problem the key is to find the underlying cause of the issue.

First consultation

To make an appointment call us at (+48) 33 816 11 00 or (+48) 33 816 04 43 from Monday to Friday between 8.00 a.m. and 08.00 p.m. One day before your appointment our staff will call you to confirm the time and date of your visit. When you call us to make an appointment, remember to tell our receptionist that you would like to have an infertility consultation. This will help us allow a sufficient amount of time for your first visit. You should arrive 15 minutes before the planned time of your appointment. It is necessary because before your appointment we need to create your medical record (in the case of couples the medical record is always created separately for a women and her partner).

 

If you have any previous medical records related to your infertility, bring them to your first consultation. During your visit the doctor will take your full history to obtain all the information necessary to plan the treatment and will perform necessary examinations.

 

Examinations performed during the first appointment:

  • Gynaecological examination
  • Ultrasound scan, plus, if necessary (suspicion of defects of the uterus, uterine fibroids), a vaginal ultrasound scan or a 3D/4D scan with the colour Doppler function
  • Breast ultrasound
  • Cytology swab (our recommendation: LBC)
  •  Cervical swab for PCR detection of Chlamydia+ Mycoplasma+ Ureoplasma – microorganism DNA testing

 

Your partner can accompany you during the examination. In order to get a broader view of your case the doctor may order additional tests or diagnostic procedures. The payment for consultation is made after the visit, at the reception desk, with cash or pay card. If you need 

Infertility diagnosis

Infertility diagnosis consists, in first place, in taking your detailed history. After that the doctor will decide on the tests which both of you should undergo. The most common tests include semen analysis and chlamydia test.

 

Based on the medical procedures we have adopted for infertility treatment we recommend that you undergo the following laboratory tests and gynaecological diagnostic procedures:

  • spermiogram (semen analysis)
  • PCR detection of Chlamydia trachomatis
  • hormone tests: LH and FSH, estradiol
  • anti-Müllerian hormone (AMH) test
  • karyotype analysis
  • hysterosalpingosonography (sono-HSG)
  • diagnostic and operative hysteroscopy
  • laparoscopy

Hormone tests:

  • FSH
  • LH
  • estradiol
  • progesterone
  • prolactin
  • TSH
  • FT3
  • FT4
  • anti-TPO
  • testosterone
  • androstenedione
  • DHEAS

Fertility tests for a woman:

  • Anti-Müllerian hormone (AMH) test
  • The Anti-Müllerian Hormone (AMH) level test allows to evaluate woman’s fertility in different periods of her life. AMH is a great tool to assess current ovarian reserve and the condition of ovarian follicles. In the case of problems with conception that tests allows us to establish the right treatment. Low level of that hormone may also indicate premature loss of ovarian function which, in turn, may be the symptom of premature menopause.
  • Klinika Galena has its own laboratory which provides the results of the AMH test within 30 minutes. The AMH test can be performed at any time of your menstrual cycle and it does not require any additional preparation.
  • FSH test
  • FSH (follicle-stimulating hormone) – it is a hormone responsible for production and maturing of Graafian follicles in the first stage of the menstrual cycle. The FSH test is performed along with the LH and estradiol test. The analysis of the level of FSH and estradiol allows to evaluate the ovarian reserve, whereas the LH/FSH ratio helps diagnose disorders of the pituitary gland and is one of the criteria used in diagnosing polycystic ovarian syndrome. The tests should be performed between the 2nd and 3rd day of the menstrual cycle.

– microbiological tests,
– bacteriological culture, mycological culture, Chlamydia, Mycoplasma, Ureoplasma, HPV – DNA, HPV – mRNA,
– comprehensive biochemical tests,
– comprehensive genetic tests.

 

Ultrasound monitoring of ovulation and menstrual cycle

  • We offer a detailed ultrasound diagnostics of ovulation and menstrual cycle with the use of the high quality 3D and 4D ultrasound equipment.
  • Klinika Galena has four ultrasound machines. Two of them are VOLUSON E8 Expert with BT13 software, equipped with a unique features: SonoAVC for automatic measurement of follicular volume (sonography-based Automated Volume Count), colour Doppler (for blood flow measurement) and cervical elastography (assessment of cervical elasticity). The device allows to automatically calculate the volume and average sizes of all ovarian follicles which increases accuracy of the test even further. Precise measurement of the size and volume of follicles combined with hormonal tests forms the basis for safe and effective stimulation. The other two machines are VOLUSON 730 Expert BT010 and GE LOGIC PRO. All our machines are equipped with transvaginal, linear, convex and volumetric probes.

Cytological tests

LBC (liquid-based cytology) Conventional smear test
Sample-taking procedure A special brush allows a broader spectrum of testing The sample is taken only from a small area of the cervix and smeared onto a glass slide
Effectiveness Detectability of high-grade endothelial lesions increased by 64% only part of the cells is transferred onto the glass slide, the cells may be destroyed by using a wrong sample-taking tool, the sample may be contaminated with mucus or blood, cells may group, forming a thick layer that is difficult to analyse
Additional tests The sample can also be used for detection of HPV and Chlamydia trachomatis additional samples must be taken
Recommendations The Polish Gynaecological Society, ESGO, The Polish Gynaecological Society

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  • What should I do if the test result is abnormal?
  • An abnormal test result does not automatically mean that you have cancer. Abnormal test results may also indicate precancerous lesions, such as neoplasia, atypy, atrophy or infection in the area of the reproductive tract. Every such test result should be consulted with a gynaecological oncologist who will decide on further diagnostics and treatment.
  • If the result of your cytology test is abnormal, arrange an appointment with the doctor at the Free Consultation Centre in Klinika Galena, ul. Żywiecka 71, Bielsko-Biała. During your appointment with a gynaecological oncologist the doctor will give you a free-of-charge analysis of your result and the information on further steps. With that information you can visit your primary doctor.
  • How to prepare to the cytology test?

It would be best to have the sample collected between the 10th and 18th day of your menstrual cycle. In order for the cytology test to be most reliable, use intimate washes with acidic pH, do not douche your vagina, do not use a tampon, abstain from sexual intercourse for at least 24 hours preceding taking of the sample.

Hysteroscopy

Diagnostic hysteroscopy is an endoscopic gynaecological procedure performed for the purpose of:

  • infertility diagnosis,
  • diagnosis of recurrent miscarriages,
  • diagnosis in the case of abnormal uterine bleeding,
  • observation of endometrial proliferative changes,
  • diagnosis and treatment of uterine fibroids, polyps, adhesions or defects.

 

Hysteroscopy may be used for both diagnosis and treatment. During the procedure a hysteroscope (endoscope) is inserted through the vagina and cervical canal into the uterus, thus allowing the doctor to visually assess the uterine cavity and cervical canal as well as the uterine orifices of the fallopian tubes. It also can help detect congenital defects of the uterus (uterine septum), adhesions, polyps or fibroids. The procedure is performed under a short-acting, intravenous local anaesthesia.

Infertility treatment

Hormonal treatment

After hormone tests have been performed, the doctor decides on the appropriate hormone therapy.

Laser removal of the foci of endometriosis

  • Endometriosis is a disease which affects woman’s reproductive organs. Endometriotic foci develop in the area of the lesser pelvis. The disease still remains mysterious because its causes are not fully known yet. Untreated endometriosis may lead to infertility.
  • The CO2 laser has been a breakthrough in the treatment of endometriosis. It allows the doctor to precisely and safely remove the endometriotic foci located in sensitive or difficult-to-access areas. The technique of tissue vaporisation allows us not to damage healthy tissues. Laser removal of the foci of endometriosis located for example on ovaries does not affect their reproductive potential. Our CO2 laser platform, manufactured by Deka and equipped with appropriate scanners, increases our chances in the fight against that powerful enemy. Combined use of the laser and laparoscope allows us to minimise the risk of complications and remove the foci of endometriosis of the size of a grain of sand. The laser can also be used for treatment of the polycystic ovarian syndrome (PCOS) which is another common causes of infertility.

 

Minor operative hysteroscopy

During the procedure the doctor inserts into the uterus, through the tube of the hysteroscope, microinstruments or a laser beam to perform the necessary examinations or treatment. A sample for histopathological examination is collected, too. Any inconvenience during the procedure can be compared to that experienced during a standard gynaecological examination. Following the procedure the patient can return home after just a couple of hours.

 

Operative hysteroscopy indications:

  • removal of adhesions, submucous myoma, polyps
  • correction of congenital defects of the uterus, e.g. uterine septum removal
  • removal of a tissue sample from the mucous membrane for hystopathological examination

Laparoscopy

Laparoscopy is a modern diagnostic and surgical method which allows the surgeon to see and diagnose the organs inside the abdominal cavity and small pelvis without the necessity to open them. It is minimally invasive and therefore it is frequently a one-day procedure. Its advantages over classic surgery include shorter stay in hospital and faster recovery. A laparoscopic surgery is more precise than a classic one, especially if a laser is used. It allows the surgeon to detect very small lesions which would remain unnoticed in the case of a classic surgery, e.g. small foci of endometriosis. During the procedure the changed tissue or a tumour can be precisely removed (biopsy) and samples of tissues can be taken for hystopathological and bacteriological examination. In infertility treatment laparoscopy can help diagnose and treat tubal obliteration, fibroids, adhesions of the small pelvis or other pathological lesions.

 

Insemination

Klinika Galena offers the insemination procedure.

Infertile couples who would like to undergo the insemination procedure have a consultation the purpose of which is to choose the procedure and stimulation that will be best and most effective in the given case.

 

The procedure we perform most frequently is intrauterine inseminationIntrauterine insemination is the “last stop” and the last hope for the longed-for baby before attempting the in vitro method. Intrauterine insemination consists in introduction of carefully prepared sperm directly into the uterus. The sperm sample is prepared in a special way in a process called semen preparation which consists in separating viable sperm cells capable of fertilisation in the fallopian tube at the moment when the egg cell is released.

 

Bearing in mind the fact that having a baby without interference with nature and without employing in vitro methods is not always possible, we work with the best fertilisation centres in Poland to prepare our patients for the insemination outside of the body.

Semen Analysis Laboratory

Klinika Galena posiada komfortowe, nowoczesne i intymne warunki w Laboratorium Badania Nasienia. Badanie to powinno być przeprowadzone u każdej pary starającej się o dziecko. Badanie wykonywane jest komputerowo w systemie CASA, co stanowi obecnie „złoty standard” postępowania. Oczywiście ważne jest, aby cała procedura przebiegała w najbardziej dogodnych i intymnych warunkach, przy jednoczesnym utrzymaniu wysokich standardów medycznych. W przypadku zupełnego braku plemników lub gdy są one pojedyncze w badanej próbce specjaliści Kliniki Galena wykonują dodatkowe badania u mężczyzny (biopsję jąder, usg i inne). W celu zapewnienia dyskretnej obsługi oraz wysokiej jakości wyniku badania, zainteresowanych Pacjentów prosimy o wcześniejszy kontakt i umówienie się na wizytę w laboratorium.

In our Semen Analysis Laboratory we ensure comfortable, modern and intimate conditions. The analysis should be performed in the case of every couple trying to get pregnant. The assessment is performed using the computer-assisted semen analysis (CASA) system which is now the gold standard for sperm evaluation. There is no doubt about how important it is for the procedure to be performed in the most comfortable and intimate conditions, while maintaining, at the same time, high medical standards. In the case of a complete absence of sperm cells or only two or three sperm cells in the examined semen sample, the specialists of Klinika Galena perform additional examinations (biopsy of testicles, ultrasound scan, etc.). In order to ensure discreet service and a high quality test result, the patients should contact us in advance to arrange his visit in the laboratory.

 

Semen analysis method

 Computer-assisted sperm analysis (CASA) means the analysis of sperm with the use of the automatic Sperm Class Analyzer (SCA) computer system. The microscope image recorded with a video camera is processed and subjected to computer analysis and the results obtained in this way allow for objective assessment of semen parameters (concentration, motility and morphology of sperm cells). Computer semen analysis in the CASA system reduces the risk of a diagnostic error to the minimum.

 

Preparation for semen analysis:

It is necessary to abstain from sexual intercourse for approx. 3-5 days before the test. A longer of shorter time from the last ejaculation may impact the test result. You should produce sample directly into a sterile plastic urine cup by masturbating in a dedicated room in the laboratory. We ensure intimacy, discretion and comfort. The following factors may have an impact on the result of the analysis: fatigue, recent fever, too short or too long abstinence from sex, alcohol consumption, antibiotics (you should wait 2 weeks after antibiotic treatment)

How to prepare to the procedure?

Hysteroscopy

Hysteroscopy requires prior consultation and qualification for the procedure

 

The following tests should be performed before the procedure (2 weeks before the procedure):

  • blood count
  • ionogram
  • Clotting time test, INR, APTT, prothrombin index
  • Blood group – the original test result is required and it should be provided on the date of the procedure.

 

The tests are preformed in Klinika Galena every day, between 8.00 a.m. and 12.00 p.m. The tests are free of charge if the procedure is to be performed as part of the NFZ refund, except for the blood group test which costs PLN 35. The patient receives original results. On the date preceding the procedure the patient should consume only easy to digest foods. On the date of the procedure the patient should be fasted which means that she should not eat or drink for 6 hours preceding the procedure. There is an exception if the patient takes hypertension, diabetes or thyroid medications or antithrombotic drugs. Before the procedure the patient should have a consultation with an anaesthesiologist. In the case of any chronic diseases a consultation with the primary physician is also necessary.

 

What to bring with you when you arrive for the procedure?

  • night gown
  • replacement footwear
  • identification document
  • test results

If there are no medical complaints after the procedure, the patient may be released and return home. You are kindly asked to arrange someone to collect you.

If you need any additional information, it will be provided by the anaesthesiologist.

 

Laparoscopy

Laparoscopy requires prior consultation and qualification for the procedure.

 

The following tests should be performed before the procedure (2 weeks before the procedure):

  • blood count
  • ionogram
  • clotting time test, INR, APTT, prothrombin index
  • Blood group – the original test result is required and it should be provided on the date of the procedure.

The tests are preformed in Klinika Galena every day, between 8.00 a.m. and 12.00 p.m. The patient must pay for the tests and receives original results.

On the date preceding the procedure the patient should consume only easy to digest foods and should not have her last meal. In the evening, please perform a rectal infusion (enema) to clean the lower part of your digestive tract. On the date of the procedure the patient should be fasted which means that her last meal should be not later than at noon of the previous day and her last drink – 12 hours before the procedure.

There is an exception if the patient takes hypertension, diabetes or thyroid medications or antithrombotic drugs. Before the procedure the patient should have a consultation with an anaesthesiologist. In the case of any chronic diseases a consultation with the primary physician is also necessary.

 

What to bring with you when you arrive for the procedure?

  • night gown
  • replacement footwear
  • identification document
  • test results

After the procedure the patient stays in the unit (for at least 24 hours).

You are kindly asked to arrange someone to collect you when you are discharged from the hospital.

If you need any additional information, it will be provided by the anaesthesiologist.

Pricing

First consultation

First consultation – 170 pln
First consultation for a couple – 170 pln
Every subsequent infertility treatment consultation – 100 pln
Ultrasound scan during examination – 100 pln

Infertility diagnosis

Basic laboratory tests

Bacteriology swab – 50 pln
Mycology swab – 50 pln
Chlamydia trachomatis detection – PCR method – 130 pln
Test for urogenital infections – 4 pathogens: HPV, Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma genitalium – 350 pln
Test for urogenital infections – 3 pathogens: Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma genitalium – 250 pln
Mycoplasma genitalium detection – PCR method – 170 pln
Ureaplasma urealyticum detection – PCR method – 150 pln
HPV detection – PCR method – 150 pln
Liquid based cytology (LBC) – 100 pln
Liquid based cytology (LBC) + HPV – 200 pln

Infertility diagnosis

Basic laboratory tests

Bacteriology swab – 50 pln
Mycology swab – 50 pln
Chlamydia trachomatis detection – PCR method – 130 pln
Test for urogenital infections – 4 pathogens: HPV, Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma genitalium – 350 pln
Test for urogenital infections – 3 pathogens: Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma genitalium – 250 pln
Mycoplasma genitalium detection – PCR method – 170 pln
Ureaplasma urealyticum detection – PCR method – 150 pln
HPV detection – PCR method – 150 pln
Liquid based cytology (LBC) – 100 pln
Liquid based cytology (LBC) + HPV – 200 pln

Diagnostic tests carried out in the doctor’s office

Fallopian tube patency – sono-HSG – 950 pln
Colposcopy – 250 pln
Ultrasound ovulation monitoring – 150 pln

Contact us

+48 33 816 11 00

Ask for consultation

+48 33 816 11 00
+48 33 816 04 43
rejestracja@klinikagalena.pl

 

Opening hours

Monday: 8:00 a.m. – 7:00 p.m.
Tuesday: 8:00 a.m. – 7:00 p.m.
Wednesday: 8:00 a.m. – 7:00 p.m.
Thursday: 8:00 a.m. – 7:00 p.m.
Friday: 8:00 a.m. – 7:00 p.m.
Saturday: closed
Sunday: closed




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