REGION

reproductive age, the question of fertility disorders,

diagnosis and treatment of their causes is obvious.

I became involved in reproductive medicine in 2010.

Why did you choose this specialisation?

The field of gynaecology and obstetrics appealed

to me during my studies at university because of

its diversity and the wide range of possibilities

for self-fulfilment. In the course of practice, each

gynaecologist profiles in a particular direction. Of

course, it depends on their skill but also on the limits

of the given clinic —what scope and quality of care

it is able to provide. I have to say that I was really

lucky in this respect and also had a lot of places to

choose from. Caring for pregnant women has grown

close to my heart. But I was becoming more and

more aware of what women who can‘t get pregnant

are missing out on. That‘s why I entered into the field

of reproductive medicine. The PRONATAL clinic

allowed me to combine these two medical directions

together, solving fertility disorder and then guiding

the woman safely through the entire pregnancy.

Helping others have a complete and happy family is

certainly worthwhile.

was becoming more and more aware

“of Iwhat

women who can’t get pregnant

are missing out on.

”

In what directions has the field moved during your

time in medicine?

Reproductive medicine is a rapidly developing field,

mainly in embryology and the technical equipment

in laboratories. This is where I see the biggest shift,

in the ways and possibilities of monitoring embryo

development where we are able to record incredible

things within five days. For example, the introduction

of polarising microscopy, which enabled the diagnosis

of the dividing spindle of the oocyte (female germ cell)

and thus the correct timing of sperm injection into

the cytoplasm of the oocyte, was a major advance.

Significant progress has also been made in the field

of genetics, in the preimplantation genetic testing of

embryos, thanks to which we are able to select embryos

without genetic defects and thus increase the success

rate of treatment. Recently, there has also been a lot of

talk about the use of artificial intelligence to, for example,

design the most appropriate stimulation protocol for

women before the first cycle of assisted reproduction,

which seems to be the right way to optimise our work

and increase the chances of conception.

Text: redakce

Foto: Kateřina

Skupieňová

Is it possible to undergo in-vitro fertilisation with

insurance reimbursement at your clinic?

Yes, we have contracts with all the insurance

companies. Infertility treatment is reimbursed by the

insurance companies to patients up to forty years

of age. The treatment cycle with embryo transfer

must be completed before the fortieth birthday.

The insurance companies reimburse the IVF cycle four

times during a woman‘s lifetime, but only in the case

that just one embryo is inserted in both the first and

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second IVF cycle. If in at least one of these cycles two

embryos were inserted, the insurance company will

reimburse the cycle only three times. The purpose

of this measure is to reduce the number of multifetal

pregnancies, which are burdened with significant risks

and complications during pregnancy and birth for both

the mother and the foetus/newborn. Examples include

premature birth, the birth of an immature or low-birthweight newborn, the development of pre-eclampsia,

a higher incidence of congenital developmental

defects and so on.

What makes PRONATAL unique in the Czech

Republic and Europe?

The PRONATAL clinic was established in 1996 by

Tonko Mardešić, CSc., becoming one of the first private

clinics of assisted reproduction in the Czech Republic.

Gradually, the PRONATAL Group has grown to

include seven more centres, of which GYNCENTRUM

Ostrava—now called PRONATAL Ostrava—has been

a part since 2016. We also have our own genetic

laboratory which allows us to offer complex care.

I see its uniqueness mainly in its long history and

the knowledge and experience accumulated during

that time. Dr. Mardešić currently serves as chairman

of the professional board of the entire PRONATAL

Group, which is undoubtedly a guarantee of highquality and safe care for infertile couples. A significant

milestone was reached in 2018 when the foreign

centres in Europe — Croatia, Bosnia and Herzegovina

and Serbia — became part of the group. In our centres,

we can offer services that are not possible according to

the legislation in that country but are possible to local

clients in the Czech Republic. Approximately half of

our clients are from abroad.

Do you have any idea how many children you have

helped into the world in your practice?

Speaking of the whole PRONATAL Group, we could

be looking at several thousand children.

You are an official teaching centre of the University

of Ostrava Faculty of Medicine. How does this

cooperation work?

Yes, we provide internships and placements for both

medical and non-medical undergraduate students.

PRONATAL Ostrava is also an accredited workplace

of the Ministry of Education for teaching physicians in

the field of Reproductive Medicine.

This profession is certainly physically and

emotionally demanding. What is your favourite way

of relaxing?

It is true that the communication of unfavourable

diagnoses and the consultation and analysis of

unsuccessful attempts at conception using assisted

reproduction methods, which are often perceived

by clients as a 100% solution, are emotionally and

psychologically demanding for both parties. But that‘s

part of the job. That‘s why I like to spend my free time

in the mountains or by the water with my closest family.

Thank you very much for the interview.