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
was becoming more and more aware
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.
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
64 ǀ POSITIV 2/2022
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
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
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.