The methods of medically assisted reproduction are a set of medical procedures used to help couples facing infertility achieve a pregnancy. These procedures involve the use of medical technologies and careful monitoring of the reproductive process, with the aim of achieving a successful conception.
The methods differ in complexity, scope of stimulation, laboratory steps and average success rates. In practice this means that MAR can be relatively straightforward, such as intrauterine insemination (IUI), or more complex, such as IVF/ICSI procedures and frozen embryo transfer (FET).
The decision to use assisted reproduction methods is not taken hastily, but when there are clear medical reasons or limited time to wait. In some situations ART methods can significantly increase the chances of achieving pregnancy.
The first step is always a conversation and a work-up. Only after that does it make sense to choose an ART method.
Although there are many terms and abbreviations, most procedures can be reduced to a few main methods. All other techniques are an extension of, or support for, one of these.
A simpler procedure in which previously prepared sperm is introduced directly into the uterus at the time of ovulation, with or without mild ovarian stimulation.
A standard assisted reproduction procedure in which egg cells are aspirated from the ovaries after stimulation, and fertilisation takes place in the laboratory.
A variant of IVF in which the embryologist injects a single sperm directly into the egg cell, particularly in cases of a more pronounced male factor.
Transfer of previously frozen embryos into a naturally or medically prepared uterine lining, without new ovarian stimulation.
Micro-TESE is a microsurgical procedure to retrieve sperm from the testicle in a man with azoospermia for the purpose of an assisted reproduction procedure.
TESA is a minimally invasive procedure of aspirating sperm from the testicle for the purposes of an IVF/ICSI procedure.
This test assesses damage to the genetic material of sperm and assists in the work-up of male infertility.
IUI is a procedure in which the doctor uses previously selected sperm from your partner and places them directly into the uterus at the most suitable moment to increase the chances of pregnancy. IUI is a lower-complexity ART method.
IUI is not the solution for every situation. If we assess that the chances are realistically very low, we will openly suggest going straight to IVF/ICSI.
What does an IUI cycle look like?Intrauterine insemination is a simple and short procedure carried out in a few clear steps:
Depending on your situation, the procedure can be performed in a natural cycle or with mild hormonal therapy that helps the egg cell mature.
With regular ultrasound examinations we monitor follicular growth and determine the best moment for the procedure.
The sperm sample is carefully processed in order to isolate the highest-quality sperm.
At the optimal time, the prepared sample is gently applied into the uterus through a thin catheter. The procedure is quick and largely painless.
IVF is the most common ART method, involving the aspiration of egg cells from the woman's ovaries, which are then fertilised with the partner's sperm in specially equipped laboratory conditions. This procedure allows the creation of embryos that are later transferred back into the uterus or frozen.
Basic steps of the IVF procedureIVF (in vitro fertilisation) consists of several clearly defined phases. Although it may sound complex, the entire procedure is well planned and carried out under the constant supervision of an expert team.
A detailed description of the IVF procedure itself is available on the IVF programme page, and during the consultation we also go through the possible risks, side effects and the course of recovery so that you enter every step informed and reassured.
ICSI is a method in which a single sperm is selected, activated and injected into the egg cell under the microscope using a glass microinjection pipette. It is used in cases of male infertility, when the sperm are unable to fertilise the egg on their own. It does not alter the genetic material, only the way in which the sperm and the egg cell meet.
What you should know about the ICSI method The decision on ICSI is made individually for each couple and for each procedure. In some couples we combine classical IVF and ICSI on different egg cells in order to gather as much information as possible about the best approach.
FET (cryo-embryo transfer) is a procedure in which previously frozen embryos are transferred into a prepared uterine lining. It is most often carried out after a successful IVF procedure in which several good-quality embryos were obtained. Instead of repeating the entire IVF cycle, FET makes it possible to use already existing embryos in one of the subsequent cycles.
FET is often part of a broader ART plan. A single IVF cycle can include several FET cycles, depending on the number of frozen embryos and your wishes, without the need to repeat the whole IVF procedure.
What does a FET cycle look like? A FET cycle is simpler and shorter than a new IVF procedure. It is carried out in a few clearly defined steps, with careful planning of the optimal moment for the transfer.
Depending on your cycle and the medical assessment, FET can be performed in a natural cycle or with mild hormonal therapy that prepares the uterine lining (endometrium).
On the day of the transfer the highest-quality frozen embryo is selected and then carefully thawed in the laboratory.
The transfer itself is quick and is most often performed without anaesthesia. Most women describe it as an uncomfortable but not a painful procedure.
Alongside the basic methods, there are also additional laboratory techniques used in selected couples when there is a clear clinical indication. They do not replace the basic procedures but complement them.
We never introduce additional techniques routinely for everyone; we consider them individually with the couple, explaining the expected effect and limitations.
The decision on the optimal ART method is not based on a single finding. We take several key elements into account and only after a conversation propose an approach that makes sense for you specifically.
How long you have been trying, whether there have been previous pregnancies or miscarriages, whether any surgeries were performed, and what previous findings and procedures look like.
Age and the ovarian reserve result are one of the main criteria – e.g. with a significantly reduced reserve we often skip IUI and propose an earlier move to IVF/ICSI.
The semen analysis, additional tests and a urological examination show whether it makes sense to plan IUI or whether it is more reasonable to go straight to IVF/ICSI.
We also take your daily life into account - time, work, family, travel and financial possibilities - so that we adapt the plan to your rhythm and not the other way round.
The question „should we first try IUI or go straight to IVF?” is one of the most common. The answer depends on several factors: age, findings, the duration of infertility and previous attempts.
There is no single rule that applies to all couples. In general, in younger patients with normal findings we consider up to 3 IUI attempts, while in women older than 35 or with a reduced ovarian reserve we often recommend a quicker move to IVF/ICSI.
These recommendations are approximate. In your case we always clearly explain why we propose a specific number of attempts and in what order. Our aim is for you to have a clear plan and realistic expectations.
| Element | IUI | IVF / ICSI |
|---|---|---|
| Invasiveness | minimal, without puncture | moderate, puncture required |
| Need for stimulation | often mild or a spontaneous cycle | always ovarian stimulation |
| Average chance per cycle* | around 5–15% | around 30–55% |
| When is it considered? | mild male factor, unexplained infertility, good reserve | a more pronounced male factor, risk to the fallopian tubes, a lower reserve |
*The figures are approximate and vary from couple to couple. At the consultation we talk about your realistic chances, not about general averages.
Advanced genetic and immunological tests are not performed routinely for every couple. We consider them when there are specific indications, such as recurrent miscarriages, certain hereditary diseases or specific findings in the medical history.
At Cito Polyclinic we do not talk only about the procedure, but about a series of decisions. It is important to us that every one of them makes sense for you.
We do not start anything without a clear diagnosis and an explanation of all findings. If we assess that a particular method does not make sense in your situation, we will tell you so openly. The plan is adapted to your findings and to the body's response during the cycle.
Gynaecologists, subspecialists in human reproduction who are leaders in the ART field with more than 4,000 completed procedures, embryologists, anaesthetists and, when needed, a urologist are involved in the planning and delivery of the procedures.
No promises, no embellishment of success rates. Each method is explained in simple language with a realistic presentation of success rates and risks, so that you can make an informed decision.
We know that questions most often arise at home, not in the surgery. From the first contact to the follow-up after the procedure we try to be available for questions and uncertainties, by phone or by email.
Prices are defined transparently and in line with the type of procedure and the medical services included. The final price is determined according to the recommended procedure and the individual plan for each couple.
At the first consultation we explain in detail all the costs, what is included in the price of an individual procedure and what is charged additionally - with no hidden costs.
You can get the first available consultation appointment by phone on +385 21 457 800 or by sending a short message via the contact form.
Specialist in Gynecology and Obstetrics
Subspecialist in Gynecological Endocrinology and Human Reproduction
Specialist in Gynecology and Obstetrics
Subspecialist in Gynecological Endocrinology and Human Reproduction
Specialist in Gynecology and Obstetrics
Subspecialist in Gynecological Endocrinology and Human Reproduction
Clinical Embryologist
Clinical Embryologist
