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Andrology is a relatively young field of medicine, particularly in the Czech Republic. Its name is derived from the Greek word "andros" which means the „male”. Its task is to take care of fertility, sexual functions and overall male health related to those functions. The primary focus of andrology is diagnosis and treatment of male fertility disorders, and thus it is closely connected to the centres for assisted reproduction.

In addition to reproductive problems, andrology deals with erectile dysfunctions (penile erection) in men and other problems associated with the penis, testiclesprostate and ejaculation. Given the significant demographic changes in the "age pyramid", the care for aging men (the "male andropause") and the issue of male contraception have recently increased in andrology. It is an interdisciplinary field, primarily related to urology, endocrinology, psychiatry, psychology, sexuology and genetics. In Gest, the andrological diagnostics, treatment and sperm collection are the fields of activity of MUDr. Jaroslav Jarabák.

Which problems can the patients address to the andrology doctor’s office:

  • The issues of male fertility and infertility, semen analysis (spermiogram);
  • Erectile dysfunction (penile erection dysfunctions) and sexual disorders;
  • Ejaculation disorders – especially premature ejaculation;
  • Disorders of production of male sex hormones in older age, and hormone replacement therapy;
  • Functional and developmental disorders of male sexual organs in adolescence and adulthood, such as delayed puberty, primary and secondary hypogonadism, etc.;
  • Inflammation and infections of the male reproductive system;
  • Sperm freezing;
  • Genital disability requiring plastic or aesthetic surgery, such as constricted foreskin, short frenulum, penile curvature, etc.;
  • Male contraception;
  • Andrological prevention

Most problems have identifiable causes and can be treated nowadays. New non-invasive, painless diagnostic procedures, new medicines, most careful microsurgical operations to genitals in ambulatory general anaesthesia and micromanipulation techniques of assisted reproduction allow the treatment of even such problems which were only hardly solvable or even unsolvable in the past. The procedure is individualized for each patient. Just as no two people are exactly the same, there are no universal medical procedures. It is therefore necessary to follow the real possibilities allowed by the current medicine with high-tech equipment. It is often necessary to solve complex problems in patients with complicated findings and repeated treatment. Even here it is possible to reach good results provided that there is good cooperation and patience of both the patient and the doctor. This requires combining the diagnostic, therapeutic and surgery medical art with knowledge, communication skills and the personality of the patient's physician.

In case of absence of sperm in the ejaculate (azoospermia) or when the ejaculate contains only a low sperm count and the sperms show abnormal morphological structure or they are present in the ejaculate only in developmental forms of sperm, there comes the possibility of obtaining sperm surgically from the epididymis (PESA, MESA) or the testicle (TESE, TESA).

PESA – Percutaneous Epididymal Sperm Aspiration, MESA – Microsurgical Epididymal Sperm Aspiration

In both methods (PESA, MESA) sperm is obtained from epididymis due to the impaired transport of sperm between the epididymis and urethra (obstructive azoospermia). For example, this is carried out in the patients after sterilization or the men who were injured in their youth and their vas deferens (the organ transporting sperm into the urethra) was damaged by this injury. It is also for patients with congenital malformation of vas deferens. In men who do not produce sperm there is also lack of cells in the epididymis.

MESA – The procedure is performed under general anaesthesia on an outpatient basis and takes about 1 hour. The access to the epididymis is obtained by about 15 mm cut in the scrotum. The epididymis is pulled into the wound and extended channels are seeked under optical magnification (10-20 times higher). If they contain sperm, they optically have a typical yellowish colour. After selecting the collection point, the content of a dilated duct is punctured and aspirated by a thin needle into a sterile set and immediately forwarded to the laboratory and then tested under high magnification for the count, motility and morphology. Based on the assessment of the quality and quantity of the sperm obtained, it is then recommended either to change the point of collection or repeat collection from a successful place. This procedure is repeated until enough sperm is collected for immediate use or for freezing. The performance ends upon the embryologist’s order after a sufficient sperm yield from punctatum.

PESA– it is a similar method as MESA. Sperm is obtained from the epididymis, but the liquid is aspirated through the skin (percutaneously). This method allows the patient to avoid the cut in the scrotum. The method is faster and can be performed under local anaesthesia. Its main disadvantage is lower sperm quality.

TESE – Testicular Sperm Extraction

It is the method of choice for patients with non-obstructive azoospermia whose primary cause of the absence of sperm in the ejaculate is in the testicle, e.g. patients with Klinefelter's syndrome, patients after testicular inflammatory diseases, etc. The TESE is also performed in the case when no sperms have been obtained by PESA/MESA.

TESE - is a microsurgical method where after opening the scrotum the testicle is subsequently cut open "like a book". Then, under an operating microscope, tubules containing sperm are searched for. They are easily recognizable - the white colour distinguishes them from translucent empty tubules. Testicular tubules are taken out and directly passed to the laboratory, where under large microscope magnification sperm or its developmental stages are searched for. This method needs 5-10 samples. If the sex cells are not yet fully developed, they are further cultured. Although this procedure is more invasive, it is simple and ultimately less traumatic than multiple minor collections from the testicle (biopsy). The procedure is performed on an outpatient basis in a short general anaesthesia. An alternative to the TESE method is TESA (Testicular Sperm Aspiration), in which the testicular tissue is not picked up, but aspired with a thin needle. The method is less invasive. The quality of sperm obtained is roughly the same as in TESE and this method is therefore suitable for the treatment of obstructive azoospermia. It can also be used for the forms of obstructive azoospermia, but the quality of such obtained sperm puts it to the third method of choice after MESA and PESA. When evaluating the results, TESE is far ahead of TESA.

Risks of sperm collection

Prior to in vitro fertilization using the sperm retrieved by the MESA or TESA methods, a man should undergo genetic testing as azoospermia is often caused by genetic defects, chromosomal defects or mutations, such as in cystic fibrosis. MESA is a method with minimal complications. All other methods such as PESA, TESA and TESE are complicated by postoperative pain in the scrotum which is often hypersensitive to touch and friction. The postoperative phase can get complicated by infection or quite common haematoma. Men are often afraid of testicular injury when having the TESE performed, but their worries are totally pointless because the tissue removed by the surgeon is very small and the ulosis does not harm the testicles in any way. The procedure has no negative effect on testicular hormonal function (production of male sex hormones) and does not affect erection (penile erection).

The specialized andrology care is not covered by public health insurance. We always inform the patient of the cost in advance, before making an appointment.


Your health and safety are our priorities


Clinic is operating daily in accordance with epidemiology instructions in Czech Republic. Your health and safety are our priorities.   If you are travelling from abroad, we offer: - Official clinic invitation to confirm that travel is of medical purpose - FREE COVID PCR test for travel purposes for our female patients as part of their IVF treatment packages Feel free to contact us for more information.


Annonymous spermiogram analysis


The same as every year, this summer in June we offer “Annonymous spermiogram analysis”. You can book your sperm analysis using specific individual code according to which we wil track your result. The cost of the analysis is 1000 Kc.  Booking is possbile at the reception, by e-mail or phone.


Easter opening hours


Dear patients,  during Easter will be the clinic opened just for urgent cases on Saturday 11th and Monday 13th only in the morning. In urgency call +420 602  758 353. The clinic opens for you on Tuesday 14th April.  Thank you for understanding. We wish you happy Easter!


Notice for patients: Coronavirus (COVID-19/ SARS-CoV-2)


Dear patients and citizens seeking advice and assistance! As an assisted reproduction centre, even we are striving to protect our patients against potential coronavirus infection as best possible. At present, there is a prevalence of uncertainty, because a vast quantity of contradictory information is available in the media and on social networks. The “infodemic” - meaning the surplus of rumors, false reports and fake news - is minimally as problematic as the epidemic itself! For this reason, we strive to provide you with objective and up-to-date information on the topic of assisted reproduction, pregnancy and coronavirus disease, and to observe the recommendations of authorities and healthcare facilities. We ask you not to visit our assisted reproduction centre if you are suffering from symptoms suggesting coronavirus infection, or if you have spent time in any of the current high-risk areas in recent weeks, or have come into contact with potentially infected individuals. Currently, the high-risk areas are: Italy Iran In China: Province Hubei (inkl. City Wuhan) In South Korea: Province Gyeongsangbuk-do (Nord-Gyeongsang) Source: Robert-Koch-Institut (RKI): Status: 10th March 2020 At present, the health risk for citizens e.g .in Germany is classified as moderate. (Source: RKI: Status: 2 March 2020, 12:30 p.m.). Contagion from person to person is the gravest means of infection. In general, the same preventive, protective and hygienic measures as those applicable during ordinary flu season should be observed. This includes proper hand hygiene, not shaking hands when greeting and keeping a distance from individuals who are ill - including people with cold or flu symptoms.( COVID-19 infection is generally mild, sometimes entirely asymptomatic. The level of danger of the pathogen cannot yet be reliably assessed - but it seems to be substantially lower than in the case of MERS or SARS, and is likely to be comparable to the seasonal flu (source: AGES, status: 3 March 2020, In some cases, the course of the illness can be severe. The illness tends to be fatal primarily among the elderly and/or individuals with a severe chronic health anamnesis. At present, there is no reason to believe that COVID-19/ SARS-CoV-2 infection would have a more severe progression among pregnant women than women who are not pregnant. Likewise, no cases of transmission of the virus to an unborn child have been described or confirmed yet (status: 2 March 2020). In addition to the usual preventive measures, we recommend that patients who wish to get pregnant be vaccinated against the flu, not least to avoid concurrent infection with COVID-19/ SARS-CoV-2 and the flu. This applies both to unvaccinated pregnant women and unvaccinated women who wish to get pregnant. Vaccination against the flu virus poses no threat to pregnant women, and does not require the postponement of pregnancy therapy, because it is a “dead vaccine”. Therefore, pregnancy is not a contraindication to flu vaccination. Although the 2019/2020 flu season has most likely already peaked, you should get a flu vaccination even now. In fact, vaccination against the flu is explicitly recommended for pregnant women. The Standing Committee on Vaccination in Germany (STIKO) recommends flu vaccination for all pregnant women from the 2nd trimester; if there is a higher health risk due to other medical problems (e.g. asthma or diabetes), from the 1st trimester of pregnancy.


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Beautiful "Thank you" from a happy, new mother

Even during COVID pandemic time babies are born, including via IVF treatments. We received this beautiful thank you message from a happy new mother.

"I wish you primarily good health, so you could handle this challenging times and continue with your work. You have helped us greatly and we will be forever grateful."

Thank you

Thank you

Dr. Šulc,

we would like to use this opportunity to thank you and your colleagues for the  care we received during our IVF treatment and following pregnancy from May 2019 until now.

We are especially grateful for your personal approach to our case, we felt cared after even when situation was not easy, we always knew we can turn to you for advice. We are aware that today it is unfortunatelly not a standard everywhere, so we value not only your medical help but also kind approach.



Finaly even me can boast with joyfull news. On 10th February 2020 was born gorgeous girl Michalka (3650 g, 51 cm). She arrived 10 days after predicted date of birth. We, happy parents, want to thank to the whole Gest team for the longwished happiness. Markéta and Lukáš



Finally can we show off our babyboy Michal. He was born on 24.12.2019, his weight was 2720g and was 48 cm long. Michal came into this world little bit earlier - at 37th week. 
Thanks a lot to the whole team - finally we have our little treasure. 
Happy parents Jaroslava and Luboš 



We would like to thank the whole GEST team for the birth of our babygirl Zuzanka. She was born on 13. 7. 2018. Her weight was just 1120g - she was early born (28+6 week). She became a healthy, beautifull girl.
Grretings and thanks a lot again. 
Milena Wágnerová  




We would like to thank to the whole GEST team for their care, namely Dr. Šulc, his colleagues, which we also met - Dr. Poláková, Dr. Černý and Dr. Alexandr. 
On 28th October was born our healthy babyboy Jakoubek. 
Thank you very much!
Jana and Martin 

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ProCrea Swiss IVF Center s.r.o.
Nádražní Str. 762/32
(entrance from Rozkošného Str. 1058/3)
150 00 Praha 5 - Smíchov

Surgery hours:

Monday 8:00 - 16:30
Tuesday 8:00 - 19:00
Wednesday 8:00 - 19:00
Thursday 8:00 - 16:30
Friday 8:00 - 16:30
Saturday Emergency only


Phone.: +420 257 212 516 - 518
Mobile: +420 602 328 346
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