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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.

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Where do you find us?

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

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Interview with Mirna Turcinovic, team manager of the coordinators


Four questions to our IVF team at the ProCrea Swiss IVF Center Prague This time with customer care manager Mirna Turcinovic "ProCrea Swiss IVF Center is a perfect mixture of a private, family clinic and advanced technologies avilable to couples who need medical support to pregnancy planning." 1) What does your working day mean to you? Adventure, tension, joy or mission? The role of our team (treatment coordinators) is to povide support to our patients in all phases of the treatment. It starts with first contact via e-mail or lasts until viable pregnancy is achieved. In our team we have only women who can relate to all female issues around infertility and provide help with not only treatment information but also empathy and understanding of what our patients are going through.  When we use the statement "I had a successful day", "I did well today", what can we imagine in that in your profession? A good day for us means a day when we received many positive pregnancy tests. For us it is biggest reward knowing we were able to help our couples on their journey to desired baby. It gives us huge energy wave and confirmation that what we do is important becasue we are able to make a difference in this world and bring joy to someone´s life. 2) How would you characterize the field of reproductive medicine. Importance, benefits for society today and in the near future? I believe that everyone, especially young women should be educated about their fertility. It is not a taboo topic, biology has its principles and many young women would benefit from understaning them. There is no reason to fear biologic clock or pressure to find a right partner at a certian time in life, there is vriety of options availble from diagnostics, fertility preservation, pregnancy planning etc. Medicine and technology have made huge progress and today we are able to help almost everyone who wishes to have a child. There are different sets of methods avilable and by creating individual treatment plans, everyone can learn about their options. As time when women become mothers has shifted from 20ies to 30ies and 40ies, many women and men will need help of reproductive medicine to achieve pregnancy. We should accept it as normal situation in 21st century and take the best from it. Everyone can manage their own fertility. 3) As an expert, what would you say to women who do not yet have a family and children? There is never a perfect timing. Many couples postpone parenthood until all conditions are met. Today in time of COVID, we face how unpredictable life is. And more then ever we understand how important family is as a basic unit of our society. Young women should learn about their fertility and their options from young age and not to wait for last minute to contact reporoductive medicine specialists. The earlier we start evaluating fertility, more options we will have to preserve it and make plan for future pregnancy. We would advise all women to contact our Info Center and learn about their options.  4) Simply and concisely: what makes ProCrea different and unique? ProCrea Swiss IVF Center is a perfect mixture of a private, family clinic and advanced technologies avilable to couples who need medical support to pregnancy planning. Many couples who come to us, complain that at the big centers they feel like a „number“ and that treatment is not indiviual enough. Our approach is opposite, we provide Individual plan for each patient and in a setting that is comfortable and does not scare the patient with its size. We support of Next Clinics (20 IVF clinics in our group) we are able to combine top knowledge and best practices from many European centers and deliver it locally in a private atmosphere.   Mirna Turcinovic, MSc Customer Care Manager v ProCrea Swiss IVF Center Prague  


COVID-19 operating information, 1.3. 2021


Dear clients, we would like to inform you and assure you that the current government measures of the Czech Republic do not have an impact on the treatment of our patients and do not limit the operation of the clinic. Please only cooperate by following the procedures below: •    Fill out a COVID-19 consent form at the clinic reception.  •    Please wear a mask when entering the clinic. •    Your temperature will be checked upon entry.  •    If you are feeling unwell please call the clinic first, do not come to the clinic. •    If consultations are not possible in person, we can reschedule it or arrange it via Skype-Zoom to make sure we give  attention on time to your case. •    If you have been in close contact to a COVID positive person, please inform us and we will postpone your treatment    for two weeks.  •    Please attend your appointments alone or with your partner, with no extra company. •    We will continue to monitor new government regulations to provide the safest treatment environment for you and your  family. •    International patients, please contact clinic Coordinators at to receive latest travel updates and receive necessary travel documentation.  Stay healthy and safe and we look forward to planning your pregnancy at ProCrea.    


We help to bloossom new lives. We are an IVF clinic with an individual and sensitive approach.


We help to bloossom new lives. We are an IVF clinic with an individual and sensitive approach. Reproductive medicine has made greate progress in recent years and can help with most reproductive problems. Even in the Czech Republic, the treatments have already helped thousands of couples with their families. The peak of a woman’s fertility is reached at around age 20 and after age 25 fertility slowly starts to decrease.  More rapid decrease happens normally after the age 35 when embryo implantation rates decreases and women face higher chances of having a miscarriages. The reason are explained by genetic abnormalities in eggs which result in genetically abnormal embryos without potential to develop into healthy pregnancy.  Men are not facing this challenges as they produce new, young sperm every 60-70 days and are not so limited by reproductive age.  Our grandmothers and mothers were more in line with this biologic factors, but today as young women deal with education, career, financial independence and are waiting to align with right partner, motherhood is postponed to late 20-ies, to be exact: 29 years old which is Czech and European average to become mothers for the first time mothers. Getting further away from biology, many couples turn to reproductive medicine to help them plan parenthood. Our job is not just to treat, but also to educate our patients when to seek help, we recommend to contact the clinic right away if: •    You are 35 or younger and you’ve been trying to get pregnant for 1 year without success •    You are over age 35 and you’ve been trying for more than 6 months without success •    You’re over age 40 and you’d like to start a family Time factor plays important role and we encourage woman to continue trying naturally but also to learn about their fertility and make realistic plan with time frame how to plan pregnancy. Contacting a clinic is not a taboo and many couples are parents today to children born with the help of assisted preproduction. Clinic has Info Center ready to answer all your questions and organize your first visit to the clinic ProCrea Swiss IVF Center in Prague.  Contacts:  Phone: +420 257 212 516 – 518 E-mail:  


Happy New Year 2021



Christmas holidays non-working day


We would like to inform you that our clinic will be closed 24th – 27th December. In case of any questions, please contact us ahead. We wish you Happy Holidays! ProCrea Swiss IVF Center Prague


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.


Client ranking

The most beautiful Christmas

The most beautiful Christmas

"We would like to thank you very much for our treasure Karolína. We are your clients and thanks to you, our little girl was born on December 20, 2020 and became our most beautiful Christmas gift. The little one was 48cm and 3210g and we are very grateful to you.” Family Ženatík


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  



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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