★ IVF Cube — Doctor Consultation Notes

• 7 eggs corresponds to AMH level — "result was normal as expected"
• Embryo development was not good — could be a bad cycle (random variation, virus, etc.) or could confirm an underlying issue with all sides
• Needs another cycle to see if development was just bad luck vs. a real problem
• Age is likely a factor — egg quality is age-dependent, turning 40 soon

Molar Pregnancy History

Partial molar pregnancy 4 years ago (likely 2 sperm + 1 egg) → doctor agreed this is another reason ICSI makes sense.

• PGT-A biopsy done in-house; genetic analysis sent to external genetic laboratory (not in-house)
• Results take ~4 weeks
• Embryo banking strategy: accumulate embryos across cycles (target ~4 before testing) then test in one batch to save cost

Embryo grading

Morphology evaluation done by embryologist via microscope; time-lapse adds algorithm-based selection.

• At age 40, expect ~20% healthy embryos (roughly 1 in 5)
• From 7-9 eggs per cycle → realistically ~2 blastocysts (best case 3)
• Aim for at least 4 embryos before PGT-A for good statistical chance of finding a healthy one
• Pregnancy rate per euploid embryo transfer: 60% (good for reproductive medicine but not 100%)
• Realistic plan: 2 stimulations minimum; 3 gives reserve for a second healthy embryo — important if aiming for a second child

• Doctor is not a fan — second stimulation of a given cycle is very unpredictable in her experience
• Only advises it when time is severely limited (e.g., "we have 3 months and need to fit everything in")
• Otherwise prefers back-to-back cycles (one per menstrual cycle)
• Three back-to-back cycles possible if tolerated well and ovaries restore normally

• No waiting list — can start with the next period
• Hungary monitoring: Fine, routine. Ultrasounds done by any local gynecologist — "does not really need a cooperating doctor." Will check if clinic has a specific Budapest partner but not sure
• Prescriptions: Electronic, valid across the EU — pick up medication in Hungary
• Informed consents: Sent electronically, print/sign/scan back
• Communication: Via coordinator (working days). Doctor reached through coordinator

Travel for retrieval

• Arrive evening before, stay overnight (anesthesia = fasting required)
• Procedure morning of
• ~2 hours monitoring after
• Half-day total at clinic, then travel home same day
• 1 night per cycle in Prague

• Cycle cost: 3,300 EUR + medication
• Each cycle includes biopsy at no extra cost (their "discount" for multi-cycle banking)
• One transfer included in the total (across whole course), not per cycle — the free biopsies offset the reduced number of transfers
• No multi-cycle discount available
• Refund policy: Bill only for what was performed — e.g., if no egg retrieval, no charge for cultivation

• Up to 10 years at clinic (Czech legal limit)
• Czech legal age cutoff for treatment: 49th birthday — cannot treat on/after that day even with frozen embryos
• Fits Andrea's situation (turning 40 May 2026) — 10 years covers planning for child 2 and potentially child 3

If time-constrained at end of banking, last cycle can include a fresh (untested) transfer while other embryos await PGT results. Either pregnant or not — either way PGT results arrive around the same time.

• ~3 East Asian patients per year (per this doctor)
• No ethnicity-specific protocol

• CoQ10 ✓ (already taking)
• Vitamin D ✓ (already taking)
• Omega-3 fatty acids — add (Andrea already eating sardines)

• Andrea's next period expected ~June 1
• Fly to Europe mid-to-late May
• Start priming cycle day 21-22 of preceding cycle (if needed)
• Plan: 2-3 back-to-back cycles over the summer
• PGT-A results: 4-week wait before transfer can be scheduled

1. Coordinator will send informed consents electronically
2. Decide on clinic by early next week (Andrea committed to deciding ASAP due to flight booking urgency)
3. Coordinator to confirm if a specific Budapest monitoring doctor is recommended
4. Confirm final plan with coordinator