Unica Clinic — Consultation Notes (Apr 29, 2026)

Impression

Joanna stood out. Very professional, very sharp coordinator — helpful, knowledgeable, fielded the logistics and pricing follow-up cleanly. Clear separation of roles between doctor and coordinator was well handled.

Doctor was fine but nothing special. Bedside manner didn’t warrant a comment either way. He hedged a bit (fair, given limited records in front of him) but his clear protocol view was higher gonadotropin dose. Not a strongly differentiating consult.

Logistics tradeoff to weigh: doctor wants Andrea in Brno before CD1 for baseline + meds, and again on CD10 for the second US (must be in person, doctor wants to see her himself). Realistically that means staying in CZ from CD10 through retrieval rather than doing two short trips.

Unanswered: doctor’s name; updated price list (Joanna confirmed prices recently changed); approximate medication cost based on doctor’s planned dosage; clinic statistics. Joanna committed to send all of this by tomorrow (Apr 30).

Assessment of Previous Cycle

Shared full Grace Fertility cycle history (March 2026): AMH 1.3 ng/mL, 7 eggs retrieved, 6 fertilized, day-3 fresh transfer of 3 embryos (one 8-cell, two 3-cell), no day-5 blastocysts, negative result
Doctor’s read on AMH 1.3: "lower-normal ovarian reserve" — not the lowest, normal range. Goal is healthy baby home, not just pregnancy → PGT-A recommended
Both Joanna and the doctor flagged the 200/400 alternating stim dosing as strange — "we don’t use this viral type of protocol... I never heard this before." Third Czech clinic now to call it out
Adam’s framing accepted: previous cycle had only one large follicle leading the cohort, the rest never caught up — suggests previous protocol underdosed and didn’t even out follicle growth

Protocol Recommendations

Element	Recommendation
Stim protocol	Stable dose, not alternating. "We don’t use this viral type of protocol." Final dose set after baseline US
Dose	Higher than previous cycle — doctor explicitly noted possible Asian-ethnicity adjustment toward higher gonadotropin dose
Medication	Pergoveris (recombinant FSH+LH, "best on the market"). Existing Puregon could be used in last days of stim. Pen-based, easy to use
Estradiol priming	OK to repeat previous protocol (Estrofem 2mg × 2 daily, 4mg/day × 6 days from CD22) if Andrea wants — doctor will accept it
Stim start	Day 2 of cycle
Trigger	Single trigger (likely hCG); not specified beyond standard
Egg-yield target	~15 eggs collected (doctor’s plan); reality TBD by response
Day-5 embryo expectation	3–5 (doctor’s estimate; very dependent on egg quality)
Fertilization	ICSI always — "supposed to be more beneficial. We just do ICSI." Note: previous cycle did not use ICSI, which Andrea & Adam now consider a likely contributor to the bad outcome
Sperm selection	MSS chip / Zymot chip microfluidic selection — standard at Unica
Embryo culture	Wait until day 5, often day 6, rarely day 7. "Strategy of the embryologist here, definitely"
Time-lapse incubator	Yes, available. Embryo selection = morphological quality + PGT-A correlation
DuoStim	Possible only if there’s a real time pressure. Default is 1-month break after retrieval; next stim no earlier than the second period after egg collection
Back-to-back cycles	Yes, supported. Joanna noted patients often respond better in the next cycle because the body is still hormone-primed
Transfers	Single transfer included with package; embryo transfer no earlier than 2 months post-retrieval (PGT-A turnaround)

Genetics & PGT-A

Item	Detail
PGT-A lab	External genetics lab in Brno (close). Biopsy samples sent; embryos stay frozen at Unica
Turnaround	3–4 weeks after biopsy
Karyotype	Not done previously; not mandatory at Unica
DNA fragmentation	Not needed when using MSS chip sperm selection
Sex selection	Not possible — CZ law prohibits unless there’s an X-linked or Y-linked disease. PGT-A report does not include gender information
Storage cap	No time limit on embryo storage. Treatment age cap is Andrea’s 49th birthday — after that they’d ship embryos to another country (e.g. Spain, where treatment up to 50+ is allowed)

Pricing

Updated price list pending. Joanna confirmed Unica recently changed prices and will send the new list by tomorrow with the consult summary. Quoted figures below are her on-the-call recall.

Item	Quote
2+1 multi-cycle package with PGT-A	€9,500 for 3 cycles — biopsy + PGT-A of 1 embryo included
Each additional embryo PGT-A	€425
Medication cost	To be calculated post-consult based on planned Pergoveris dose; Joanna will send approximate cost
Storage	Confirmed at clinic; price unconfirmed (covered by separate price list)
Multi-cycle discount	Yes — the 2+1 package is the multi-cycle discount

Logistics & Hungary Cooperation

Two in-person visits required per cycle. First: Brno before CD1 for baseline US + collect meds. Second: Brno on CD10/11 for the key ultrasound (cannot be remote). Stay through retrieval.

Hungarian monitoring partly accepted — first US (after ~6 injections) can be done at a Hungarian partner clinic, but the second US (day 10/11) must be in Brno. Joanna has clinic contacts in Hungary she will send
Stim begins on CD2, started in Hungary
Standard stim has 2–3 ultrasound checks total (vs. 4–5 at Grace Fertility) — Unica considers more frequent checks unnecessary
Doctor wants to see Andrea personally on the second US: "sometimes patients do the whole stimulation in another country and just come for retrieval, and sometimes it doesn’t end up good — follicles weren’t measured well"
Cohort: >50% of Brno patients are Hungarian. Austrian and German patients also significant
Clinic history: 30 years, >10,000 babies (Joanna’s estimate; will check)
Health advice: avoid sauna / heat / sun for Adam in coming months; flag any infections promptly

Proposed Timeline (May/June Cycle)

May 25 — arrive Hungary (flights already booked YVR → BUD via LHR)
May 26 or 27 — drive to Brno for baseline US + collect Pergoveris (~1 day after arrival)
~May 28 — expected CD1; begin Estrofem priming if continuing previous protocol (CD22 of current cycle)
~May 30 — CD2, begin stim injections in Hungary
~Jun 4–5 — first US (after 6 injections); can be done at HU partner
~Jun 7–8 — CD10/11, second US must be in Brno; stay through retrieval
~Jun 11–14 — retrieval (CD13–15, depends on response)
1-month break before next stim if banking; embryo transfer no earlier than 2 months post-retrieval

Comparison vs. Other Finalists

	IVF Cube	ReproGenesis	Repromeda	Unica
Doctor met	Dr. Stasna	Dr. Maderka	Coordinator only	Doctor (name TBC)
Location	Prague	Brno	Brno	Brno
Doctor impression	Strong, decisive	Excellent bedside manner	n/a (call w/ coord.)	Fine, nothing special
Coordinator impression	Solid	Solid	Strong (Adéla)	Strong (Joanna)
Preferred med	Pergoveris	Menopur	Gonal-F + Pergoveris	Pergoveris
ICSI	Always	Standard	Always	Always
Sperm selection	Microfluidic standard	Not needed if normal	MAX + Zymot + PIXI	MSS / Zymot chip
HU monitoring	Limited	Yes	Yes (LilyMed)	Partial (1st US only)
2nd US in person	Not specified	Yes	Recommended	Required (CD10/11)
DuoStim	Not a fan	Possible, last cycle	Likely recommended	Only if urgent
Sex selection	No (CZ law)	No (CZ law)	Preference noted, not guaranteed	No (CZ law)
200/400 dosing	Flagged	Flagged	n/a	Flagged ("strange")
3-cycle headline	~6,150/cyc	~6,705/cyc	~5,847/cyc (SpermPacket)	~3,167/cyc + meds + extra PGT-A
Multi-cycle discount	None	Ask	Ask financial dir.	Yes — 2+1 deal €9,500
HU patient share	n/a	n/a	n/a	>50% in Brno

Next Steps

Send Joanna the full Grace Fertility medical record PDF (more detailed than the questionnaire); we promised this on the call
Wait for Joanna’s summary email by Apr 30 with: doctor’s name, updated price list, planned Pergoveris dose + approximate medication cost, Hungary partner clinic contacts
If continuing Estrofem priming — ask Grace Fertility for a fresh prescription before May 23 departure (priming starts CD22 of current cycle, ~mid-May)
Decide where Unica fits in the final shortlist after the Repromeda doctor call (May 7) — current finalist set: IVF Cube, ReproGenesis, Repromeda, Unica
If Unica advances: confirm 2+1 package details in writing, confirm Hungarian partner clinic for first US