PRICE LIST - Therapy using egg donation Price valid as of April 1st, 2015 EXCLUSIVE CARE 5900 Monitoring of donor's cycle and egg collection Medication for the donor Reimbursement of the donor Multiple choice of donors - the patient chooses from three possible donor candidates which have been pre-selected according to the patient s request (commencement of treatment with a doctor consisting of a short consultation, an ultrasound, a probing examination, instructions regarding the Treatment Plan) Complete set of medication for the period up until the pregnancy test which is sent to the recipient's address, including medication for the down-regulation Testing for HIV, Hep B, C and Syphilis for the male partner at the time of the egg collection Detailed Sperm analysis Prolonged embryo cultivation and monitoring of embryos using the EmbryoScope Other Premium Benefits VIP logistical care - in the event of any unexpected logistical problems or negative reaction of the recipient (e.g. bleeding in the transfer cycle), Unica will cover any these associated costs Our Guarantees minimum of 8-12 ripe oocytes 4-6 embryos (depending on sperm quality) 76% cumulative success rate of one IVF cycle 4 th IVF cycle free of charge if first 3 egg donation cycles are not successful Registered Place: Barvicova 53, CZ-60200 Brno, Czech Republic 1
Services not included Vitrification of non-transferred embryos + one year of storage... 300 Vitrification up to 2 straws. Every additional straw (2 oocytes/embryos) Frozen Embryo Transfer (FET) cycle... 970 PREMIUM CARE 4900 Monitoring of donor's cycle and egg collection Medication for the donor Reimbursement of the donor Multiple choice of donors - the patient chooses from three possible donor candidates which have been pre-selected according to the patient s request (commencement of treatment with a doctor consisting of a short consultation, ultrasound, probing examination, instructions regarding the Treatment Plan) Sperm analyses Registered Place: Barvicova 53, CZ-60200 Brno, Czech Republic 2
Guarantee minimum of 8-12 ripe oocytes 4-6 embryos (depending on sperm quality) 76% cumulative success rate of one IVF cycle 4 th IVF cycle free of charge if first 3 egg donation cycles are not successful The price does not include Tests for HIV, Hep B, C and Syphilis for male partner at the time of egg collection... 95 Prolonged embryo cultivation and monitoring of embryos using the EmbryoScope... 490 Vitrification of non-transferred embryos + one year of storage... 300 Vitrification up to 2 straws. Every additional straw (2 oocytes/embryos) FET cycle... 970 VIP logistical care - in the event of any unexpected logistical problems or negative reaction of the recipient (e.g. bleeding in the transfer cycle)... 350 Registered Place: Barvicova 53, CZ-60200 Brno, Czech Republic 3
SHARED DONOR CARE 3500 Monitoring of donor's cycle and egg collection Medication for the donor Reimbursement of the donor note: patient shares a donor with another recipient. Recipient receives donor description in advance note: there are usually no embryos available for vitrification in the shared donor program. In these cases, FET cycles are not an option. This treatment is recommended and suitable only for those patients with positive spermiogram results. (commencement of treatment with a doctor consisting of a short consultation, ultrasound, probing examination, instructions regarding the Treatment Plan) Detailed Sperm analyses Guarantee Minimum guarantee of 4 ripe oocytes Guarantee of 2 embryos when proceeding with sperm donor Usually 2 embryos, depending on sperm quality 40% success rate of one cycle (fresh egg transfer only) The price does not include Tests for HIV, Hep B, C and Syphilis for male partner at the time of egg collection... 95 Vitrification of non-transferred embryos including one year of storage... 300 FET cycle... 970 VIP logistical care - in the event of any unexpected logistical problems or negative reaction of the recipient (e.g. bleeding in the transfer cycle)... 350 Registered Place: Barvicova 53, CZ-60200 Brno, Czech Republic 4
Registered Place: Barvicova 53, CZ-60200 Brno, Czech Republic 5