TREATMENT

Intrauterine Insemination (IUI) is a fertility technique which is normally applied for a couple that has a sperm amount lower than a standard proposed by World Health Organization (WHO) or a couple that has an ejaculation dysfunction or unexplained fertility problems.

This treatment selects most active and effective sperms and insert sperms directly into the uterus during ovulation period. This is to reduce the selected sperms traveling distance and help increasing pregnancy opportunity.

Patient Instructions before IntrauterineInsemination

1. Husband must not have sexual intercourse or any ejaculation for 3-5 days before IUI appointment date.

2. On IUI appointment date, a husband will have to provide semen sample by masturbation at a clinic sperm collection room one hour and a half before IUI process.

3. Please get enough rest and sleep. Relax and avoid stresses.

4. Please avoid drinking any alcohol or smoking prior to IUI.

5. Please avoid using any fragrance, perfume, spray and cosmetic products including powder on the day of IUI.

Patient Instructions after Intrauterine Insemination (IUI)

1. You may eat regular food after the procedure.

2. You can have regular work and normal exercise.

3. You can have sexual intercourse as usual.

4. Please avoid the use of medications that may affect pregnancy such as an acne treatment or medicines, antibiotics and etc. In case you need to use certain medications or have any question, please consult with your doctor first.

5. You may experience a mild to moderate lower abdominal cramping discomfort for 2-3 days, which is similar to abdominal pain during menstruation but possibly more severe. This is normal and has no negative effect towards pregnancy rate. You may take one or two regular strength Paracetamol tablets for discomfort and rest.

6. Driving a car, riding a motorcycle, riding a boat, and flying in an airplane, are considered safe after IUI.

7. In case you receive medication(s) after IUI, you shall continue taking medication(s) as instructed. Do not stop taking medication(s) unless instructed otherwise by your doctor. And please come for your further appointment as scheduled.

8. If you do not have menstruation more than 14 days after IUI, or more than you expected, you shall contact your doctor to have a pregnancy test.

9. If you have abnormal symptoms, such as vaginal spotting or bleeding, or drug allergy. Please contact your doctor for advice immediately.

10. After a positive pregnancy test, you should come for an ultrasound follow-up in order to confirm a normal pregnancy, a number of gestation sac(s) or embryo(s), and a confirmation of fetus heartbeat.

By Assoc.Prof. Matchuporn Sukprasert

IVF procedure

1.  Women will meet with doctor within the first three days of their menstrual period to receive an ultrasound and hormones checkup. Doctor will prescribe egg stimulating medication that is suitable for each patient.

2.  Women will meet with doctor after receive egg stimulant 2 – 3 times in order to do an ultrasound. It depends on the development of eggs. After the egg is in a good size (bigger then 17 – 18 millimeters), doctor will order ovulation induction medication. At the same time, men will be recommended to ejaculate 2 – 3 days before the day for egg’s collecting.  

3.  On the appointment for egg’s collecting, both partners should come together. Men will be asked to collect their sperm while women’s eggs will be collected by using local anesthesia. 

4.  The process of fertilizing egg and sperm together is called ICSI. Once it becomes an embryo and continue to culture is called blastocyst.

5.  During egg transferring in the stimulant process, patient will have embryo transferred to uterine cavity 3 – 5 days after collecting the eggs. However, if doctor recommends patient to do embryo freezing and transfer during the following period, she will meet with doctor within the first two days of menstrual period to do an ultrasound and receive medication to prepare uterine cavity. Then there will be a hormone checkup for pregnancy within 7 – 10 days after embryo transferring.

Ovum Pick Up: OPU or Egg Retrieval

Ovum Pick Up (OPU) is a technique used in conjunction with In – Vitro Fertilization (IVF) process. It is normally established within 34 – 36 hours after trigger ovulation. OPU technology is to remove eggs from ovaries by an ultrasound guided procedure performed under intravenous sedation. This process is approximately no longer than 30 minutes. Embryologist then carefully examine and select these removal eggs. After that, all good quality eggs are proceeded to Intracytoplasmic sperm injection (ICSI) process.

Patient Instructions before Ovum Pick Up (OPU)

1.  Please review your appointed date and time for an ovulation induction trigger shot as instructed by your doctor.

2.  Please do not eat or drink for at least 8 hours prior to the egg retrieval.

3.  Please arrive at N.I.C IVF Clinic 1 hour before the egg retrieval.

4.  Please take a shower and clean your genital area before coming for the egg retrieval.

5.  Husband must prepare for semen collection around the same time as egg retrieval.

6.  Please avoid sexual intercourse prior to the egg retrieval. Since it could cause damages to the ovary.

7.  Please avoid using any fragrance, perfume, spray, cosmetic products including powder on the day of egg retrieval.

8.  Please remove any nail polish or any nail chemical at least 1 day before the egg retrieval.

9.  Please do not wear any jewelry or accessory on the egg retrieval date.

10.  Please get enough rest and sleep.  Relax and avoid stresses.

Patient Instructions after Ovum Pick Up (OPU)

1.  After recover from anesthesia, you may experience nausea, abdominal pain or small amount of vaginal bleeding.

2.  All patients must take rest at least 1 to 2 hours in the recovery room before being discharged.

3.  You may use a prescribed pain medicine when symptom occurs.

4.  Please take the injectable/oral/suppository medications as instructed by your doctor.

5.  Please relax and take rest as much as possible.

6.  Please do not drive a car by yourself after the procedure.

7.  If following symptoms such as abdominal distension, severe bloating, severe abdominal pain, difficulty breathing or vaginal bleeding occur, please call and / or come to the clinic immediately.

Embryo Transfer (ET)

Embryo transfer (ET) is a final step assisting reproduction process. It is the most concerned phase by many patients. However, it is commonly known as a simple step since it is almost similar to annual pelvic examination. In embryo transfer (ET), a doctor who is an IVF specialist places embryos into the uterus of a female. It is important to plant these embryos properly to effectively increase patient’s pregnancy opportunity.

Patient Instructions before Embryo Transfer (ET)

1.  Please arrive at the N.I.C IVF Clinic 1 hour before your appointment.

2.  Please take a shower and clean genital area before coming for the embryo transfer.

3.  You can eat regular food and drink water before the procedure.

4.  Please avoid using any fragrance, perfume, spray and cosmetic products including powder on the day of your embryo transfer.

5.  Please do not wear any jewelry or accessory on the embryo transfer date.

***If your embryo transfer appointment is BEFORE 12.00 PM, DO NOT USE the morning dose of vaginal suppository medication.

***If your embryo transfer appointment is AFTER 12.00 PM, PLEASE USE the morning dose of vaginal suppository medication as usual.

Patient Instructions after Embryo Transfer (ET)

1.  Please lie in bed at least 30 minutes after the embryo transfer.

2.  You may eat regular, clean, easily digested food after the procedure.

3.  Please take some rest at the clinic at least 1 hour before going home.

4.  Please take the injectable / oral / suppository medications as directed by your doctor.

5.  After embryo transfer

•    No sexual intercourse for 14 days or until the day of scheduled blood test. And no vaginal douching.

 •    No heavy lifting. You may use stairs if necessary.

•    No heavy exercise and please avoid high temperature places such as sauna or hot tub.

•    Please avoid hard working and stresses.

•    Please avoid any food that could easily cause constipation or diarrhea.

•    Please avoid any public areas in order to prevent communicable diseases such as flu, cold, measles and rubella. Please avoid using swimming pool or any other pools to prevent infection through vaginal route.

•    Please get enough rest and relax. You may lie on your back or on your side. There is no need for absolute bed rest.

•    Please avoid driving any vehicle by yourself.

6.  Please come for follow-up blood test and pregnancy test which is normally 7 – 14 days after embryo transfer.

7.  If following symptoms such as vaginal bleeding, severe  abdominal pain or abnormal vaginal discharge, please  call and / or come to the clinic immediately.

By Assoc.Prof. Matchuporn Sukprasert

The technology of pre-implantation genetic testing has been progressed tremendously. Pre-implantation genetic testing from was first developed in 1980 from PCR process to increase DNA in sex chromosome diseases. Due to some technical limitation, the testing could only find out gender of embryo but unable to examine genetic or chromosome disorders. The method could only transfer embryo in gender that there was no disease or could be only a carrier. So, the other embryo that could have a serious disease or could be normal was not used. Therefore, it is crucial to develop a specific method that can identify both gender and abnormal genes and chromosomes. This is why the technology of pre-implantation genetic testing has been improving in order to increase DNA and more precise treatment such as Comparative Genomic Hybridization (CGH), Next Generation Sequencing (NGS), real time PCR and Karyomapping. Now, the technology that is used to perform pre-implantation genetic testing is Next Generation Sequencing (NGS). 

Next Generation Sequencing is to a parallel sequencing technology that can find out the sequence of bases quickly and can check all 24 of embryo chromosomes at the same time as shown in picture 1 and 2, and it is 95-97% accurate. Because now we examine embryo during the stage of Blastocyst, we can obtain more cells and more correct results. In addition, besides finding out the absence and the excessiveness of whole chromosomes, we can find out segmental aneuploidy too while the old techniques as such FISH or CGH are unable to perform. Moreover, NGS helps increase the chances of getting pregnant and reduce having miscarriage to 50%. 

Picture 1 demonstrates female embryo with normal chromosomes using NGS method: 46 XX.

Picture 2 demonstrates male embryo with normal chromosome using NGS method: 46 XY.

By Assoc.Prof. Matchuporn Sukprasert

Nowadays, people in Thai society tend to get married at older ages. According to the figure in picture 1, we can see that age plays as an important role in the quality of eggs. The best time for reproductive systems is between 25 – 29 years old and then will continue to decrease especially when women are more than 35 years old. This is why there is a recommendation for women to do egg freezing before turning 35 years old in order to stop egg ageing. 

Picture 1 demonstrates the relationship between ages and reproductive percentile.

Additionally, the eggs in women who are more than 35 years old tend to have embryos with abnormal chromosomes when fertilize with sperm.  This fact is shown in picture 2.

Picture 2 demonstrates the relationship between age of women and percentile 

of having Down syndrome babies.

Due to egg production stops since being in mother’s womb and have the most amount during 7 months of pregnancy. Then the amount will gradually decrease that is why women should consider egg freezing when they are still young according to picture 3.

Picture 3 demonstrates egg production and ages of women (Puberty)

The process of egg freezing begins by stimulating ovaries in order to produce multiple eggs as same as doing IVF / ICSI procedure.  It is to make sure that we have enough eggs. After eggs are in an appropriated size, they will be retrieved and stored separately from sperm by the method of eggs freezing which is the same as embryo. The only differences are the chemicals being used. However, after being frozen, the endurance of eggs is less then embryos.  After eggs are dissolved to prepare for fertility, the remaining eggs are only 80% from overall.

Egg Freezing Indications

1. Egg freezing is done to fertilize with sperm that belongs to legal husband in the future.

2. Egg freezing is done after being diagnosed with a certain cancer which the plan of treatment: for example, chemotherapy can affect eggs production.  In addition, treatments for other diseases can cause lower quality in egg production as well. 

By Assoc.Prof. Matchuporn Sukprasert

A surgical procedure to extract sperm from epididymis can be done when men have the following abnormalities:

1. Sperm cannot be found in the fluid due to blockages in vas deferens, or there is no vas deferens since birth.

2. Not being able to store sperm with natural methods.

3. Not being able to ejaculate sperm normally, or having a problem to do so because of other health problems. All the sperm that come out are not alive.

4. Those who have been done a vasectomy and do not want to have a reversal.

In the past, men who had been diagnosed for infertility were unable to have children unless they received donated sperm. However, with the advanced technology, now doctor can perform a procedure that retrieves healthy sperm directly from the source which is the epididymis or testis. Doctor will examine an appropriate method of surgery according to the condition of each patient.  

These are the steps of the procedure:

1.)  PESA (Percutaneous Epididymal Sperm Aspiration)

PESA is a surgical procedure that requires a small needle with a radius of 2 millimeters to extract sperm from epididymis. The epididymis is on the top part of testicles which is where sperm is. After retrieving the fluid, doctor will examine, look for sperm, evaluate the quality, and use it for ICSI procedures. PESA usually take about 10 – 20 minutes, and the patient will be given local anesthesia before the procedure. The patient should rest for an hour after the procedure is done then he can go home.

2.) TESE (Testicular Sperm Extraction)

This method is used after trying to retrieve sperm but cannot find sperm in the epididymis. Doctor will use a small blade to trim the skin that covers the testicles. The cut is not more than 1 – 2 millimeters. Doctor will bring the tissue that produces sperm in order to examine for sperm. Local anesthesia will be given, and it will be a bit painful. Therefore, painkiller medicine might be given, and all the pain will be gone within 3 days.

Guidelines before the procedure

Doctor will require a blood test to evaluate overall health and to prepare for the surgery. Patient must refrain from eating and drinking 6 – 8 hours before the procedure.

Guidelines after the procedure

1.  Keep the wound dry and avoid swimming or being in a bathtub until the wound is completely dry and healed.

2.  After using toilet, make sure to wipe the wound dry and always keep it clean and dry. 

3.  Take painkiller medication and antibiotic according to doctor’s prescription to reduce being swollen and avoid inflammation.

4.  Avoid doing exercises for 2 weeks to avoid pain and inflammation.

5.  Refrain from having sexual intercourse until the wound is completely dry and healed. 

Risks and side effects for the procedure

We only found less than 2% that has an infection, blood clot in the testicles, and having pain after the surgery. However, these can be treated and go back to normal.

The Success for this treatment

TESE procedure is very successful especially in patients with blockage in vas deferens. However, the success rate also depends on the causes of each individual.

Are PESA/TESE safe procedures?

In general, they are very safe procedures, and they offer better options for patients with infertility. From a current study, the rates of having abnormalities and disabilities in babies from doing the procedures are not different from normal cases.

By Assoc.Prof. Matchuporn Sukprasert

Hysteroscopic Surgery in Uterine Cavity for Infertility Patients

When some patients did not have successful treatments even though their embryo chromosomes have been examined to be normal, or there were no obvious problems after an evaluation, we can assume that this group of patients may have embryo implantation problem. Usually, the patients will be recommended to be examined for possible causes in uterine cavity whether they have any symptoms or not. In general, the symptoms that can cause pathology of uterine cavity are abnormal heavy menstrual bleeding, irregular menstrual cycle, or menstrual pain.

Nowadays, the well-known examination for pathology of uterine cavity is Hysteroscopy, which can be used for diagnosis and also for treatments.

Generally, there are two types of the method.

1.  Diagnostic Hysteroscopy

It is a minor surgery that can be done at outpatient department. A small hysteroscope with the size around 2.9 – 4 millimeters will be inserted inside uterine cavity to perform pathology examination. These are the types of uterine cavity that usually can be found:

- Normal endometrium is a normal uterine cavity with no fibroid or polyps that might be an obstacle for embryo implantation. The surface is smooth with the size shown in picture 1.

Picture 1 demonstrates a normal uterine cavity from performing diagnostic hysteroscopy.

- Endometrial polyp is uterine polyp that is commonly found in abnormal uterine cavity, and might have no symptoms. With the small size, the polyp could come out with menstrual bleeding, and it is noncancerous. After a treatment, it could occur again.  However, endometrial polyp surgery needs to be dome because it can interfere with embryo implantation as shown in picture 2. 

Picture 2 demonstrates endometrial polyp inside uterine cavity.

- Submucous myoma is a fibroid that usually can be found in reproductive age women. The one that develops in uterine cavity can interfere with pregnancy. As shown in picture 3, this can create no symptoms at all or can cause excessive heavy menstrual bleeding, and it will lead to anemia.  This kind of fibroid mostly will not be cancerous, but need to be removed before pregnancy.

Picture 3 demonstrates fibroid that grows inside uterine cavity.

- Septate uterus is a deformity that happens before birth. The inner portion of the uterine cavity was divided by a wall of tissue, and the embryo cannot be implanted, or there is a high risk for having miscarriage later.  This could be treated with a surgery to remove the wall of tissue inside uterine cavity as shown in picture 4.

Picture 4 demonstrates the surgery to remove a wall of tissue inside uterine cavity.

- Uterine synechiae is a condition that usually happens after having dilatation and curettage or after having severe infection in uterine cavity that can cause adhesion. Therefore, a surgery needs to be done to remove the adhesion before pregnancy. 

Picture 5 demonstrates adhesion band inside uterine cavity.

2.  Hysteroscopic surgery 

The procedure is done in surgery room. Usually, the size of hysteroscope will be bigger than the one used during diagnosis, and the cervix needs to be enlarged before inserting the camera.  These are additional tools such as electric loops, small scissors, and morcellator to help remove polyps, fibroids, adhesions or a wall of tissue inside uterine cavity. So, the patient may be given medication to help her relax and to block the pain during the surgery. 

The appropriate time to schedule for diagnostic hysteroscopy and the surgery is after menstrual period until before ovulation. During the time, uterine cavity is not thick and not swollen from ovulation’s discharge, so we can clearly see the pathology. 

Preparation for uterine cavity hysteroscopy

1.  Diagnostic Hysteroscopy

This procedure can be done at outpatient department (OPD), and anesthesia is not required. So, the patient does not have to prepare many things in particular. However, the procedure should not be performed right after having a meal to avoid vomiting during the hysteroscopy. So, the patient should avoid having food 2 – 3 hours before the procedure.  Make sure to use toilet and may also take some pain killer medicines an hour before the procedure. 

2.  Hysteroscopic surgery 

- Refrain from eating and drinking 6-8 hours before the surgery.

- Medicine will be inserted into vagina 6-8 hours before the surgery. This is necessary because it will open the cervix and help with the process to be smoother. However, there might be some side effects such as having a low grade fever, stomach pain, or having blood show from vagina due to the medicine that causes contraction. These symptoms will be gone after the surgery.

Post-surgery Instructions

1.  Complete the course of antibiotics.

2.  Avoid having sexual intercourse, swimming and heavy exercise for the first 2 weeks after the surgery.

3.  Eat healthy meals. There is no specific restriction. 

4.  There might be some blood from vagina within the first week after the surgery but it should not have any smell.  Stomach cramps that are similar to menstrual cramps might occur, but they are not harmful.  Should there be any serious symptoms, please contact your doctor. 

By Doctor Warawun Lupthalug

These techniques are as of followings.

1. Next Generation Sequencing (NGS)

This is a testing technique that screens all 24 chromosomes or whole-genome human sequencing in the least amount of time. This particular method, when applied to pre-implantation process, allows a doctor or scientist to select only embryos with a normal chromosome profile to transfer. This could yield to a higher chance of effective pregnancy rate comparing to Fluorescence in situ hybridization (FISH) technique which is able to screen only 5 pairs of chromosomes.

2. Macs® Art Annexin V system

This is a technology that optimizes sperm separation in assisted reproduction. It helps separating sperm with activated apoptosis signaling (dead cell) before entering fertilization process. This results in enhanced clinical pregnancy rate comparing to an old technique which cannot distinguish the sperm.

3. Halosperm® G2

This technique allows the visualization of sperm that contains highly degraded DNA compared to other sperm. It is a fast, simple and cost-effective method that provides an IVF doctor 

to examine sperm DNA fragmentation easily. Therefore the good quality sperm selection could be obtained for a fertilization process. This could increase a fertilization rate and embryo implantation rate accordingly.

4. Endometrial Receptivity Test (ERA® Test)

ERA is a genetic test that evaluates the state of endometrial receptivity, which is the optimal time for embryo transfer.  It diagnoses the time that a uterus is ready to receive the embryo. Since implantation period for each woman is different. The ERA test enables us to personalize embryo transferring time  for each couple accurately. This greatly increases a chance of successful embryo transfer rate and pregnancy rate.

5. Oosight® Spindle view

This computerized high power microscope technology enables a doctor or an embryologist to see spindles of retrieved eggs when performing Intracytoplasmic sperm injection (ICSI). This is to avoid corrupting the egg spindles when injecting sperm cell into the egg. Therefore, a successful chance of fertilization becomes higher comparing to one without Oosight technique which the doctor or embryologist can perform the ICSI procedure merely from educated guess.

6. Preimplantation Genetic Testing for Monogenic Disease (PGT-M)

The PGT-M are created uniquely for each family or each fertile couple who has a risk of transmitting a genetic disorder to their offspring. The genetic disorder includes, for example, Thalassemia, Huntington disease, Duchenne Muscular Dystrophy, Hemophilia and etc. This exceptional technique must be solely performed by a doctor who is a specialist and graduated from Reproductive Genetic. One of our clinic team, Assistant Professor Dr. Matchuporn Sukprasert is the first doctor in Thailand who graduated in this particular field. She was a fellow from Weill Cornell Medical College, Cornell University, New York, United states. She and our scientists are ready to consult willingly with any couple who is possibly related to monogenetic diseases.

Embryo transfer into the uterine cavity is the final step in assisted reproductive technology. Although this process is often the most anxiety inducing for patients, in reality, it is similar to a routine gynecological pelvic exam that women undergo annually only even more gentle. The procedure is painless in order to avoid stimulating uterine muscle contractions, thus sedation or pain relief medication is generally unnecessary.

The embryo transfer involves inserting a small, soft plastic catheter into the uterine cavity at the appropriate location, followed by the placement of the embryo through the catheter. This process is typically guided by abdominal ultrasound to determine the optimal position for embryo placement, maximizing the chances of pregnancy.

Patient Instructions before Embryo Transfer (ET)

1. Please arrive at the N.I.C IVF Clinic 1 hour prior to your scheduled time for preparation

2. Shower and maintain personal hygiene.

3. Fasting is not required; you may eat and drink as usual.

4. Avoid using scented products such as perfumes, sprays, cosmetics, or body powders on the day of embryo transfer.

5. Please do not wear any jewelry or accessory or bring valuables on the embryo transfer date.

Note :

***If your embryo transfer appointment is BEFORE 12.00 PM,DO NOT NEED TO INSERT VAGINAL MEDICATION that morning.

***If your embryo transfer appointment is AFTER 12.00 PM, PLEASE INSERT VAGINAL MEDICATION as usual.

Patient Instructions after Embryo Transfer (ET)

1. Remain lying down for at least 30 minutes immediately after the procedure.

2. You may resume eating normally, preferably light, easily digestible, and hygienic food.

3. You may go home after resting for at least one hour post-procedure.

4. Strictly follow the doctor's prescription for any injectable, vaginal, or oral medications.

5. After embryo transfer

• Avoid sexual intercourse for approximately 14 days or until the scheduled blood test.

• Do not douche the vaginal area.

• Do not lift heavy objects. You may use stairs only when necessary.

• Refrain from intense physical activities such as heavy workouts, hot yoga, or sauna.

• Avoid strenuous work or highly stressful tasks during this period.

• Prevent constipation or diarrhea by managing your diet carefully.

• Avoid crowded places to reduce the risk of infection (e.g., colds, rubella) from others.

• Avoid swimming in shared pools to prevent potential infections.

• Get adequate rest. You may lie on your back or side (left or right). It is not necessary to stay in bed all day, but avoid sudden or vigorous movements.

• Do not drive yourself to avoid sudden jolts or impacts.

6. Return for a blood test to check for pregnancy approximately 7–14 days after embryo transfer.

7. If you experience any abnormal symptoms such as bleeding, lower abdominal pain, or unusual vaginal discharge, contact your doctor immediately.

By Assoc.Prof. Matchuporn Sukprasert

If you’d like to learn more, we’re always here to help:
Line@: @nic_clinic or https://lin.ee/Mmq6m2K
Tel: 02-007-3973 or 095-370-2483

ERA®  Test is a technology that allows calculating the most suitable time of the endometrium for embryo implantation. Normally, this time period is different for each person. This technique can be used to find the best time for that specific couple. Makes the embryo transfer have a higher success rate. and have a better pregnancy rate.

ERA® Test is an examination using a Micro Array. Analyze the appropriate time for embryo implantation from the endometrium. They will be able to know at what stage of the menstrual cycle the embryo should be implanted.

Who is the ERA® Test suitable for?

1. Patients who have had good quality embryos transferred multiple times but have not been successful in getting pregnant.

2. Patients who have had repeated miscarriages.

3. Patients who have a history of difficult endometrial preparation.

4. Patients with relatively few embryos.    

How does ERA® Test test?

1. The doctor prepares the endometrium by using preparation medication. and follow up with ultrasound to assess the thickness of the endometrium.

2. The doctor schedules an appointment to collect an endometrial tissue sample. and analyze and calculate the appropriate date.

3. Wait for the analysis results for 1 month.

4. Embryo transfer is performed on the appropriate day. After knowing the results of the ERA® Test

Benefits of doing the ERA® Test

ERA® Test technology calculates the optimal timing of the endometrium to implant an embryo at the most appropriate time. to have a higher pregnancy rate

By Assoc.Prof. Matchuporn Sukprasert

If you’d like to learn more, we’re always here to help:
Line@: @nic_clinic or https://lin.ee/Mmq6m2K
Tel: 02-007-3973 or 095-370-2483