Contact details
- Rue Wayez 35, 1420 Braine-l'Alleud
- Building F - Floor -1
Secretariat:
- +32 2 434 95 55
Coordinatrice des secrétariats de PMA
The team at the CHIREC Fertility Centre (CPMA) is made up of gynaecologists specialising in reproductive medicine.
Their areas of expertise are wide-ranging, from reproductive endocrinology to andrology, as well as other specialities such as reproductive surgery and ultrasound.
The team works in close collaboration with other specialists as part of a multidisciplinary approach to patient care.
These are:
- psychologists,
- geneticists,
- radiologists,
- anatomopathologists,
- endocrinologists,
- haematologists
- and obstetricians.
The Fertility Centre's many collaborations mean that the CHIREC team is able to direct and cover patient requests in all areas of reproduction, such as pre-implantation diagnosis (PGD or PGS), ovarian tissue preservation in specific cases of cancer in young women, and referrals for couples with positive serologies.
Gynaecologists specialising in fertility
Head of Department - Gynaecologist
Gynaecologist
Gynaecologist
Gynaecologist
Gynaecologist
Gynaecologist
Gynaecologist
Gynaecologist
Biologists
Laboratory manager
Scientific coordinator
Quality coordinator
Biologist
Biologist
Biologist
Biologist
Biologist
Biologist
Biologist
Biologist
Biologist
Medically assisted reproduction techniques
In practice
This is the simplest technique.
Intrauterine artificial insemination involves preparing the sperm by centrifugation or migration and instilling a suspension of capacitated spermatozoa at the bottom of the uterus.
This technique is used to treat mucus problems and mild sperm insufficiency.
It is also used in idiopathic infertility. It is simple to implement, both for patients and for the MAP centre.
It is inexpensive and gives appreciable results which vary, of course, according to age and the associated ovulation control techniques: from 10 to 15% according to published studies.
Artificial insemination can be carried out using your partner's sperm or donor sperm (DAI).
In practice
In Vitro Fertilisation (IVF) involves stimulating the maturation of several follicles in women, and removing the oocytes by transvaginal ultrasound-guided puncture.
The oocytes are then placed in a culture medium, a suspension of capable sperm is added and fertilisation occurs spontaneously in an incubator.
After culturing the embryos for 2 to 5 days, a limited number of embryos are placed back into the uterus in accordance with legal requirements.
IVF is indicated for the treatment of tubal obstructions, endometriosis, moderate sperm deficiency, idiopathic and immunological infertility.
The success rate can be expressed in a variety of ways and depends, among other things, on the woman's age.
Complications of IVF
IVF has few complications:
- In around 5% of cases, ovarian hyperstimulation may result in swelling of the abdomen (which fills with fluid), rarely requiring hospitalisation for a few days with vaginal evacuation and infusion to restore the altered hydromineral balance.
- In less than 2/1000 of oocyte retrievals, it leads to the reactivation of an old infection of the fallopian tubes, requiring antibiotics and hospitalisation for a few days.
- Just as exceptionally (1/1000), it can cause delayed bleeding from the multiple follicles punctured, sometimes necessitating laparoscopy to evacuate the blood.
The highest risk associated with IVF used to be twin pregnancies (20% of pregnancies until 2003) and triple pregnancies (formerly 2% of pregnancies).
With the current provisions (transfer of a single embryo in young women), these risks are respectively reduced to around 10% and 0.2%, i.e. more or less the same as for spontaneous multiple pregnancies without recourse to MAP.
In practice
As with IVF, ICSI involves stimulating the maturation of several follicles in the woman, removing the oocytes by transvaginal puncture and then placing them in a culture medium.
But then, unlike conventional IVF, a single sperm cell (from an ejaculate or taken from the testicle or epididymis) is injected directly into the cytoplasm of the oocyte.
After culturing the embryos for 2 to 5 days, a limited number of embryos are placed back in the uterus, in accordance with legal requirements.
ICSI may be indicated in cases of major sperm insufficiency (oligoasthenoteratospermia and idiopathic fertilisation failure).
What are the risks?
ICSI carries the same risks as IVF:
- In around 5% of cases, ovarian hyperstimulation may result in swelling of the abdomen (which fills with fluid), rarely requiring hospitalisation for a few days with vaginal evacuation and infusion to restore the altered hydromineral balance.
- In less than 2/1000 of oocyte retrievals, it leads to the reactivation of an old infection of the fallopian tubes, requiring antibiotics and hospitalisation for a few days.
- Just as exceptionally (1/1000), it can cause delayed bleeding from the multiple follicles punctured, sometimes necessitating laparoscopy to evacuate the blood.
The highest risk associated with IVF used to be twin pregnancies (20% of pregnancies until 2003) and triple pregnancies (formerly 2% of pregnancies).
With the current provisions (transfer of a single embryo in young women), these risks have been reduced to around 10% and 0.2% respectively, i.e. more or less the same as spontaneous multiple pregnancies without recourse to MAP.
In practice
We perform donor insemination (DAI) on heterosexual couples, although they do not have to be married.
We also accept female couples and single women, but sometimes only after a favourable opinion from a psychiatrist or psychologist.
The maximum age for IAD is 40, in principle, because of the poor results after this age.
After the age of 40, in vitro fertilisation with donor sperm (IVF-D) may be proposed.
The duration of the assessment for DAI is short.
Multidisciplinary management of fertility
Some of the treatments used to treat cancer will have negative effects on the future fertility of patients.
Treatments such as chemotherapy or radiotherapy can have toxic effects on the ovarian reserve (the stock of gametes contained in the ovaries).
The age at diagnosis and at the start of cancer treatment is therefore crucial in determining which techniques reproductive medicine specialists, in agreement with oncologists, will use to preserve fertility in their patients.
Multidisciplinary management of fertility when cancer is diagnosed can be defined as oncofertility.
Several techniques are available depending on the cancer treatment
Cryopreservation of ovarian tissue :
This technique allows a fragment of ovary to be removed under general anaesthetic by laparoscopy.
This technique can only be offered to patients under the age of 36 when urgent chemotherapy treatment is required.
It is the only option for preserving fertility in prepubertal patients.
Part of the ovarian tissue removed is analysed to ensure that there are no malignant cells. The rest is frozen.
After chemotherapy, if the patient does not return to normal cycles, the previously frozen tissue is transplanted using the same laparoscopic technique.
Oocyte and embryo freezing :
When the cancer is announced, the patient has not necessarily met the father of her future children.
In this case, it is possible to cryopreserve oocytes for a legal period of 10 years.
If the couple is already together and wants to become pregnant, embryos can be frozen.
The storage period in this case is 5 years.
Oocyte retrieval is carried out in the same way as IVF retrieval, under local or general anaesthetic (with or without stimulation).
In the case of oocyte freezing, after recovery and at the patient's request, the oocytes are thawed and fertilised with sperm from a partner or sperm donor.
In the case of embryo freezing, after recovery and when the couple so wishes, the embryos will be thawed and transferred to the uterus (legal maximum of 2 embryos transferred at a time).
In vitro maturation :
This technique allows oocytes to be retrieved at an immature stage, in the same way as a standard oocyte retrieval procedure, but with special technical modifications.
The oocytes are then matured in the laboratory to a defined stage where they can be frozen or fertilised with sperm.
As in the case of oocyte and embryo freezing, they can be used once the patient has recovered.
Ovarian stimulation can be used for all these treatments, as it is for in vitro fertilisation.
Given the hormone-sensitive nature of some cancers, anti-oestrogen drugs may be used in combination, which does not limit the use of the various fertility preservation techniques.
The choice of these treatments is made with the patient or couple, in agreement with a multidisciplinary team of oncologists, radiotherapists, psychologists and reproductive medicine specialists.
And what about male patients?
For male patients, one or more sperm samples will be produced by masturbation, then processed in the laboratory and finally frozen in straws.
A societal phenomenon
These days, the age of first pregnancy is getting later and later.
Whether it's a societal phenomenon, long studies or a lifestyle choice with demanding professional priorities, more and more women are turning to social freezing.
What is it about?
Social freezing is the technique used to freeze oocytes for non-medical reasons with the aim of using them at a later date.
The term social freezing is used in contrast to oocyte conservation as part of gonadotoxic treatment (destruction of ovarian tissue): in this case it is referred to as oncofertility.
It is therefore a way of preventing age-related infertility, but it is not an absolute guarantee of maternity.
How does it work?
Social freezing is carried out in the same way as standard IVF treatment, with stimulation by daily injections of medication under the skin for around 11 days.
The oocytes are then retrieved vaginally under local or general anaesthetic during an outpatient session.
When the patient decides, she can ask for her oocytes to be thawed so that they can be fertilised with her partner's sperm or a donor's sperm.
A few figures
The best chances of achieving pregnancy are before the age of 35, either naturally or by in vitro fertilisation (including social freezing).
For social freezing, for example, the chances of pregnancy using mature oocytes harvested before the age of 35 are estimated to be around 5%.
Although not guaranteed, it is preferable to freeze around 20 oocytes to achieve pregnancy. But these figures decrease with age.
This is why oocyte freezing is not offered to patients over the age of 40.
There is currently no mutual insurance reimbursement under the social freezing scheme.
The costs of the assisted reproduction laboratory, stimulation drugs and oocyte preservation are therefore borne by the patient.
Surrogate motherhood (GPA) is when a woman, generally referred to as a ‘surrogate mother’, carries a child on behalf of a ‘couple of intended parents’ to whom the child will be handed over after birth.
Who is this type of treatment intended for?
Recourse to a surrogate mother is necessary when the woman is unable to carry the pregnancy for various possible reasons:
- Either the woman does not have a uterus, in particular as a result of a birth defect or an operation (hysterectomy).
- Or the woman has a uterus but it is unable to carry a pregnancy (malformation, multiple fibroids, severe synechiae, etc.).
- Or when pregnancy is contraindicated for the woman and poses a threat to her life or that of the child.
- Or, more rarely, in the event of repeated IVF failures or repeated miscarriages with no identifiable and/or correctable causes.
Surrogacy can also enable a gay male couple to become parents.
Depending on the different parental projects and the different medical situations, either the members of the couple are the child's genetic parents, or the couple of intention has only a partial genetic link with the child, or the couple of intention has no link at all.
The law in Belgium
Surrogate motherhood is not (yet) regulated by law in Belgium. It is therefore not prohibited as such, but this also means that neither the future parents, the surrogate mother and her family, nor the future child are legally protected.
In Belgium, a woman who gives birth to a child is automatically the legal mother. The father of intention may recognise the child during the pregnancy. Subsequent steps will therefore be necessary to enable the intended parents to become the child's legal parents.
In Belgium, surrogate motherhood is a non-commercial, altruistic practice based on a relationship of trust between the various parties involved.
How does this work in practice?
Surrogacy is possible at our CHIREC fertility centre, but it is a long and complicated process.
First of all, you will need to discuss your plans with one of our specialist doctors.
If you are a couple, you must both attend the consultation. The doctor will check whether you meet the criteria for this procedure.
Your surrogate mother and any spouse will also have to be seen by the doctor. The surrogate mother must have already had a child and be no more than 38 years old. She must be in good health and must not have any personal, family or obstetric history, or any high-risk behaviour. She must meet a specialist obstetrician in order to assess whether a pregnancy poses any additional risk to her or to the unborn child.
After that, you will have to meet the psychologist for several interviews and the lawyer specialising in family law.
Finally, your case will be discussed at a multidisciplinary meeting and, if it is accepted, you will be given another appointment to explain the procedure and the medical treatment.
Agreements and informed consents
Contact form
If you would like more information about your particular case, please fill in this contact form.
Our team will get back to you as soon as possible.
Would you like to become an anonymous egg/sperm donor?
Please complete this form.
Our team will contact you as soon as possible.
What is sperm donation?
This is a medically assisted procreation practice involving the use of sperm from a man other than the one involved in the parental project, either because the latter cannot conceive with his own sperm or because there is no man involved in the initial parental project (single woman, female couple).
Who is this type of treatment intended for?
Sperm donation may be indicated :
- For couples whose man has no spermatozoa (azoospermia), too few spermatozoa (oligospermia), or of too poor a quality (teratospermia) to achieve pregnancy despite access to IVF treatment.
- If the man is a carrier of a serious genetic disease that could be transmitted to the child if his own sperm is used.
- For couples or single women wishing to have a child.
The law in Belgium
Sperm donation is permitted not only for heterosexual couples, but also for single women and female couples.
Anonymous donation is permitted, as is directed donation resulting from a direct agreement between the donor and the recipient couple.
Sperm from the same donor may not be used to give birth to more than 6 different women (or female couples).
Sperm may not be marketed.
Once a sperm donation has been made, it is irrevocable and the donor has no legal rights or duties with regard to the child.
Who are the donors?
- Voluntary anonymous donors who want to help another couple conceive. Donation is altruistic and donors are not paid. They only receive a small compensation for the loss of salary caused by the time required to make the donation.
- Or direct donors: this is most often a close friend of the couple who will donate sperm directly to a woman or couple, enabling the child to have access to his or her origins at a later date.
What tests are carried out on donors?
Anonymous donors must be aged between 18 and 45.
They will be seen by a child psychiatrist or psychologist, a geneticist and a doctor specialising in reproductive medicine, who will carry out an in-depth interview to check their motivations, their medical history and ensure that there is no risk of transmitting a disease to the child.
A blood sample will be taken to screen for sexually transmitted diseases, the most common genetic diseases (such as cystic fibrosis) and certain chromosomal abnormalities via a karyotype.
The same tests will be carried out on directed donors.
Treatment in practice
Sperm donors will produce a sperm sample by masturbation. The sperm is then processed in the laboratory and frozen in straws.
It is then quarantined to ensure that there is no risk of sexually transmitted disease.
Sperm from the donor with the best physical match is selected for treatment.
If the woman has no fertility problems, the treatment consists of intrauterine insemination. At the moment of ovulation, the sperm is thawed, prepared and deposited inside the uterine cavity using a fine catheter.
In certain situations, in vitro fertilisation may be necessary (blocked fallopian tubes, severe endometriosis, etc.). In this case, the woman's oocytes are retrieved and fertilised in the laboratory using the donor's sperm.
The embryo(s) thus formed will then be transferred to the woman's uterus, where they will be able to attach and continue to develop.
Results
Pregnancy success during the sperm donation procedure varies according to the patient's age, any pathology and the quality of the embryo that will be formed if IVF is carried out.
Possible risks
Pregnancies obtained following sperm donation are no different from pregnancies obtained after normal sexual intercourse.
The rates of miscarriage and congenital malformations are identical.
Who is this type of treatment intended for?
Oocyte donation may be indicated when:
- The woman has no more oocytes (premature ovarian failure or advanced age)
- The woman has few and/or poor quality oocytes, making pregnancy impossible despite in vitro fertilisation techniques.
- The woman is a carrier of a serious genetic disease that could be transmitted to the child if her own oocytes are used.
Legal provisions
Belgian law allows egg donation between 2 people who know each other (direct or directed donation) or 2 people who do not know each other (anonymous donation).
Oocytes can be taken from a sister, close relative or friend, fertilised and then transferred to the recipient (directed donation).
There is also the option of anonymous oocyte donation or anonymous cross-donation.
In Belgium, there are very few spontaneous anonymous egg donors. What's more, it is forbidden to pay donors or advertise them.
Donors receive only small compensation for the loss of salary caused by the time taken to donate.
In the case of anonymous cross-donation, you can bring a donor that you have found in your circle. She could donate her oocytes anonymously to another couple and in exchange we will give you oocytes just as anonymously from another donor (anonymous cross-donation).
In principle, for anonymous donation, the donor must:
- Be over 18 and under 36 (35 years and 364 days).
- Meet the anamnesis criteria (personal and family medical history) and the para-clinical examinations requested by the doctor.
- Must meet the psychologist.
- Must meet with a geneticist.
In principle, for direct donation, the donor must:
- Be over 18 and under 39 (38 years and 364 days)
- Have at least one child
- Meet the medical history criteria (personal and family medical history) and the para-clinical examinations requested by the doctor
- Must meet the psychologist.
- Must meet with a geneticist
However, these conditions are discussed on a case-by-case basis.
The donor candidate must, of course, meet strict medical criteria before being accepted.
As far as the recipient is concerned, she must have applied for MAP before the age of 45.
Embryo transfer is authorised up to the age of 48 (47 years and 364 days).
Treatment
The donor must undergo ovarian stimulation treatment to obtain several follicles and oocytes. This stimulation lasts approximately 12 days. It is based on the same principle as the treatments used in standard in vitro fertilisation.
The maturation of the follicles needs to be monitored by a gynaecologist: this requires a few blood tests and ultrasound scans, which can be done close to home if the results are received by fax or e-mail before 4pm the same day.
When the follicles are mature, ovulation will be triggered by an injection that will take place late in the evening.
The donor must be at the clinic on the day of the egg retrieval for day hospitalisation. Oocyte retrieval is normally carried out under sedation (light general anaesthetic).
The recipient must have a medical check-up confirming her suitability for embryo transfer, and she must also undergo treatment to prepare the uterus.
The recipient's cycle does not necessarily have to be synchronised with that of the donor. In fact, it is perfectly possible for the donor to start her cycle and for the oocytes or embryos to be frozen before being transferred to the recipient at a later date, without any reduction in the chances of pregnancy,
In practice, most of the time, the recipient's and donor's cycles are out of sync, thanks to high-performance oocyte and embryo freezing techniques.
Results
The results of oocyte donation are good and depend essentially on the age of the donor.
On average, over 60% of recipients will become pregnant after their third transfer.
Brochures et vidéos
Admission and consultations
Braine l'Alleud-Waterloo Hospital - Building F
- Open Monday to Friday, 8am to 6pm
- Office: 02 434 95 55
- Nurse: 02 434 95 61
- Emergencies: 02 434 93 21
Steps to follow :
- Please go to Admissions in Building F (floor -1) between 7.15am and 7.30am at the latest.
- Once you have registered at the PMA Centre, you will be taken to your room.
Documents you will need to present on the day of admission:
- The agreements (informed consents) completed and signed by the 2 partners. (A countersigned copy from the doctor will be given to you after the sample has been taken).
- The pre-operative questionnaire.
- Identity cards for each partner in the parental project.
- Power of attorney if your partner is unable to attend + a copy of both sides of his or her identity card.
Important information :
- Don't eat, drink or smoke after midnight the night before.
- Do not bring any jewellery, valuables or piercings.
- Do not wear make-up or nail varnish.
- Bring a container for any contact lenses or dentures you may have.
- Be aware that you won't be able to drive that day!
- Be accompanied and supervised for 24 hours.