Fertility Centre - HBW

• Rue Wayez 35, 1420 Braine-l'Alleud
• Building F - Floor -1

Secretariat:

• +32 2 434 95 55
• @email

Mrs. Angela KOTTORA

Coordinator of the PMA secretariats

+32 2 434 95 55

czn/qbg/uoj/ng/puverp/qbg/or

Mrs. Stéphanie BAYENS

Secretary

+32 2 434 95 55

czn/qbg/uoj/ng/puverp/qbg/or

Mrs. Ornella GRIMALDI CALERO

Secretary

+32 2 434 95 55

czn/qbg/uoj/ng/puverp/qbg/or

The team at CHIREC Fertility Centre comprises gynaecologists specialising in reproductive medicine.

Their areas of expertise are wide-ranging, from reproductive endocrinology to andrology, as well as other specialist fields such as reproductive surgery and ultrasound.

The team works closely with other specialists as part of a multidisciplinary approach to ensure the best possible care for patients.

These include:

• psychologists,
• geneticists,
• radiologists,
• pathologists,
• endocrinologists,
• haematologists
• and obstetricians.

The Fertility Centre's numerous collaborative partnerships enable the CHIREC team to refer patients and meet their needs across all areas of reproductive medicine, such as pre-implantation genetic diagnosis (PGD or PGS), ovarian tissue preservation in specific cases of cancer in young women, and the provision of guidance to couples who are seropositive.

Gynaecologists specialising in fertility

Dr. Romain IMBERT

Head of Department - Gynaecologist

Dr. Frédérique DESSY

Gynaecologist

Dr. Sophie HENDRICKX

Gynaecologist

Dr. Sana JABRY

Gynaecologist

Dr. Luc MATHIEU

Gynaecologist

Dr. Walid NOUR

Gynaecologist

Dr. Kristel VAN DEN BROECK

Gynaecologist

Dr. Barbara VAN ELST

Gynaecologist

Dr. Vivian RITTENBERG

Gynaecologist

Biologists

Dr Sc. Anne VANSTEENBRUGGE

Head of the laboratory at the fertility centre

Dr Sc. Anne VAN LANGENDONCKT

Scientific Coordinator

Mrs. Célia ANDRE

Quality Coordinator

Mrs. Catherine BOURGUET

Biologist

Mr. Dimitri DEFER

Biologist

Mrs. Marie DE MUELENAERE

Biologist

Mrs. Amandine HELSON

Biologist

Mr. David JARENO MARTINEZ

Biologist

Mrs. Nina MANZANO

Biologist

Mrs. Eloïse TOUSSAINT

Biologist

Mrs. Sabine VANDERZWALMEN

Biologist

Mrs. Laura VANDERBIEST

Biologist

NURSES

Mrs. Sabrina BUIX

Nurse

Mrs. Charlotte LACROIX

Nurse

Mrs. Frédérique SERVAIS

Nurse

Mrs. Cindy SLEGERS

Nurse

Mrs. Muriel VANDEN ABEELE

Nurse

In practice

This is the simplest assisted reproductive technology (ART) technique.

Intrauterine artificial insemination involves preparing the sperm by centrifugation or migration and instilling a suspension of motile spermatozoa into the fundus of the uterus.

This technique can be used to treat cervical mucus problems and mild sperm deficiencies.

It is also used in cases of idiopathic infertility. It is straightforward to carry out, both for patients and for the assisted reproduction centre.

It is inexpensive and yields significant results, which vary, of course, depending on age and the associated ovulation control techniques: between 10 and 15 per cent according to published studies.

Artificial insemination can be carried out using the partner’s sperm or donor sperm (AID).

In practice

In vitro fertilisation (IVF) involves stimulating the maturation of several follicles in the woman and retrieving the oocytes via ultrasound-guided transvaginal aspiration.

The oocytes are then placed in a culture medium, to which a suspension of viable sperm is added, and fertilisation takes place spontaneously in an incubator.

After the embryos have been cultured for 2 to 5 days, a limited number of embryos are transferred back into the uterus in accordance with legal provisions.

IVF is indicated for the treatment of tubal blockages, endometriosis, moderate sperm abnormalities, and idiopathic and immunological infertility.

The rate of success can be expressed in various ways and depends, amongst other factors, on the woman’s age.

Complications of IVF

IVF results in few complications, namely:

• In around 5% of cases, ovarian hyperstimulation may occur, manifesting as abdominal swelling (caused by fluid build-up), which rarely requires hospitalisation for a few days involving vaginal drainage and intravenous fluid replacement to restore altered fluid and electrolyte balances.
• In fewer than 2 per 1,000 oocyte retrievals, it can trigger a recurrence of a previous infection of the fallopian tubes, requiring a course of antibiotics and hospitalisation for a few days.
• Just as rarely (1 in 1,000), it can cause delayed bleeding from the multiple follicles that have been aspirated, sometimes requiring a laparoscopy to drain the blood.

The highest risk associated with IVF used to be that of twin pregnancy (20 per cent of pregnancies up to 2003) and triplet pregnancy (previously 2 per cent of pregnancies).

Under current guidelines (transfer of a single embryo in young women), these risks have been reduced to approximately 10% and 0.2% respectively, which is more or less the same as for spontaneous multiple pregnancies without the use of assisted reproductive technology.

In practice

As with IVF, ICSI involves stimulating the maturation of several follicles in the woman, retrieving the oocytes via transvaginal aspiration and then placing them in a culture medium.

However, unlike conventional IVF, a single sperm (from an ejaculate or retrieved from the testicle or epididymis) is injected directly into the cytoplasm of the egg.

After the embryos have been cultured for 2 to 5 days, a limited number of embryos are transferred back into the uterus, in accordance with legal provisions.

ICSI may be indicated in cases of severe sperm abnormalities (oligoasthenozoospermia) and in cases of idiopathic fertilisation failure.

What are the risks?

ICSI carries the same risks as IVF:

• In around 5% of cases, ovarian hyperstimulation may occur, manifesting as abdominal swelling (caused by fluid build-up), which rarely requires hospitalisation for a few days, involving vaginal drainage and intravenous fluid replacement to restore the disturbed fluid and electrolyte balance.
• In fewer than 2 in 1,000 oocyte retrievals, it can reactivate a previous infection of the fallopian tubes, requiring a course of antibiotics and hospitalisation for a few days.
• Just as rarely (1 in 1,000), it can cause delayed bleeding from the multiple follicles that have been aspirated, sometimes requiring a laparoscopy to drain the blood.

The highest risk associated with IVF used to be that of twin pregnancies (20 per cent of pregnancies up to 2003) and triplet pregnancies (previously 2 per cent of pregnancies).

Under current guidelines (transfer of a single embryo in young women), these risks have been reduced to approximately 10% and 0.2% respectively, which is more or less the same as for spontaneous multiple pregnancies without the use of assisted reproductive technology.

In practice

We carry out donor-assisted artificial insemination (DAI) for heterosexual couples, who do not necessarily have to be married.

We welcome female couples as well as single women. In certain situations, a prior consultation with a psychiatrist or psychologist is recommended in order to provide the best possible support for the couple’s plans to become parents.

The maximum age for DAI is generally 40, due to poor results beyond this age.

For women over 40, in vitro fertilisation with donor sperm (IVF-D) may be offered.

The assessment process for donor artificial insemination is quick.

A multidisciplinary approach to fertility care

Certain treatments used to treat cancer can have a negative impact on patients’ future fertility.

Treatments such as chemotherapy or radiotherapy can have toxic effects on ovarian reserve (the supply of gametes contained within the ovaries).

The patient’s age at the time of diagnosis and at the start of cancer treatment is therefore crucial in determining which techniques reproductive medicine specialists, in consultation with oncologists, will recommend to their patients for the preservation of their fertility.

Multidisciplinary fertility care at the time of a cancer diagnosis can be defined as oncofertility.

Several techniques are available depending on the cancer treatments

Ovarian tissue cryopreservation:

This technique involves removing a fragment of ovarian tissue under general anaesthesia via 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 fertility preservation in pre-pubertal patients.

A portion of the removed ovarian tissue is analysed to ensure the absence of malignant cells. The remainder is frozen.

After chemotherapy, if the patient does not resume normal menstrual cycles, the previously frozen tissue will be transplanted using the same laparoscopic technique.

Freezing of oocytes and embryos:

At the time of the cancer diagnosis, the patient may not yet have met the father of her future children.

In such cases, it is possible to cryopreserve oocytes for a statutory period of 10 years.

If the couple are already together and wish to conceive, it is possible to freeze embryos.

The storage period in this case is 5 years.

Oocyte retrieval is carried out in the same way as for standard in vitro fertilisation, under local or general anaesthesia (with or without ovarian stimulation).

In the case of oocyte freezing, once the patient has recovered and when she so wishes, the oocytes will be thawed and fertilised with sperm from a partner or a sperm donor.

In the case of embryo freezing, once the patient has recovered and when the couple so wishes, the embryos will be thawed and transferred to the uterus (the legal maximum is two embryos transferred at a time).

In vitro maturation:

This technique allows oocytes to be retrieved at an immature stage, as in a standard oocyte retrieval procedure, but with specific technical modifications.

The oocytes are then matured in the laboratory to a defined stage at which they can be frozen or fertilised with sperm.

As with oocyte and embryo freezing, these can be used once the patient has recovered.

During all these treatments, ovarian stimulation, as used in in vitro fertilisation, is possible.

Given the hormone-sensitive nature of certain cancers, anti-oestrogen drugs may be used in combination, thereby ensuring that the use of various fertility preservation techniques is not restricted.

The choice of these treatments is made in consultation with the patient or the couple, in agreement with a multidisciplinary team comprising oncologists, radiotherapists, psychologists and specialists in reproductive medicine.

And what about male patients?

For male patients, one or more semen samples will be collected via masturbation, then processed in the laboratory, and finally frozen in straws.

A societal phenomenon

Nowadays, women are having their first child later and later.

Whether due to societal trends, long periods of study or lifestyle choices involving demanding career priorities, more and more women are turning to social freezing.

What is it?

Social freezing is a technique that involves freezing oocytes for non-medical reasons with a view to their future use.

The term social freezing is used in contrast to the preservation of oocytes as part of gonadotoxic treatment (destruction of ovarian tissue): in this case, the term ‘oncofertility’ is used.

It is therefore a means of preventing age-related infertility, but it does not offer an absolute guarantee of motherhood.

How does it work?

Social freezing follows the same procedure as a standard in vitro fertilisation (IVF) treatment, involving stimulation through daily subcutaneous injections of medication for approximately 11 days.

The oocytes are then retrieved vaginally under local or general anaesthesia during a day-case procedure.

When the patient is ready, she will request that her oocytes be thawed for fertilisation with her partner’s sperm or donor sperm.

Some figures

The best chances of achieving a pregnancy are before the age of 35, whether through natural conception or IVF (including social freezing).

For social freezing, for example, the chances of pregnancy using mature oocytes retrieved before the age of 35 are estimated at around 5 per cent.

Although there is no guarantee, it is advisable to freeze around 20 oocytes to enable pregnancy. However, these figures decrease further with age.

This is why egg freezing is not offered to patients over the age of 40.

There is currently no provision for reimbursement by private health insurance in the context of social freezing.

The costs of the assisted reproductive technology laboratory, as well as the medication for ovarian stimulation and egg preservation, are therefore borne by the patient.

Surrogacy is the process whereby a woman, generally referred to as a ‘surrogate mother’, carries a child on behalf of an ‘intended parent couple’, to whom the child will be handed over after birth.

Who is this type of treatment for?

The use of a surrogate mother is necessary when a woman is unable to carry a pregnancy for various possible reasons:

• Either the woman does not have a womb, particularly as a result of a congenital malformation or an operation (hysterectomy).
• Or the woman has a uterus but it is unable to carry a pregnancy (malformation, multiple fibroids, severe adhesions, 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 cases of repeated failures of in vitro fertilisation or recurrent miscarriages without identifiable and/or correctable causes.

Surrogacy can also enable a male same-sex couple to become parents.

Depending on the couple’s parenting plans and their medical circumstances, either the couple are the child’s genetic parents, or the intended parents have only a partial genetic link to the child, or the intended parents have no genetic link at all.

The law in Belgium

Surrogacy is not (yet) regulated by law in Belgium. It is therefore not prohibited as such, but this also means that neither the intended parents, nor 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 intended father may recognise the child as his own during the pregnancy. Further steps will therefore be necessary to enable the intended parents to become the child’s legal parents.

In Belgium, surrogacy 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 an option at our CHIREC assisted reproduction centre, but it is a long and complicated process.
 

Firstly, 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 her partner, if any, will also need to be seen by the doctor. The surrogate mother must have already had a child and must be aged 38 or under. She must be in good health and must not have any personal, family or obstetric history of medical conditions, nor engage in any high-risk behaviour. She must consult a specialist obstetrician to assess that a pregnancy does not pose any additional risk to either her or the unborn child.

You will then be required to attend several consultations with a psychologist and a lawyer specialising in family law.

Finally, your case will be discussed at a multidisciplinary meeting and, if approved, you will be given a further appointment to explain the procedure and the medical treatment.

These documents are currently only available in French.

These documents are currently only available in French.

These documents are currently only available in French.

These documents are currently only available in French.

These documents are currently only available in French.

These documents are currently only available in French.

These documents are currently only available in French.

These documents are currently only available in French.

These documents are currently only available in French.

These documents are currently only available in French.

These documents are currently only available in French.

If you would like more information about your specific situation, 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 or sperm donor?

Please complete this form.

Our team will contact you as soon as possible.

What is sperm donation?

It is a form of medically assisted reproduction in which sperm is used from a man other than the one involved in the parenthood project, either because the latter is unable to father children using his own sperm, or because no man is involved in the original parenthood project (single woman, female couple).

Who is this treatment intended for?

Sperm donation may be appropriate:

• For couples where the man has no sperm (azoospermia), too few sperm (oligospermia) or sperm of poor quality (teratospermia) to achieve a pregnancy despite access to in vitro fertilisation treatments.
• If the man is a carrier of a serious genetic condition that could be passed on to the child if his own sperm were used.
• For female couples or single women who wish to have a child.

The law in Belgium

Sperm donation is permitted for heterosexual couples, as well as for single women and female couples.

Anonymous donation is permitted, as is matched donation based on a direct agreement between the donor and the recipient couple or the recipient woman.

Sperm from the same donor may not result in the birth of more than six children to different women (or female couples).

The commercialisation of sperm is prohibited.

Once carried out, sperm donation is irrevocable and the donor has no legal rights or obligations towards the child.

Who are the donors?

Anonymous voluntary donors who wish to help another couple have a child. The donation is altruistic and the donors are not paid. They receive only a small allowance to compensate for the loss of earnings due to the time taken for the donation.

Alternatively, direct donors: these are usually close friends of the couple who donate sperm directly to a woman or a couple, thereby enabling the child to trace their origins later in life.

What tests are carried out on donors?

Anonymous donors must be aged between 18 and 45.

They attend a consultation with a child psychiatrist or psychologist, a geneticist and a doctor specialising in reproductive medicine, who ask them detailed questions to assess their motivation and medical history and to ensure there is no risk of transmitting diseases to the child.

A blood sample is taken to screen for sexually transmitted infections, the most common genetic disorders (such as cystic fibrosis) and certain chromosomal abnormalities via a karyotype.

The same tests are carried out on selected donors.

The treatment in practice

Sperm donors provide a sperm sample through masturbation. The sperm is then processed in the laboratory and subsequently frozen in straws.

It is placed in quarantine to ensure there is no risk of sexually transmitted infections.

The sperm from the donor with the most suitable physical characteristics is selected for treatment.

If the woman has no fertility problems, treatment consists of intrauterine insemination. At the time of ovulation, the sperm is thawed, prepared and inserted into the uterine cavity using a thin catheter.

In certain situations, it is necessary to use in vitro fertilisation (blocked fallopian tubes, severe endometriosis, etc.). In such cases, the woman’s eggs are retrieved and fertilised with the donor’s sperm in the laboratory.

The resulting embryo(s) is or are then transferred into the woman’s uterus, where they can implant and continue to develop.

Results

The success rate of achieving a pregnancy through a sperm donation procedure varies depending on the patient’s age, any underlying medical conditions and the quality of the embryo formed during in vitro fertilisation.

Possible risks

Pregnancies achieved through sperm donation are no different from those achieved through normal sexual intercourse.

The rate of miscarriages or congenital abnormalities is identical.

Who is this treatment intended for?

Egg donation may be appropriate when:

• The woman no longer has any eggs (premature ovarian failure or advanced age).
• The woman has few eggs and/or poor-quality eggs, making pregnancy impossible despite in vitro fertilisation.
• The woman is a carrier of a serious genetic disorder which could be passed on to the child if her own eggs were used.

Legal provisions

Belgian law permits egg donation between two people who know each other (direct or matched donation) or two people who do not know each other (anonymous donation).

It is possible to collect eggs from a sister, a close relative or a friend, to fertilise them and then transfer them to the recipient (directed donation).

There is also the option of using an anonymous egg donation or a cross-anonymous donation.

In Belgium, there are very few spontaneous anonymous egg donors. Furthermore, it is prohibited to remunerate donors or to advertise for them.

Donors receive only a small allowance to cover the loss of earnings they incur due to the time taken for the donation.

In the case of an anonymous cross-donation, you may bring along a donor whom you have found in your own circle of acquaintances. She can anonymously donate her eggs to another couple and, in exchange, we will allocate eggs from another donor to you in an equally anonymous manner (anonymous cross-donation).

In principle, for an anonymous donation, the donor must:

• Be over 18 and under 36 (35 years and 364 days).
• Meet the criteria for medical history (personal and family medical history) and undergo the paraclinical tests requested by the doctor.
• It is compulsory to make an appointment with the psychologist.
• Must make an appointment with a geneticist.

In principle, for direct donation, the donor must:

• Be over 18 and under 39 years of age (38 years and 364 days)
• Have at least one child
• Meet the criteria for medical history (personal and family medical history) and the paraclinical tests requested by the doctor
• It is compulsory to book an appointment with the psychologist.
• It is compulsory to book an appointment with a geneticist

However, these conditions are assessed on a case-by-case basis.

The prospective donor must, of course, meet strict medical criteria before being accepted.

The recipient must have submitted her application for assisted reproductive technology before her 45th birthday.

Embryo transfer is permitted up to the age of 48 (47 years and 364 days).

Treatment

The donor must undergo ovarian stimulation treatment to obtain multiple follicles and eggs. 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 must be monitored by a gynaecologist: this requires a few blood tests and ultrasound scans, which may be carried out near the donor’s home, provided that the results are sent to us by fax or email on the same day before 4 pm.

Once the follicles are mature, ovulation is triggered late in the evening by means of an injection.

The donor must be present at the clinic on the day of the egg retrieval for a day’s stay. The egg retrieval normally takes place under sedation (light general anaesthesia).

The recipient must undergo an examination to confirm that she is suitable for an embryo transfer and must also undergo treatment to prepare the uterus.

The recipient’s cycle does not necessarily need to be synchronised with that of the donor. Indeed, it is entirely possible for the donor to begin her cycle and for the eggs or embryos to be frozen before being transferred to the recipient at a later date, without this reducing the chances of pregnancy.

In practice, the recipient’s and donor’s cycles are usually not synchronised, thanks to advanced techniques for freezing eggs and embryos.

Results

The results of egg donation are good and depend mainly on the donor’s age.

On average, it can be assumed that more than 60% of recipients will be pregnant after their third transfer.

Please complete this form to let us know that you are starting your treatment cycle.

The Assisted Reproduction Centre’s administration team will contact you within 3 hours of receiving your request.

Please note: If you submit your treatment cycle registration form at the weekend, it will be processed on the following Monday.

Please ensure you can be reached by telephone.

Most of the documents are currently available in French only

Braine-l'Alleud Hospital – Building F

• Open Monday to Friday, from 8.00 am to 6.00 pm.
• Reception: 02 434 95 55
• Nursing staff: 02 434 95 61
• Emergencies: 02 434 93 21

Steps to follow:

• Please go to the admissions department in Building F (level -1) between 7.15 am and 7.30 am at the latest.
• Once you have registered at the MBV centre, you will be shown to your room.

Documents you must present on the day of admission:

• The forms (informed consent forms) completed and signed by both partners. (A copy co-signed by the doctor will be given to you after the sample has been taken).
• The pre-operative questionnaire.
• Identity cards for both partners in the parenthood project.
• A power of attorney if your partner is unable to attend, plus a copy of both sides of his or her identity card.