Am I allowed to smoke cigarettes during treatment?
Smoking increases the hormone doses necessary for ovarian stimulation. Therefore, we recommend stopping smoking before you start fertility treatment. Smoking also reduces the weight of the newborn child.
Can I use semen from open donors?
No. The Danish Law says explicitly, that physicians are only allowed to treat with anonymous donor semen.
Can we have sex after insemination?
Yes. Actually, we recommend that you go home and have sex later on the day of insemination. The seminal fluid contains substances that seem to promote pregnancy.
Definition of infertility
When a couple has had regular unprotected intercourse 2-3 times a week for a year without obtaining a pregnancy, it is reasonable to start looking for an explanation for the reduced fertility in the man and the woman.
During the first year, 84 % of all fertile couples will obtain a pregnancy. Waiting for another year, about 92 % will become pregnant.
Do I have to inject myself during treatment?
Yes, the hormone stimulation substance is given as subcutaneous injections into the abdominal skin. Our nurses will demonstrate for you how to do this. If you feel difficulties in doing it yourself, your partner or a good friend can do it for you.
Do I use all my eggs during hormonal stimulation?
No. Every single day, a certain number of eggs start the maturation process towards ovulation. Normally, only a single egg or follicle continues growing, the others die. By adding a little amount of hormone, more eggs continue growing and mature until ovulation instead of dying due to shortage of follicle stimulating hormone.
Do we have to be married to have treatment?
No. Married, cohabiting and single women can have treatment.
Does smoking affect the semen quality?
Yes. It has been shown, that sperm cells from smokers contain more DNA-injuries than sperm cells from non-smokers. Especially men with severely reduced semen quality can improve the chances by stopping or reducing the number of cigarettes.
Does the hormonal treatment increase my risk of cancer?
No. So far, no investigations have demonstrated an increased risk of cancer. On the contrary, women who have given birth to a child seem to have a reduced risk of ovarian cancer compared to women who have never been pregnant. It is the pregnancy itself that decreases the risk.
Does the oocyte aspiration procedure hurt?
No, you will not feel pain; it feels more like a menstruation-like discomfort. Before we obtain the oocytes, we give you an effective local anesthetic in the vagina and you will also have an intravenous pain-killer. After the procedure, you rest for 20 minutes and are able to leave the clinic afterwards.
For how long time can frozen embryos be stored?
According to Danish law, embryos can be stored for 5 years. With the exception that after their 46th birthday, women are no longer allowed to have their embryos replaced.
How do you investigate the patency of the Fallopian tubes?
It can be done by ultrasound (HSU), X-ray (HSG) or laparoscopy. Using the HSU or HSG technique, a small catheter is inserted into the uterine cavity, and the uterine cavity is filled with contrast fluid. The outflow through the Fallopian tubes is visualised by either ultrasound or X-ray. Using laparoscopy, blue dye is inserted into the uterine cavity and the spillage through the open ends of the tubes is observed directly.
How many embryos are transferred after IVF?
Transferring more than a single embryo increases your risk of having twins. The risk depends both on the woman’s age and the embryo quality. The Danish National Board of Health has the following recommendations: If the woman is younger than 37 years and she has more than a single embryo of top-quality, it is advisable to replace a single embryo and freeze the others at the first and second replacement. If there are no embryos for freezing, two are often recommended. In women over 40 years we are allowed to replace up to three fresh embryos, depending on the embryo quality.
How many inseminations can we have?
It depends on the reason for your infertility.
Normally, it is reasonable to try insemination with the husbands sperm
three times. After that, you should consider IVF
instead. Is the woman young, healthy and has donor inseminations, you
can try up to six inseminations, depending on the woman’s age.
How many women become pregnant with twins after insemination?
The Danish Fertility law says that insemination must
be cancelled when more than 3 large follicles (>14 mm) are present
at the day of ovulation induction. The pregnancy chance per follicle is
about 10 %. About 12 % of all women pregnant after insemination have a
twin pregnancy, see results.
How many women will have twins?
In women less than 35 years with two top-quality embryos replaced, about 50 % will have a positive pregnancy test
and 25 % will have a twin pregnancy. With single embryo transfer, about
40% will become pregnant and the risk of monozygotic twins is very
small. In elder women, the risk of twins is decreasing. In our clinic,
about 15% of all pregnant women have a twin pregnancy.
How much alcohol I am allowed to drink during my treatment?
New scientific investigations have shown, that even small amounts of alcohol influence on the chances of becoming pregnant. After a positive pregnancy test, the woman should not drink any alcohol at all. In the man, large quantities of alcohol also influence on semen quality.
I have started bleeding before the pregnancy test. Is it necessary to have the test done?
Yes. Even if you have started bleeding, you can still be pregnant and continue with a normal pregnancy. In case the pregnancy test is positive and the woman has her menstruation, she might have an ectopic pregnancy.
Is insemination treatment free?
Yes. If you are a Danish citizen and are covered by the Danish health security (Sygesikringen), investigations and insemination treatment is for free if you bring with you a referral from your GP. However, you have to pay for medication and donor semen. All other patients have to pay themselves.
Is it necessary to examine the woman for Chlamydia before an investigation of the patency of the Fallopian tubes?
The investigation of the tubes can result in a Chlamydia infection if they are present in the cervix during the investigation. Therefore a negative Chlamydia test is necessary before examination of the tubes.
Is IVF free of charge?
Unfortunately not, even not for Danish citizens covered by the Danish health insurance (Sygesikringen). Only treatments in public hospitals are free.
Is there a long waiting time for treatment?
Is there a risk of having an ectopic pregnancy using IVF?
Yes. One to two percent of all pregnancies after IVF are ectopic, even though the embryos were placed correctly inside the uterus.
Is there a waiting time for treatment?
No. When you bring all necessary tests with you for the introductory interview, treatment can start immediately afterwards and there will be no further waiting time for treatment start.
Is there an age limit for treatment?
Yes. We are allowed to treat women up to their 46th birthday. However, due to the very poor prognosis for insemination-treatment after 43 years, we do not perform inseminations on women 44 years or older.
May we have sex after embryo replacement?
In the days just after oocyte retrieval and embryo replacement, most women feel painful in their abdomen and do not want to have sex. One week after embryo replacement, the embryo has implanted into the uterine mucosa if everything goes well, and now sexual intercourse cannot do harm any more.
Previous sterilising treatment. What treatment do I need?
Tubal ligation of the woman: IVF.
Vasectomy of the man: after vasectomy semen production continues, however, the sperm cannot leave the testicles. Therefore, it is possible to extract living sperm cells in a small biopsy from the testicles. This procedure is called TESE (TEsticular Sperm Extraction). After sperm recovery, a single sperm cell is injected into each oocyte to enable fertilisation. The procedure requires that the woman must have IVF in order to recover the oocytes.
Should occluded salpinges be surgically removedbefore fertility treatment?
Scientific investigations have proven that it is beneficial to remove hydrosalpinges (salpinges filled with fluid) before fertility treatment. If hydrosalpinges are present, they reduce the chance of obtaining a pregnancy with 50 %. Therefore we recommend their removal before fertility treatment is started. It is normally done by laparoscopy.
What can I do myself to improve the treatment?
What happens, if I become pregnant during down-regulation?
It is not dangerous for the foetus. What happens is the following: you will not have your menstruation during down-regulation. Once you have a positive pregnancy test, down-regulation is discontinued and the pregnancy progresses normally.
What is endometriosis?
In some women, endometrial mucosa is found outside the uterus in the abdominal cavity. It is observed in the ovaries, on the Fallopian tubes, the bladder and on the intestines. The most frequent symptom is abdominal pain just before menstruation begins. Endometriosis can also cause blood cysts inside the ovaries. Endometriosis is more frequently found in infertile compared to fertile women. However, it is not proven that endometriosis is the reason for infertility in affected women. For some reason women with endometriosis have reduced pregnancy chances with insemination, and IVF is often recommended instead.
What is ICSI?
ICSI means IntraCytoplasmic Sperm Injection. By gently introducing a single sperm cell into each oocyte, the chance of fertilization is increased when only few sperm cells or sperms with decreased motility are present.
What is IVF?
What is PCOS?
What is TESE?
What is the chance of becoming pregnant without fertility treatment?
A healthy women 25 years old will become pregnant every 4th month. A healthy women 35 years old will become pregnant every 8th month.
What is the reason for infertility?
When do I have to inject the ovulation induction?
36 hours before the insemination is scheduled.
When do I have to take the ovulation induction?
The ovulation inducing substance (ovitrelle or pregnyl) has to be taken exactly 36 hours before the planned oocyte pick-up. If you take it too early, ovulation will already have occurred when you arrive at the clinic. If you take it too late, the oocytes will not be ready for aspiration. In case you have forgotten to take the ovulation induction, please call us directly and ask for instructions. Often, it can be done 24 hours later.
When is blastocyst culture recommended?
The embryo develops into a blastocyst on the fifth day after oocyte aspiration. By culturing to the blastocyst stage, some embryos will stop development before that stage, and this makes it easier to identify the embryo with the best chance of resulting in a viable pregnancy. However, it does not improve the quality of the single embryo. We especially recommend blastocyst culture to young women with good quality embryos who want single embryo replacement. If there are several good quality blastocysts, the others can be frozen stored.
Who can have treatment with IVF for free?
For having this treatment for free in a hospital, the couple must not have common children or shared custody. Only women under 40 years are treated and the couple must have lived together for a certain period of time.
Who is allowed to have treatment in Denmark?
According to Danish Law, we are allowed to treat
* heterosexual couples
* lesbian couples
* single women
Why do I need hormone stimulation for insemination?
It depends on the reason of your infertility. By stimulating two follicles, the chance of becoming pregnant is twice the chance with a single follicle. Therefore, we often advise hormone stimulation if the twinning risk is not too large.
Why do I need hormones for IVF?
For IVF, we aim at having 6-8 follicles for oocyte pick-up. We do not necessarily obtain oocytes from all follicles, and not all oocytes are fertilized correctly. By having 6-8 follicles we feel pretty sure that there will also be 1-2 good embryos for replacement.
Why do I need to have a blood test one week after insemination?
During the first treatment, we would like to control whether the corpus luteum is functioning correctly by measuring your progesterone blood level one week after the insemination.
During the first treatment, we would like to control whether the corpus luteum is functioning correctly by measuring your progesterone blood level one week after the insemination.
During the first treatment, we would like to control whether the corpus luteum is functioning correctly by measuring your progesterone blood level one week after the insemination.
Why do the Fallopian tubes (salpinges) occlude?
Most often, the reason is a sexual transmitted infection, especially Chlamydia. The woman does not necessarily have had symptoms, as 50% of Chlamydia infections are asymptomatic. Beyond this, an ectopic pregnancy or a severe appendicitis can destroy the passage in the tubes.
Why does the man have to deliver 2 semen samples?
Men’s semen quality is fluctuating. It can be normal one day, and reduced 2 days later. To get an impression of the fluctuations in the single male, we often ask for 2 different semen samples for diagnostic tests with a one week interval.
Why must the woman’s gonadotrophic hormones be analysed on a specific day of the menstrual cycle?
Will assisted hatching improve my pregnancy chances?