UZ Brussel-VUB - Frequently asked Questions

Frequently asked Questions

What can we to improve our chances of success?

Even though IVF treatment is a medical process on which you have no influence, there are a number of things connected to your lifestyle which you can change to increase your chances of benefiting from the treatment. Stopping smoking - for both partners is the most important thing to do. If you would like to know what else you can, see lifestyle.

What can you do yourself to improve your chances of success?

Do we have to inform people that we are having treatment?

Will IVF cause me to have premature menopause?

Is hormone treatment harmful?

Is there an increased risk of multiple pregnancy?

Is there an increased risk of ectopic pregnancy?

Are the replaced embryos really ours?

Are frozen embryos as good as fresh ones?

What happens if our personal life situation changes?

Do IVF children have more abnormalities?

Can we choose the sex of our baby?

Do we have to inform people that we are having treatment?
It would be advisable to inform certain people. The woman should inform her employers as soon as possible. During the treatment, you will need to make several trips to the hospital for the various tests and procedures which will be necessary. It will be easier if your employers know the real reasons for your absence. With an honest approach, you will probably receive a more understanding reaction from people if you are distracted and stressed during the treatment. It can also be a form of great support and relief if you are able to discuss your feelings with family of friends.

You should however refrain from telling too many people about it. Otherwise you will be bombarded with questions about your progress from all sides, which can become stressful especially if there is no resulting pregnancy. Both professionally and privately, you'll probably find that one or two trusted people are enough.
There is no need for you to feel ashamed about the fact that you are receiving fertility treatment. 10-20% of couples experience some kind of fertility problem. However if you find it difficult to talk about with other people, you can always obtain support from your counsellor at the CRG.

will ivf treatment cause me to have premature menopause?

Certainly not. During the stimulation, ten or more follicles are developed. This is also the case in nature. The only difference is, in nature only one follicle reaches full maturity and the rest die, whereby in IVF, they all ripen. Therefore IVF makes egg cells available, which would otherwise be lost.
Apart from that, a woman has a stock of over 400.000 egg cells at the start of her fertile years, the majority of which degenerate and die over time. IVF treatment makes use of a huge supply of eggs, most of which would never be used in nature.

Is hormone treatment harmful?
The hormones administered can have side effects, this much is true. These are however not dangerous and are only temporary (see ovarian hyperstimulation syndrome).

Claims that the hormones used during IVF are cancer causing have not been medically proven. These hormones have been in use as part of fertility treatment since before IVF was even invented, without harmful side effects ever having been reported. The influence of hormone treatment is constantly examined worldwide. So far there has never been any cause for concern.

is there an increased risk of multiple pregnancy?

No, not anymore. The medical stance of the CRG has always been to transfer only a limited number of embryos, and the statutory rules as well have as principal goal to restrict the number of embryos that will be transferred.

Why is this so important? Well, if a woman younger than 37 becomes pregnant as a result of IVF, the chances of her having twins is 30% when two embryos are replaced and almost 40% if three are replaced. In the last case there is also a 5% chance of her having triplets.
Multiple pregnancies run an increased risk of miscarriage, premature birth and other complications. With triplets, the risks are so high, that in the past selective embryo reduction, whereby the number of embryos in the uterus is reduced, was applied.
The higher incidence of multiple births associated with IVF explains why the perinatal mortality rate (the number of children who die between the 28th week of pregnancy and the 7th day after birth) of children born as a result is clearly above average. This has nothing to do with the fact that fertilization occured in the laboratory.
To avoid these health risks, the Belgian legislator has made the maximum allowed number of embryos that can be transferred dependant on the age of the woman and the number of treatments she has already received in the past. See financial information for further reading. Since the law was passed, the laboratory costs of treatment are reimbursed in most cases.

is there an increased risk of ectopic pregnancy with ivf?
In women who conceive naturally, there is a 1% chance of an ectopic pregnancy. In women who become pregnant through IVF, the chance is not higher unless she has damage to her fallopian tubes.
It is not difficult to understand why IVF treatment might lead to ectopic pregnancy. Despite careful placement of the embryos in the uterus, they don't implant immediately and can sometimes drift into the fallopian tubes and implant there. In this case the pregnancy must be terminated. See termination of ectopic pregnancy.

How can we be sure that the embryos transferred are ours?
The CRG insists upon and adheres to strict identification procedures for egg cells, sperm and embryos. Since April 2005, we have acquired the ISO 15189 accreditation as a result.

Absolutely no risks are taken. Two separate people control every single step of the procedure, independent of one another. During the treatment you will constantly be asked your name: now you know why that is. In practice, mistakes, loss, or switches are out of the question.

Are frozen embryos just as good as fresh ones?
The new legislation regarding assisted fertilization and everything related specifies that prior to commencing your treatment you must decide what needs to be done with surplus embryos. These are embryos that originated from your treatment, but that you didn't need for transfer. You need to stipulate in the consent form that you sign prior to your treatment whether you want to have tose frozen or not.

If you chose to have them frozen, you will first have to use the frozen material at the next IVF attempt or if you wish another child, unless there is a good medical reason to use fresh embryos again and thus to start over the whole IVF treatment.

From a health perspective of the baby that possibly ensues from the embryo there is no objection against freezing. The misconception that thawed embryos produce more babies with abnormalities is not supported by any medical or scientific evidence.

But from a viewpoint of efficiency of the treatment we must note that not all embryos survive the freezing process, whilst thawed embryos have a smaller chance than fresh ones of implanting and developping successfully in the womb. Therefor the chances of success of a treatment with frozen embryos are less than one with fresh embryos, and this could be an argument against freezing.

Furthermore there also is an emotional-psychological aspect to consider, because you also need to stipulate in the contract what needs to be done with the frozen embryos once you have no (further) need for them: donation, destruction or releasing them for scientific research. You might have moral difficulties subsequently, especially if the IVF treatment would have resulted in the fulfillment of your child wish.

WHAT HAPPENS TO OUR FROZEN GENETIC MATERIAL IF OUR PERSONAL LIFE SITUATION CHANGES?

Prior to commencing your fertility treatment you have to sign a form where you will stipulate what needs to be done with your frozen genetic material once you have no (further) need for it. This concerns you - the man - as well if you had (sperm) cells frozen that were harvested through surgery as part of a treatment.

If your child wish is fulfilled or if you abandon further treatment you have the choice to donate the material, to have it destroyed or to release it for scientific research.

However, if your personal life situation changes while you might in principle still have need for the genetic material a different set of rules apply. The new legislation (2007) regarding assisted fertilization and everything related stipulates that you have to consider this possibilitity as well and make your decision known in a permission form. So should you divorce during the treatment or should one of the partners pass away, it will depend on your contractual decision what happens with the stored material and if one partners still can claim it after the other partner has passed away. As long as the agreed upon storage period is in effect your decision can be revised, but this needs to be done unanimously: each and every revision needs to be signes bu both original partners.

do ivf children have more abnormalities?
Children born of treatment in the CRG are examined by the Centre for Medical Genetics (CMG) at the ages of two months, one year and two years. Abnormalities are observed in about 3%. This result corresponds not only with that of other IVF centres, but also of that observed in children born of natural means. As for the newer techniques of fertility treatment, it is still too early to be able to form definite conclusions. Much more data needs to be gathered. There is so far no evidence to suggest that ICSI poses a greater risk of birth defects, but this cannot yet be said for sure.

Can we choose the sex of our child?
Nowadays it is possible to determine the sex of an embryo before it is placed in the uterus (see laboratory examinations on embryos). However sexual selection is only implemented if there is a specific medical reason for doing this, for example the risk of hereditary conditions which effect only one sex.

Sex selection based upon personal choice is not possible under any circumstances.