Your ART treatment at the CRG in practice

CRG stands for patient centered care: care for (the comfort of) the patient.
This is why we created a quality framework, with well-defined procedures that jointly determine the success of our treatments. Because although Assisted Reproductive Treatment (ART) is primarily a (specialised) medical treatment, the chances of success not only depend on our medical expertise. A good organisation, alert communication and qualitative support are also crucial success factors. And yes, even the administrative framework of your treatment is part of this.

How do we make sure your treatment runs smoothly?

   

Sound advice

What can I do to give my treatment a greater chance of success? Read it all here.

And click Folic acid if you want to know what every woman who wants to be pregnant should know about it.

Preliminary examinations
Counselling
Start date ovarian stimulation
Daily Patient Monitoring (DM) 
Pre-operative blood test

Throughout your treatment you receive professional support by people of the CRG team. On the one hand this is of course the fertility doctor, but you can also talk to a counsellor. This is the nurse or midwife who provides information about the treatment, and provides support.

Preliminary examinations       

Because both men and women play crucial roles in reproduction, they will both be subject to a variety of medical examinations. These examinations are discussed at the first appointment with the CRG doctor.
  • For an efficient consultation, it is important you fill out a questionnaire about your medical and family history. The form can be downloaded here: questionnaire woman, questionnaire man
  • To avoid unnecessary examinations, please provide the results of any previous examinations and all relevant medical information. 
  • If this information is elsewhere you can request it. Current legislation allows you to make this request yourself. You can request a copy of your medical record, regardless of whether it is with your GP, gynaecologist or the hospital where you were treated.
  • Any examinations deemed necessary by the doctor can be performed at UZ Brussel or elsewhere:

Preliminary blood test     

Practical

Read more about the where-when-and-how of blood samples during your treatment at the CRG.

Every fertility treatment at the CRG is preceded by a blood test. This allows us to establish detailed information regarding hormonal balance, to determine the structure and number of chromosomes and detect possible antibodies for, among others, jaundice (hepatitis), the HIV virus (aids) and syphilis.
Women are also checked for immunity against Rubella (German measles) and toxoplasmosis. Both of these conditions can lead to serious damage to the child during early pregnancy.

Sperm analysis     

Practical

Read more about the where-when-and-how of providing a sperm sample.

A man's fertility is determined mainly by the number of sperm present in his semen, their motility and form. That is why all three of these elements are studied in depth: see routine sperm analysis. We check immediately whether sufficient usable sperm can be separated for the insemination or fertilisation of eggs in the laboratory.
If at the time of the medical examination you have not had an ejaculation for three to five days you can immediately produce a sample. Simply by masturbation in a separate room, possibly aided by your partner.
The sample may also be produced elsewhere than the CRG, provided that it is delivered to the lab within an hour in a special container. For this, you have to make an appointment with the andrology lab beforehand (see contact). The container must be kept at body temperature, e.g. by putting it in the inside pocket of your coat.  

Other tests   

Depending on your specific medical situation other tests or procedures may be necessary. See the overview for men and women.

Counselling      

About five weeks after the first doctor's consult all preparatory tests have been carried out and the results are known. This is followed by your second appointment with the doctor, during which he/she goes over the results with you. Based on this the doctor suggests treatment.
You will then have an appointment with the counsellor for an information session during which your treatment is discussed from various angles. The counsellor will discuss the following with you:
  • the practical aspects, such as the start date and the consultation with the planning coordinator, opening hours, the process for making appointments at the CRG, where and when, which procedure takes place, etc.
  • the medical side: what your treatment involves, which medication you will be taking, how you should administer it and how you should prepare for a procedure; 
  • the communication with the CRG: with the Centre's Daily Patient Monitoring department (DM) during your treatment, and with the follow-up team afterwards in case of a pregnancy; 
  • the legal aspects, such as consent forms you have to sign; and 
  • the financial side of the treatment with information on the reimbursement conditions for Belgian patients with national health insurance.

If the doctor has not yet done so, the counsellor will advise women to start taking folic acid as soon as you decided to start fertility treatment. See folic acid for the why.

During the entire treatment, the counsellor will be your confidential adviser whom you can contact at any time during office hours for advice and information. Thanks to his/her vast experience, your counsellor will be able to guide you through any practical, physical or psychological problems. If necessary, your counsellor will make additional appointments for you with your doctor, or with the psychologist at the CRG. She (or he) will also be there to help you through additional ART attempts.
For some aspects of your treatment, you will be on the VP03 ward at the CRG. The role of counsellor will temporarily be taken over by the nursing staff on the ward.

Agreements on the start date of ovarian stimulation     

General rule

In all cases when the start date has not yet been laid down during the consultation at the CRG or needs to be changed for some reason: contact us for a specific date as soon as you have made the decision. Please contact the planning coordinator for this (see contact)
The longer in advance you do this, the greater the chances of starting the treatment on the date you want to.

There is a very important date on the medication scheme of the IVF treatment, i.e. the date on which you (the woman) start the hormonal stimulation phase of the treatment. We refer to this date as the start date. As long as it has not been scheduled, your treatment has not been included in the CRG's planning and therefore cannot be started.

Why?

IWe want to guarantee the very best quality for every IVF treatment at our centre. This is why we take great care to support our patients - you and your partner - but also the actual in-vitro fertilisation, i.e. the laboratory work.
Quality standards and control procedures need to guarantee the best possible lab results. But quality costs time. There is a limit to the number of actions that the embryologists, nurses and doctors are able to carry out in a day. And this is why a strict planning is required based on the start date of the ovarian stimulation. All the next stages of the treatment are based on this date.

Practical

  • If this is your first IVF treatment, the start date is agreed during your interview with the counsellor and will be specified on your treatment plan.
  • If the treatment is unsuccessful and you wish to start a new treatment cycle, a new start date will be chosen by you, your gynaecologist and counsellor. For medical and organisational reasons often it won't be possible to immediately start the next menstrual cycle.

In both cases you may not immediately decide with the counsellor or the gynaecologist to start with the (new) treatment. In this case a provisional start date is usually agreed.
  • As soon as you have decided to start a (new) IVF cycle, you will need to confirm this start date before you start taking the stimulation medication again.
  • The same applies when you interrupt your treatment. Sometimes the ovarian stimulation does not give the desired result and is therefore terminated. For reasons of quality it is often decided therefore to skip a cycle before starting again.
    Again, a new start date needs to be agreed and your treatment rescheduled.

In short, if a start date has not been laid down in joint consultation between you and either your counsellor (during a first treatment) or your gynaecologist (at the next attempts) there is no point to start taking the stimulation medication. Because, if you have not agreed on a start date, your treatment will not have been scheduled.
Determining or changing a start date (later) needs to be done in consultation with the planning coordinator.

Daily Patient Monitoring department (DM)   

Hormonal tests and ultrasound scans are an inextricable part of ART:
  • hormonal analysis of blood samples allow us to check and adjust the treatment, 
  • ultrasound scans allows us to see whether there are any ripe follicles in the ovaries.
The department of the CRG which coordinates and communicates the results of these tests is called the Daily Patient Monitoring department (DM).
For the most part of your treatment, you will be in daily contact with this department: they call you with the results of the tests and with instructions about the continuation of your treatment.

Pre-operative blood test     

Egg retrieval, the procedure whereby the ripe eggs are collected, is usually done under a local anaesthetic and does not require pre-operative blood tests.
However, if it has been agreed that the procedure needs to be done under general anaesthetic, due to either personal choice or medical reasons, pre-operative blood tests will be required (see blood tests).