Information in English

Effective, safe treatment, education, research, exchange of knowledge and patient satisfaction represent our key aims and objectives. Meeting these are of high priority, and this is reflected in our policies for hiring new employees or planning activities.

Treatment

The Fertility Clinic places great importance on providing the highest quality of infertility treatment. It is essential to us that the treatment is planned based on the couple’s individual needs. Through continuous and detailed exchange of information, the couple can influence and share reponsibility for their treatment pathway

Education

Our staff members are encouraged and expected to maintain and develop their knowledge and skills by a programme of ongoing education, both internal and external.

Treatments offered

Insemination with sperm from partner or donor

Insemination with sperm from the partner is called IUI-H (Intrauterine insemination with homologous semen)

Insemination with sperm from donor partner is called IUI-D (Intrauterine insemination with donated semen)

The purpose of insemination is to increase the pregnancy rate by optimizing the number of living sperm cells in the fallopian tubes at the time of ovulation.

• The ovaries are gently stimulated with hormones, with the aim of maturing one or two follicles.
• The development of follicles is monitored by vaginal ultrasound scans.
• When the follicles are mature, ovulation is triggered by a specific hormone injection.
• Insemination is performed 36-40 hours after the ovulation injection

 Insemination can be used if:

• There is a need of donor sperm
• The cause of infertility is unknown, meaning there is a normal sperm count, the fallopian tubes are not blocked, and regular ovulation takes place.
• Infertility is caused by a slightly reduced sperm quality.
• There is mild endometriosis.
• In case of ovulation disorders which for example, can commonly occur in women with PCOS.
  
  

Treatment with IUI implies:

Patent, open fallopian tubes, viewed by passage of fluid on X-ray or water scan.

Treatment Plan

At the first visit to The Fertility Clinic, a treatment plan will be made in consultation with a physician.

Registration for treatment

On the first day of your menstrual period you call the clinic and register with the nurse.

The nurse will return your call the same day and arrange for the first ultrasound /scan. The day of the first ultrasound scan depends on the treatment plan and the length of your cycle.

IUI treatment

Stimulated cycle:

A mild hormonal stimulation is given as injections with FSH (follicle stimulation hormone).

The development of the follicles is monitored by ultrasound scans and the injection to trigger ovulation is given when the largest follicle is mature.

During hormone stimulation, more than one follicle may develop and you may ovulate spontaneously. Whilein most cases, only one egg will be fertilized, on occasion more eggs may be fertilized. There is therefore an increased risk of multiple pregnancy when hormonal stimulation is used. However, this risk is small (around 5 % of pregnancies). If we consider that there is a risk of triplets, the cycle will be cancelled.

Medication and possible side effects

Gonal-f ® or Menopur ®

FSH hormone which stimulates the growth of the follicles; it is given as injections in the skin below the navel.

Side effects: Brief pain and tenderness at the injection site, breast tenderness, fatigue and bloating.

Ovitrelle ®

HCG Hormone (used for triggering ovulation), induces ovulation after 36-40 hours; it is given by injection in the skin below the navel.

Side effects: Brief pain and tenderness at the injection site, fatigue, nausea, headaches and bloating.

The sperm test

If donor sperm is used, you wil get further information in the Fertility Clinic.

If husband sperm is used, and the sperm sample is collected ​​at home, it must be delivered to the Fertility Clinic within one hour. The sperm sample must be kept near the skin during transportation to maintain the correct temperature. If this is likely to be difficult, , there are special facilities for the sperm sample to be produced at the Fertility Clinic.

On the day of the insemination, a sperm sample must be delivered to the Fertility Clinic's sperm laboratory by 8 am. We recommend that you refrain from ejaculation one day before the sperm test

The sperm sample is delivered in a cup supplied from the clinic. You will be asked to write your names and CPR numbers on a label. The label must be put on the cup before delivering it to the sperm laboratory.

Sperm is very sensitive to inflammation and body temperature rises. It is very important that the man, prior to treatment, advise us of any illnesses within the last three months.

When does insemination take place?

Insemination take place ​​approx. 36-40 hours after the ovulation induction injection is given.

This procedure is simpler if you have a full bladder, so you will be asked to refrain from urinating approximately two hours before insemination.

The number of follicles growing in the ovaries will be monitored by regular ultrasound scans and the thickness of the lining of the womb (the endometrium) will be measured.

Then, a speculum is placed into the vagina, so that the cervix (neck of the womb) can be seen. After lightly wiping the cervix, a thin, soft plastic catheter is inserted through the cervical canal, where the prepared sperm is injected into the uterine cavity.

The sperm will swim into the fallopian tubes, where fertilization normally takes place.

The procedure is usually without discomfort and takes only a few moments. Occasionally, there may be a brief, period-like, pain. If this is your first insemination, we recommend that you sit/rest in the waiting room for 15 minutes after the treatment. Rarely, some women may feel uncomfortable the first time.

If you have been inseminated before without problems, you can go home immediately after insemination/treatment.

Recommendations after insemination

Pregnancy Test

17 days after insemination, you meet at Herlev Hospital, for an blood sample pregnancy test.
Even if you have started to bleed, a pregnancy test should still be taken, as there remains a chance of a positive pregnancy test.

Pregnancy Result

It is important that you call us to get the result of the pregnancy test, later the same day or the next day, whether you think the test is positive or negative.

If the test is positive, an appointment for a pregnancy scan/ultrasound will be made for three weeks later. If you begin bleeding or experience abdominal pain in those three weeks, please contact us.
Often, these symptoms indicate that the pregnancy is perishing in a natural way. Rarely however, the pregnancy may be located in the fallopian tube. If this is the case, it is very important to know since the embryo can invade through the tube and lead to serious bleeding in the abdominal cavity.

If the urine test is negative, you will be asked to follow the previously made plan.

Who is responsible for the treatment?

The doctor is always responsible for the treatment and the treatment plan, made in collaboration with the nurses.

The nurses perform the treatment with scans and inseminations.

How many treatments are offered?

For insemination with the husband's sperm, three attempts are usually offered. If artificial insemination with donor sperm, six attempts are usually offered. When  FSH hormone is given, treatment can continue each month without a break inbetween.

After each insemination, you will be informed about the plan for the next treatment. This does not mean that we do not think it will succeed. However, it is our experience that many couples are happy to have a plan.

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In vitro fertilization

In vitro fertilization is also known as IVF. 

ICSI stands for intra-cytoplasmic sperm injection, a means of IVF, fertilizing the egg when very few sperm cells are available.

We normally offer 3 IVF treatments (with ICSI if necessary) with transfer of fresh embryos. If you have any “spare” embryos suitable for freezing/of a good quality, we can/will freeze and store the embryos for transfer at a later time.

The principles of IVF in brief:

The ovaries are stimulated with hormones (FSH) to develop an appropriate number of mature eggs.
Under local anesthesia, the follicles are emptied by a needle which is passed through the vagina into the ovary under ultrasound monitoring.
The eggs are then fertilized in the laboratory.
One embryo is returned (transferred) to the womb via a soft catheter through the cervical canal.

We use different stimulation treatments. Here we will described the two most common:

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The long protocol
The short protocol

Besides the two most commonly used protocols, we also use a number of other treatment protocols, if this is justified by the results of previous treatments (treatment in this clinic, but also treatment from/in other clinics).

When you start the treatment, you will receive a copy of the stimulation form.

The long protocol

On the first day of your menstrual period:

You call us to register for treatment and get an appointment (to start the treatment) approximately 21 days later.

Around day 21 of your cycle

You will attend the Fertility Clinic as planned.

The individual stimulation plan is made; if necessary, preceded by an ultrasound.
Prescriptions for the medication for this treatment will be handed to you.
The treatment is reviewed by a nurse, who will provide you with the necessary syringes and relevant guidance.
The treatment then begins with what is called the downregulation period. This phase of treatment involves:

Gonapeptyl 0,1 mg daily. It will be given as an injection under the skin, below the navel the next 2-3 weeks, or
Nasal Spray (Synarela ®). 3 puffs daily, then 1 puff every 8 hours for 2-3 weeks.
During this period you will probably menstruate.

 After the 2-3 week down regulation period you will start follicle stimulation treatment.

 On day 1 of the stimulation period, we will perform an ultrasound scan of the ovaries and the endometrium. This should now be thin as a result of the menstruation during the down regulation treatment. We also check that no ovarian cysts have developed.

From this day and the following (approximately) 7 days you will receive an injection every day with a FSH hormone which stimulates the follicles growth.
The treatment with the down regulating hormone continues. The dosage, 0,1 mg Gonapeptyl or 2 sprays Synarela a day is given until the day you get the ovulation-triggering injection.

Day 8, approximately:

A further ultrasound scan is performed to monitor and observe the number and size of the follicles.
A plan for you is now made. Sometimes,you can plan already at day 8 when the eggs can be collected. However, usually you will need a few more days of hormone treatment, before the eggs are mature enough to collect. We will need to monitor the follicles every other day at this stage.

Day x: The Ovulation trigger injection.

Day x indicates the day which, in most cases, you will take the ovulating hormone (Ovitrelle ®) at 10.00 PM. It is usually either day 9, 10, 11 or 12 - the same day you stop taking FSH.
The down regulating medicine is agreed on individually.

Day x + 2: Egg collection:

Approximately 34-38 hours after ovulation injection, the eggs are collected and then fertilized in the laboratory.

Day x + 4-7: Embryo transfer:

After another 3 or 5 days, 1 fertilized egg are transferred to the uterine cavity.
We recommend that the bladder is full during embryo transfer. Try to refrain from urinating two hours before transferring.

Day x + 4: progesterone:

The day after the egg collection you start treatment of the endometrium with a progesteron hormone: Lutinus ® or Crinone ®
Progesterone is taken for 2 weeks 

The short protocol

You will register on the first day of your menstrual period

Day 2-3:

Stimulation period begins on the second or third day of bleeding:

An ultrasound is performed.
You will, from this day, take one daily FSH hormone injection to stimulate the follicle growth.
From 5 day, you must also take Orgalutran ® or Cetrotide ®, 0.25 milligrams once a day, which prevents ovulation.

Day 8, approximately:

Renewed ultrasound to monitor the follicles growth.
A plan for you is now made.
Sometimes, you can already plan at day 8 when the eggs can be collected. However, most times you will need a few more days of hormone treatment before the eggs are mature enough to be collected. We will need to monitor and observe the follicles every other day.

Day x: The Ovulation injection.

Day x indicates the day which, in most cases, you will take the ovulating hormone (Ovitrelle ®) at 10.00 PM. It is usually either day 9, 10, 11 or 12 - the same day you stop taking FSH.
The down regulating medicine is taken last time on the day of Ovitrelle.

Day x + 2: Egg aspiration:

Approximately 36-40 hours after ovulation injection, the eggs are collected and then fertilized in the laboratory.

Day x + 5-7: Embryo transfer:

After another 3 or 5 days, 1 fertilized egg are transferred into the uterine cavity.
​It is an advantage if the bladder is full during embryo transfer. Try to refrain from urinating two hours before transferring.

Day x + 4: Progesterone:

The first day after the egg collection you start treatment of the endometrium with a progesteron hormone: Lutinus ® or Crinone ®
Progesterone is taken for 2 weeks.

Pregnancy Test

16 days after oocyte pick up/egg collection, a blood sample for pregnancy test is taken.

Even if you have started to bleed, a pregnancy test should still be taken, as there remains a chance of a positive pregnancy test.

Pregnancy Result

It is important that we can call you later the same day, to give the result.

If the test is positive, an appointment for a pregnancy scan/ultrasound will be made for three weeks later. If you begin bleeding or experience abdominal pain in those three weeks, please contact us.
Often, these symptoms indicate that the pregnancy is perishing in a natural way. Rarely however, the pregnancy may be located in the fallopian tube. If this is the case, it is very important to know since the embryo can invade through the tube and lead to serious bleeding in the abdominal cavity.​