Doctor to doctor
Doctor to doctor – information about the first steps here in the clinic
We always start with a journal discussion where we review investigations that you have already had and any previous treatments. Prior to the visit, you should complete the electronic journal on our homepage. We will do a gynaecology ultrasound scan. If we think that further investigations are necessary, we will do those as far as possible in connection with the discussion. Types of treatment and options will be reviewed.
We always draw up an individual plan that takes your age, previous test results and wishes into consideration. We think it is really important to have the client at the centre of treatment, and we provide honest guidance to the best of our ability.
Doctor to doctor – information about donor sperm
There are differences from sperm bank to sperm bank regarding how different donor types are defined, but here in the clinic we use the following descriptions:
- Anonymous: basic information (eye colour, hair colour, height, weight)
- Anonymous plus: basis basic information + blood type and occupation/education
- Open: the same as anonymous plus and also the option to learn the donor’s identity
- Known donor: A known sperm donor is a donor that the woman/couple know and that has agreed to donate sperm for artificial fertilisation of the woman, even though the woman and donor are not married to or in a relationship with each other. The known donor has an obligation to support the child, and the child is entitled to inherit from the known donor.
The law requires the known donor to have a completely separate investigation that includes screening for infectious diseases and hereditary disorders.
Treatment with fresh sperm is not possible as the law requires the sperm to be frozen until the results of infection markers including the NAT test are available.
Doctor to doctor – information about in vitro fertilisation (IVF)
In vitro fertilisation is the primary treatment if it becomes obvious following investigation that the chances of attaining pregnancy through “homework” or insemination are poor. This could be due to blocked fallopian tubes, very poor-quality sperm or advanced maternal age.
In vitro fertilisation is also used if the woman does not become pregnancy after 3–6 inseminations (depending on the cause of infertility).
You can have the short stimulation protocol (stimulation with FSH from day 3 of your cycle) or the long protocol (downregulation with GnRH agonists from day 21 of your cycle for 2 weeks followed by stimulation with FSH).
IVF (without micro insemination) is used when, the quality of the sperm sample is thought to be suitable to fertilise the eggs.
ICSI (micro insemination) is used with very poor-quality sperm, where experience has shown that the sperm cells cannot directly fertilise the eggs. This method is also used with egg donation.
Egg donation is used if the woman’s eggs are not suitable to achieve a pregnancy (several failed IVF treatment attempts) or other illness or hereditary disorders in the woman.
Double donation: Double donation uses both a donor egg and donor sperm and can be used by couples or single women. One donor should be an open donor, and there should be a medical reason for the procedure. This is not an option for lesbian couples who want to bear each other’s children.
Is done as an outpatient under local anaesthetic. This procedure normally takes 10–15 minutes and is usually painless as the woman is given an injection of a fast-acting morphine-type preparation during the procedure.
In the laboratory
IUI: The sperm sample should be provided in the morning. The sperm cells are washed by density gradient centrifugation and prepared for insemination. Are placed into the womb with a very small catheter.
IVF: 100,000–150,000 sperm cells are added to each oocyte. Are then stored in the incubator at a carefully controlled temperature, CO2, O2 and humidity.
ICSI: An individual sperm cell is injected into each oocyte (egg cell). Then the fertilised egg cells are also stored in the incubator.
Is done on day 2, 3 or 5 (blastocyst) following egg retrieval. Generally, the transfer of one embryo or blastocyst is recommended. The transfer of two embryos/blastocysts is recommended if the embryo quality is poor, in the case of advanced maternal age and where there have been several previous attempts without achieving a pregnancy.
Doctor to doctor – information about the chances of becoming pregnant
IUI: The chance of becoming pregnant through insemination is about 18–20% if the woman is under 40. If the woman is over 40, her chance of becoming pregnant is about 10–14% per treatment.
IVF/ICSI: The chance of becoming pregnant through IVF depends on the woman’s age, the number of eggs transferred and the length of time the eggs having been cultured. You can find our results for IUI and IVF/ICSI here.
Doctor to doctor – information regarding what tests are required or those we recommend
The woman: Analysis of the hormones FSH, LH, oestradiol (these are taken on days 2–4 of your cycle) as well as TSH, Prolactin and AMH Viral analysis; HIV 1+2, Anti-HBc, HBsAg, Anti-HCV (from an ISO-certified laboratory; ISO certification 15189 or 17025)
- A cell sample from the cervix (a smear test)
- A swab for chlamydia (not a home test)
- Rubella immunity
- Blood pressure result
- An ultrasound scan of the womb and ovaries with AFC (antral follicle count)
If you have previously had fertility treatment, we would like a copy of your old notes
If you are male, we need a sperm sample and viral analysis: HIV 1+2, Anti-HBc, HBsAg, Anti-HCV (from an ISO-certified laboratory; ISO certification 15189 or 17025).
Similarly, you should have completed the electronic journal on our homepage.