Below you will find an overview of the most frequently asked questions.
Yes, we offer emotional support during your treatment. You can make an appointment yourself with one of our psychologists or the medical social worker. Nij Clinics | Elsendorp also has nurses from the Extra Support team (Extra Steun) available to support you.
We are here to support you throughout your fertility journey. Please do not hesitate to contact us if you would like to make use of this.
We aim to have your treatment planning consultations with the same doctor (your lead clinician) as much as possible. For ultrasound scans and other cycle-dependent appointments, you may be seen by a different doctor or an ultrasound/IUI nurse, depending on who is on duty at the time.
This way, we ensure that you always receive the care you need in good time.
For a smooth intake, we would like to receive a copy of your medical records, with information about any previous fertility treatments or tests, at least one week in advance. You will also need a referral letter from your GP or gynaecologist. Complete the questionnaire in the patient portal in good time so that we can properly assess your situation. Bring a valid proof of identity on the day of your appointment. This way, your intake will run smoothly and your file will be complete from the start.
Referral letter
You need a referral from your GP or medical specialist to be seen at our clinic. We work with Zorgdomein, the Dutch digital referral system, so that the person referring you can easily send the referral digitally. If you do not have a referral letter, you will be seen as a 'self-referral', which means that you will have to pay the costs yourself.
Intrauterine insemination (IUI) is a fertility treatment in which sperm cells are placed directly into the uterus around the time of ovulation using a thin tube. This increases the chance of fertilisation, because the sperm cells are brought closer to the egg. Before the insemination, the most motile sperm cells are selected and prepared in the laboratory.
With the EmbryoScope, our embryologists use time-lapse technology to monitor the development of the embryos without opening the incubator and disturbing the embryos' environment. A photo of the embryos is taken every 10 minutes. You can request a video of the development of the transferred embryo.
No, an intake at Nij Clinics is not free of charge. In the Netherlands, there are always costs involved in an intake consultation with a doctor. You can find the current fees in our list of fees.
After the intake, you are under no obligation to start treatment; likewise, the clinic is under no obligation to offer treatment.
The insemination itself is a simple and often painless procedure. The only part that may feel uncomfortable is the insertion of a speculum, which allows us to see your cervix. You will feel little or nothing of the thin catheter being inserted and the sperm being introduced.
Yes, you can prepare your body for pregnancy by following a healthy lifestyle. This means eating a varied diet, getting enough exercise, not smoking and not drinking alcohol or using drugs. A healthy weight also contributes to better fertility. We also recommend taking folic acid daily from the moment you want to become pregnant.
We can support you in leading a healthy lifestyle through lifestyle coaching and MijnFertiCoach. Do you have questions about your personal situation? Please discuss them with your fertility doctor.
During your fertility treatment you can, in principle, use over-the-counter medicines that do not require a prescription. If you use prescription medication, always mention that you are trying to conceive, so that this can be taken into account.
Discuss with your fertility doctor which medicines you use or plan to use, including any medication you are already taking before the start of treatment. After the embryo transfer, it is important to be extra careful with medication.
Hormones can cause side effects such as headaches; you may take paracetamol in the recommended dose for this.
No, you cannot choose between IVF and ICSI yourself. The doctor decides on ICSI based on medical indications. ICSI is recommended, for example, if the semen contains fewer than one million motile sperm cells, if antibodies are present in the semen, or if previous IVF treatments did not result in fertilisation.
Your doctor will discuss this indication with you and explain why IVF or ICSI is the best option in your situation.
Yes, of course we would like to see you together; after all, you share the wish to have a child! You each register via our website, each with your own (unique) email address and phone number. Please fill in the questionnaires before the intake consultation.
If you wish to have a child, we recommend taking folic acid, because folic acid is important for the baby's early development. It can help reduce the risk of certain birth defects, such as spina bifida.
We recommend starting folic acid at least 4 weeks before conception and continuing to take it until at least the 10th week of your pregnancy.
Always consult your doctor about the right dose and whether any other vitamins or supplements are suitable for you.
If you have been having unprotected intercourse for more than a year without becoming pregnant (or six months if you are over 35), you may want to consider a fertility assessment. A fertility treatment can also be an option if there are medical reasons, such as reduced sperm quality, endometriosis or an irregular menstrual cycle.
It is not possible to single out one fertility treatment as the most successful. Success depends on factors such as the woman's age, sperm quality, medical history and other personal circumstances. Together with your treating doctor, we look at the treatment that offers the best chance of pregnancy in your situation.
If a treatment has been successful, we would like to see you again at around 7 weeks for a pregnancy scan and to determine your due date. Curious about your due date before then? On the website of the patient association Freya, you can calculate your due date based on your treatment date.
Intake and treatment planning consultations that are not linked to your cycle are only scheduled on weekdays. For cycle-dependent appointments, such as inseminations and IVF/ICSI egg retrievals, you can also come to us at the weekend. We also schedule ultrasound scans that cannot wait until Monday at the weekend, so that you always receive the care you need at that moment.
Hormones can cause side effects such as bloating, mood swings, headaches and pain at the injection site. The extent and type of side effects vary from person to person and from medicine to medicine. For specific information, you can consult the patient information leaflets on our website.
Do you have questions or concerns? Please feel free to contact our team for advice and support.
IVF can be experienced as painful, especially during certain steps of the treatment. Injecting hormone medication into your abdomen may cause small bruises, but is usually not very painful.
Egg retrieval
The egg retrieval can be painful, because a needle is passed through the vaginal wall and the ovaries cannot be anaesthetised. You may take painkillers before the procedure to relieve the pain. However, the level of pain varies from person to person and depends on individual sensitivity.
The Danish sperm banks Born, Cryos and European Sperm Bank usually send the ordered sperm to Nij Clinics every week.
Message in the patient portal
Once the donor sperm arrives, it must first be processed and registered (linked) administratively. You can only start your treatment once you have received a message from us in the patient portal confirming that the sperm has been received and processed.
Yes, a multiple pregnancy can occur with fertility treatment. However, it is important to know that a multiple pregnancy is not our primary goal. We do not deliberately aim for a multiple pregnancy.
Minimising complications
Although a multiple pregnancy can occur, we always aim to minimise the risks for both mother and children. That is why we usually transfer a single embryo, to prevent complications and aim for a healthy pregnancy.
Yes, you can! Fill in the form on our website to receive the video of your transferred embryo.
Yes, you can come to Nij Clinics for a second opinion, provided you have a referral letter.
Once you have registered, you will receive an appointment confirmation within a few working days for an intake consultation with one of our doctors. During the consultation, the doctor will assess your situation and advise you on the options for fulfilling your wish to have a child.
For heterosexual couples, the male partner also receives an invoice for the intake consultation¹. After all, you share the wish to have a child, his medical history is also evaluated and a semen analysis usually takes place.
NZa
This is a national arrangement set by the Dutch Healthcare Authority (Nederlandse Zorgautoriteit, NZa).
¹ Unless you are coming for a KID treatment
Eleven days after the embryo transfer, you do a pregnancy test at home using morning urine. Exciting! Let us know the result as soon as you have it.
If getting pregnant naturally does not happen and previous fertility treatments, such as IUI, have not led to a pregnancy, your treating doctor may issue a medical indication for starting IVF treatment.
Indications for IVF
Possible indications for IVF include poorly functioning fallopian tubes, endometriosis, absence of ovulation, unsuccessful previous OI or IUI treatments and/or poor sperm quality.
If several embryos have developed, the remaining embryos are frozen and stored for future attempts at pregnancy. This gives you the option of having the embryos transferred at a later stage, for example if an earlier attempt has not been successful.
Before starting IVF or ICSI treatment, it is important to discuss clearly what should happen to any remaining embryos; we record this in a freezing declaration.
The laboratory will always inform you, including when no embryos can be frozen. You will receive a separate explanation during a consultation, usually within a few weeks of an unsuccessful fresh transfer or a freeze-all policy.
We attach great importance to starting your treatment quickly and efficiently. We understand that waiting for care can be difficult, which is why we want to keep you as well informed as possible about the current waiting times.
On this page you will find all the information about our waiting times.
Your health insurance usually covers 3 IVF treatments. Before starting treatment, make sure to check with your health insurer which reimbursement rates it applies.
Read more about health insurance and personal contribution.
If a later wish to have a child is not fulfilled naturally, you can contact Nij Clinics. If the intake shows that using your frozen eggs is the best option, ICSI fertility treatment will be started. This is the only way to fertilise eggs after thawing (with sperm from your partner or a donor) and allow them to develop into an embryo that can be transferred. A well-developed embryo is transferred to your uterus, after which a pregnancy can occur.
ICSI
More information about ICSI treatment.
The number of treatments needed varies from person to person and depends mainly on your age. Women under 35 often need only one treatment, because their egg reserve is larger and the quality is better. Between the ages of 35 and 38, several treatments may be needed, as both the reserve and the quality decline.
During the intake, the doctor performs a transvaginal ultrasound scan to estimate how many eggs can be stimulated in one treatment.
Egg freezing treatment takes about two weeks on average from the start of your menstrual cycle. Shortly after your period starts, you begin hormonal stimulation with daily injections, which you give yourself for about 8 to 11 days. These hormones stimulate the ovaries to mature several follicles, instead of the single follicle that normally matures each cycle. During this phase you will have several ultrasound scans to check how the follicles are developing.
Egg retrieval
When enough follicles have reached the right size, an egg retrieval is scheduled. This procedure, in which the eggs are removed from the follicles, takes about 15 minutes. After the retrieval, the laboratory assesses the eggs and freezes them using a specialised technique. Immediately after the retrieval, you will hear how many eggs were collected and whether a second treatment is recommended to increase your chances of a pregnancy later on.
The technique used for freezing is called vitrification. This is a rapid freezing method in which no ice crystals form. Before freezing, the eggs are mixed with a cryoprotectant (antifreeze). This is a fluid that protects the egg against damage during freezing and thawing.
Storage
The frozen eggs are stored in a tank of liquid nitrogen at a temperature of -196 °C. In principle, the eggs can be kept at this temperature for many years.
When assessing your fertility, we do not only look at your AMH level, although this often already provides a lot of information. We also perform a transvaginal ultrasound scan to count the number of antral follicles in your ovaries. Together with your age, lifestyle and the scan results, this gives the doctor a complete picture, after which we decide whether you get the green light for treatment.
Egg freezing treatment is usually not painful, but can sometimes feel tender or uncomfortable. The hormone injections are generally well tolerated. During the stimulation phase you may experience bloating and mild cramps.
Ultrasound scans and egg retrieval
The ultrasound scans can be a little uncomfortable, but they do not hurt. The follicle puncture is carried out with pain relief and a sedative, so most women cope with it well. After the retrieval you may experience mild cramps for a few days. We recommend resting on the day of the retrieval; your cycle will then recover by itself.
Yes, you need to stop taking the contraceptive pill temporarily before we can start egg freezing treatment.
If you have an IUD (coil), it can stay in place throughout the egg vitrification treatment. This applies to both a copper IUD and a Mirena IUD.
Egg vitrification is highly age-sensitive. Women are born with a large supply of eggs. Over the years, this supply declines in both number and quality. Particularly from the age of 35, quality and number decline more rapidly, which reduces the chance of a successful pregnancy.
Optimal age
By freezing your eggs at a younger age, preferably between 30 and 35, you increase your chance of a successful pregnancy later on. At that point the eggs are still of high quality and, once frozen, they remain in that optimal state.
If you have had your eggs frozen, you may end up not using them. This may be because you later became pregnant naturally with the eggs you had at that time, or because you no longer wish to have a child.
Sometimes it is sensible to keep the eggs frozen for a possible second or third child, in case this unexpectedly does not happen naturally.
Are you completely sure that you no longer want to (or are no longer allowed to) use your frozen eggs? Then you can consider these options:
Together with your doctor, you will discuss which option suits you best.
This depends on a number of factors, of which age is the most important. The younger your eggs, the greater the chance that they are genetically healthy. There is no fixed number of eggs that guarantees a pregnancy later in life, but on average:
Women up to 35 who freeze 10 eggs have around a 70% chance of having a child. If you freeze 20 eggs within this age range, you have around a 90% chance of having a child.
Women between 35 and 38 who freeze 10 eggs have around a 45% chance of having a child. If you freeze 20 eggs between the ages of 35 and 38, this percentage is around 70%.
The older you are, the more eggs you need for a reasonable chance of a pregnancy later on.
The difference between egg freezing and egg donation lies in the purpose and use of the eggs.
With egg freezing, a woman has her own eggs frozen so that later, when she wishes to have a child, they can be fertilised with sperm from her partner or a donor. This offers the possibility of becoming pregnant at a later age with her own eggs.
With egg donation, a woman donates her eggs to someone else who does not have suitable eggs of her own. The recipient is then treated with the donated eggs in order to become pregnant. This process also has legal consequences.
You can find more information about egg donation on our website.
A hysteroscopy can help to prepare the uterus optimally for a pregnancy, for example by removing abnormalities that could interfere with implantation. Some women become pregnant sooner after a hysteroscopy, particularly when an obstruction has been removed.
After the hysteroscopy you may have mild cramps or some bleeding, but most women can resume their daily activities the same day. If a procedure has been carried out, you may need a few days of rest.
Providing a semen sample for testing or treatment
For a semen analysis, insemination, IVF or sperm freezing (cryopreservation), the sample may be produced at home, provided it reaches our centre within 60 minutes of collection. In that case, we will give you a sterile sperm container labelled with your name and date of birth. This container with a blue lid is specially designed for collecting sperm and contains no harmful substances. Containers from your GP or pharmacy are not suitable for this and must therefore not be used.
If you live further away and cannot deliver the sample to us within an hour, we ask you to produce it on site. Our clinics have special rooms available for this. You will then receive the container from our laboratory, labelled with your name and date of birth.
Please note: for ICSI treatment, the sample must always be produced at our centre.
Yes, you can improve your sperm quality by living more healthily: stop smoking, limit alcohol, eat a varied and healthy diet, exercise regularly, avoid being overweight and avoid excessive heat around the testicles. Reducing stress and avoiding harmful substances also contribute to better sperm quality. You can read more about this in our blog.
15 days after the IUI, you do a pregnancy test at home using morning urine. Exciting! Let us know the result as soon as you have it.
A fertility assessment can be exciting and emotionally charged. Doubts and uncertainty are part of it, but you are not alone. There are various sources of support, such as Freya (the Dutch association for people with fertility problems) or peer support forums where you can share experiences.
An egg lives for about 12 to 24 hours after ovulation. This means that fertilisation is only possible within this short window. That is why it is important that sperm cells are already present around ovulation – after all, they can survive for 3 to 5 days – so that they can fertilise the egg in time. Determining the right moment is therefore essential if you want to become pregnant.
After sex, sperm cells survive an average of 2 to 4 days in the female body. In a favourable environment – especially around ovulation, when the cervical mucus is thin and nourishing – they can even survive up to 5 days. Outside those fertile days, their survival is much shorter, often only a few hours.
It is therefore possible to become pregnant from intercourse that took place a few days before ovulation.
After a positive ovulation test, ovulation usually takes place within 24 to 36 hours, sometimes up to 48 hours. The LH surge itself usually lasts 1 to 2 days. So you still have some time – there is no need to rush.
Having intercourse around the LH surge
We recommend having intercourse at least twice around your positive ovulation test. For example: on the day of the positive ovulation test and again 24–36 hours later. When you see the test line getting stronger, you can also have intercourse one to two days before the expected positive test.
Using donor material, such as donor sperm or donor eggs, involves important legal aspects. It is essential to be well informed about your rights and obligations as a donor, intended parent or person using donor material. You can read more about these legal aspects here.
16 days after the egg retrieval, you do a pregnancy test at home using morning urine. Exciting! Let us know the result as soon as you have it.
The treatment itself is generally not painful. Hormone injections can sometimes cause skin irritation at the injection site, and some patients experience mild side effects such as bloating or mood swings.
This varies from person to person. Your treating doctor will discuss the number of treatments in the treatment plan. If these attempts are unsuccessful, a follow-up treatment such as IUI may be considered.
IVF treatment always carries some risks; for example, too many follicles may develop. You can read more about this under overstimulation.
Our doctors will inform you about possible complications before your IVF treatment.
With IVF using ROPA, only the birth mother is automatically a legal parent. Do you both want to become legal parents? Then the legal parenthood of the genetic mother (who donated the egg) must be arranged separately. How this is done depends on your situation:
Married or in a registered partnership:
Are you married or registered partners and are you using a sperm bank donor? Then the partner of the birth mother does not automatically become a legal mother as well. For this, a declaration must be submitted. In this case, however, the partner of the birth mother does immediately become a joint holder of parental authority.
Known sperm donor:
When using a known sperm donor, the birth mother decides who becomes the second legal parent: her partner or the donor. This must be properly arranged in advance. Always seek guidance from a specialised lawyer.
Not married and not registered partners:
If you are not married or not registered partners, legal parenthood can only be obtained through acknowledgement or adoption.
With ROPA in a Dutch clinic, the partner donating the egg is registered as a donor. The details are recorded with the Donor Data Board for Artificial Fertilisation (College donorgegevens kunstmatige bevruchting, CDKB), as required under the Artificial Fertilisation Donor Data Act (Wet donorgegevens kunstmatige bevruchting, Wdkb).
No, the woman who donates the egg is not automatically the legal mother. By law, only the woman who gives birth to the child is. The genetic mother must arrange legal parenthood separately through acknowledgement or adoption, depending on the situation.
There are various options when it comes to choosing a sperm donor.
Your own donor
At our Elsendorp and Wolvega locations, you can use your own donor. Your own donor attends an intake and must successfully complete the screening process.
Nij Clinics sperm banks
Nij Clinics has its own sperm banks at the Wolvega and Elsendorp clinics. If you would like to use these donors, we try to find a match based on a number of selection criteria. As soon as there is a match, treatment can start.
International sperm banks
Nij Clinics works with the international donor banks Cryos, ESB and Born. With these, you need to take a number of administrative matters into account.
You can read more about choosing a sperm donor here: sperm banks.
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