Voortplantingscentrum | Voor professionals

BeterMeter

Met behulp van uw mening en ervaringen kunnen wij onze kwaliteit van zorg blijven verbeteren. Op basis van ruim 400 ingevulde patiënttevredenheidsenquêtes kunnen we u met trots uw waardering van onze kliniek presenteren van een 8.9.

"Voor de vriendelijkheid en het op je gemak stellen willen wij een groot compliment geven."

"Informatie en uitslagen worden altijd zo snel mogelijk doorgegeven, waardoor je zo kort mogelijk in spanning zit. Dat vind ik erg goed geregeld."

"Het zijn vriendelijke verpleegkundigen en fijne artsen."

"Er wordt altijd gedaan wat er gezegd is."

Resultaten

Het slagingspercentage van onze kliniek over de afgelopen 15 jaar is uitstekend, ook ten opzichte van andere klinieken in Nederland. Het succes van ons zeer efficiënte behandelprogramma wordt gekenmerkt door twee factoren; de hoge slagingskans van de behandeling en het lage percentage meerlingen dat daaruit geboren wordt.

Hieronder ziet u het percentage doorgaande zwangerschappen per gestarte behandeling, dat de slagingskans weergeeft.

Hieronder ziet u het percentage meerlingen per zwangerschap. Hieruit blijkt dat het LUMC een voorloper is geweest in het verlagen van het meerlingrisico.

Uw patiënten kunnen bij ons terecht voor deze reguliere en gespecialiseerde behandelingen:

• OFO: Oriënterend fertiliteitsonderzoek
• OVS: Ovariële stimulatie
• IUI: Intra-uteriene inseminatie
• IVF: In vitro fertilisatie
• ICSI: Intra-cytoplasmatische sperma injectie
• Eicel- en zaaddonatie met eigen donor
• Onderzoek en behandeling bij herhaalde miskramen
• Tubapathologie: tubachirurgie
• Fertiliteitspreservatie, bijvoorbeeld voorafgaand aan chemotherapie en bekkenchirurgie, invriezen zaad- of eicellen, embryo’s en ovariumweefsel (cryopreservatie)

Second opinion aanvragen

U kunt als arts een second opinion aanvragen voor uw patiënt door een verwijzing te sturen – inclusief de benodigde medische gegevens – naar het LUMC Voortplantingscentrum. Onze medisch specialisten zullen de verwijzing bekijken en beoordelen. Valt de verwijzing binnen het expertisegebied van het LUMC Voortplantingscentrum? Dan ontvangt uw patiënt een schriftelijke uitnodiging voor een second opinion op onze polikliniek.

Fertiliteitspreservatie

Gezien het spoedeisende karakter van fertiliteitspreservatie is de dienstdoende VPG arts binnen kantooruren direct op 071 529 85 98 of via het secretariaat (071 526 33 39) bereikbaar. Buiten kantooruren kunt u via het algemene nummer (via de dienstdoende gynaecoloog) met de dienstdoende fertiliteitsarts contact opnemen.

Intercollegiaal consult

Onze medewerkers zijn binnen en buiten kantooruren bereikbaar voor overleg met collega’s uit de eerste en tweede lijn. Tijdens kantooruren kunt u contact zoeken met de betreffende polikliniek en overleggen met de specialist. Het spoedeisende karakter van het overleg bepaalt of dat direct of later op afspraak plaatsvindt. Het directe telefoonnummer van de dienstdoende VPG arts is 071 529 85 98.

Alle verwijsinformatie is te vinden in de ZorgApp.

Terugkoppeling verwijzer

Wij streven er naar direct na afronding van diagnose en vaststellen van het behandelplan de terugrapportage aan de huisarts te versturen. De verwijzend specialist ontvangt deze rapportage in kopie per e-mail of per post. Ook na de behandeling ontvangt u bericht over het resultaat.

Voor intercollegiaal overleg zijn wij tijdens kantooruren bereikbaar op telefoonnummer: 071 529 85 98 of 071 526 33 39 of 071 526 40 52.

Voor minder spoedeisende zaken kunt u per mail overleggen met de fertiliteitsartsen via ivf@lumc.nl.

Biobank

We use Biobanks for research. Your data and materials are processed and stored under a code. When you are under our care, you may be asked to participate in the LUMC Biobank. Participation is always voluntary and has no effect on the care you receive from us.

More information can be found at LUMC Biobanken.

ANTARCTICA-2 Study

When placing a cryo-embryo in the natural cycle, it is important to know when ovulation occurs. This can be done in two ways: monitoring natural ovulation by means of ovulation tests (LH tests) at home or monitoring by means of ultrasounds and finally inducing ovulation by means of an hCG-trigger injection in the hospital. The ANTARCTICA 2 study compares these two methods. It also looks at the chance of missing ovulation, which method women find most comfortable and to what extent the partner provides support.

ART Childhood Cancer Study

The LUMC is participating in a national study into the risk of cancer in children born after fertility treatments (in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI)) of mothers who were treated in the period 2001-2012. In order to investigate this, data from IVF and ICSI children will be combined with data on cancer, which will be collected through a link with the Dutch Cancer Registry. The results of this study will provide an important contribution to the understanding of the possible long-term health effects of children conceived with fertility treatments.

The study complies with the current privacy law (General Data Protection Regulation (GDPR)).

DONOR Study

In an egg donation pregnancy, the baby can be completely foreign to the mother. In this situation, the mother is pregnant with a baby, which carries paternal genes and genes from the egg donor. However, it is possible that this pregnancy will continue without additional measures being taken during the pregnancy. The DONOR study investigates how the mother's immune system is adapted to maintain the pregnancy. See the video for more information.

REMI 3 Study

Little is known about possible underlying causes of recurrent miscarriages in men. In the REMI 3 study we want to better understand which characteristics of the father can influence the miscarriage. You can participate in this study if you have repeated miscarriages for which no explanation has been found.

Participation means that you complete a digital questionnaire, which is mainly about lifestyle factors. In addition, we ask for blood and semen from the man once. Ultimately, we hope this research will provide clues for new treatment options.

SCRATCH-OFO Study

This study investigates whether applying a superficial scratch in the uterus leads to a better chance of pregnancy. The idea is that the uterine lining is better prepared for the implantation of an embryo by reacting to the scratch. The study is aimed at couples who have not gotten pregnant after trying for some time for unknown reasons. Participants raffle whether or not they get a scratch.

Scratch Study

The Scratch study has been completed; no more patients can be included. As soon as the results are known, we will post more information.

This study investigated whether the application of a superficial wound in the endometrium ('scratching') just before an IVF/ICSI treatment has a beneficial effect on the chance of implantation of an embryo.

LIFEstyle Study

On May 19, 2016, the results of the LIFEstyle study were published in the scientific journal The New England Journal of Medicine. The LIFEstyle study investigated the influence of lifestyle counseling aimed at weight reduction on the chance of pregnancy in overweight and subfertile women.

Severe overweight (BMI>29) in women leads to a higher risk of reduced fertility (subfertility), lower chances of pregnancy with the help of fertility treatments and higher chances of complications during pregnancy.

In the LIFEstyle study, half of the participants were offered lifestyle counseling for a period of six months. After the lifestyle counseling, the participants were offered fertility treatments. If the participants reached their target weight earlier, they were also allowed to start fertility treatment earlier. The other half of the women (control group) were immediately offered fertility treatments.

The duration of follow-up of the participants was 24 months. The outcome was a healthy live birth (over 37 weeks) who was born after a normal delivery.

A total of 577 women participated in the study; 290 were randomized into the lifestyle counseling group and 287 were randomized into the control group of the study. The lifestyle counseling ensured that the women lost an average of 4.4 kilos in a maximum of 6 months; 38% of the women in the lifestyle counseling group reached the target weight of 5% weight reduction. In the group of women with standard care without lifestyle guidance, the average weight loss was one kilogram and none achieved 5% weight loss.

The women who had drawn the lifestyle counseling had more natural pregnancies than the women who had drawn for direct fertility treatment. As a result, fewer fertility treatments are needed after lifestyle guidance. There was no difference in pregnancy complications and child outcomes in both groups.

Conclusion: the LIFEstyle study shows that lifestyle counseling aimed at weight reduction prior to fertility treatments does not increase the chance of a healthy live birth. The chance of a natural pregnancy does increase with lifestyle guidance.

inSIGHT trial

At the end of April 2016, the results of the inSIGHT trial were published in the scientific journal The Lancet. The inSIGHT trial investigated the influence of routine hysteroscopy to improve pregnancy chances after In-Vitro Fertilization (IVF) treatments. A summary of the results can be found below.

Hysteroscopy is a visual examination that detects abnormalities in the uterine cavity. In 13% of women with a normal ultrasound prior to IVF treatment, small abnormalities in the uterine cavity are still found during hysteroscopy. However, it was unclear whether detecting and treating these abnormalities by means of hysteroscopy increases the chance of a live birth.

In this study, hysteroscopy prior to IVF treatment was compared with immediate initiation of IVF treatment without hysteroscopy. The primary outcome measure was the number of live births at 18 months of follow-up.

A total of 750 patients were included in the study, of whom 373 women underwent a hysteroscopy and 377 women immediately started IVF treatment. The number of live births in the hysteroscopy group did not appear to be increased compared to the group that started directly with IVF.

Conclusion: the inSIGHT trial shows that routine hysteroscopy is not useful prior to IVF treatment because detecting and subsequently treating minor abnormalities does not result in an increase in live births after IVF. It can therefore be stated that hysteroscopy should no longer be performed in women with a normal ultrasound who are scheduled for IVF treatment.

ProMISE trial

At the end of November 2015, the results of the PROMISE trial were published in the scientific journal The New England Journal of Medicine. The PROMISE trial studied the influence of progesterone administration on the reduction of miscarriage risk in women with unexplained recurrent miscarriages. A summary of the results can be found below.

Progesterone is essential for maintaining a pregnancy. However, it was unclear whether progesterone administration in women with unexplained recurrent miscarriages increased the risk of a live birth.

In this study, the effect of progesterone administration was compared with that of placebo. From a positive pregnancy test up to 12 weeks of pregnancy, women used either 400 mg progesterone or placebo capsules twice a day. The primary outcome measure was live birth at 24 weeks gestational age.

A total of 1,568 women were recruited, of whom 836 became pregnant and could be randomized (404 received progesterone, 432 placebo). The number of live births and miscarriages in the progesterone group did not differ from the number of live births and miscarriages in the placebo group.

The PROMISE trial shows that the administration of progesterone in the first trimester of pregnancy in women with unexplained recurrent miscarriages does not increase the risk of a live birth.

Cosy/Zin en Zwanger Study

The Cozy/Zin en Zwanger study has been completed. Why was this research set up? Scientific research has shown that many couples who have been trying to conceive for a long time develop problems with sexuality. This usually manifests itself in less frequent intercourse, less desire for intercourse and more difficulty enjoying sexuality. We investigate the effect of 6 months of online sex counseling. Do couples get pregnant faster thanks to online sex counseling than couples who don't receive counseling?

ExIUI

The ExIUI study has been completed. The aim of the study was to find out whether watchful waiting for 6 months does not lead to a lower chance of a live birth, compared to IUI with mild hormone stimulation during the same period.

As soon as the results are known, we will post more information.

ToF Study

Stands for Three Or Five. The study compares on which day of embryo transfer, day 3 (cleavage stage) or day 5 (blastocyst stage), there is the highest percentage of live births after one complete IVF/ICSI treatment cycle.

If you do not want your data and/or those of your child(ren) to be included in this study, you can unsubscribe from Mw. Dr. ir. Van der Westerlaken, clinical embryologist, via L.A.J.van_der_Westerlaken@lumc.nl.