FAQ - Frequently Asked Questions

Answers to Frequently asked questions

Below is a list of answers to frequently asked questions. There is a good chance that you also will find the answer to your questions in our treatment guides. For your convenience, we have grouped the questions into several themes. Click on the question, and the answer will appear.

How do I get started?

If you live abroad
Go to EXAMINATIONS AND TESTS and have a look at our PATIENT INFORMATIONS. Please, fill in the questionnaires and send them back to us together with the tests we need for the introductory interview. You also find our treatment guides on this page. If you are in doubt what treatment you will need, send the questionnaire and an e-mail to booking@danfert.dk. We are happy to help you further.

If you have a Danish cpr. no.
Ask you GP for a referral for a gynaecologist. After this you call us at 3834 9030 to make an appointment

Can I use a referral from my GP at the clinic?

Yes, you can if you have a Danish cpr. no. Examinations and insemination treatment will be for free with a referral. The man and the woman need a referral both.

Definition of infertility

When a couple has had regular unprotected intercourse 2-3 times a week for a year without obtaining a pregnancy, it is reasonable to start looking for an explanation for the reduced fertility in the man and the woman.

During the first year, 84 % of all fertile couples will obtain a pregnancy. Waiting for another year, about 92 % will become pregnant.

What is the reason for infertility

The woman:

  • damage to the fallopian tubes
  • ovulatory problems (PCOS)
  • endometriosis
  • conditions affecting the uterus
  • the age of the woman (and her oocytes)
  • life style factors

The man:

  • low sperm quality
  • problems with the tubes carrying sperm
  • problems getting an erection
  • life style factors
  • the age of the man

In 20 % of all couples there is no identifiable reason

What is the chance of becoming pregnant without fertility treatment?

  • A healthy women 25 years old will become pregnant every 4th month.
  • A healthy women 35 years old will become pregnant every 8th month.

Have you tried more than 12 months there is good reason to start examinations.

What happens during the introductory interview?

If you live abroad
You will talk to one of our Fertility Specialists, who will inform you about the treatment options you have. Since you bring all necessary test for the interview, the woman only needs a vaginal ultrasound scan which is performed during the interview, and we are ready to plan when you want to start treatment. If you have had IVF treatment before, please, bring a copy of your stimulation- and embryo schedules with you.

If you have a danish cpr. no.
You will talk to one of our Fertility Specialists who will inform you about your treatment options. The woman will have a vaginal ultrasound examination, and both will have blood tests done. Remember to read the information we have send to you before the interview and return the questionnaire at least one week before you come to the clinic.
If you have had IVF treatment before, please, bring a copy of your stimulation- and embryo schedules with you.

What happens once all necessary tests are done?

When the initial consultation ends, you will be informed by the doctor when to contact us again. If you need a passage examination of your tubes, call us once you have the result. We will inform you when we expect to have the results of all blood tests and then you will be ready to start. Meanwhile, you can read more in out patient information.

When do I call the clinic for treatment start?

Please, call us when your period starts. The secretary will inform you when you need to come for the first ultrasound scan. It might already be on your 2nd day of menses.

Why does the man have to deliver 2 semen samples?

Men’s semen quality is fluctuating. It can be normal one day, and reduced 2 days later. To get an impression of the fluctuations in the single male, we often ask for 2 different semen samples for diagnostic tests with a one week interval.

Is insemination treatment free?

Yes. If you are a Danish citizen and are covered by the Danish health security (Sygesikringen), investigations and insemination treatment is for free if you bring with you a referral from your GP. However, you have to pay for medication and donor semen. All other patients have to pay themselves.

Is there a long waiting time for treatment?

No. Once you have been to the introductory interview and we have all necessary test results, you can start treatment.

How much alcohol I am allowed to drink during my treatment?

New scientific investigations have shown, that even small amounts of alcohol influence on the chances of becoming pregnant. After a positive pregnancy test, the woman should not drink any alcohol at all. In the man, large quantities of alcohol also influence on semen quality.

Am I allowed to smoke cigarettes during treatment?

Smoking increases the hormone doses necessary for ovarian stimulation. Therefore, we recommend stopping smoking before you start fertility treatment. Smoking also reduces the weight of the newborn child.

What can I do myself to improve treatment outcome?

Have a look at LIFESTYLE at our homepage or in our patient information. Smoking, alcohol, under- and overweight for both women and men are some of the factors with best evidence so far.

Does smoking affect the semen quality?

Yes. It has been shown, that sperm cells from smokers contain more DNA-injuries than sperm cells from non-smokers. Especially men with severely reduced semen quality can improve the chances by stopping or reducing the number of cigarettes.

Previous sterilising treatment. What treatment do I need?

Tubal ligation of the woman: IVF. Vasectomy of the man: after vasectomy semen production continues, however, the sperm cannot leave the testicles. Therefore, it is possible to extract living sperm cells in a small biopsy from the testicles. This procedure is called TESE (TEsticular Sperm Extraction). After sperm recovery, a single sperm cell is injected into each oocyte to enable fertilisation. The procedure requires that the woman must have IVF in order to recover the oocytes.

May I choose open or anonymous donor semen?

  • From October 1st 2012, you may decide yourself whether you want open or anonymous donor semen. If you take open donor semen, the child has the possibility to have a single contact with the donor after his or her 18 year birthday. Only the child has the right to get to know the identity of the donor. You can buy the donor semen directly at the clinic or at the sperm bank.
  • If you decide for anonymous or open donor semen you can decide on the height, weight and colour of the hair and the eyes of the donor and buy the semen directly at the clinic. Once you are pregnant we will tell you the donor identity no., so you can buy more semen for siblings at the spermbank.
  • You also have the choice of buying open or anonymous sperm with an extended profile. Here you can get more information about the donor. (Contact one of the danish sperm banks for more information.)
  • If you decide to buy your own donorsperm, you also accept the risk, that the donor might be blocked. In that case, we are not allowed to use the semen, even if it is present at the clinic.
  • In case you buy your personal donorsperm, you have to pay for the transportation from the spermbank to Dansk Fertilitetsklinik, and also for receipt and storage of your private semen depot at the clinic. We recommend that you order the transportation as soon as possible, in order to avoid extra payment for acute delivery and receipt. Have a look at our pricelist.

How do I get donor sperm?

  • Anonymous donor sperm: you can buy it directly at the clinic. We have approximately 30 different donors available.
  • Open donor sperm: you can buy it directly at the clinic or contact European Spermbank and ask for “IUI-ready” sperm.
  • Donor sperm with extended profile: contact European Spermbank directly and ask for “IUI-ready” sperm.
  • If you decide to buy your own donorsperm, you also accept the risk, that the donor might be blocked. In that case, we are not allowed to use the semen, even if it is present at the clinic.
  • If you buy your personal donorsperm, you have to pay for the transportation from the spermbank to Dansk Fertilitetsklinik, and also for receipt and storage of your private semen depot at the clinic. We recommend that you order the transportation as soon as possible, in order to avoid extra payment for acute delivery and receipt. Have a look at our pricelist.

Can I bring my personal donor?

From October 1st 2012 you can bring your personal donor. He must be examined and tested like all other donors. This is a possibility for heterosexual couples. Ask the Fertility Specialist for detailed information.

If you are single or a lesbian couple and want your own donor, the donor will be regarded being the legal father of the child and must also pay child support. The child is also named as heirs to the donor. Ask the Fertility Specialist for detailed information.

What if I want to buy my own semen?

You are welome to buy your own semen and have a private deposit at the clinic. This is often the case if you want to have another child after having becoming pregnant with semen from a specific donor before.

You have to be aware that there are circumstances under which we are not allowed to treat you with your own semen. This might happen if:

  • the donor is in quaratine because of a report of disease in another child
  • the donor hos been closed because of a report of disease in the donor
  • the donor has met his quota of children

If you want the donor for a sibling, you will not have problems with the quota. This is only valid for the first child. You also have the possibility to re-use the donor, even if he has been diagnosed with a specific disease, if you have a child already from that specific donor. However, you have to sign a paper that you are aware of and accept the risk of transmitting a disease to your child.

If you buy your personal donorsperm, you have to pay for the transportation from the spermbank to Dansk Fertilitetsklinik, and also for receipt and storage of your private semen depot at the clinic. We recommend that you order the transportation as soon as possible, in order to avoid extra payment for acute delivery and receipt. Have a look at our pricelist.

Why is a Chlamydia test necessary?

The investigation of the tubes can result in a Chlamydia infection if they are present in the cervix during the investigation. Therefore a negative Chlamydia test is necessary before examination of the tubes. The Danish National Board of Health says that every woman has to be tested for Chlamydia before any fertility treatment is initiated.

Why do the Fallopian tubes (salpinges) occlude??

Most often, the reason is a sexual transmitted infection, especially Chlamydia. The woman does not necessarily have had symptoms, as 50% of Chlamydia infections are asymptomatic. Beyond this, an ectopic pregnancy or a severe appendicitis can destroy the passage in the tubes.

Should occluded tubes be surgically removed before fertility treatment?

Scientific investigations have proven that it is beneficial to remove hydrosalpinges (salpinges filled with fluid) before fertility treatment. If hydrosalpinges are present, they reduce the chance of obtaining a pregnancy with 50 %. Therefore we recommend their removal before fertility treatment is started. It is normally done by laparoscopy.

Why must hormones be analysed on a specific day of the menstrual cycle?

The gonadotrophic hormones FSH and LH vary throughout the menstrual cycle. Therefore, only analyses obtained on cycle day 2 or 3 can be used for fertility evaluation.

What does the FSH value say?

FSH is an abbreviation for “Follicle Stimulating Hormone”. FSH tells us about the egg reserve in the ovaries.

The lower the FSH value is, the more eggs are left. Normal FSH values are between 3 and 10 IU/l.

FSH values fluctuate during the cycle. Therefore they must be analysed on the womans 2nd or 3rd day of menstruation. FSH is also dependent on the blood levels of Oestradiol. Therefore it is important to have Oestradiol measured simultaneously.

If the woman is 40 or older and her FSH is above 10 IU/l, it is not sure we can offer treatment.

What does AMH mean?

AMH stand for “Anti-Müllerian Hormone”. It tells us about the ovarian reserve and the number of eggs in the ovaries. AMH can be measured on either day of the menstrual cycle. If AMH is below 10 picomol/l or 1.4 ng/ml your ovarian reserve and your fertility is reduced. With an AMH value below 3 picomol/l or 0.3 ng/ml your fertility is critically reduced.

Who can have treatment with IVF for free?

For having this treatment for free in a hospital, the couple must not have common children or shared custody. Only women under 40 years are treated and the couple must have lived together for a certain period of time.

What is IVF?

IVF means IVitro Fertilisation (fertilisation in a glass tube). IVF is used when

  • The fallopian tubes are damaged
  • The woman has severe endometriosis
  • The man has low semen quality
  • You cannot find a cause, but you have not succeeded with insemination treatment (unexplained infertility)

At IVF the eggs are aspirated from the ovaries and fertilised in the laboratory. Two days later the fertilised egg is transferred into the womb.

What is ICSI?

ICSI means IntraCytoplasmic Sperm Injection. By gently introducing a single sperm cell into each oocyte, the chance of fertilisation is increased when only few sperm cells or sperms with decreased motility are present.

What is TESE?

TESE means that you take sperm cells directly from the testicles (Testicular Sperm Extraction). This is necessary when the man has had a vasectomy or has missing vas deferens.

Is IVF free of charge?

Unfortunately not, even not for Danish citizens covered by the Danish health insurance (Sygesikringen). Only treatments in public hospitals are free.

Who can have treatment with IVF for free?

For having this treatment for free in a hospital, the couple must not have common children or shared custody. Only women under 40 years are treated and the couple must have lived together for a certain period of time.

What is endometriosis?

In some women, endometrial mucosa is found outside the uterus in the abdominal cavity. It is observed in the ovaries, on the Fallopian tubes, the bladder and on the intestines. The most frequent symptom is abdominal pain just before menstruation begins. Endometriosis can also cause blood cysts inside the ovaries.

Endometriosis is more frequently found in infertile compared to fertile women. However, it is not proven that endometriosis is the reason for infertility in affected women. For some reason women with endometriosis have reduced pregnancy chances with insemination, and IVF is often recommended instead.

What is PCOS?

PCOS means “Poly Cystic Ovarian Syndrome”. To meet the criteria, two out of three symptoms must be present:

  • The woman has long cycles (> 35 days)
  • There are > 10 small follicles in the ovary at ultrasound image
  • The woman has acne, increased hairiness or elevated androgen hormones in the blood

Women with PCOS have problems ovulating. They are often also obese. Weight loss and diet modifications can often help. Alternatively, she must have hormone stimulation for egg maturation.

Does the hormonal treatment increase my risk of cancer?

No. So far, no investigations have demonstrated an increased risk of cancer. On the contrary, women who have given birth to a child seem to have a reduced risk of ovarian cancer compared to women who have never been pregnant. It is the pregnancy itself that decreases the risk.

Do I use all my eggs during hormonal stimulation?

No. Every single day, a certain number of eggs start the maturation process towards ovulation. Normally, only a single egg or follicle continues growing, the others die. By adding a little amount of hormone, more eggs continue growing and mature until ovulation instead of dying due to shortage of follicle stimulating hormone.

Why do I need hormones for IVF?

For IVF, we aim at having 6-8 follicles for oocyte pick-up. We do not necessarily obtain oocytes from all follicles, and not all oocytes are fertilised correctly. By having 6-8 follicles we feel pretty sure that there will also be 1-2 good embryos for replacement.

Do I need to inject myself during treatment?

Yes, the hormone stimulation substance is given as subcutaneous injections into the abdominal skin. Our nurses will demonstrate for you how to do this. If you feel difficulties in doing it yourself, your partner or a good friend can do it for you.

What happens, if I become pregnant during down-regulation?

It is not dangerous for the foetus. What happens is the following: you will not have your menstruation during down-regulation. Once you have a positive pregnancy test, down-regulation is discontinued and the pregnancy progresses normally.

When do I have to take the ovulation induction?

The ovulation inducing substance (ovitrelle or pregnyl) has to be taken exactly 36 hours before the planned oocyte pick-up. If you take it too early, ovulation will already have occurred when you arrive at the clinic. If you take it too late, the oocytes will not be ready for aspiration. In case you have forgotten to take the ovulation induction, please call us directly and ask for instructions. Often, it can be done 24 hours later.

Help! I have forgotten to inject the ovulation induction.

Try to call your contact doctor at the clinic. During evening times you find the phone no. on the letter to your physician. Do not take the medication at random time since this can spoil the treatment (remember egg collection has to take place 36 hours later!)

Does the oocyte aspiration procedure hurt?

No, you will not feel pain; it feels more like a menstruation-like discomfort. Before we obtain the oocytes, we give you an effective local anesthetic in the vagina and you will also have an intravenous painkiller. After the procedure, you rest for 20 minutes and are able to leave the clinic afterwards.

How many embryos are transferred after IVF?

Transferring more than a single embryo increases your risk of having twins. The risk depends both on the woman’s age and the embryo quality. The Danish National Board of Health has the following recommendations:

If the woman is younger than 37 years and she has more than a single embryo of top-quality, it is advisable to replace a single embryo and freeze the others at the first and second replacement.

If there are no embryos for freezing, two are often recommended.

For women over 40 years we are allowed to replace up to three fresh embryos, depending on the embryo quality.

When is blastocyst culture recommended?

The embryo develops into a blastocyst on the fifth day after oocyte aspiration. By culturing to the blastocyst stage, some embryos will stop development before that stage, and this makes it easier to identify the embryo with the best chance of resulting in a viable pregnancy. However, it does not improve the quality of the single embryo. We especially recommend blastocyst culture to young women with good quality embryos who want single embryo replacement. If there are several good quality blastocysts, the others can be frozen stored.

Will assisted hatching improve my pregnancy chances?

Assisted hatching means that the embryologist applies a small hole in the zona pellucida to allow the embryo to escape from the eggshell. It is not recommendable to perform assisted hatching for all women. The following groups may have advantage from this procedure:

  • women who have not obtained pregnancy after transfer of good quality embryo 2-3 times earlier
  • women over 40 years
  • women who received very high FSH doses for stimulation
  • when the zona pellucida is thickened
  • when frozen embryos are transferred

Can we have sex after embryo transfer?

After oocyte retrieval, the woman normally feels some tenderness in the lower abdomen and does not want to have sex. After one week the embryo has implanted into the uterus and sex does not hurt.

How many women will have twins?

In women less than 35 years with two top-quality embryos replaced, about 50 % will have a positive pregnancy test and 25 % will have a twin pregnancy. With single embryo transfer, about 40% will become pregnant and the risk of monozygotic twins is very small. In elder women, the risk of twins is decreasing. In our clinic, about 15% of all pregnant women have a twin pregnancy.

For how long time can frozen embryos be stored?

According to Danish law, embryos can be stored for 5 years. With the exception that after their 46th birthday, women are no longer allowed to have their embryos replaced.

What can I do myself do improve treatment outcome?

Have a look under lifestyle here at our homepage. Smoking, alcohol and obesity for both men and women have documented influence on the treatment outcome.

Is it necessary to have the pregnancy test done when I have started bleeding?

Yes. Even if you have started bleeding, you can still be pregnant and continue with a normal pregnancy. In case the pregnancy test is positive and the woman has her menstruation, she might have an ectopic pregnancy. Therefore we recommend she always makes the pregnancy test.

Is there a risk of having an ectopic pregnancy using IVF?

Yes. One to two percent of all pregnancies after IVF are ectopic, even though the embryos were placed correctly inside the uterus.

When do I have the pregnancy scan?

You must have a pregnancy scan 3 weeks after the positive pregnancy test. At this time point we expect to be able to see a foetus with a heartbeat.

When do I have to stop the luteal phase support?

Normally, you must stop 3 weeks after the positive pregnancy test, which means you stop after the pregnancy scan. Some clinics already stop when the pregnancy test is positive. However, the clinical investigations demonstrating that you can stop that early cannot exclude that up to 5% of women will have an abortion stopping early. Therefore we recommend that you continue until the pregnancy scan.

Women who have become pregnant with frozen-thawed embryos in a hormone controlled cycle need to continue until 3 weeks after the pregnancy scan.

Is insemination treatment free?

Yes. If you are a Danish citizen and are covered by the Danish health security (Sygesikringen), investigations and insemination treatment is for free if you bring with you a referral from your GP. However, you have to pay for medication and donor semen. All other patients have to pay themselves.

Is there a long waiting time for treatment?

No. Once you have been to the introductory interview and we have all necessary test results, you can start treatment. (Brian, her skal der sættes et link til listen med undersøgelser “Preliminary examinations” for både insemination og IVF ). Foreign patients can send all necessary tests before the introductory interview and we can plan your treatment immediately during the interview.

How many inseminations can we have?

It depends on the reason for your infertility. Normally, it is reasonable to try insemination with the husbands sperm three times. After that, you should consider IVF instead.Is the woman young, healthy and has donor inseminations, you can try up to six inseminations, depending on the woman’s age. For women 40 years and elder, we offer three inseminations, as the chance of becoming pregnant is much lower as for younger women.

Why do I need hormone stimulation for insemination?

It depends on the reason of your infertility. By stimulating two follicles, the chance of becoming pregnant is twice the chance with a single follicle. Therefore, we often advise hormone stimulation if the twinning risk is not too large.

Do I use all my eggs during hormonal stimulation?

No. Every single day, a certain number of eggs start the maturation process towards ovulation. Normally, only a single egg or follicle continues growing, the others die. By adding a little amount of hormone, more eggs continue growing and mature until ovulation instead of dying due to shortage of follicle stimulating hormone.

Do I have to inject myself during treatment?

Yes, the hormone stimulation substance is given as subcutaneous injections into the abdominal skin. Our nurses will demonstrate for you how to do this. If you feel difficulties in doing it yourself, your partner or a good friend can do it for you.

When do I have to inject the ovulation induction?

36 hours before the insemination is scheduled.

I have started bleeding before the pregnancy test. Is it necessary to have the test done?

Yes. Even if you have started bleeding, you can still be pregnant and continue with a normal pregnancy. In case the pregnancy test is positive and the woman has her menstruation, she might have an ectopic pregnancy.

Can we have sex after insemination?

Yes. Actually, we recommend that you go home and have sex later on the day of insemination. The seminal fluid contains substances that seem to promote pregnancy.

Can I have an ectopic pregnancy after insemination treatment?

Yes, you can. Therefore it is important that you perform the pregnancy test even if you have started bleeding, and you come for the early pregnancy ultrasound scanning to confirm that you have an intrauterine pregnancy. Your risk of having an ectopic is the same as with spontaneous conception.

How many women become pregnant with twins after insemination?

The Danish Fertility law says that insemination must be cancelled when more than 3 large follicles (>14 mm) are present at the day of ovulation induction. The pregnancy chance per follicle is about 10 %. About 12 % of all women pregnant after insemination have a twin pregnancy. The risk is higher for young women than for women over 40 years.

When do I need to come for the early pregnancy ultrasound?

You must come 3 weeks after the positive pregnancy test. At this time point we expect to be able to see a foetus with a heartbeat.

When do I have to stop the luteal phase support after IVF treatment?

Normally, you must stop 3 weeks after the positive pregnancy test, which means you stop after the early pregnancy scan. Some clinics already stop when the pregnancy test is positive. However, the clinical investigations demonstrating that you can stop that early cannot exclude that up to 5% of women will have an abortion stopping early. Therefore we recommend that you continue until the pregnancy scan.

Women who have become pregnant with frozen-thawed embryos in a hormone controlled cycle need to continue until 3 weeks after the pregnancy scan.

When do I need to consult my GP?

You must contact your GP after the pregnancy scan.

What about medication, alcohol, smoking, tea and coffee?

Have a look at our homepage under Research and Lifestyle where you find more information.

I have become pregnant with donor semen. What about paternity?

If you need documentation that you have become pregnant using donor semen, you can send a letter to us and we will confirm that this is correct.

How can I reserve donor semen for a sibling?

If you have bought the donor semen at our clinic, you can contact us and ask for the donor number and cryobank. Thereafter you can contact the cryobank and create a depot for siblings. It is important that you tell the cryobank you already have a child with this donor. If you have bought the semen yourself at the cryobank, you contact the cryobank directly for reservation of more semen for a sibling.

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