Brussels IVF 2021 annual report FIGURESFACTSINSIGHTS,& 30ICSIyears at Brussels IVF
30 years ICSI 12 The future of ART 14 Implantation clinic 16 Patient satisfaction and well-being 18 2021 at a glance 04 Preface 06 Our fertility experts 08
training 22 In the press 32 About Brussels IVF and UZ Brussel 34
TABLE OF CONTENT
Page 4 - Annual report Brussels IVF 19.134* patient-doctor consultations *47% tele-consultations 23.542 ultrasounds 55.646 blood samples 1.948 interventionssurgical 2.428 intra-uterineinseminations 5.610 egg collections 135 preservationsOncofertility 7.194 embryo transfers 4.358 frozen embryo transfers 2.836 fresh embryo transfers at2021aglance5.638 patient counseling sessions to start ART 663 IVF-cycles GeneticPreimplantationwithTesting frompatientsallover Belgium
Annual report Brussels IVF - Page 5 Brussels IVF staff 20+ fertility experts 200+ employees, including: BELRAP overview* * Belgian Register for Assisted Procreation - 2019 data on 34 Belgian IVF centres (incl. 18 B-centres) 31,8 % of all IVF treatments in Belgium are performed at Brussels IVF 41,2 % chance of a live born child for fresh embryo transfer in reference group (vs. rest of Belgian centres: average 30,6%) 37,6 % chance that an embryo will implant and give rise to a live birth if under age 36 (all ranks) (vs. rest of Belgian centres: average 28,4%) 83 % of all IVM cycles 74 % of all ICSI cycles with fresh surgically retrieved sperm 66 % of all oocyte donations 65 % of all cycles after oocyte banking Brusselsperforms:IVF 48.217 oocytes collected 6.241 semen processedsamples 8.114 embryos transferred 9.910 embryos cryopreserved 6.325 oocytes donated 2.930 donated sperm straws for ART treatment
unique2019.
Page 6 - Annual report Brussels IVF
Dear colleague, Dear reader, Dear employee,
Now that everyone is slowly breathing again since COVID came on our path, we can look back on 2021 with great satisfaction. Once again, all employees of Brussels IVF, the centre for reproductive medicine of the university hospital of the Vrije Universiteit Brussel (VUB), have proven their resilience. Everyone supported and helped each other so that we could, once again, provide the best service to both our patients and referring colleagues.
As the numbers in this annual report tell us, in 2021 we were able to return to our 2019 activity level. More than 5600 IVF cycles performed, says it all. In addition more than 4300 transfers of frozenthawed embryos and more than 2400 treatments via insemination were performed. According to the most recent BELRAP report that lists all medically assisted reproduction treatments over all Belgian fertility centres, 32% of the oocyte retrievals for IVF were performed in our centre in the pre-COVID year
Butreimbursed.whatalso
characterises our service is the diversity of treatments thanks to our domain experts. For example, there is a unique approach to oncofertility in which all possible preventive treatments are even offered in combination. For example, a 16-year-old girl undergoing a sterilising treatment for cancer can opt to bank both a piece of ovarian tissue for future transplantation and oocytes after ovarian stimulation with, on top of that, initially immature oocytes from the ovarian tissue that were further matured in-vitro. Such trio combinations are unique, even on a global scale and bear witness to our extensive domain expertise and commitment to offer our patients with the best possible chances of success..
ISO-15224/ISO-15189 clinic-laboratory combination, we continue to reconcile quantity with
Such domain expertise is only made possible thanks to a close collaboration with our researchers within Brussels IVF and our “Biology of the testis” (BITE), “Follicle Biology” (FOBI), “Reproductive Immunology” (REIM) and “Reproduction and Genetics” (REGE). In 2021, this collaboration proved to be very fruitful with many ongoing studies, both translational and fundamental, resulting in 39 international peer-reviewed publications according to Web of Science.
quality. The same report shows, for example, that for patients under 36 years of age, the chance of having a child after an IVF cycle in Brussels IVF is almost a third higher than the average success rate of all our competitors together. And that is no mean feat when you know that only 6 treatments are
Annual report Brussels IVF - Page 7
Nevertheless,indications,… we face all these challenges with great
In 2021, Brussels IVF was committed as a healthcare provider on working across expert domains in reproduction to provide our patients with the best possible solution for their desire to have children and we hope to continue this mission in the years to come.
Nevertheless, Brussels IVF also faces a number of challenges Not only did Covid-19 force us to work differently, but it the highest possible quality of service. This remains a daily challenge. Many projects are in their starting blocks or intelligence in the IVF laboratory in day-to-day operations but also in our quality control, or the development of a mobile application to facilitate communication with our Furthermore,patients. there are also social developments that force us to adapt continuously, for example, intentional increasing demand for “social freezing” (almost 300 cycles in 2021), fertility preservation in the context of gender dysphoria, the expansion of surrogacy to non-medical
Brussels IVF
Prof. dr. Herman Tournaye Medical &
and its employees. That is why we will continue to strive for a culture where patients feel heard and valued, as demonstrated again by our 2021 patient satisfaction survey, but also in which employees feel this way and therefore enjoy working with us and continue to give the best of themselves.
As far as training is concerned, after the gloomy COVID year 2020, in 2021 we resumed our tradition of expert training through clinical fellowships of both our own staff but also of our peers not only from Belgium, from Europe and beyond. Besides, a structured educational programme was introduced under the umbrella of “Brussels IVF Academy” including training courses in our “Reproductive Skills Centre Brussels” (RSCB).
Preface
Dr. Liese Boudry Junior Medical Director Reproductive infectiology Prof. dr. Herman Tournaye Head of Department Andrology & Oncofertility Prof. dr. Shari Mackens Medical Director Recurrent miscarriage & implantation failureProf.dr. Willem Verpoest Senior Medical Director Expertise: Reproductive genetics & Immunology Prof. dr. Christophe Blockeel Senior Medical Director endocrinologyReproductive Prof. dr. Michel De Vos Senior Medical Director endocrinologyReproductive&oncofertility Dr. Caroline Roelens Junior Medical Director Fertility diagnostics & treatmentDr.Michelle Soares Junior Medical Director fertility diagnostics & treatment Our fertility expertsDr.VeerleVloeberghs Medical Director Andrology & Oncofertility
Prof. dr. Michael De Brucker Consultant
Dr. Sien Delattre Consultant
Dr. Sophie Hendrickx Clinical Fellow
Annual report Brussels IVF - Page 9
Dr. Elisabeth Soete Clinical Fellow
Dr. Guy Verhulst Consultant
Dr. Valerie Uvin Clinical Fellow
Dr. Lynn Opdecam Clinical Fellow
Consultants and Senior Clinical Fellows
Page 10 - Annual report Brussels IVF
•
•
•
Clinical Fellows:
Popovic • Dr.
Dr. Margot Moeykens
Pais
Research Fellows:
Dr. Ana Rita Puga Leal
Dr.
Junior
Dr.
Racca • Dr.
•
Dr. Cynthia D’Hondt
Frederix
• Panagiotis Biljana Annalisa Francisca
Dr.
Dr. Maria Petra Agius
•
Dr. Maxime Vromman
•
• Billie
Dr. Sara Loreti
• Valerie
Drakopoulos • Dr.
•
Junior Clinical Fellows & Research Fellows
Schutyser
Dr. Elzbieta Bumbul-Mazurek
• Case studies
• Theoretical sessions & lectures
• Hands-on laboratory & clinical training sessions
• Guided tour of Brussels IVF
Brussels
The RSCB is led by Prof. dr. Herman Tournaye, Clinical include senior Brussels IVF staff.
The Reproductive Skills Centre Brussels (RSCB) is Brussels IVF’s ART training centre. The RSCB consists of a training and a clinical training room with simulators for oocyte pick-up, embryo transfer, hysteroscopy and laparoscopy.
Reproductive Skills Centre
The Reproductive Skills Centre Brussels is located at the
The courses are given by experienced clinicians and embryologists in both in-depth theoretical lectures and hands-on sessions under expert supervision.
In addition to the RSCB “Brussels IVF Academy” was introduced to further professionalise our training programme, providing a platform and structured course materials to help prepare subspecialist trainee MD’s and midwives for the ESHRE subspeciality exam leading to productive medicine.
• Teaching & demo videos
All courses include:
The training rooms are used for internal training of our medical staff, nurses and midwives, lab technicians and embryologists. But the RSCB provides external courses as well, thanks to close collaboration with pharmaceutical companies. The RSCB courses offer a comprehensive training in the clinical and laboratory aspects and practices of assisted reproductive technologies and reproductive surgery.
Get in touch: rscb@uzbrussel.berscb.brusselsivf.be
Reproductive Skills Centre Brussels
• Q&A – Interactive discussion
ThisMelbourne.workshop would turn out to be the last trigger to kick off our own IVF programme at UZ Brussel in 1983. We were even allowed to stay up to 10 days following the workshop to observe the daily practice of IVF in Melbourne.
ICSI: a revolution in ART
“At the time, we had little or no resources because we were still in the process of setting up the fertility service. So I remember we spent two days travelling to Australia. The experience there and what we were able to learn from our colleagues prompted me to be open and to share knowledge in my work as well. I remain convinced that what you share, you will also get back.”
Sperm quality impacted success rates
in november ‘83.
There we learned that later that year in July ‘82 Monash
FOCUS ON
partial zonal dissection and subzonal sperm injection. We estimated SUZI, or subzonal insemination, as the most promising technique and invested to improve and research tests turned out to be successful; we could see a successful fertilisation of the oocyte, a developing embryo and birth of new ánd reproductive mice after transfer. So we were granted approval of the Ethics Committee allowing human research under the condition of a strict follow-up policy of all pregnancies obtained and children born. With the SUZI technique a single sperm is placed in the zone just beneath the zona pellucida (the protein shell surrounding the oocyte) to give the sperm an advantage in penetrating the barriers surrounding the ovum. This technique required tremendous skill and precision from the staff in the lab.
IVF in UZ Brussel
Prof. Em. André Van Steirteghem, is an MD trained as a pediatrician, a clinical biologist and a fertility expert. Together with Prof. Em. Paul Devroey he was one of the founding fathers of our fertility centre at UZ Brussel and VUB.
factor of infertility was involved and sperm quality was low. That is why the medical world carried out research into ways to assist the fertilisation process in the lab.
clinic and the hormone laboratory was established for patients receiving hormonal treatment. In 1982 Paul Devroey invited me to join him in a meeting in La Grande Motte
Prof.INTERVIEWEm.AndréVan Steirteghem
“The ICSI technique could only have found its orand unfailing perseverance”
IVF has revolutionised reproductive medicine. But
One woman was undergoing a reproductive treatment in which SUZI was applied on her 12 oocytes. During one of the sub-zonal injections, a human slip occurred; the sperm cell was inserted too deep and was injected into the egg cell. This was meticulously documented in the
The embryo gained after ICSI, was transferred back into the patients womb, after approval. We were allowed to use the ICSI technique by the hospital’s Ethics Committee on the conditions that we had patients’ full approval ánd all resulting children would be subject to extensive follow-up after birth. This was already the case for children born through IVF.
“WtoThe Lancet for publication, I remember
acceptance note from the publisher. “We hope this will not just be a red herring”, the response stated. That was also indicative of the perception of our peers.”
But after a few days it became clear that only one of the 12 eggs had successfully developed into an embryo. The
In the early nineties, there were worldwide workshops staff from the Netherlands, France and all over the world and successfully applied.
And the article in The Lancet, our herring, has already been “consumed” more than 2,800 times, making it one of the most cited articles in reproductive medicine.
the deliberate injection of a sperm into the egg cell had been tested, with little success, in cattle, rabbits and mice. An earlier publication in ‘88 reported no successful pregnancy when using ICSI in human patients. When I spoke in early 1992 about our results with colleagues at an FWO contact group in Brussels, one
Serendipity
Red herring
ICSI; intracytoplasmic sperm injection.
It was only after the publication in The Lancet that our claims were believed and there was worldwide interest in coming to see our ICSI lab
“I am still very proud of all the people who were involved; their skills and competence but also their attitude towards peers to let each other learn and grow. I remain very much convinced that science has to be communicated, it’s not about making big money. “
During the following months extra research was carried out on 300 cycles. Half of the gained oocytes were fertilised via SUZI and half via ICSI. And so we quickly realised that ICSI was much more effective for these Therepatients.was much skepticism among colleagues about the potential success of the ICSI technique. At that time
Annual report Brussels IVF - Page 13
“At that time, there were not even any manufacturers in our country of suction pads and pipettes that were thin and precise enough to manipulate delicate oocytes and sperm cells. So these were made here by ourselves for using in our lab“
Prof.INTERVIEWdr.HermanTournaye
But apart from technological developments, Brussels IVF is also investigating, in cooperation with industrial partners, how we can make the entire IVF treatment more patient-friendly. For example, we are investigating how existing hormonal stimulation protocols can be limited in terms of medication administration and monitoring. We are also the only centre in Europe that can successfully grow immature oocytes in-vitro with success rates comparable to the classical approach, and, in selected patients, without the need for hormonal stimulation.
technology can optimise and automate in-vitro fertilisation itself.
“In the past, Brussels IVF, then called ‘Centre for Reproductive Medicine (CRG)’, has always played a pioneering role in terms of innovation within reproductive medicine, the introduction of intracytoplasmic sperm injection within IVF being our main achievement.”
FOCUS ON The future of ART in Brussels IVF
Innovation is in our DNA
Page 14 - Annual report Brussels IVF
new technologies. We are working on the potential
for example, to isolate sperm cells from testis tissue
In 2022, we celebrate the 30th anniversary of this more than 70% of all IVF cycles worldwide and makes it possible to cope with the sterility of those couples where surgically retrieved spermatozoa are of this combination in men with azoospermia due to primary testicular dysfunction, including men with rely on donor sperm to realise their desire to have tochildren.startbanking testicular stem cells in prepubertal boys who needed a sterilising treatment for cancer.
Patient-centered care
“We have to be very concious of the changes in society as they will also determine our future as a centre for reproductive medicine to a great extent.”
But to this day, Brussels IVF continues to actively innovate. Ou focus remains on the introduction of
In 2021, a care pathway was launched for intentional co-parenting - a parenting concept
Annual report Brussels IVF - Page 15
Receptive to the needs of an ever-evolving society
the cancellation of a TV series on the subject after heavy criticism, even from political stakeholders. It reminds one of the early 80’s when we were strongly criticised for helping lesbian couples and single women to get pregnant. In the meantime, this has become common practice and is even embedded in Belgian legislation since 2007.
Finally, we must not forget the rapid succession of patient generations: after the Millennials
to offer “social freezing” to women who were forced to delay their desire to have children. Although we were heavily criticised at the
been adopted in many Belgian centres. This is an example of a development that illustrates our future-proof role: more preventive than curative, or in other words: securing fertility rather than treating infertility. Our world-leading oncofertility programme is another example.
Gen Alpha (2011-) are knocking at our door.
We have therefore decided to include them in our new strategic plan, to invest in the development of an mobile application that will guide them through their treatment, and to focus on telemedicine where possible.
We are undoubtedly entering interesting times with a focus on more preventive medicine and patient-centeredness. Quite a challenge that we at Brussels IVF, novelty seekers as we are, are happy to take on.
“Our current and surely our future patient demands an individual approach with an important role for themselves in medical decision making. They want to be in charge of their own care path. This should encourage us to make them a part of our medical care plan by not only involving them in decisions but also informing them as fully and transparently as possible. “
Through a close colaboration between research and the clinic we want to unravel the (patho)physiological of implantation ánd optimise reproductive outcomes for our patients. path couples having problems implantation: implantation early pregnancy created a multidisciplinary care path focus on the most with one goal: a healthy baby in a healthy mother.
failure (RIF) - recurrent
Who?
loss (REPL) We
How?
Implantation failure after IVF can be distressing for couples trying to conceive. Especially since for most patients currently no apparent cause is found after standard work-up.
A dedicated care
- recurrent
to
conceive
3 medicinetoimplantationFromplacentationprenatal pregnanciesofFollow-upevolutive in case of high(er) risk (f.e. pre-eclampsia). THE EMBRYO well-developedcanimplant THE WOMB the uterus should be receptive to the embryo THE TEAM quality control during the entire treatmentt; in the clinic and the lab Studies & researchPillars 1. determining the best conditions for achieving a full-term pregnacy from monitoring the natural cycle to PGT-A 2. critical discussion with the patient about possible add-ons to ensure joint, well informed decision-making 4.3. genetic analysis of the miscarriage in case of recurrence to determine cause MackensShariDr.Prof.
ImplantationON failure
f.e. the FLORA-project : in search for the microbial cause of chronic endometritis and the most appropriate treatment to obtain a successful pregnancy IVF/ICSI.
with
important aspects
Why a dedicated care path?
f.e. the HEART-study - High risk for pre-Eclampsia after Assisted Reproductive Technology: unraveling pre-eclampsia following ART. This study targets the increased risk of pre-eclampsia
Patients who experience repeated implantation failure, this means that after multiple embryo transfers after IVF/ICSI no positive pregnancy test is obtained.
FOCUS
1 implantationnormalStudying Prospective patients.implantationsuccessfuldeterminingvariousinvestigatingretrospectiveandstudiesthefactorsinART For
Brussels IVF is working closely with the Department of Microbiology on this project to gain insight into the micro-organisms present in the female reproductive and bypass the impact of chronic endometritis in failing ART treatments.
undergoing ART which can be up to 12% instead of the 4% in the general population. The study envolves extensive screening during preconception and the first trimester of pregnancy for the recipients after oocyte donation and women with polycystic ovarian syndrome (PCOS).
histologically. Fertilisation rate, embryo development and clinical outcomes after embryo transfer were reassuring.
Samples from sixteen patients were analysed. Cycle threshold (Ct 65 ) values < 40 were considered positive. All samples were negative for SARS-CoV-2 viral RNA. No
BoudryLieseDr.
In women infected with SARS-CoV-2 who underwent ART, and endometrium. Caution is warranted in view of the small sample size, and the risk of SARS-CoV-2 affecting the embryo via ART cannot be ruled out. Adequate counselling of women and couples undergoing ART is crucial in parallel with further research on the effect of exposure of the early human embryo to SARS-CoV-2.
Results:
Covid-19
y are hand
UNDETECTABLE VIRAL RNA IN FOLLICULAR FLUID, CUMULUS CELLS AND ENDOMETRIAL TISSUE SAMPLES IN SARS-COV-2 POSITIVE WOMEN
The method of all these procedures in itself is no different to the treatment of patients with negative serology. Only the precausionary measures of our staff, such as wearing gloves, is mandatory for each procedure. The tissue and gametes of patients with positive serology are handled separately in a parallel cleanroom.
An infectious lab, trained lab-technicians and a designateed proces, enabled us to also keep helping patients who were diagnosed with covid-19 during their fertility treatment.
Infectious procedure:
An important COVID-19 study on RNA detection in reproductive cells was conducted in our centre.
The primary outcome parameter was the detection of viral cells. Fertilisation rate, embryo developmental potential and clinical outcome after frozen embryo transfer were secondary outcome parameters.
Conclusions:
FOCUS Covid-19ONlearnings
ES
The guidelines regarding Covid-19 evolved with the access to vaccination. Since the number of covid-19 positive lab has a limited capacity, we are now treating covid-19 positive women in the regular lab with extra precautions. For covid-19 positive men, the samples are collected in the usual semen jars, but also enclosed in an extra plastic bag (as for other infectious patients). Semen collection is also performed with a ProInsert kit, as is the case for other infectious patients.
Since the beginning of the pandemic, treatment of Covid-19 positive patients was carried out in the infectious cleanroom to minimise the risk of cross-contamination and to protect our staff. Additional precautions were taken such as wearing a second pair of gloves, FFP2 mask and a cover coat. All used material was collected in a sealed bag before disposal and additional decontamination of the consumables and equipment was performed. In December 2021, as a safety measure it was decided to have all patients submit to a PCR test 24h before an oocyte retrieval.
THE ADVANTAGES OF AN INFECTIOUS CIRCUIT DURING A GLOBAL PANDEMIC
Tissues and cells from a patient with positive serology are treated in the cleanroom infectious lab. This concerns all possible procedures such as oocyte pick-up, sperm from patients with positive serology.
We take patient feedback and complaints very seriously. That is why we have a dedicated quality manager who in close cooperation with the patient.
made in 2021.
Quality manager Brussels IVF Clinic
1,4 complaints per every 100 interventions performed.
91%
91% with Brussels IVF.
Patient feedback and patient satisfaction
FOCUS ON Patient satisfactionPatient
Survey results (n = 1057)
94% of patients would recommend Brussels IVF to other patients.
Feedback & complaints:
Patients are the centre of Brussels IVF. We have a long history of conducting patient satisfaction surveys and involve patients in our operation and strategy.
complaints172reports
Mrs. Dina Brackman
8 complaints per 10.000 services provided and patient contacts.
Page 18 - Annual report Brussels IVF
We invest in a culture where also internal reporting is valued. Complaints from employees, but also ideas and improvements can be reported and implemented.
scared and initimidated by the procedure but the doctors and nurses I’ve met were very empathetic and I felt I was in good hands. “ Goal: opinions, ideas,experiences Open conversation For patients and partnersGenera
“I recommend this fertility centre to everyone: excellent organisation, kindness of the entire staff and pleasant atmosphere.”
Each year we invest in focus groups in order to better understand the needs of our patients and their Sadlypartner.during the Covid pandemic two years passed without the opportunity of bringing people together safely to talk about their experiences, ideas and our Theservice.next
“Everyone is always very helpful, warm and human. I felt in very capable hands during the entire process. The daily monitoring (DM) was always accessible in case of questions or doubts and they always took time and listened to all my concerns. A big thank you for all your work.”
Qualitative approach to patient satisfaction
“ I am extremely grateful to all the people of the operating theatre and nursing unit for their kindness.”
•
Neutral moderator & location
Although it does often feel like I’m going to a big factory and it doesn’t matter who you are or what your story is. During the corona pandemic, this was suddenly different. It looked like the staff had a little more time for you and that was very pleasant”.
focus group will be organised in autumn 2022.
ISO 15189:2012 •
Annual report Brussels IVF - Page 19
•
surgery under general anaesthetic is available every “Iday.“was
Some quotes from the patient satisfaction survey
Share your experience with us and others
“For us, it was a very positive experience. In our previous fertility centre, we were warned that it was very big and that we would get lost. However, we do not have this experience at all. We felt very at ease within Brussels IVF regardless of the size of the organisation. And we feel that we were always approached very personally and professionally.”
•
“You are all very professional, and at the same time very kind. I always felt like I was in good hands.”
Fortunately, psychological interventions, especially those emphasising stress management and coping-skills, have
More than 80 million people worldwide are confronted with sub-fertility or infertility. The inability to conceive children is experienced as a stressful situation by individuals and couples all around the world.
In addition to qualitative lab work and medical expertise, Brussels IVF offers an integrated approach to fertility treatment. For years now a team of psychologists working in our fertility centre provides guidance and support in
Lize Leunens
The team has knowledge of the fertility treatments, insight in the functioning of the centre and the legislation
MENTAL RESILIENCE WHEN DEALING WITH INFERTILITY
The consequences of infertility often include societal repercussions and personal suffering. While the infertility itself is not a disease, it often affects many aspects of people’s lives, which can cause various psychological and emotional consequences including frustration, depression, anxiety, hopelessness, guilt, and feelings of worthlessness.
FOCUS ON Well being
Rani Cooreman
Advances in assisted reproductive technologies (ART), such as IVF, can offer hope to many couples where treatment is available. The medicalisation of infertility should always be considered of the emotional responses that impact couples experiences. These can include distress, loss of control, disappointment, stigmatisation,.... Since every patient, and every couple, is unique, it is our conviction they should be approached holistically.
The psychologists also have an important role in the Ethics Advisory Committee when it comes to the evaluation of certain patient applications. This committee is a multidisciplinary panel responsible for issuing decisions in ethically complex cases.
Julie Nekkebroeck
parents need to make.
Eveline Buyse
Page 20 - Annual report Brussels IVF
FERTILITY WEBINAR: Starter
12 October 2022 - 20h
FERTILITY WEBINAR: Starter
Focus: resilience and stress management
Program 2022 - 2023
Focus: from oocyte retrieval to embryo transfer
FERTILITY WEBINAR: Psychological impact
FERTILITY WEBINAR: the Embryo
FERTILITY WEBINAR: Starter
in January 2023
Focus: single mothers + lesbian couples
24 April 2023
Focus: Resilience and stress management
Focus: heterosexual couples in March 2023
Focus: heterosexual couples
PATIENT WEBINARS
FERTILITY WEBINAR: Psychological impact
For the time being, the webinars are offered in Dutch only.
have many questions, we started organising interactive patient
FERTILITY WEBINAR: Starter
Annual report Brussels IVF - Page 21
! Coming soon:
Due to the interest shown and thanks to the feedback of participants, we are extending our webinars and including a session on the embryo and a session dedicated to psychological resilience in a fertility process.
Focus: single mothers + lesbian couples
These webinars are one of the ways in which we want to support and help patients in their process and with the questions they are facing. So don’t hesitate to refer your patients.
22 September 2022 - 20h
GET TO KNOW: Patient Webinars
Focus: single mothers + lesbian couples
The webinars help guide patients who are thinking about ART, have just started a treatment or wish to transfer to our centre, through the world of fertility treatments. From the comfort of their own home, they can learn more about the treatment, the practical
7 February 2023
9 November 2022 - 20h
FERTILITY WEBINAR: Starter
Since its creation in 1983, Brussel IVF has been driven by and strengthens clinical practice. Thanks to this powerful combination, Brussels IVF, often together with the Centre for Medical Genetics (CMG) - has achieved
PCOS is one of the most common endocrine conditions in women of reproductive age. We have an active focus on translational and clinical research aimed at the understanding of transgenerational effects of PCOS on health of the
Reproductive endocrinology
Regarding ovarian stimulation, a lot of clinical questions remain unanswered. We are searching for the optimal protocol to treat poor responder patients in two clinical studies. Besides, progesterone at the end of the follicular phase is one of our hobbyhorses. Individualisation of the preparation of a frozen embryo transfer cycle is an important topic
trimester screening program that tries to identify patients who are pregnant following ART and are at increased risk for placental dysfunction and the development of pre-eclampsia.
To reach a successful implantation three elements are essential: a competent embryo, a receptive endometrium and
We also work with the Human Embryonic Stem Cell laboratory (hESC lab) and with the REGE (Reproductive Genetics), REIM (Reproduction and Implantation), FOBI (Follicle Biology) and BITE (Biology of the Testis) research groups of the Vrije Universiteit Brussel (VUB).
In new upcoming research projects, we will work towards a standardised diagnosis and treatment of chronic endometritis and we will investigate its impact on implantation following IVF. Emerging new technologies like for example culturomics will be explored within this context. Furthermore, we will
Polycystic Ovary Syndrome (PCOS)
Assisted Reproductive Technologies laboratories. However, we also collaborate with other researchers. Genetic research mostly takes place in the laboratories of the CMG, for example. Together, the CMG and Brussels IVF make up the PGT clinic, where we test the embryos genetically before they are transferred to the prospective mother’s womb and help couples with genetic problems to have a child free of the genetic defect.
ical and basic research protocols we aim to further unravel the role of the endometrium in this rate-limiting step. Our goal is to better understand how it prepares for implan-
Research & Training
offspring; optimising success rates after fertility treatment in subfertile women with PCOS; reducing the risk of obstetric complications in pregnant women with PCOS.
Page 22 - Annual report Brussels IVF
ence of the thyroid function on pregnancy outcome.
Endometrial receptivity and implantation
Research at the clinical level
• the technique to remove a few cells from the embryo for genetic diagnosis (embryo biopsy);
The aim of this research is to determine whether it is possible
• crucial role in early embryonic development. We do this by eliminating them and studying their effects on embryonic development.
Children follow-up
Embryonic development and implantation of the embryo in the uterus
• the best way to freeze and store embryos;
The aim is to improve existing techniques in the fertility clinic and to develop and validate new procedures in the
Genetic state of the embryo
Laboratory techniques
• to check DNA mutations, hereditary disorders and chromosomal abnormalities in embryos.
Embryonic development starts when the oocyte is fertilised by a sperm cell. A fertilised oocyte develops into a multicellular embryo, a morula and a blastocyst. Research into embryonic development and implantation in-vitro is aimed at understanding why embryos grow poorly or do not implant. Our aim is a better understanding of the function of the genes and proteins that play a crucial role in early embryonic development. We hope this will lead to better diagnosis and treatment of couples with fertility problems.
Annual report Brussels IVF - Page 23
• to prevent embryos with a genetic disorder from being transferred in a fertility treatment;
• development and implantation.
• laboratory techniques to fertilise an oocyte outside the body (IVF and ICSI);
Embryonic stem cell research
• to avoid serious diseases by correcting the gene responsible for the disease;
Unique research into the pregnancies and children resulting from assisted conception.
Research in the ART lab
• conditions under which embryos grow outside the body;
contains unique stem cells that, under certain conditions, can develop into any type of cell in the human body, such as nerve cells, muscle cells, blood cells, oocytes and sperm. This research wants to investigate whether these stem cells can be used in the future to replace damaged cells in diseases such as Parkinson’s, heart failure and diabetes.
This domain studies techniques to examine the DNA of embryos before they are returned to the uterus. The bestknown application is Pre-Implantation Genetic Testing (PGT), in which we remove a few cells or a little tissue from the embryo for analysis in the lab. There are two main reasons
• In a clinical framework, reproductive medicine has joined forces with the medical genetics for a followup study into the health of children born using various assisted reproduction methods. Research is also carried out into the possible role of genetics in fertility issues, or simply put, into the possible genetic causes for male or female infertility
REGE: Reproduction and Genetics
Page 24 - Annual report Brussels IVF
• Research into the design of optimised culture systems for ovarian follicles and immature oocytes
• Developing and implementing methods to transplant spermatogenesis with a special focus on spermatogonial stem cells (SSCs) or testicular tissue
BITE: Biology of the Testis
• Fundamental research into embryonic stem cells and the possibility to use embryonic stem cells in regenerative medicine
• Research of oocyte in-vitro maturation (IVM), i.e. the culture or ripening of eggs in the laboratory
• Research into molecular markers that determine oocyte quality
• into the impact of the immune system on implantation.
Research at the faculty
• Research into the mechanisms that positively or negatively affect the development and the implantation of the embryo in the uterus, and
FOBI: Follicle Biology
• Epigenetic safety testing of oocyte culture
REIM: Reproduction and Implantation
• Research into the origin of aneuploidy in human embryos
• Studying Klinefelter Syndrome related infertility
• Generating sperm cells in-vitro
• Research into the role of mitochondrial DNA variants in infertility and ART outcomes
• Research focusses on the long-term effects of a testicular tissue biopsy procedure performed at young age
Fernandez AM, Drakopoulos P, Rosetti J, Uvin V, Mackens S, Bardhi E, De Vos, M, Camus M, Tournaye H, De Brucker M. Reprod Biomed Online. 2021 Apr;42(4):768-773.
Van Der Kelen A, Santos-Ribeiro S, De Vos A, Verdyck P, De Rycke M, Berckmoes V, Tournaye H, Blockeel C, De Vos M, Hes FJ, Keymolen K, Verpoest W. Hum Reprod. 2021 Aug 18;36(9):2558-2566.
Expanding the time interval between ovulation triggering and oocyte injection: does it affect the embryological and clinical outcome?
Van Reckem M, Blockeel C, Bonduelle M, Buysse A, Roelants M, Verheyen G, Tournaye H, Hes F, Belva F. Hum Reprod Open. 2021 Feb 19;2021(1):hoab002
Vandenberghe LTM, Santos-Ribeiro S, De Munck N, Desmet B, Meul W, De Vos A, Van de Velde H, Racca A, Tournaye H, Verheyen G. Hum Reprod. 2021 Feb 18;36(3):614-623.
Annual report Brussels IVF - Page 25
Parameters of poor prognosis in preimplantation genetic testing for monogenic disorders.
oocyte donation in comparison with peers born after fresh oocyte donation.
Personalized ovarian stimulation based on expected number of euploid embryos.
Must read publications in 2021: selected for you
Drakopoulos P, Blockeel C, Makrigiannakis A, De Vos M, Tournaye H, Pluchino N. Hum Reprod. 2021 Jan 1;36(1):261-262.
Erratum in: Hum Reprod Open. 2021 Apr13;2021(2):hoab013
IVF in women aged 43 years and older: a 20-year experience.
domized multicenter, parallel group pragmatic trial in infertile women with at least one patent tube at Hysterosalpingo-foam sonography (Hyfoil study).
Sponsored studies in the clinic
treatment to follitropin delta (REKOVELLE) in women undergoing controlled ovarian stimulation in a long GnRH agonist protocol: RAINBOW. Blockeel C., Tournaye H.
Blockeel C., Tournaye H.
Schutyser V., Tournaye H.
39 peer-reviewed papers
35,05
citation per
Blockeel C.
Transdermal testosterone gel for poor ovarian responders. A multicentre double-blind placebo controlled randomized trial (TTransport study).
Hyalobarrier®GEL ENDO versus no Hyalobarrier®GEL ENDO following operative hysteroscopy for improving reproductive outome in women with intrauterine pathology wishing to become pregnant (AGNOHSTIC trial).
Blockeel C.
VIDAS® HCG study on women with ectopic pregnancy (VIDAS trial). Blockeel C., Anckaert E., Tournaye H.
Prospective Multicentre non-Interventional Study to Assess the Patterns of Use of REKOVELLE in Women Undergoing In Vitro Fertilisation or Intracytoplasmic Sperm Injection Procedures in Routine Clinical Practice: PROFILE. Blockeel C., Tournaye H.
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articles published
30+ ongoing research
Average publication:
Main research ongoing in 2021 Research
A randomized, double-blind, placebo-controlled, parallell-group, dose-range trial to investigate
projects
1.230 peer-reviewed from 1983 until 2021
AURORA-REC (Aurora test for patients treated with recombinant gonadotropins) An observational cohort study to evaluate the expresian cumulus cells from ICSI patients that are treated with recombinant gonadotropins (AURORA study).
Natural cycle versus hormone replacement therapy cycle for a frozen-thawed embryo transfer in PGT patient (HRT_NC-FET study).
granulosa cells in natural and stimulated cycles in oocyte donors (MITO-ART study).
A prospective observational study on the relationship between meiosis gene mutations and dysfunction of meiosis in oocytes (Meiosis dysfunction study).
Clinical pregnancy rate for Frozen embryo transfer with HRT: a pilot study comparing 1 versus 2 weeks of treatment (Short-trial).
thyroid function and preganancy outcome after assisted reproductive technologie (TGAB-study).
Racca A., Blockeel C.
Effect of recombinant FSH dosing following corifollitropin alfa in patients undergoing IVF/ICSI in a GnRH antagonist protocol: a randomized controlled
before IVF/ICSI-treatment in women with intramural
Investigator-initiated studies in the clinic
Cosyns S., Tournaye, H.
The Effect of Ulipristalacetate (UPA) on serum Antimüllerian hormone levels.
after IVF/ICSI (Microbiome-study).
Annual report Brussels IVF - Page 27
Schutyser V., Tournaye H.
anxiety management during outpatient hysteroscopy and endometrial biopsy in subfertility patients (HYSVIR trial).
Blockeel C., Racca A.
Boudry L., Blockeel C.
fRozen thawed EMbryo replacement using Oral Dydrogesterone or vaginal progEsterone for Luteal phase support (REMODEL study).
Roelens C., Blockeel C.
Mackens S., Blockeel C., Van de Velde H., Tournaye H.
Uvin V., Verpoest W., De Brucker M.
Double trigger and ovum retrieval vs. conventional antagonist ovarian stimulation protocol in poor prognosis women undergoing IVF/ICSI: a randomized pilot study (DUOPICK study).
De Rijdt S., Blockeel C.
Blockeel C., Mackens S., Tournaye H.
Oral dydrogesterone (OD) versus micronized vaginal progesterone (MVP) for luteal phase support (LPS) in IVF/ICSI: pharmacokinetics and the impact on the endometrium, the microbiota of the genital tract and the peripheral immunology (DYDRA study).
Roelens C., Blockeel C.
Initiation of ovarian stimulation with recombinanthuman FSH (Bemfola®) in the late follicular phase, a randomised controlled pilot study (D2D12Bemfola study).
Spits C., Tournaye H., Blockeel C.
Histological and Transcriptional Changes caused by Endometrial Flushing with Lipiodol: A Cross Over Study (Lipiodol study).
Racca A., Blockeel C.
Verpoest W., Tournaye H., De Vos M., Van de Velde H.
Cosyns S., Tournaye H.
Conventional ovarian stimulation vs. in-vitro oocyte maturation (IVM) followed by in-vitro fertilisation (IVF): differences in patients’ emotional adjustment and quality of life (EMAQOL-study).
Optimising preconceptual health in subfertile PCOS program before fertility treatment, impact on health related quality of life and obstetric outcome (Lifestyle_ Mostinckxin_PCOS).
De Vos M., Tournaye H., Segers I.
L., De Vos M.
Page 28 - Annual report Brussels IVF
A comparison between corifollitropin alfa and recombinant FSH for follicular recruitment in women with polycystic ovaries who undergo IVM treatment (IVM-ELONVA study).
Segers I., De Vos M., Tournaye H.
De Vos M.
Anckaert E., De Vos M.
Translational research trial investigating the development potential of embryos obtained after in-vitro oocyte maturation (IVM) of oocytes from follicles < 10mm following a pre-maturation culture (Capacitation - CAPA-IVM) modulating the maintenance of meiotic arrest and the resumption of meiosis (IVM-CAPA study).
Novel molecular characterization of oocytes and cumulus cells from women with polycystic ovarian syndrome (PCOS) phenotype A (IVM-MOLPA).
De Vos M., Verheyen G., Segers I., Anckaert E.
Trial investigating the developmental potential of embryos obtained after biphasic in vitro oocyte maturation (IVM) of oocytes including a pre maturation culture step (‘capacitation step’) compared with standard IVM. (IVM-CAPA Sibling study).
PCOS trials in the clinic
Onco Fertility trials
Autologous testicular tissue transplantation for fertility Vloeberghsrestoration.V.,Tournaye H.
Annual report Brussels IVF - Page 29
Sars-CoV-2 trials
mulus-oocyte-complexes from COVID-19 patients during controlled ovarian stimulation for ICSI treatment (COVID_OFF study). Boudry L., Mateizel I.
COmbining Interventions of fertility preservation to Mitigate fertility loss after BReAst cancer (COIMBRA). Delattre S., De Vos M.
Follow-up of fertility in young adults who did or did not store testicular tissue before gonadotoxic treatment for fertility preservation. Goossens E., Tournaye H., Vloeberghs V., Gies I., Van der Werff Ten Bosch J., Braye A.
Detection of SARS-CoV-2 in semen of COVID-19 positive males (COVID_SPERM study). Uvin V., De Brucker M., Verheyen G.
Blastocyst-stage versus cleavage-stage transfer: neonatal follow up of singletons born from three randomized controlled trials.
Effect of abstinence duration on embryo development: a prospective sibling oocyte study. Mateizel I., De Munck N., Verheyen G.
De Vos M., Segers I.
Is the use of SpermMobil a valid approach in case of immotile spermatozoa, based on embryo quality and clinical outcome?
Verheyen G.
Embryo culture at a stable temperature of 36.6°C or 37.1°C: a randomized study. Wouters K., De Munck N.
Van de Velde H.
De Vos A.
Page 30 - Annual report Brussels IVF
Evaluation of embryo quality after sperm selecling oocytes. Wouters K.
man embryo: is GATA3 the gatekeeper of trophectoderm differentiation?
sions during human peri-implantation development. Van de Velde H.
Generation of a sub-cellular organization map dehuman development. Van de Velde H.
Inhibitor treatments and microscopy in human early human embryonic development
Fertility treatments in PCO(S) patients: what are the success rates and risks after an in vitro maturation (IVM) treatment compared to a standard controlled ovarian stimulation (COS).
“Simply the best”: embryo selection for IVF using non-invasive biomarkers.
Studies in the IVF-laboratory
Van de Velde H.
Van de Velde H.
Optimization of the cryopreservation procedure of very-low number of human spermatozoa from testicular samples: study on sibling oocytes. Mateizel I.
Annual report Brussels IVF - Page 31
Reproductive outcomes after fertility preservation in female adolescents with Turner syndrome.
positive pregnancy test.
Association between genetic variation in gonadotrophin and gonadotrophin receptor genes and late follicular phase progesterone elevation. Secondary analysis of a prospective cohort study. (Polymorphisms in gonadotrophin and gonadotrophin receptor genes and pro-gesterone elevation). Blockeel C., Spits C.
Association between genetic variation in gonadotrophin and gonadotrophin receptor genes and ART reproductive outcomes. Secondary analysis of a prospective cohort study. (Genetic variation in gonadotrophin and gonadotrophin receptor genes and pregnancy outcomes).
Prevalence of antinuclear antibodies in woman with recurrent miscarriages and impact of antinuclear antibodies on pregnancy outcome after IVF/ICSI treatment.
De Vos M., Strypstein L.
Mackens S., Unuane D.
Blockeel C., Spits C.
Embryological and clinical outcomes after ICSI with ejaculated autologous immotile sperm. Mateizel I., De Munck N., Verheyen G., Vloeberghs V., Wouters K.
Start and duration of compaction and its association with clinical outcome. Wouters K., Mateizel I., Van Landuyt L., Van de Velde H.
Blockeel C., Mackens S., Pais F.
Verheyen G., Wieme P., Pletincx I.
Impact of dydrogesterone supplementation in patients with low serum progesterone on the day
Prematurity in Twin Pregnancies: differences between Fresh and Frozen-Thawed Embryo Transfer. Blockeel C., Pais F.
De Vos M., Strypstein L.
Retrospective research
Ten years of social freezing in a single center: a retrospective cohort study.
Can testicular sperm be more easily recruited after a density gradient compared to the standard mincing method, without loss of quality?
PRESS AROUND ‘92
Annual report Brussels IVF - Page 33
BRUSSELS IVF IN THE PRESS IN 2021
As a centre specialising in reproductive medicine, Brussels IVF has performed groundbreaking work developing and improving reproductive techniques and their application.
Since 1983, the Centre for Reproductive Medicine, now Brussels IVF, has been active within UZ Brussel, the university hospital of the Free University of Brussels (VUB).
IVF is compliant with the highest international
A quick calculation shows that there are now more than six million ICSI children in the world, which is roughly the population of the whole of Denmark.
January 14th 1992 at UZ Brussel. In the Belgian IVF centres, about 80 per cent of IVF procedures are with ICSI. Worldwide, around 30 percent of fertility treatments are carried out by IVF and 70 percent by ICSI.
About Brussels IVF and its history
Our researchers are also working on methods to safeguard the fertility of patients who must undergo chemo- or radiotherapy.
The breakthrough and success is based on continuous at the forefront of its expertise, both nationally and internationally.
A worldwide breakthrough was realised in 1991 with the introduction of the ICSI technique. This year, we are celebrating 30 years of ICSI technology, since
its inception, the centre has played a pioneering role in the development and study of reproductive techniques,
Page 34 - Annual report Brussels IVF
The Reproductive Skills Centre Brussels is our own inhouse training centre. Moreover, Brussels IVF provides accredited trainings for the European Board and College for OBGYN (EBCOG), the European Society of Human Reproduction and Embryology (ESHRE) and the European
Brusselsaverage.
ESHRE centre for good clinical practice. The collaboration with the medical genetics centre of UZ Brussel (CMG) also results in a top position in Europe for embryo testing.
The centre accounts for more than 30% of in-vitro fertilisation treatments carried out in Belgium (based on the latest Belrap data). For years, it has achieved markedly higher pregnancy and live birth rates than the national
Universitair Ziekenhuis Brussel (University Hospital Brussels) stands for quality medical care. It offers both basic care and innovative, hightech healthcare solutions at regional, national and international level at an affordable
commitment and human-oriented tuition ensures the highest degree of competence in
Vrije Universiteit Brussel (VUB, the Free University of Brussels) is a dynamic and modern university with two parkland campuses in the Brussels Capital Region. The main campus in Etterbeek is home to seven faculties. The medical campus and UZ Brussel, the university hospital which incorporates the Brussels IVF, the centre for reproductive medicine, are located in Jette at the Brussels Health Campus.
Annual report Brussels IVF - Page 35
employees are driven by the patients’ quality of life. Care is provided in a respectful way, regardless of origin, language or religion.
A fertility clinic with a broad range of care
Brussels IVF offers its patients a broad care programme, ranging from • Ovulation induction and timed intercourse •• IVF and ICSI • Surgery for sperm extraction, including micro TESE • Microsurgical vasectomy reversal • IVM (in-vitro maturation) • IVF/ICSI programme for prospective parents with a viral infection (HIV, hepatitis) • PGT programme for couples with a hereditary condition or for embryo selection • Recurrent miscarriage clinic • Treatments with third-party gametes (donor sperm, donor eggs) • Fertility preservation for patients with a cancer diagnosis (both male and female, including prepubertal patients) • AGE banking (social freezing) • Gestational surrogacy
This material is protected by copyright. No part of this report may be reproduced without prior permission in writing from the responsible publisher. Inappropriate or unlawful use is an infringement of the copyright and is a criminal offence. Photography: © Bart Moens © Ahmed Ben Afennas © Lies Willaert © UZ Brussel Responsible publisher: An Truyts Brussels UniversitairIVFZiekenhuis Brussel Laarbeeklaan 101 1090 BelgiumBrussel Publication date: August 2022 CONTACT US www.brusselsIVF.bewww.uzbrussel.be CONTACT CENTRE +32 2 477 66 info@brusselsivf.be99 DEDICATED WEBSITES Oncofertility: www.brusselsoncofertility.be PGT: www.brusselsgenetics.be Reproductive Skills Centre Brussels (RSCB www.rscb.brusselsivf.be): Sperm donation: www.spermadonor.be Egg donation: Followwww.idonatehappiness.beusonsocialmedia:Twitter: @BrusselsIVF LinkedIn: Brussels IVF Explore Brussels IVF in a virtual tour:
