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What is medical fertility preservation? Medical fertility preservation is offered when a disease or its treatment may endanger fertility. Certain treatments, such as ovarian or testicular surgery, chemotherapy, radiotherapy, or certain genetic conditions, can damage the ovaries or testes. These are often cancer treatments that may be harmful to fertility. Such treatments are called “gonadotoxic.”In this context, it is recommended to plan fertility preservation if possible before starting treatment. The medical field that assesses fertility risks and offers preservation techniques in cancer cases is called oncofertility. Oncofertility concerns women and men of reproductive age, as well as adolescents and children.It is also important to know that certain non-cancerous diseases, such as benign hematological diseases (e.g., sickle cell disease) or autoimmune diseases, also require gonadotoxic treatments. Some genetic diseases can be associated with premature ovarian failure or risk of testicular insufficiency. Fertility preservation may also be indicated in these cases. Fertility preservation may also be considered if a surgical treatment risks reducing ovarian reserve, such as endometriosis surgery.The INAMI/RIZIV covers only part of these indications. Medical services Various methods of gamete cryopreservation have been offered at Erasmus Hospital for around twenty years. Cryopreservation is a technique that allows human cells and tissues, including oocytes, sperm, and ovarian tissue, to be preserved long-term at -72°C.Fertility preservation in girls and womenOocyte and/or embryo preservationIf you are a young woman and your gonadotoxic treatment can be postponed for a few weeks, ovarian stimulation may be considered to collect oocytes via transvaginal aspiration. Depending on your preference, these oocytes can be frozen as-is and/or fertilized with your partner’s sperm or donor sperm. Oocytes are stored for 10 years, and embryos for 5 years. Storage periods can be shortened or extended upon request. In case of future infertility, these oocytes or embryos can be thawed and used for pregnancy. As with any assisted reproductive procedure, success cannot be guaranteed. The INAMI/RIZIV covers this procedure up to age 37. In Belgium, the maximum age for fertilization of oocytes is 45, and for embryo transfer 47.Ovarian tissue preservationWhen gonadotoxic treatment must start urgently, has already started, or in adolescents or children, an alternative to oocyte preservation is to harvest an ovarian fragment or whole ovary via laparoscopic surgery under general anesthesia. The goal is to cryopreserve ovarian tissue fragments, which contain a large number of oocytes. This procedure can be offered up to age 36. Storage of ovarian tissue fragments is 10 years, which can be shortened or extended upon request. If there is a desire for pregnancy after recovery, and fertility has been irreversibly affected, the ovarian tissue can be transplanted to restore fertility. Before transplantation, further analysis is needed to exclude tumor cells. Transplantation must occur before age 45. In Belgium, the maximum age for fertilization of oocytes from transplanted tissue is 45, and 47 for embryo transfer. Over 200 children have already been born worldwide using this technique, including several at Erasme Hospital. Success cannot be guaranteed, and this technique is considered innovative.Fertility preservation in boys and menSperm preservationCryopreservation of mature sperm obtained from ejaculate (by masturbation) has existed for many years and is a simple method to preserve male fertility long-term.Depending on your diagnosis and urgency of treatment, you will have multiple appointments (usually 3) at the andrology lab to preserve several samples for 10 years, which can be shortened or extended upon request. In case of infertility following gonadotoxic treatment, the frozen sperm can be used to achieve pregnancy with your partner. Depending on the quality and number of samples, artificial insemination or IVF with ICSI may be considered. If sperm cannot be obtained via ejaculation, a testicular biopsy under general anesthesia may be performed.In children, it is also possible to harvest and store testicular tissue in collaboration with other hospitals. Currently, this technique remains experimental, and no pregnancies have yet been achieved from testicular tissue collected from children. Advice Before starting your treatment or upon diagnosis of a disease, it is important to discuss the possible impact on fertility with your treating physician. You may be referred to one of our fertility preservation specialists, who will inform you about the options according to your personal situation.In Belgium, under certain conditions, fertility preservation procedures may be reimbursed by INAMI/RIZIV for women under 38 and men under 45, if they are insured.

What is fertility preservation? Unlike men, who can remain fertile later in life, women are born with a predetermined stock of eggs that gradually decreases over time. With age, the quality of eggs also decreases, leading to reduced fertility and lower chances of pregnancy starting around age 30, with a more significant decline after 35.In today’s world, women (and men too) increasingly wish to have children later in life for various reasons (wanting to enjoy life before starting a family, meeting the right partner, economic or professional constraints).There is also widespread lack of knowledge about fertility changes in women. Many believe that medicine will be effective in cases of age-related infertility, which is not entirely true, as only anonymous egg donation can help in this case. The idea of egg preservation is to plan a “self-donation” for the future, with the advantage of maintaining a genetic link. Medical services Oocyte (egg) vitrificationThis rapid-freezing technique allows mature oocytes collected after ovarian stimulation to be preserved intact for future use. These oocytes will be fertilized with sperm from the partner (or a donor). The embryos obtained in the laboratory will be transferred one per cycle into the uterus, with pregnancy chances similar to those at the age of freezing.At Erasmus Hospital, we perform this procedure until the day before your 39th birthday, but oocyte preservation should ideally be done before age 36 to provide the best chance of pregnancy. The ideal age for this procedure is around 32-33, especially if you want multiple children: the first may come spontaneously, but you may need your preserved oocytes for the second.Collected and vitrified oocytes are stored for 10 years, which can be shortened or extended upon request. Regarding the use of these oocytes for a parental project, in Belgium, the maximum age is 45 for the request to fertilize your oocytes and 47 for embryo transfer.In practice, you should contact the clinic before your 38th birthday to schedule appointments with the doctor and psychologist. They will evaluate your request, define your expectations and options regarding the gametes, and provide all necessary information and assessments before considering the procedure.What you should know:This procedure is not fully covered by health insurance: ovarian stimulation treatments and laboratory egg freezing costs are fully at your expense, between €2,500 and €4,000 depending on your personal situation.If your ovarian reserve has already decreased, multiple stimulation cycles may be needed to reach the ideal number of 20 oocytes in storage (90% chance of a child later).“Storage fees” apply from the second year of preservation, also at your expense. A detailed cost estimate will be provided during consultation.Sperm preservationCryopreservation of mature sperm obtained via masturbation has existed for many years and is a “simple” method to preserve male fertility long-term.The most common non-medical reason is vasectomy.You will then have one or more appointments (usually 1 to 3) at the andrology laboratory to collect several samples, which will be stored for 10 years, with the possibility of shortening or extending upon request. Annual storage fees are your responsibility.Depending on the quality and number of samples, artificial insemination or IVF with ICSI may later be considered with your partner. Advice Reverse family planningIt is possible to schedule an appointment at any age with one of our specialized doctors and/or psychologists to receive personalized information on your probable fertility evolution and recommendations for optimal family planning. Focus Fertility evaluation and advice: both women and men can have an assessment of their current fertility and its likely evolution in the coming years. For men, this involves a sperm analysis; for women, Anti-Müllerian Hormone testing and follicle count via gynecological ultrasound. Scientific research Infertility ConsortiumEvaluation of the demand for AGE banking in the Belgian population, contribution of the procedure to birth rates, and reflection on equitable coverage of the process.Dr Catherine HOUBA & Prof Anne DELBAERE Our specialists Erasmus Hospital is a pioneer in oocyte vitrification thanks to numerous internationally recognized research projects conducted by the ULB Research Laboratory and Prof Demeestere.Associated servicesInformation contact:Phone: 02/555 36 89, Monday to Friday, 8:30 – 12:30Email: secmed [dot] fiv [at] hubruxelles [dot] beFor appointments:Phone: 02/555 48 57Gynecology-ObstetricsProf Anne DELBAEREDr Catherine HOUBADr Isabelle DUPONTDr Fabienne DEVREKERDr Serge DELATHOUWERPsychologist team:Chantale LARUELLEIsabelle PLACEDenis WALRAVENS

What is fertility imaging? These are medical examinations using ultrasound or X-ray imaging to understand infertility or to perform a fertility assessment. Medical services Endovaginal UltrasoundPelvic ultrasound is the first exam performed to assess female reproductive organs. It is performed using a probe inserted vaginally. The number of small follicles, called “antral follicles,” in each ovary is counted. This number provides an idea of your ovarian reserve, i.e., your potential response in case of ovarian stimulation.Several pathologies associated with infertility are also checked:Uterus: presence of fibroids, polyps, or congenital anomalies such as a septum.Ovaries: detection of cysts, particularly related to endometriosis.Fallopian tubes: assessment for hydrosalpinx, commonly called “dilated tube.”This ultrasound is usually performed in the first days of the menstrual cycle.SIS (Saline Infusion Sonography or Hysterosonography)This exam allows visualization of your uterine cavity (endometrium) and uterine walls (myometrium). It is ideally performed at the end of your period, before the 11th day of your cycle. You are positioned gynecologically, and after vaginal disinfection, a soft catheter is placed in the uterus to instill saline solution to detect possible intrauterine pathologies causing infertility. The sonographer explains each step during the exam.HyFoSy (Hysterosalpingo-foam-sonography)This exam is performed in gynecological position after vaginal disinfection to evaluate the patency of the fallopian tubes and detect any pathologies that could explain infertility. It is performed at the end of your period, before the 11th day of your cycle. It requires the injection of a specific foam gel (ExEm® Foam) using a soft balloon catheter placed inside your uterus.It is recommended to take a painkiller one hour before the exam, as it can be painful like heavy periods for some patients.Your prescribing physician will evaluate whether antibiotics are necessary before the exam. A PCR test for chlamydia or gonorrhea in the cervix or urine is useful for prevention. If a tubal pathology is discovered, the sonographer will reassess the need for antibiotics if it has not been done previously. The sonographer explains each step during the exam.Complete Fertility AssessmentThis exam first involves a complete endovaginal ultrasound, followed by a SIS. The catheter used for this exam remains in place and is used for the injection of ExEm® Foam. This allows visualization of both the inside of the uterus and the patency of the fallopian tubes in a single appointment. Ideally, it is performed before the 11th day of your cycle. Prophylactic antibiotics may be prescribed if necessary. It is also recommended to take a painkiller one hour before the exam.Assessment of Vascularization / Endometrial ReceptivityThis exam is proposed in cases of repeated embryo implantation failures.The sonographer examines the vascularization of your uterine arteries and the volume of your endometrium. This exam is ideally performed the week after ovulation or following a specific hormonal treatment prescribed by your gynecologist.If the results are abnormal, the sonographer may propose a treatment of at least three months before reassessing endometrial receptivity.During the second exam, a biopsy of your endometrium may be performed for histopathological analysis to detect acute endometritis. You can discuss with your doctor the relevance of this analysis in your specific case.HysterosalpingographyThis exam tests tubal patency and the shape of the uterine cavity. It takes place in the radiology department since it uses X-rays and contrast medium instilled into the uterus by a gynecologist. The radiologist interprets the images.It is performed at the same time of the cycle and with the same precautions as HyFoSy.It is now rarely prescribed since HyCoSy was developed. Advice Take a painkiller, such as an anti-inflammatory (e.g., Ibuprofen 400) or a spasmolytic like Buscopan, about 1 hour before the exam, as uterine contractions may occur during the procedures.Do not forget your written request signed by your prescribing physician. Focus Our fertility imaging team consists of gynecologists who are also part of the IVF team. You benefit from their dual expertise for detecting abnormalities and understanding your infertility. Our Specialists Appointment procedures for gynecological ultrasound (route 178):For evaluation ultrasounds, SIS, or HyFoSy: call 02/555.36.36 as soon as your period starts to schedule an appointment before the 11th day.For hysterosalpingography: call 02/555 33 12 as soon as your period starts to schedule an appointment before ovulation.Gynecology-Obstetrics ServiceDr. Margherita CONDORELLIDr. Noé MOUTARDDr. David PENINGDr. Mélodie VANDER BORGHTAssociated ServicesRadiology ServicePr SADEGHI MEIBODI NILOUFAR

What is intrauterine insemination? Intrauterine insemination (IUI) is a simple assisted reproductive technique that involves placing a prepared sperm sample into the uterine cavity using a thin catheter. The goal of IUI is to facilitate the meeting of gametes (eggs and sperm) within the female reproductive tract. If the sperm used is from the partner, it is called homologous insemination (IAC); if donor sperm is used, it is called donor insemination (IAD).Who is intrauterine insemination intended for?IUI may be recommended in the following cases:Certain abnormalities of the cervix or cervical mucus.Mild or moderate endometriosis.Moderate sperm quality issues, such as reduced sperm count or motility.Erectile or ejaculation disorders of anatomical, neurological, or psychological origin.Idiopathic infertility, meaning no identifiable cause after fertility evaluation.When using donor sperm.Should ovarian stimulation be combined with intrauterine insemination?Ovarian stimulation aims to correct ovulation disorders and/or increase the number of pre-ovulatory follicles containing mature eggs. Stimulation increases the chances of pregnancy, but also the risks of multiple pregnancy and ovarian hyperstimulation. This treatment is available as oral tablets or subcutaneous injections. In the absence of female infertility factors, IUI without ovarian stimulation is preferred. Medical services What tests should you undergo before intrauterine insemination?The assessment includes:Blood tests for both partners.Semen analysis for the male partner.Examination of the uterine cavity and tubal patency using ultrasound or radiography (cf - Fertility Imaging)In practice:IUI should be scheduled on the day of ovulation.Ovulation monitoringDuring the first part of the menstrual cycle, regular blood tests, sometimes combined with transvaginal ultrasounds, confirm follicular maturation and determine the timing of ovulation or the need for ovulation triggering (via subcutaneous injection). In regular cycles, ovulation monitoring can initially be done using urine tests.Sperm preparationOn the day of IUI, a sperm sample is provided by the partner through masturbation, though in some cases, frozen sperm may be thawed. The laboratory prepares the sample to isolate the most fertilizing sperm. This preparation takes about one hour.In IUI-D, thawed donor sperm is used.The insemination procedureAfter placing a speculum and cleaning the cervix, the prepared sperm is injected into the uterine cavity using a thin catheter and syringe. The procedure lasts a few minutes and is generally painless. After about ten minutes of rest, you can resume normal activities.The luteal phaseDuring the first IUI cycle, a blood test is commonly performed one week after insemination to measure progesterone and ensure proper ovulation. If progesterone levels are insufficient and pregnancy has not occurred, progesterone supplementation will be systematically offered in subsequent cycles.Pregnancy testTwelve to fourteen days after insemination, a blood test determines the presence of an early pregnancy. A follow-up is scheduled the following week, followed by an ultrasound to confirm pregnancy progression.In case of failure, and depending on prior discussions with your doctor, you may undergo another IUI cycle or consult your physician to discuss other options. Our specialists Associated servicesGynecology-Obstetrics DepartmentPr. Anne DELBAEREPr. Fabienne DEVREKERDr. Soraya AMIRGHOLAMIDr. Elisabeth ANAGNOSTOUDr. Margherita CONDORELLIDr. Serge DE LATHOUWERDr. Michel DIKETEDr. Isabelle DUPONDDr. Oranite GOLDRATDr. Catherine HOUBADr. Christian KAMTO FOTSODr. Caroline LECOCQDr. Noé MOUTARDDr. David PENING Dr. Asma SASSIDr. Mélodie VANDER BORGHT 

Description Neurofibromatosis type 1 (NF1), also known as Von Recklinghausen syndrome, is a rare genetic disease. It is characterised in particular by skin anomalies such as birthmarks known as café au lait spots. Symptoms linked to the development of tumours along the nerves (neurofibromas) can occur and develop over time. The brain, eyes, bones and kidneys can be affected, to a variable degree but sometimes seriously.   Treatment This disease requires an early diagnosis, in early childhood, and must be monitored by a specialised multidisciplinary team. The Children’s Hospital has provided this follow-up for many years, in the form of regular and systematic consultations with a number of specialists. For the comfort of the children and their families these consultations are arranged on the same day and take place once a year, although sometimes more frequently depending on the age and particularities of the child. The monitoring begins before birth and continues through the growth years of childhood and into adulthood. As they reach adulthood a transition consultation can be arranged at the Erasmus Hospital. Patients can be prescribed innovative medicines, depending on their individual situation and in line with international recommendations. Our team works in close cooperation with other specialists and paramedical teams at the Children’s Hospital as well as with GPs and paediatricians, child therapists (physiotherapists, speech therapists, occupational therapists, psychologists, etc.), support services, respite care services, associations and psycho-medico-social centres.    Our specialists Children's patients (Children's Hospital)The multidisciplinary consultation is organised by the Neuroaediatrics Department (Co-ordinating doctor: Dr Anne Monier; Co-ordinating secretary: Ms Daniela Wayllace). Co-ordinating doctor and neuropaediatrician: Dr Anne MonierDermatologist: Dr Pamela El NemnomOphthalmologist: Dr Sophie LhoirOrthopaedist: Dr Jean-Paul KaleetaNephrologist: Dr Khalid IsmailiGeneticist: Dr Catheline VilainSecretary coordinator: Mrs Daniela Wayllace (02 477 39 67) Adult patients (Erasmus Hospital)The consultation is organised by the Neurology Department (Cons [dot] Neuro [dot] erasme [at] hubruxelles [dot] be)Neurologist: Dr Chantal DepondtNeurologist: Dr. Gauthier RemicheNeurologist: Dr Michela Bisciglia 

What is Tuberous sclerosis? Tuberous sclerosis, also known as Bourneville disease,  is a rare genetic disease characterised by the development of benign tumours principally affecting the brain, skin, eyes, kidneys, heart and lungs. The consequences are of variable severity but are potentially serious. There is a high risk of epilepsy and also retarded development, intellectual disability and autism when the brain is affected. There can also be a significant impact on health and quality of life when other organs are affected.  Treatment This disease requires an early diagnosis, in early childhood or even before birth, and monitoring by a specialised multidisciplinary team. This is arranged at the Children’s Hospital in the form of regular and systematic consultations with the various specialists. For the comfort of the children and their families the consultations are held on the same day and take place once a year, although sometimes more frequently depending on the age and particularities of the child. The monitoring begins before birth and continues through the growth years of childhood and into adulthood.   As they reach adulthood a transition consultation can be arranged at the Erasmus Hospital. An early screening for epilepsy, before the appearance of the first symptoms, is proposed systematically so as to avert the consequences. Depending on their individual situation, patients can benefit from innovative treatment in line with international recommendations. Our team cooperates closely with other specialists and paramedical teams  at the Children’s Hospital and with specialist teams, for epilepsy surgery in particular, if the child’s situation requires it. We network with GPs and paediatricians, child therapists (physiotherapists, speech therapists, occupational therapists, psychologists etc.), support services, respite care services, associations and psycho-medico-social centres.    Specific care pathways Our team cooperates closely with national and international centres that care for persons with tuberous sclerosis as well as with parents’ associations to achieve a continuous improvement in patient care and to disseminate information on this rare disease and its treatment.  Our specialists Children's patients (Children's Hospital)The multidisciplinary consultation is organised by the Neuroaediatrics Department (Co-ordinating doctor: Dr Anne Monier; Co-ordinating secretary: Ms Daniela Wayllace).Coordinating doctor and neuropaediatrician: Dr Anne MonierDermatologist: Dr Pamela El NemnomOphthalmologist: Dr Sophie LhoirNephrologist: Dr Khalid IsmailiCardiologist : Dr Hugues DessyGeneticist: Dr Catheline VilainCoordinating secretary: Mme Daniela Wayllace (02 477 39 67)Adult patients (Erasme Hospital)The consultation is organised by the Neurology Department (Cons [dot] Neuro [dot] erasme [at] hubruxelles [dot] be (Cons[dot]Neuro[dot]erasme[at]hubruxelles[dot]be))Neurologist: Dr Chantal Depondt

What is Sturge-Weber syndrome? Sturge-Weber syndrome is a rare disease affecting the small blood vessels of the face and brain. It is characterised by the presence of an angioma (port wine stain) on the face that often leads to the diagnosis. The presence of an angioma in the brain can result in neurological complications such as epilepsy, hemiplegia, retarded development, intellectual disability and stroke.  Eye complications (glaucoma) can also develop. Treatment An early diagnosis of the disease makes it possible to limit the complications, inform parents of important signs to look out for and identify (notably epilepsy, stroke), rapidly begin drug or local treatment (epilepsy, face angioma, glaucoma) and, if necessary, initiate early rehabilitation therapy. Multidisciplinary monitoring (neurological, dermatological and ophthalmological) is essential throughout childhood and into adulthood.  Specific care pathways Our team cooperates closely with specialist teams when the child’s condition requires it (epilepsy surgery, laser treatment of the angioma). We also network with GPs and paediatricians, child therapists (physiotherapists, speech therapists, occupational therapists, psychologists, etc.), support services, respite care services, associations and psycho-medico-social centres. A transition consultation can be arranged at the Erasmus Hospital when the child enters adulthood.      Our specialists Children's patients (Children's Hospital)The multidisciplinary consultation is organised by the Neuroaediatrics Department.Neuropaediatrics: Dr Anne MonierDermatologist: Dr Pamela El NemnomOphthalmologist: Dr Deborah BuisseretGeneticist: Dr Catheline VilainAdult patients (Erasmus Hospital)The consultation is organised by the Neurology Department (Cons [dot] Neuro [dot] erasme [at] hubruxelles [dot] be (Cons[dot]Neuro[dot]erasme[at]hubruxelles[dot]be))Neurologist: Dr Chantal Depondt 

What is Down syndrome? Trisomy 21, also known as Down syndrome, is the most common genetic disease. The physical characteristics are well known and are the syndrome’s visible signature. However, these are just some of the symptoms that patients may experience. In addition to certain malformations present at birth, especially cardiac, children with trisomy 21 can have a number of medical problems, affecting psychomotor development, vision, hearing, growth, hormone functioning, immunity, teeth, skin, etc. Associated with an early ageing, other medical problems can arise in adults, affecting the heart, brain, vision and hearing. Treatment An early diagnosis of common problems associated with trisomy 21 is essential to limit their impact on health and quality of life and to permit better progress for the child  in terms of psychomotor development, social skills, learning ability, well-being and general behaviour. To this end, for many years now the Children’s Hospital has provided children with Down’s syndrome with systematic and regular monitoring through multidisciplinary consultations involving a range of specialists, commencing before birth and continuing throughout their growth and childhood into adulthood. For the comfort of children and their families these consultations are arranged on the same day and take place once a year, although sometimes more frequently depending on the particularities of each patient.  Depending on the individual child’s needs, our team cooperates closely with other specialists and paramedical teams at the Children’s Hospital as well as with GPs and paediatricians, therapists (physiotherapists, speech therapists, occupational therapists, psychologists, etc.), support services, respite care services, associations and psycho-medico-social centres.  A transition consultation can be arranged at the Erasmus Hospital when the child enters adulthood.  Specific care pathways Our team works in close cooperation with national and international centres that care for children with trisomy 21. We helped draw up a medical follow-up logbook for children and organise regular conferences on various aspects of the pathology, in cooperation with the national teams and parents’ associations.     Our specialists Children's patients (Children's Hospital)The multidisciplinary consultation is organised by the Neuroaediatrics Department (Co-ordinating doctor: Dr Anne Monier; Co-ordinating secretary: Ms Daniela Wayllace).Coordinating doctor and neuropaediatrician: Dr Anne MonierPaediatrician: Dr Pascale PerlotENT : Dr Benoit DevroedeOphthalmologist: Dr Lavinia PostolacheOrthopaedist: Dr Jean-Paul KaleetaCardiologist: Dr Hugues DessyNeonatologist: Dr Daniela AvinoGeneticist: Dr Catheline VilainCoordinating secretary: Mme Daniela Wayllace (02 477 39 67)Adult patients (Erasmus Hospital)The consultation is organised by the Neurology Department (Cons [dot] Neuro [dot] erasme [at] hubruxelles [dot] be (Cons[dot]Neuro[dot]erasme[at]hubruxelles[dot]be))

IVF: Why? What? How? For whom? Why consider IVF?In vitro fertilization (IVF) is a medically assisted reproduction (MAR) technique that helps couples or single women conceive a child when natural conception is difficult or impossible. It is recommended in several situations, including:Blocked or absent Fallopian tubesMale infertility (insufficient sperm motility and/or quality)Repeated failure of other fertility treatmentsInfertility lasting more than 3 yearsAge over 40IVF is also necessary when embryos need to be tested in the laboratory before implantation to prevent having a child with a genetic disease (PGD - Pre-implantation Genetic Diagnosis).What does IVF involve?IVF consists of:Stimulating the ovaries to produce multiple eggs.Retrieving the eggs under medical supervision through a minimally invasive procedure performed in a day hospital.Fertilizing them with sperm in the laboratory (in vitro).Transferring one of the embryos into the uterus a few days later.Supporting the implantation phase with hormonal and medical follow-up.How does it work?The process involves several stages:Initial consultation: hormonal, genetic, and serological screening, ultrasound, semen analysis (spermogram).Treatment plan consultation: review of screening results, therapeutic proposal, informed consent, administrative procedures.Cycle start consultation: explanation and prescription of the different treatment phases.Ovarian stimulation: medication to produce multiple eggs.Egg retrieval (oocyte puncture): harvesting the eggs under light anesthesia.Laboratory fertilization: eggs and sperm are brought into contact.Embryo culture: monitoring development for 2 to 6 days.Embryo transfer: an embryo is placed into the uterus.Post-transfer follow-up: blood test followed by an ultrasound to confirm pregnancy.For whom?Heterosexual couples or single women experiencing infertility.Women up to 45 years old in Belgium (depending on hospital regulations).Patients with a reasonable chance of achieving the birth of a child. Practical Information on Coverage and Reimbursement Social Security and Mutual Insurance (Mutuelle)In Belgium, IVF treatments are partially reimbursed by the INAMI (National Institute for Health and Disability Insurance), depending on medical conditions and the patient's age (6 cycles up to and including 42 years of age).Basic reimbursement includes: consultations, lab tests, hormonal treatments, egg retrieval, fertilization, and the freezing of surplus embryos.Supplementary mutual insurance funds may cover the remaining costs (co-payments/out-of-pocket fees and sperm or egg donation).Individuals wishing to undergo IVF should check their personal situation with their insurance provider to find out the exact amount reimbursed.Private InsuranceFew private health insurance companies offer supplementary coverage to cover the portion of MAR treatments not reimbursed by the INAMI. Introducing the IVF Teams at H.U.B The Fertility and MAR Clinic has a multidisciplinary team specializing in IVF, supporting patients at every stage:MAR specialist physicians carry out evaluations, prescribe treatments, manage medical follow-up, and perform technical IVF procedures.Laboratory biologists carry out the fertilization of the eggs, as well as the culture and monitoring of the embryos.Coordinating nurses support patients, explaining protocols and practical care arrangements.Anesthesiologists ensure patient safety and comfort during egg retrieval.Every member of the team is available to answer questions and reassure the patient at all stages of the treatment. Discover our Fertility clinic Useful resources and links on IVF in Belgium [SITE WEB] Société Belge de Fertilité (SBF) : informations fiables sur les tech… [SITE WEB] Présentation de la Clinique de Fertilité et de PMA de l'Hôpital Univ… FAQ on IVF 1. How do the hormone injections work? Injections are administered subcutaneously (into the belly or thigh). Our nurses will train you during a dedicated appointment, providing a demonstration and written guide. Most patients quickly become independent in doing this. 2. IVF: What should I do if I miss an injection? In case of a missed or delayed injection, contact our team immediately. In most cases, a simple solution can be found to adjust the protocol without putting the cycle at risk. 3. Are hormone injections for IVF painful? They are generally well tolerated. Some patients experience mild discomfort or bloating related to ovarian stimulation, but these effects are temporary. 4. How long does an IVF cycle last? A full cycle lasts an average of 4 to 6 weeks, from the start of stimulation to the pregnancy test 5. How many appointments are required for an IVF cycle? A cycle includes several blood tests and monitoring ultrasounds to precisely adjust hormone dosages. The exact number varies depending on how your body responds to the treatment 6. Can I continue to work during IVF treatment? Yes, the majority of patients continue their professional activities. Appointments are scheduled to best fit your personal and work organization 7. What happens during the egg retrieval process? Egg retrieval (oocyte puncture) is performed under anesthesia (local or general, depending on the case) and takes about 15 to 20 minutes. You can return home on the same day. 8. IVF: Do I need to change my diet or lifestyle? A balanced lifestyle is highly recommended: a varied diet, moderate physical activity, and smoking cessation. The experts at the Brussels University Hospital will provide you with personalized advice. 9. What happens after the embryo transfer? A blood test is performed about 10 to 12 days after the transfer to confirm pregnancy. 10. What happens if the IVF attempt does not work? A follow-up review appointment is systematically arranged to analyze the cycle and adapt the strategy if necessary.

What is acute pancreatitis? Pancreas: What is it? The pancreas is a gland located behind the stomach that performs two essential functions: digesting nutrients, through the secretion of digestive enzymes, and regulating blood sugar levels, through the secretion of insulin.Acute pancreatitis is a sudden inflammation of the pancreas, mainly associated with excessive alcohol consumption or the presence of gallstones. In the vast majority of cases, the inflammation resolves within a few days without leaving any lasting effects. In the most severe cases, it can lead to failure of certain organs (kidneys, lungs, etc.), requiring admission to the intensive care unit. Subsequently, pancreatic fluid collections may form: these are pockets of fluid that may become infected and then require antibiotic treatment, supplemented, if necessary, by drainage of the infected fluid. Symptoms Severe abdominal painFeverOther digestive symptoms such as nausea, vomiting and diarrhoea  How is acute pancreatitis diagnosed? The diagnosis is often made using a blood test and an abdominal CT scan. An abdominal ultrasound may also be performed to identify the presence of gallstones (stones in the gallbladder). Treatment and care management Initially, treatment aims to relieve symptoms and prevent the pancreatitis from worsening, notably through intravenous hydration and pain management.In the context of severe acute pancreatitis, interventional endoscopy techniques—that is, without surgery—can be used to drain the infected fluid directly through the stomach or duodenum (the first part of the small intestine).In the most complex cases, a multidisciplinary approach combining several specialities may be necessary:Interventional radiology, which can drain infected collections through the skin using catheters.Surgery, as a last resort when other approaches are insufficient. Our specialists Prof. Marianna Arvanitakis Director of the Pancreatology and Nutritional Support ClinicGastroenterologist, specialising in pancreatic diseases, interventional endoscopy and clinical nutrition.Professor Marianna Arvanitakis specialised in pancreatology and interventional endoscopy as part of Professor Jacques Devière’s team at Erasme Hospital. After obtaining a University Diploma in Clinical Nutrition in 2005, she took over the medical coordination of the nutritional support service in 2018. Research conducted within the clinic focuses in particular on optimising the management of patients with severe acute pancreatitis and chronic pancreatitis, as well as on the management of patients suffering from short bowel syndrome. A member of several scientific societies, she is Secretary General of the European Society of Gastrointestinal Endoscopy (ESGE) for the 2025–2027 term, and a gastroenterology clinical supervisor for the Université Libre de Bruxelles (ULB). Languages spoken: French, English, Greek. Professor Alia Hadefi Professor Hadefi is a gastroenterologist with expertise in clinical nutrition and metabolic liver diseases. She defended her doctoral thesis on the interaction between the intestine and liver diseases in 2024, and completed additional training in 2025 within the Department of Gastroenterology, Chronic Inflammatory Bowel Diseases (IBD) and Nutritional Support at Beaujon Hospital (Paris).Languages spoken: French, English, Arabic. Dr Michael Fernandez Y Viesca Dr Fernandez is a gastroenterologist with expertise in pancreatology, acquired after obtaining a university diploma in Pancreatology in 2017 (Sorbonne). He is the coordinating physician for Benign Pancreatic Diseases within the multidisciplinary pancreatology consultation and is currently preparing a doctoral thesis on severe acute pancreatitis.Languages spoken: French, English, Spanish. Contact To make an appointment for a consultation, please email ConsGastroMed [dot] erasme [at] hubruxelles [dot] be or call +32 (0)2 555.35.04. Alternatively, contact the H.U.B. Gastroenterology Department directly at SecMed [dot] GastroMed [dot] erasme [at] hubruxelles [dot] be. Discover the Pancreatology Clinic

What is chronic pancreatitis? The pancreas: What is it? The pancreas is a gland located behind the stomach that performs two essential functions: digesting nutrients through the secretion of digestive enzymes, and regulating blood sugar levels through the secretion of insulin. Chronic pancreatitis is prolonged inflammation of the pancreas. Over time, the pancreas changes and may develop stones or narrowing of its main duct (strictures). These changes cause pain, difficulty digesting food and disturbances in blood sugar regulation. Excessive alcohol consumption is the most common cause of chronic pancreatitis. Sometimes, there are genetic alterations that explain chronic pancreatitis. However, in some cases, no cause can be identified: this is referred to as idiopathic chronic pancreatitis. Sometimes, the disease is of autoimmune origin—that is, it is caused by an abnormal reaction of the immune system against the pancreas—with or without specific antibodies in the blood: in this case, it is referred to as autoimmune pancreatitis. Symptoms Abdominal pain, either in the form of acute episodes (attacks of acute pancreatitis) or continuously.Greasy stools (steatorrhoea), caused by poor digestion of fats.Weight loss and malnutrition, due to insufficient absorption of nutrients.Biological abnormalities: deficiencies in certain minerals (sodium, potassium), vitamins and trace elements.Diabetes, caused by damage to the insulin-producing cells. How is chronic pancreatitis diagnosed? You will first meet a pancreas specialist (gastroenterologist), who will review your symptoms and medical and surgical history. Further examinations will then be carried out:A complete blood test to assess your general condition, kidney function, blood sugar level, vitamin and mineral levels, and the condition of your liverBlood antibody testing if an autoimmune origin is suspectedA genetic analysis, depending on your situationA stool examination, if necessaryA CT scan and magnetic resonance imaging to assess your pancreasA bone densitometry scan (to check the strength of your bones) Treatments and care management Management involves several specialists working together under the coordination of your gastroenterologist:A dietitian will help you adapt your dietMedicines and vitamin supplements will be prescribed to control pain and correct deficienciesPancreatic enzyme replacement therapy if necessaryDiabetes medication if necessary, with follow-up by an endocrinologistSpecific medicines (e.g. corticosteroids or immunosuppressants) may be indicated if you have autoimmune pancreatitisA consultation with a geneticist will be offered if necessaryIn some cases, an intervention may be proposed:  Extracorporeal lithotripsy uses shock waves to fragment stones present in the pancreatic ductEndoscopy (endoscopic cholangiopancreatography) may help to further unblock the pancreatic duct by removing stones and placing small plastic tubes (stents) to keep the duct open Surgery may be necessary if part of the pancreas needs to be removedWhat does follow-up involve?Regular follow-up is essential to ensure that your care proceeds smoothly:At least one consultation per year with your gastroenterologistBlood tests at each visitAn abdominal CT scan or magnetic resonance imaging every yearA bone density scan every 2 years (or more often if necessary) Our specialists Prof. Marianna Arvanitakis Director of the Pancreatology and Nutritional Support ClinicGastroenterologist, specialising in pancreatic diseases, interventional endoscopy and clinical nutrition.Professor Marianna Arvanitakis specialised in pancreatology and interventional endoscopy as part of Professor Jacques Devière’s team at Erasme Hospital. After obtaining a University Diploma in Clinical Nutrition in 2005, she took over the medical coordination of the nutritional support service in 2018. Research conducted within the clinic focuses particularly on optimising the management of patients with severe acute pancreatitis and chronic pancreatitis, as well as on the management of patients suffering from short bowel syndrome. A member of several scientific societies, she is Secretary General of the European Society of Gastrointestinal Endoscopy (ESGE) for the 2025–2027 term and a gastroenterology clinical supervisor for the Université Libre de Bruxelles (ULB). Languages spoken: French, English, Greek. Professor Alia Hadefi Professor Hadefi is a gastroenterologist with expertise in clinical nutrition and metabolic liver diseases. She defended her doctoral thesis on the interaction between the intestine and liver diseases in 2024, and completed additional training in 2025 in the Department of Gastroenterology, Inflammatory Bowel Diseases (IBD) and Nutritional Support at Beaujon Hospital (Paris).Languages spoken: French, English, Arabic. Dr Michael Fernandez Y Viesca Dr Fernandez is a gastroenterologist with expertise in pancreatology, acquired after obtaining a University Diploma in Pancreatology in 2017 (Sorbonne). He is the coordinating physician for Benign Pancreatic Diseases within the multidisciplinary pancreatology consultation, and is currently preparing a doctoral thesis on severe acute pancreatitis.Languages spoken: French, English, Spanish. Contact To make an appointment for a consultation, email ConsGastroMed [dot] erasme [at] hubruxelles [dot] be (ConsGastroMed[dot]erasme[at]hubruxelles[dot]be) or call +32 (0)2 555.35.04, or contact the H.U.B Gastroenterology Department directly at SecMed [dot] GastroMed [dot] erasme [at] hubruxelles [dot] be (SecMed[dot]GastroMed[dot]erasme[at]hubruxelles[dot]be). Discover the Pancreatology Clinic

What are pancreatic cysts? The pancreas: What is it? The pancreas is a gland located behind the stomach that performs two essential functions: digesting nutrients through the secretion of digestive enzymes, and regulating blood sugar levels through the secretion of insulin. A pancreatic cyst is a fluid-filled sac that forms in or around the pancreas. There are several types:Pseudocysts: these most often appear after acute pancreatitis or abdominal trauma. They are not true cysts, but collections of pancreatic fluid surrounded by a wall. They often disappear spontaneously.Mucinous cysts (IPMN and mucinous cystadenoma): these cysts produce a thick fluid (mucus) and may, in some cases, develop into a tumour. They require careful monitoring.Serous cysts (serous cystadenoma): these cysts are almost always benign and rarely develop into a tumour.Rare cysts of other types, sometimes associated with hereditary or autoimmune diseases. Symptoms The vast majority of pancreatic cysts are discovered incidentally during an imaging examination performed for another reason and do not cause any symptoms. When symptoms are present, the most common ones are:Abdominal pain or a feeling of heavinessWeight lossDiabetes How are pancreatic cysts diagnosed? You will first meet a gastroenterologist specialising in the Pancreatology and Nutritional Support Clinic, who will review your symptoms and medical and surgical history. Further tests will then be carried out:A complete blood test to assess your general condition, kidney function, blood sugar level, vitamin and mineral levels, and liver function.An MRI (magnetic resonance imaging) with cholangiopancreatography (MRCP): this is the reference test for characterising a pancreatic cyst and assessing its relationship with the pancreatic duct.An abdominal CT scan, to complete the assessment if necessary.An endoscopic ultrasound : this is an ultrasound examination performed from inside the stomach using an endoscope, allowing the cyst to be analysed very closely and, if necessary, a sample of the cyst fluid to be taken for analysis. Treatments and care management The vast majority of pancreatic cysts do not require specific treatment. The most important step is to assess the risk of the cyst transforming into a tumour, based on the results of the tests performed and on a multidisciplinary consultation involving specialised gastroenterologists and radiologists, pathologists and surgeons. It is following this collegial discussion that the best management strategy — monitoring, endoscopy or surgery — will be determined for each patient.What does follow-up involve?Regular follow-up is essential for your care to proceed properly:Regular consultations with your gastroenterologist (frequency adapted to the type and size of the cyst)Blood tests at each visitAn abdominal CT scan or magnetic resonance imaging at regular intervals, in accordance with international recommendations  Our specialists Prof. Marianna Arvanitakis Director of the Pancreatology and Nutritional Support ClinicGastroenterologist, specialising in pancreatic diseases, interventional endoscopy and clinical nutrition. Professor Marianna Arvanitakis specialised in pancreatology and interventional endoscopy as part of Professor Jacques Devière’s team at Erasme Hospital. After obtaining a university diploma in Clinical Nutrition in 2005, she took over the medical coordination of the nutritional support service in 2018. Research conducted within the clinic focuses in particular on optimising the management of patients with severe acute pancreatitis and chronic pancreatitis, as well as on the management of patients suffering from short bowel syndrome. A member of several scientific societies, she is Secretary General of the European Society of Gastrointestinal Endoscopy (ESGE) for the 2025–2027 period, and a gastroenterology clinical supervisor for the Université Libre de Bruxelles (ULB). Languages spoken: French, English and Greek. Professor Alia Hadefi Professor Hadefi is a gastroenterologist with expertise in clinical nutrition and metabolic liver diseases. She completed her doctoral thesis on the interaction between the gut and liver diseases in 2024, and completed additional training in 2025 in the Department of Gastroenterology, Inflammatory Bowel Diseases (IBD) and Nutritional Support at Beaujon Hospital (Paris).Languages spoken: French, English, Arabic. Dr Michael Fernandez Y Viesca Dr Fernandez is a gastroenterologist with expertise in pancreatology, acquired after obtaining a university diploma in pancreatology in 2017 (Sorbonne). He is the coordinating physician for Benign Pancreatic Diseases within the multidisciplinary pancreatology consultation team and is currently preparing a doctoral thesis on severe acute pancreatitis.Languages spoken: French, English, Spanish. Contact To make an appointment for a consultation by email at ConsGastroMed [dot] erasme [at] hubruxelles [dot] be (ConsGastroMed[dot]erasme[at]hubruxelles[dot]be) or by telephone on +32 (0)2 555.35.04, or to contact the Gastroenterology Department of H.U.B directly at SecMed [dot] GastroMed [dot] erasme [at] hubruxelles [dot] be (SecMed[dot]GastroMed[dot]erasme[at]hubruxelles[dot]be)  Discover the Pancreatology Clinic