Yes, finally you are ready to take that big step to have children. If you are not one of the lucky couples whose wish to get pregnant becomes true pretty swiftly, you might need assistance in making this dream come true. According to the Dutch Infertility Association Freya, 1 in 6 couples in the Netherlands are in this situation, so it is much more common than one might think.


In the Netherlands, couples are advised to try to conceive naturally for one year, unless there is a clear female fertility issue, like irregular menstruation. Once the family doctor refers you to a fertility clinic, you can make an appointment. It takes about a month or two to obtain your first appointment. During this first appointment, the gynecologist goes through your medical and family history and makes an ultrasound check. Then a series of diagnostic tests and checks are made. This might take up to three months depending on the menstrual cycle of the woman. After that, there is a diagnosis and a treatment plan.

The Dutch fertility system, like the Dutch healthcare system, is quite conservative in the sense that the basic approach is to trust nature and to interfere as lightly and gently as possible with the body. This means in practice that it can take 1-2 years until the step to advanced fertility methods are taken, unless there is a clear indication that that is needed. Furthermore, only treatments which are proven with research to be effective are applied.

Typically, the first step is to stimulate ovulation with pills. This is usually repeated up to 6 times, depending on how the woman’s body reacts to it. If the reaction to pills is not satisfactory, then injectable medicines are used.

If there is no resulting pregnancy and or there is a male fertility issue, then the IUI (IntraUterine Insemination), whereby sperms are brought into the uterus, is used to help sperms reach the egg. Depending on the situation, IUI is combined with hormonal treatments and is repeated up to 6 times.

The last step is the IVF (In Vitro Fertilization) or Intracytoplasmic sperm injection (ICSI). For IVF/ICSI, the natural hormonal cycle of the woman is suppressed, so that multiple eggs can grow per cycle. Ovulation is hyper stimulated with injectable hormones. When these eggs are ripe, then the eggs are collected, so that the fertilization can take place in the laboratory. In case of successful fertilization, the embryo is placed back into the mother’s uterus. If there are multiple embryos, they are frozen to be transferred later on if necessary. The Dutch insurance policies cover all the above mentioned treatments and 3 IVF/ICSI cycles.


Only a selection of (starred) fertility clinics have IVF laboratories. The other clinics work together with these hospitals for performing IVF procedures.





The fertility journey can be a long and lonely process. If you are an expat, it can be extra hard not to have dear family and friends to support you in this process. Unfortunately, there is little time and room in the medical process to pay attention to the emotional aspects of this journey.


Doula Semin has set up Birth Wish to offer assistance to women and couples who are searching for extra support in dealing psychologically with the fertility process. On request, she also organizes group workshops in Delft and Rotterdam. You can contact her to discuss your questions and needs at, as well as join the online Fertility Support Group on Facebook at

The credits for this wonderfully informative page on fertility assistance goes out to Doula Semin and Birth Wish. Thank you for your hard work!