Assisted Conception

assisted

.

Contact Details:

01625 264 110       01625 569 448

info@cheshirefertilitycentre.com

Sunderland Street, Macclesfield, Cheshire, SK11 6JL

Cheshire Fertility Centre (CFC)

Welcome to our Assisted Conception Programme.

CFC is committed to providing a complete fertility service to help our clients achieve the fulfilment of a healthy live birth.

CFC is a satellite arrangement with two licensed centres (Liverpool Hewitt Centre and Manchester Fertility Services in Cheadle) where some procedures take place (i.e. sperm insemination, egg recovery and embryo transfer).

Our priority is to:

The Team

 

 

 

 

 

 

Dawn Sadler

 

 

 

 

 

 

Holly Scott

 

 

 

 

Dawnan Fastiggi

           mem5      Elliot Browne                

Consultant: Dr Edmond Edi-Osagie, Dr Yasmin Sajjad

Fertility Nurses: Dawn Sadler

Counsellor: Ann Curley

Nutritionist: Zoe Wilde

Business Manager: Holly Richards

Business Administration: Dawnan Fastiggi

General Manager: Elliot Browne

What is Assisted Conception?

Assisted conception (AC) describes methods used to help subfertile couples achieve pregnancy when standard fertility treatment is unsuccessful. About 1 in 6 couples experience delay in conceiving and some of those require AC. AC includes Intrauterine Insemination (IUI), In Vitro Fertilisation (IVF), Intra Cytoplasmic Sperm Injection (ICSI) and their variants. IVF and ICSI are the most advanced and effective treatments currently available for subfertility.

AC can be very demanding and stressful for couples and so we have developed this booklet to help simplify that journey. It provides explanations of how, when and why things happen during AC treatment cycles.

Every effort is made to give each couple an individualised plan of care to maximise their chances of live birth. Treatment cycles can vary from 4-8 weeks and may not necessarily synchronize with the female menstrual cycle. Different couples could have different drug regimes and the number of embryos replaced may also vary.

Please read this information booklet carefully. Should you have any queries please contact a member of staff for assistance.

Treatments options

We are able to offer the following treatment options as standard:

This list is not exhaustive and we are confident that we can accommodate the vast majority of clients’ fertility needs.

Please speak to a staff member if you are unsure of how we can help you.

Natural ovarian cycle

natural

Most women will release (ovulate) one egg during each menstrual cycle.

Natural fertilisation

fertilisation

The egg released during ovulation gets fertilised by a single sperm within 24 hrs

embryo

Implantation

implantation

The embryo that results from fertilisation implants into the womb about 7 days lat

pregnancy

IUI

iui

Who benefits from IUI?

Types of IUI

Natural cycle IUI

iui_graph

Stimulated IUI

iui_graph2

IVF and ICSI

ivf_and_icsi

Who benefits from IVF/ICSI?

Females with these factors:

Males with these factors:

Please note: ICSI is the recommended treatment for situations where sperm is suboptimal.

Prerequisites for assisted conception

The Female Screen

We will arrange a number of investigations for the female partner to assess her ovaries and pelvic organs.

Ovarian reserve tests

These tests assess the state of health of the ovaries and are performed during days 2-5 of the menstrual cycle. We recommend that women keep a record of their menstrual cycles. The tests include:

Baseline ultrasound scan

A baseline ultrasound scan is undertaken during days 2-5 of the menstrual cycle. This is a transvaginal scan and involves introducing a sterile probe into the vagina. The scan is used to assess:

HyCoSy test

The HyCoSy test is a test of tubal patency that is performed under ultrasound control. This test can tell us if the fallopian tubes are healthy and it is a vital test whenever IUI treatment is planned. Further more detailed information is available for women who require this test.

Other female tests

It is necessary to perform some other tests on the female including:

Additional tests for women who are donating eggs

The law requires us to undertake additional blood tests on women who wish to act as egg donors and these tests include:

The Male Screen

We will arrange standard semen analysis for male partners to assess sperm function. This test is undertaken at St. Mary’s Hospital in Manchester. Further information and instructions for the test will be provided to patients.

Other male tests

We will sometimes arrange certain additional tests for men with abnormalities of their sperm including:

The Virology Screen

As part of routine investigations prior to fertility treatment, we require both partners to be tested for HIV, Hepatitis B & C and Syphilis. Additionally, we require the female partner to be tested for Rubella, Varicella-Zoster and CMV. We also require HTLV 1 & 2 viral screening for egg and sperm donors.

What is a virus?

A virus is a very small living thing which can reproduce and spread. It can’t live on its own – viruses need another person for them to live within. Viruses damage the cells they live in, which is how they make the infected person become ill.

What is HIV?

HIV stands for ‘Human Immunodeficiency Virus’. It can attack the body’s immune system and cause AIDS (Acquired Immune Deficiency Syndrome).

What is Hepatitis B & C?

Hepatitis is a medical term meaning inflammation of the liver. Hepatitis B & C are viruses that attack the liver and can cause it to become inflamed.

What is Syphilis?

Syphilis is a curable sexually transmitted disease (STD). It is caused by Treponema pallidum, a type of bacteria called a spirochete. The spirochete first causes a sore called a chancre and then spreads throughout the body. Syphilis progresses through four stages: primary, secondary, latent, and tertiary (late).

What is Rubella?

Rubella is the virus that causes German measles. Although the virus causes only a mild infection in adults, acquiring it for the first time during pregnancy can cause severe damage to the baby.

What is Varicella-Zoster?

Varicella-Zoster is the virus that causes Chicken pox. This virus causes only a mild infection in adults but acquiring it for the first time during pregnancy can cause severe damage to the baby.

What is CMV?

Cytomegalovirus is a member of the herpes virus group. This virus causes only a mild infection in adults but acquiring it for the first time during pregnancy can cause severe damage to the baby. The virus has the ability to remain dormant in the body for a long time.

What is HTLV 1 & 2?

HTLV stands for Human T-cell Lymphotropic Virus. It infects a type of white blood cell called T-cell or T-lymphocyte. It is similar to HIV which causes AIDS but does not itself cause AIDS. HTLV-1 can cause cancer of the blood (leukaemia and lymphoma) and diseases of the nervous system (myelopathy, tropical spastic periphrasis).

What are my chances of having these viruses?

These viruses are more common in certain groups e.g. men who have sex with men, intravenous drug users and people from certain geographical areas e.g. Africa, South East Asia, South America, Australia, Japan and the West Indies. If you belong or have belonged to one of these groups your chance of catching one of these viruses may be increased. In addition, it is possible (though rare) for these viruses to be transmitted by tattooing, body piercing and acupuncture if contaminated equipment is used. CMV can be spread occupationally from person to person by contact with body fluids, including urine and saliva. A person can pass the virus to another person even though they do not have symptoms. Good hygiene and other control measures can be very effective in preventing the spread of CMV.

Why do we need to test you?

These tests are carried out to protect patients, their embryos and their babies from becoming infected.

How do we test you?

Te viruses can be detected in blood. A blood sample will be taken from both partners and tested.

What happens if my test is positive?

If your test is positive you will be contacted without delay and referred for specialist care, counselling and possible treatment.

Can I have treatment with a positive test?

This depends on several things such as which virus you have and how well you are. Each case would be considered individually.

Can I have treatment without being tested?

No. The Human Fertilisation & Embryology Authority (HFEA) requires both of you to be screened before you start treatment if storage is a possibility.

Will having this test affect my insurance status?

The information we hold regarding all aspects of your care, including test results is confidential and will not be forwarded to any third party. As screening for HIV and Hepatitis is a consequence and requirement of your treatment it does not suggest that you are at risk of infection and therefore will not affect your insurance status. However, if you belong to a risk group (see previous column) an insurance company might expect to be given that information.

The Consultation

IVF/ICSI cycle types:

The protocol for each cycle is tailor made to the individual based on various parameters, including ovarian reserve test results, previous cycle response and medical history.

Women are categorised into ovarian reserve bands based on their AMH levels as shown below:

Band AMH Ovarian Reserve
1A <3 Extremely low
1B 3-6 Very low
2 6-15 Low
3A 16-30 Optimum
3B 16-30* Optimum-PCO*
4 >30 Excessive*
*(+Polycystic ovary syndrome)

 

AFC, FSH, Age, BMI and previous response to stimulation are used to calculate optimum start doses of Gonadotrophins.

DHEA

What is DHEA?

DHEA is short for De-Hydro-Epiandrosterone Acetate, a hormone naturally produced in the body by the adrenal glands and it has been shown to play a crucial role in the maturation and selection of dormant eggs in the ovaries. The amount of DHEA in the body falls with increasing age.

Diminished Ovarian Reserve (DOR) and Premature Ovarian Aging (POA)

Ovarian reserve is a term used to indicate the number of eggs left in a woman’s ovaries and this has been shown to be the most reliable indicator of a woman’s fertility and her chance of success with IVF treatment. Women are designated as having Diminished Ovarian Reserve (DOR) when their egg counts fall beyond a critical level such that fertility becomes severely impaired and we would expect DOR to set in from about 41 years of age. About 1-in10 women (10%) have DOR occurring well before the age of 41 years and these women are categorized as having Premature Ovarian Aging (POA).

How we diagnose DOR/POA

The most reliable assessment of ovarian reserve is with a blood test that measures a hormone called Anti-Mullerian Hormone (AMH). AMH is produced by small dormant eggs in the ovaries and so its assessment gives a fairly reliable reflection of the number of eggs left in the ovaries. In addition to AMH, we also use the following tests to assess a woman’s ovarian reserve:

Fertility implications of DOR and POA

Presence of DOR and POA indicate poor prognosis for successful fertility treatment and many fertility centres routinely refuse to treat such women using their own eggs. This means their only recourse becomes use of donated eggs which some women find unattractive for cultural, ethical or other reasons.

How DHEA helps

Recent research demonstrated that DHEA supplementation improves both egg yield and quality in women with DOR and POA and this has enabled such women go through IVF treatment using their own eggs. Besides stimulating mature egg production from the ovaries and helping trigger ovulation, DHEA appears to also help the egg’s genetic divisions thereby reducing chromosomal abnormalities associated with aging cells. These effects have translated into more successful IVF treatment cycles in these groups of women by increasing pregnancy rates and reducing miscarriage rates.

How is DHEA administered?

DHEA is taken as a 75mg daily dose (most conveniently at bedtime). The effects of DHEA increase with time and it is recommended that treatment is in place for 6-12 weeks before commencing ovarian stimulation. We recommend stopping DHEA at egg collection.

How safe is DHEA?

DHEA is relatively new and we do not have long-term data on it but available evidence indicates there is no cause for concern with its use. DHEA remains controversial as it is not yet recommended for use by NICE.

Side effects of DHEA

DHEA is naturally occurring in the body and there are only rare reported side effects with its use for fertility treatment. Potential side effects include:

Immediate side effects:

Long-term side effects:

The following precautions are advised with use of DHEA

Women should not use DHEA for fertility treatment if they belong in any of the following groups:

Please let us know if you’re taking any medication as these might interact adversely with DHEA.

How you can get DHEA

We provide our patients for whom we prescribe DHEA the drugs directly from our pharmacy at RFS. DHEA is licensed for treatment of women with DOR and POA in the United States of America and some countries in Europe but not in the UK and so it is not available in pharmacies in the UK.

Endometrial Scratch

What is endometrial scratch?

Endometrial scratch is a procedure used to help improve the chances of embryos implanting into the womb after in-vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) or frozen embryo transfer (FET) treatment cycles. Research has shown that superficially interrupting (scratching) the lining of the womb (uterus) can stimulate the womb to repair itself in such a way that it becomes more receptive to an implanting embryo thereby helping to improve the chances of pregnancy. This leaflet has been produced to inform women undergoing endometrial scratch about what is involved

Who is the procedure for?

Endometrial scratch is performed on women undergoing any form of assisted conception that includes embryo transfer including in-vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) or frozen embryo transfer (FET) treatment cycles.

How does scratching help implantation?

The way endometrial scratch works is not very clear but recent research evidence suggests scratching the uterine lining causes a ‘repair reaction’ which may increase the chance of embryo implantation by:

Research is still being gathered to understand exactly how this procedure works.

When is the best time to have the procedure?

The best time to perform endometrial scratch is in the later part (mid-luteal) of the menstrual cycle preceding your active treatment cycle. For most women, this is approximately a week before the active IVF, ICSI or FET treatment cycle begins. We will advise on the best time for the procedure based on your menstrual periods.

What preparations are needed for endometrial scratch?

It is vital that you do not have unprotected intercourse from the beginning of the menstrual period in which the endometrial scratch will occur. It is recommended you use a condom for contraception during that cycle. For the actual procedure:

What happens during the procedure?

The procedure is similar to an embryo transfer or cervical smear test and usually takes 10-15 minutes. It is not generally a painful procedure and although you may experience some discomfort, no anaesthesia is required.

What happens after the procedure?

After the procedure, we recommend you use a panty liner or sanitary towel for a day or two because of the anticipated mild bleeding. You will be able to carry on life as normal immediately afterwards and can eat and drink normally immediately after. You may need to take more painkillers if pain persists afterwards.

What risks are involved?

Endometrial scratch is a very safe procedure but like everything else in life things can go wrong with it.

Pain: although most women will not require an anaesthetic for the procedure, some may find it too painful and so would require injection of a local anaesthetic into the cervix. Some women experience severe menstrual-type cramping pains during and after the procedure and these could be severe enough to make us abandon the procedure. Although most women will not require this, we recommend that women who feel they have a low pain threshold should make arrangements for a relative or a friend to drive or accompany them home after the procedure. We will ensure you are well enough before you leave the clinic.

Infection: very rarely, the procedure can give rise to pelvic infection as there is a small risk that any infection within the cervix may spread to the uterine cavity during the procedure. This would become apparent some days following the procedure. This is one of the reasons why we recommend screening all women for Chlamydia/Gonorrhoea prior to fertility treatment. If you suspect an infection and/or experience any of the following signs/symptoms within a few days of the procedure, please contact us or your GP immediately and inform him/her that you had endometrial scratch with us:

endometrial_scratch

Long agonist protocol

Please ring 01625 569 448 or 07500 806 319 on the first day of your period (the morning you wake up bleeding) to request treatment. The Fertility Nurse will review your files and discuss with the Consultant as necessary.

Pre-treatment assessment

Having checked through your medical notes and ensuring all relevant information is up to date and conferring with our designated Licensed Unit the Fertility Nurse will ring you back later that day. Please note that it may not be possible to commence your treatment in the month you ring and you may be told to ring again the following month (this is very rare).

Treatment cycle procedures

You need to avoid unprotected intercourse and engage in only protected intercourse (usually with condoms) once your treatment commences. You will be asked to begin injections of a drug called ‘Buserelin’ on a particular day of your cycle (usually around Day 21). The Fertility Nurse will teach you how to give the injections.

Approximately 2 weeks later, you will attend CFC for a blood test. If this is satisfactory, you will start an additional lot of daily injections of either ‘Menopur’ or ‘Gonal-F’ to stimulate the follicles in your ovaries aiming for an egg to develop within each follicle. Please continue these injections until you are told to stop.

You will be monitored by regular blood tests and scans usually with blood tests on days 3 and 6 and blood tests and scans on days 8 and 10 of the cycle of stimulation. Blood tests and scans are done between 7.30am and 8.30am so they cause minimal disruption to work routines. You will receive telephone calls from the Fertility Nurse in the afternoon of the days you attend CFC informing you of any changes to your drug dose and to let you know your next appointment.

An average of 10-12 days stimulation with either Menopur or Gonal-F is usual but you may be ready for egg collection sooner, or even later, than this. The Fertility Nurse will advise you and your partner when it is best for him to avoid ejaculation near the end of the treatment cycle.

When you are ready for egg recovery, you will be requested to give yourself a final injection of ‘Pregnyl’. This helps to mature the eggs and needs to be taken about 36 hours before your egg collection. The nurses will explain what to do with this and how and when to take it. On egg collection day you will be required to report to our designated Licensed Unit with your partner at 7.30am. This is the day your partner will be required to provide a semen sample, unless frozen sperm is being used.

Long down-regulation protocol phase lasts for 2-3 weeks

Short antagonist protocol

Requesting treatment

Please ring 01625 569 448 or 07500 806 319 on the first day of your period (the morning you wake up bleeding) to request treatment. The Fertility Nurse will review your files and discuss with the Consultant as necessary.

Pre-treatment assessment

Having checked through your medical notes and ensuring all relevant information is up to date and conferring with our designated Licensed Unit the Fertility Nurse will ring you back later that day. Please note that it may not be possible to commence your treatment in the month you ring and you may be told to ring again the following month (this is very rare).

Treatment cycle procedures

You need to avoid unprotected intercourse and engage in only protected intercourse (usually with condoms) once your treatment commences. You will be asked to attend CFC for a blood test/scan and a teach appointment (if not already done) the next day.

If the blood test result is fine, you will be asked to begin injections of ‘Menopur with/without Gonal-F’ later that day (Day 1 of stimulation) to stimulate the follicles in your ovaries aiming for an egg to develop within each follicle. You will be asked to start another injection called Cetrotide on Day 4 of stimulation. Please continue these injections until you are told to stop. The Fertility Nurse will teach you how to give the injections.

You will be monitored by regular blood tests and scans usually with blood tests on days 3 and 6 and blood tests and scans on days 8 and 10 of the cycle of stimulation. Blood tests and scans are done between 7.30am and 8.30am so they cause minimal disruption to work routines. You will receive telephone calls from the Fertility Nurse in the afternoon of the days you attend CFC informing you of any changes to your drug dose and to let you know your next appointment.

An average of 10-12 days stimulation with either Menopur or Gonal-F is usual but you may be ready for egg collection sooner, or even later, than this. The Fertility Nurse will advise you and your partner when it is best for him to avoid ejaculation near the end of the treatment cycle.

When you are ready for egg recovery, you will be requested to give yourself a final injection of ‘Pregnyl’. This helps to mature the eggs and needs to be taken about 36 hours before your egg collection. The nurses will explain what to do with this and how and when to take it. On egg collection day you will be required to report to our designated Licensed Unit with your partner at 7.30am. This is the day your partner will be required to provide a semen sample, unless frozen sperm is being used.

Short agonist (Co-Flare) protocol

Requesting treatment

Please ring 01625 569 448 or 07500 806 319 on the first day of your period (the morning you wake up bleeding) to request treatment. The Fertility Nurse will review your files and discuss with the Consultant as necessary.

Pre-treatment assessment

Having checked through your medical notes and ensuring all relevant information is up to date and conferring with our designated Licensed Unit the Fertility Nurse will ring you back later that day. Please note that it may not be possible to commence your treatment in the month you ring and you may be told to ring again the following month (this is very rare).

Treatment cycle procedures

You need to avoid unprotected intercourse and engage in only protected intercourse (usually with condoms) once your treatment commences. You will be asked to attend CFC for a blood test/scan and a teach appointment (if not already done) the next day.

If the blood test result is fine, you will be asked to begin injections of Buserelin later that day (Day 1 of stimulation). You will be asked to start injections of ‘Menopur with/without Gonal-F’ two days after Buserelin start (Day 3 of stimulation) to stimulate the follicles in your ovaries aiming for an egg to develop within each follicle. Please continue these injections until you are told to stop. The Fertility Nurse will teach you how to give the injections.

You will be monitored by regular blood tests and scans usually with blood tests on days 3 and 6 and blood tests and scans on days 8 and 10 of the cycle of stimulation. Blood tests and scans are done between 7.30am and 8.30am so they cause minimal disruption to work routines. You will receive telephone calls from the Fertility Nurse in the afternoon of the days you attend CFC informing you of any changes to your drug dose and to let you know your next appointment.

An average of 10-12 days stimulation with either Menopur or Gonal-F is usual but you may be ready for egg collection sooner, or even later, than this. The Fertility Nurse will advise you and your partner when it is best for him to avoid ejaculation near the end of the treatment cycle.

When you are ready for egg recovery, you will be requested to give yourself a final injection of ‘Pregnyl’. This helps to mature the eggs and needs to be taken about 36 hours before your egg collection. The nurses will explain what to do with this and how and when to take it. On egg collection day you will be required to report to our designated Licensed Unit with your partner at 7.30am. This is the day your partner will be required to provide a semen sample, unless frozen sperm is being used.

Stimulation phase of the cycle with gonadotrophin injections

Gonadotrophin daily injections – starting drug dose is decided based on Anti-Mullerian Hormone (AMH) levels and other parameters including AFC, Age, BMI and FHS. The daily drug dose can change during the stimulation cycle depending on the woman’s response.

gonadotrophin_injections

Two types of Gonadotrophin are commonly used in this Center: Menopur and Gonal-F. The stimulation band determines which of these is used.

The Fertility Nurse will arrange a Teach appointment for you at which you will be taught how to prepare and administer the drugs and discard the syringe and needle after.

 

 

 

 

 

 

 

 

 

Injections are subcutaneous (beneath the skin) – given into the abdomen or thigh at 90º angle.

injection2

We recommend you change the site of injections daily – usually from side to side (left/right).

We recommend you do the injections at the same time every day (between 4.00pm and 8.00pm).

You may experience a feeling of heaviness or pressure inside the abdomen as the ovaries get bigger – this is normal.

It is important to follow all instructions on drug dosages and timing. The Unit should be informed immediately if there are any problems with this.

Duration of injections: usually 10-12 days (occasionally longer if your response is slow).

Ultrasound scans before and during the treatment cycle

ultrasound

Ultrasound scans performed before and during the treatment cycle are done vaginally and in the morning along with blood tests – usually between 7.00am and 8.30am

Pre-treatment scans are done as baseline scans to rule out problems that can affect treatment success such as polyps, fibroids, septate uterus, endometriosis and ovarian cysts.

septate_uterus
Scan image of septate uterus

Down-regulation scans are not commonly done. They are done following Buserelin injections (long protocol) if the blood tests done following the period do not indicate the desired effect on the lining of the womb (thin lining) and ovaries (‘quiescent’ – meaning there is no ongoing follicular activity in the ovaries).

stimulated_ovary
Scan image of stimulated ovary

A number of scans are done during the active stimulation phase of the treatment cycle to monitor response to treatment – by way of growth of follicles in the ovaries.

Final egg maturation trigger with Ovitrelle or hCG injection

Final egg maturation is achieved by giving an injection of Pregnyl (hCG) or Ovitrelle approximately 36 hours before egg recovery is performed.

Timing of this injection is very crucial

If you miss your allocated time slot, please DO NOT inject at any other time as this can compromise your treatment.

Instead, ring CFC first thing the following morning as we might be able to provide a new time slot for you. This may occasionally not be feasible and wee may have no other choice than to cancel the cycle of treatment. We would try our very best to rescue the cycle but we strongly recommend that you comply with all drug dosages and timings.

NB. You should NOT have any more injections following this final injection.

Egg recovery

egg_recovery

NB. You may experience some abdominal and/or pelvic pain and a mild degree of vaginal bleeding after the procedure.

Sperm sample on the day of egg recovery

sperm_morohology

If sperm parameters on the day are suboptimal, we may have to switch your treatment from IVF to ICSI (this would be discussed and agreed with you first).

What happens in the laboratory?

clean_root

The egg (oocyte)

egg

This is especially important for couples undergoing ICSI – as only mature eggs can be injected with sperm.

The IVF Process

ivf_process

The fertilisation dish

fertilisation_dish

incubator

Couples are notified of the number of fertilised eggs the next morning.

The ICSI Process

ICSI is performed when there are sperm abnormalities or previous failure of fertilisation with standard IVF

mature_egg
Mature egg

Recovered eggs are stripped of their surrounding cells to reveal which eggs are mature.

icsi

One good quality sperm is selected from the sample and injected into each mature egg

The injected eggs are placed in an incubator overnight (similar to IVF)

Embryo: Pronuclear stage (Day 1)

pronuclear_embryo
Pronuclear embryo

NB. The Laboratory will keep you informed of the progress of your embryo and the date and time that your embryo transfer will take place.

Embryo: Early cleavage stage (Day 2-3)

Embryo: Blastocyst stage (Day 5)

NB. Women may not achieve embryo transfer if none of the embryos survive to this stage in the laboratory.

Embryo Transfer Policy (subject to change)

embryo_transfer_policy

NB. Consideration will be given to freezing or vitrifying good quality embryos not utilised for fresh transfer. We will discuss and agree this with you at the time as it would involve further expense for you.

Embryo transfer (ET)

NB. We recommend you carry on as normal following embryo transfer; there is no evidence that resting in bed, taking time of work or engaging in any particular activities improve the chances of a successful outcome

Luteal phase support – Cyclogest pessaries

Embryo freezing and vitrification (cryopreservation)

Early pregnancy

early_fetus
Early Fetus

early_pregnancy
Scan image of early pregnancy

NB. It is imperative that you inform us of the outcome of your treatment cycle as we have a statutory obligation to report it to the HFEA. We also need to know of any complications and/or hospital admissions.

Live birth after IVF/ICSI treatment

assisted

Multiple pregnancy

Side effects and risks of IVF/ICSI

Ovarian Hyperstimulation Syndrome (OHSS)

Costs of assisted conception

pound

Package fees generally cover:

Additional fees not covered by package fee:

Package fee for cycle of IUI:

Package fee for cycle of Stimulated-IUI:

Package fee for cycle of Donor-IUI:

Package fee for cycle of Gonadotrophin ovulation induction:

Package fee for cycle of IVF:

Package fee for cycle of ICSI:

Package fee for cycle of IVF Egg Share Donor:

Package fee for cycle of IVF Egg Share Recipient:

Package fee for cycle of IVF with Donor sperm:

Package fee for cycle of IVF with donor eggs:

General advice

Impact of smoking

NB. Your GP will be able to advise you of NHS resources locally available to help you quit smoking.

smoke

COUPLES should aim to quit smoking 2 months before starting fertility treatment. Your GP can help you with this process.

NB. Avoid booking holidays during the treatment period.

NB. You may have protected intercourse (with condoms) during the treatment period.

Counselling

Implications counselling

Welfare of the child (WoC) assessment

Potential Egg Donors

Please read this section if you wish to donate eggs. We would be pleased to arrange a visit to the Unit and for you (and your partner) to meet a counsellor and our Consultant.

Egg donation and the law

Eggs may be donated ‘directly’ to a known couple or ‘indirectly’ to a couple not known to you but who are registered with the Unit and who wish to receive treatment with donated gametes.

In 2005 the law relating to gamete donation changed. Egg and sperm donors can no longer donate anonymously.

Donors will have the right to find out limited non-identifying information about their genetic off spring, including the number of children born from their eggs, and the year and sex of each child.

A donor will not be the legal parent of any resulting children and will not have legal rights, claims or responsibilities towards the child.

If you wish to donate indirectly, you are not entitled to know any information about the recipient(s).

Who do we use as donors?

In line with Human Fertilisation and Embryology Authority (HFEA) recommendations:

Who do we treat?

Donated eggs are required to treat women who have undergone premature menopause, for couples who have had failed IVF cycles of their own due to poor egg quality or to avoid passing on a serious genetic disorder. Unfortunately the number of couples who require treatment with donated eggs far exceeds the supply.

How do I start the process?

Potential donors (and where applicable, their partners) are required to discuss the moral, ethical and legal aspects of egg donation with a counsellor and doctor. Written information will be sent to you before the counselling session.

As well as meeting with the counsellor, you will be asked to attend for baseline blood tests and an ultrasound scan. You will then be seen for a medical consultation. If the decision has been made that you are a suitable candidate for egg donation, the risks associated with egg donation and the process of ovarian stimulation and egg recovery will be discussed in detail. Should you wish to proceed with donating your eggs, additional screening tests will be required, following which all the necessary consents will be completed.

Communication

By Telephone: 01625 569 448

By Mobile: 07500 806 319

By Email: info@cheshirefertilitycentre.com

NB. It is extremely important that we have a reliable method of contacting you during your treatment cycle. Please ensure we have an up-to-date telephone number for you where we can leave messages if necessary.

Zero Tolerance Policy

Suggestions, Concerns and Complaints

Mr Elliot Browne

General Manager

Cheshire Fertility Centre

Macclesfield Health Hub

Sunderland Street

Macclesfield

SK11 6JL

Confidentiality

In accordance with the relevant UK legislation, RFS ensures that all your information is kept confidential and only disclosed in circumstances permitted by law. To that end, RFS has processes in place to ensure that access to your health data and records is secure at all times, conforms with UK legislative requirements and is only available to persons named on our licence or authorised by the Person Responsible.

No Smoking Policy

This establishment has a no smoking policy. Please protect yourself, patients, visitors and staff by adhering to our no smoking policy. Smoking is not permitted within the hospital building or grounds.

© Cheshire Fertility Centre 2014