How do we start the process?

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Getting started

Your current GP/Consultant/Healthcare practitioner will refer you to us for treatment.

We will ask you to fill in a pink eligibility form and return it to us with your passport photographs attached.

If you meet the initial eligibility criteria, the female receiving treatment will be asked to attend for a blood test and a pelvic ultrasound scan; the male will attend for a sperm test.  Occasionally, it may be necessary for the woman to re-attend for additional blood tests and ultrasound scan.

When we receive all your results, an appointment will be made for you as a couple to see a member of the Assisted Conception team to plan your treatment.

Your first consultation for assisted conception treatment

  • An appointment will be made for you to see one of the clinicians or a specialist nurse, who will take your history and examine you if required (it is very important that both partners attend all clinic appointments).
  • At this clinic appointment a detailed history will be obtained from you and your results will be discussed. Based on the blood, scan and semen results, your treatment will be planned and explained to you. You will both sign consent forms at the appointment – for disclosure of information, welfare of the child, permission for treatment and the HFEA legal forms.
  • At this appointment, you will be asked if you would be happy to take part in the research. If you agree, then you will be seen by one of our research nurses (if available) after the clinic. You will be asked to request treatment on the first day of your next period after receiving a copy of the clinic letter that was sent to your GP.  You will be required to book in for treatment within 3 months of your clinic appointment or we will refer you back to your GP.
  • Additional investigations might be performed before your treatment can begin.

Welfare of the child

It is a requirement of the Human Fertilisation and Embryology (HFE) Act 1990 (as amended) and a HFEA licence condition that “a woman shall not be provided with treatment services unless account has been taken of the welfare of any child who may be born as a result of the treatment (including the need of that child for supportive parenting), and of any other child who may be affected by the birth.” Section 13 (5).

As a licenced clinic, we are required by law to ensure that we know of no medical or social reason why our patients might not be suitable to receive treatment, including anything that may adversely affect the welfare of any resulting child.

All our patients are routinely asked to complete a ‘Welfare of the Child Form’.  If there are any child protection/safeguarding issues or evidence of a previous relevant conviction, it may be necessary for us to make further enquiries through the GP, Social Services, the Probation Service and the Police Department. In order to do this, we would require your written consent. Refusal to give consent may be taken into account when considering whether or not to offer treatment.

Treatment may be refused on clinical grounds if the clinic staff believe that it would not be in the best interests of any existing or resulting child to provide you with such treatment.

You would be given the opportunity to meet with senior members of the Clinical Team and given the opportunity to state your views before any decision is made not to offer treatment. In certain circumstances, a case may be referred to the hospital’s Ethics Committee. This is an independent body of professional and lay people who meet to advise the hospital. They have a responsibility to ensure that any treatment provided is ethically acceptable.

Your baseline tests

In order to give you the most accurate advice, our doctors require you both to attend for the following tests:

Female:

  • Blood test for Oestradiol, LH, FSH & AMH
  • Blood test for Hepatitis B & C, HIV, Syphilis and Rubella or German Measles.

All the above blood tests can be done with one needle.

  • An ultrasound scan of your uterus or womb and ovaries
  • Urine test for Chlamydia
  • A blood pressure check
  • Height & weight measurement to work out your BMI (body mass index)

Male:

  • Blood test for Hepatitis B & C, HIV and Syphilis
  • Urine test for Chlamydia
  • Semen analysis

You may already have had some of these tests performed, but these can change over time and therefore need to be repeated.

We also need up to date (within last 2 years) viral screening results.

When do I come for these tests?

We ask that the female partner rings the nurses on the first day of her period (the day you wake up bleeding).  We will aim to call you back by telephone within 72 hours to invite you to attend for tests, which can be undertaken up to day 5 of your cycle.  You should already have received an initial letter from the Department which gives the number to call and further details.

So as not to cause delay it is preferable for both partners to attend on the same day for blood tests.  The male partner will be given a subsequent appointment for his semen analysis by the Andrology Department.

Where do I go for the tests?

The Department of Reproductive Medicine is based in old Saint Mary’s Hospital building.  Our entrance is on Oxford Road opposite Whitworth Park.  Please note that you cannot access the Department through the new hospital building.

Please report to the reception desk when you arrive.  You can then go to the blood room which is on the ground floor and down the corridor on the left as you entered the building.  Scans are carried out on the first floor. The Andrology Department is also on the first floor; turn right at the top of the stairs.

How is the scan done?

The ultrasound scan is done vaginally and carried out by a sonographer. All our sonographers are female.

You may still be menstruating when you attend for the scan.  You must remove any tampons prior to having your scan, and you will also need to have an empty bladder.

The scan should not take any longer than 10 minutes and is not painful. Your partner can accompany you if you wish.

What is AMH?

AMH stands for Anti-Mullerian Hormone and is produced by the ovarian follicles.

It is measured by taking a blood sample, and all women referred to The Department of Reproductive Medicine will have their AMH level checked. The test takes around 21 days to process.

AMH, along with performing an ultrasound scan in which the number of antral follicles are counted, is a used to help predict a woman’s response to an IVF cycle as it gives an indication of ovarian reserve, or function.  AMH can range between 0 to more than 100.  A result showing ‘satisfactory fertility’ would be between 21-40.  It is thought a woman with an AMH between these levels should respond well to treatment ie, is likely to produce around 8-10 eggs as part of her IVF cycle.  A woman who has a lower AMH and has lower numbers of antral follicles will be advised that she may not respond as well and could produce fewer or no eggs.  These issues will be discussed with you at your clinic appointment.

It is worthwhile to note that different clinics use different scales to measure AMH levels and so some patients may have had a previous result taken elsewhere that does not match the result from Saint Mary’s.

If your treatment hasn’t started within 6 months of being seen in clinic, you will be asked to have this test repeated so the doctors can more accurately set the dose of stimulation drugs for your treatment.

You’ve had your baseline investigations – What happens next?

Once all the necessary baseline investigations are complete, your results will be looked at by a clinician you will be asked to attend a clinic appointment together.  You will be given the earliest available appointment.  Please be aware this could be up to 12 weeks after attending for your baseline investigations.  IVF isn’t the only assisted conception treatment offered in our Department so at your appointment the Clinician will discuss what type of treatment will suit you best.

Also, should your baseline results identify that you first need additional treatment such as surgery, you will be given a gynaecology appointment or your surgery will be arranged.  If men have a problem with their sperm or no sperm are found in the sample, they will be referred internally to our Andrology clinic to be seen by one of our Andrologists for further management. Once you are both deemed suitable for assisted conception you will be referred internally.  Your clinician will then tell you when you are able to request treatment.