• Photo identification should be bought in for both partners.
• The registration forms that were mailed prior to the consultation should be completed. If you do not wish to sign them outside the unit please complete the demographic details in advance. This helps to ensure that you will be seen in as timely a manner as possible.
• Any copies of previous investigations or treatments.
• Male partners should ejaculate two to three days prior to the consultation to ensure that the semen analysis best reflects the quality of the sperm.
  

Below is a table of test results that all patients are required to have the results of on file prior to commencing treatment.aaa

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All of the tests listed below (with the exception of the Rubella immunity) must be within twelve months of the procedure going ahead. We are happy to accept copies of laboratory tests from previous clinics or from GP surgeries.

Two concurrent scan lists run from 9.00am to 12.45pm.

The Treatment Room commences at 2pm. The Treatment Room is for procedures such as IUI, Dummy Embryo Transfer & HyCoSy.

Theatre commences at 9am and embryo transfers begin at the end of the theatre list.

A nurses list commences at 9am. If you require a blood test result to be available that day (for example a beta HCG) the appointment needs to be prior to 1pm.

During active treatment, scans are done Monday to Friday from 9am to 12.45pm.

This is to ensure that blood test results, if requested by the doctor, are available for review that evening and treatment can be adjusted accordingly.

The blood test result will often determine the dosage of medication, whether a treatment can proceed or needs to be delayed or if a patient can commence treatment.

If a scan is needed over the weekend the on-call clinic starts at 9am and appointments are given successively.

Day one of the period is considered to be the day of the full flow period. Spotting or a light brownish, pinkish or reddish discharge or flow is not considered to be the period.

The clinic is not open for routine appointments on the weekend.

We do have an on-call clinic that is available for the following appointments:-

-          OST

-          IUI procedure

-          Day 4 Blood tests for IVF/GIFT stimulation

-          Embryo Transfer

-          Delayed Egg Collections.

This ensures that essential services are delivered at the most efficacious time to maximise success.

This clinic is staffed by one Doctor, one nurse and one embryologist and begins at 9am.

This depends largely on where you are in your treatment.

The first thing to do is look at the protocol that you were given with your dates when you attended for Dummy Embryo Transfer and HyCoSy.

On the second page under the heading Buserilin/Nasal Spray it will give you instructions. If you have misplaced your protocol or cannot remember what protocol you have been assigned, please contact a member of nursing staff.

The reception staff are able to book all appointments and are aware of the dates and times that these appointments can be done.

Blood test results that require an interpretation need to be discussed with your doctor.  (i.e. OST, AMH, Semen analysis)

Nurses can give out basic blood and swab results (ie HIV, Chlamydia etc)

If you are booked in for a follow-up with your doctor, the results of the blood/swab/semen analysis will be discussed at this point.

Yes. Please ensure that you have been given a full prescription well in advance of commencement of stimulation.

Yes. Please write a letter, signed by both parties and addressed to the receptionists. The file will be copied and mailed to you. A nominal charge of £20 will be incurred.

No. Legally we do not have access to records you hold outside of the clinic. Please contact your previous clinic directly to request a copy of notes.

During your initial consultation a detailed history will be taken from you and your partner and the treatment options will then be discussed. In all cases treatment will be tailored to your individual circumstances. The Ovarian Stimulation Test (O.S.T.) and Ovarian Reserve Test (O.R.T) is also designed to help with this.

Provided that you are having treatment involving the use of your own eggs and sperm there is currently no waiting list. Once the necessary investigations are complete, treatment can usually begin immediately.

You can complete one cycle of I.V.F in around six to eight weeks from start to finish. There are usually around 11 or 12 visits involved. Some patients prefer to divide the treatment over two or three months depending on their other commitments.

You can refer to our full price list for details of all our charges. Once your treatment route has been decided upon we can provide you with a more detailed breakdown of the costs that apply to you individually.

Embryos are graded according to the size and shape of blastomeres and the degree of fragmentation.
 

Grade 1/1-      Even size blastomeres, little or no fragmentation. Less than 10% fragmentation

Grade 2+        Even size blastomeres, moderate degree of fragmentation.Between 10 and 25% fragmentation.

Grade 2         Uneven size blastomeres and/or moderate to heavy fragmentation. 25-50% fragmentation.

Grade 2-        Heavy fragmentation. Over 50% fragmentation 

Grade 3         Totally fragmented

Embryo quality and specifically fragmentation of the embryo has long been an imperative factor when determining which embryos are to be placed back at the time of embryo transfer.  Generally, it is understood that the better quality the embryo (even blastomeres, minimal fragmentation), the higher the implantation rate.

However, it is vital to recognise that poorer quality and fragmented embryos can and do implant and result in live births, just less frequently than better quality embryos.

An embryo that is approximately five to six days old which consists of 60 to 100 cells.  Two cell lineages form; firstly the inner cell mass which develops into the foetus and secondly the trophectoderm which develops into the placenta.

 

Blastocyst Grading System

 

When grading blastocysts, we use the Cornell grading system which includes 3 separate factors:-

 

Firstly there can be a varying degree of expansion from 1 (least expanded) to grade 6 (hatched).  The grading of expansion is as such:

 

Grade 1:  Early blastocyst; the blastocoel filling more than half the volume of the conceptus, but no expansion in overall size and notable thinning of the zona pellucida (ZP).

 

Grade 2:  Blastocyst; the blastocoel fills more than half of the volume of the conceptus with slight expansion in overall size and notable thinning of the ZP

 

Grade 3:  Full blastocyst; a blastocoel of more than 50% of the conceptus volume and overall size fully enlarged with a very thin  ZP.

 

Grade 4:  Hatching blastocyst, the trophectoderm has started to herniate through the zona.

 

Grade 5:  Fully hatched blastocyst (non-preimplantation diagnosis (PGD)).

 

Grade 6:  Hatching or hatched blastocyst derived from an embryo having undergone PGD.

 

Secondly, the quality of the inner cell mass (which becomes the foetal cells) is graded as such:

 

A:  Tightly packed, compacted cells.

B:  Larger, loose cells

C:  No ICM distinguishable.

D:  Cells of ICM appear degenerative

 

A:  Many healthy cells forming a cohesive epithelium.

B:  Few, but healthy cells large in size.

C:  Poor, very large or unevenly distributed cells; may appear as few cells squeezed to the side.
D:  Cells of the trophectoderm appear degenerative.

All that blastocyst transfer involves is observing the embryos for 2-3 days longer before deciding which are the best embryos to put back. The way in which it can increase pregnancy rates is by refining the embryo selection process. 123
 
When there are lots of good embryos to choose from on Day 3 of development it is not possible to tell which of these embryos have the best potential to implant and the decision on which embryos to transfer is better made at the blastocyst stage.
 
However, if there are very few embryos that look good and the best embryos to transfer are obvious there are no benefits in waiting to the blastocyst stage and therefore the embryos are better put back in their natural environment at the cleavage stage.

A sophisticated, micromanipulation technique for perforating the shell surrounding the embryo enabling the embryo to 'hatch' and implant in the uterus.  This hole is made using a laser.