Selection Criteria

 

The success rates are very poor once a woman is aged 40 years or over. We may only offer to treat women over 40 years of age following counselling and tests to ensure the ovaries are functioning satisfactorily; subject to the Medical Director's discretion, we are able to commence treatment up until the date of the lady's 46th birthday.  We will not offer treatment to anyone under the age of 18.  Women over the age of 44 can not be put on the waiting list for donated eggs. 

 

Independent counselling is offered to all patients no matter what treatment you are having.  Implications counselling is mandatory for all patients considering the use of donated sperm, eggs, or embryos.

We have a legal obligation to the welfare of existing children, and any child born as a result of any treatment, and must refuse treatment if doubts about such welfare exist.  In order to assess the welfare of the child we will give you a letter to take to your general practitioner, who will sign it to indicate to us that he/she knows no reason why you should not be treated.  We will also ask each partner to complete a questionnaire from the HFEA.

Your general health is relevant to the risks and chance of success of therapy and for this reason we discourage smoking, alcohol and poor diet. 

Folic Acid:  Trials have confirmed that there is an association between reduced folic acid intake and the development of neural tube defects in infants.  We advise all patients to take 400 mcg of folic acid daily to reduce the risk of spina bifida in the newborn.

Female Body Mass Index (BMI) –BMI is a measure of body “fatness”.   With effect from 1st April 2006, the IVF Unit does not treat any new patient with a body mass index greater than 35 at the time of treatment.

BMI is calculated by dividing your weight in kgs, by your height in metres squared.    Weight (kg) / [height (m)]2

Normal Range:  18.5 – 25:  Overweight:  25 – 30:  Obese:>30

 

The reason for this restriction is that an increased BMI is associated with a decreased pregnancy rate – and an increased risk of miscarriage and other complications if pregnancy is achieved.  If you have problems calculating your BMI before we see you, you could ask the practice nurse at your GP surgery to work out the BMI for you or use an online BMI calculator.

Anti-Mullerian Hormone – Very low levels of this hormone (<1) suggest that either stimulation will fail or no pregnancy will result, therefore we would not offer treatment using your own eggs.

Single women who wish to be considered for treatment may require counselling, a Welfare of the Child assessment,  a social work report and agreement at the Ethics Committee that treatment should be offered.

The First Step

Should you meet the selection criteria, the next step in your patient journey is to attend an initial consultation here at the Hull IVF Unit.  In order for an appointment to be made, we require a referral letter either from your general practitioner or the consultant looking after you.  

Once we have received a referral letter we shall forward you an appointment in the post, along with a registration pack.     Please complete the enclosed forms and bring them with you to your appointment, along with two current passport sized photographs and a form of photo-ID, ie a photographic driving license or a passport.  

    

Consultation & Investigations

Consultation

At your initial appointment, the consultant will take a detailed medical history, discuss any relevant lifestyle issues that could affect your fertility, initiate welfare of the child assessment http://www.hfea.gov.uk/5473.html , take details of previous investigations, tests or treatments you have had, previous pregnancies and any children born to either partner. 

There will be an opportunity for you to ask questions about the Unit and investigations and treatments we offer.

Further investigations will be booked at this stage along with a planned follow up appointment where the consultant will go through all of your test results and discuss the best treatment option for you.

Investigations

Your baseline investigations will be booked at the initial consultation. 

Your blood will be taken for screening and these tests include Anti-Mullerian Hormone, prolactin, and rubella immunity.   You will also need to be booked in for an antral follicle count, which is a scan performed between day 2 and day 5 of your menstrual cycle.

Both partners will be screened for HIV, Hepatitis B core and antibody & Hepatitis C and chlamydia carrier status.  For more information regarding viral screening, please discuss with your consultant or visit the HFEA website. www.hfea.gov.uk

Where applicable, the male partner will be booked into the clinic for a detailed semen evaluation.

Some of the above investigations carry a further charge, please see Fees for more information or contact one of our office administrators for further details.

Please note; all treatment and investigations are carried out on an individual basis therefore you may require further tests or investigations that are not outlined above.  The consultant will discuss these with you in more detail at your appointment.

Egg Sharing

Compensated Egg Sharing Programme - A way to reduce the cost of IVF/ICSI treatment:

One of the ways of helping to reduce the cost of your IVF/ICSI treatment is through our Egg Sharing Programme.  As you can see on the price list there is a fixed price for this treatment option, the “egg sharing arrangement fee”, which is substantially lower than the cost of standard IVF/ICSI.  The charge listed covers both treatment and drugs.  In return, you would have to agree to share the eggs collected from you in that cycle, with a woman who requires egg donation.

 Suitability:

For a woman to be considered for the Egg Sharing Programme she has to be less than 36 years of age with no personal or family history of inherited illnesses or abnormalities.  She will be seen by a doctor and a specialist nurse for assessment, and she will also have independent counselling.  The response to any previous fertility treatment she may have had, and the result of hormonal tests (basal serum FSH) will be reviewed before deciding on her suitability.  The AMH reading should be within normal limits and a scan of the ovary should show normal activity.  The GP will be contacted via the patient for details about medical and family history.

Prior to treatment she will be screened for Hepatitis B and C, HIV (the Aids virus), Syphilis, Cystic Fibrosis, Chromosomes, CMV, Rubella and Chlamydia antibodies.

 Egg Sharing Arrangements:

The woman sharing your eggs will remain anonymous and you will not be given any details about her or her treatment and its outcome.  You will also be anonymous to her.

Any child born as a result of donor gametes has a right to be informed, on reaching 18 years of age, of the identity of the gamete donor.

If you get 8 eggs or more, you will share them equally with her.  If you get an even number, each one of you will get half the eggs.  If you get an odd number, you will get the extra egg.  She will never be given more of your eggs than you get yourself.

Note:  If both you and the recipient are having ICSI treatment, you will receive at least 3 eggs for ICSI injection.

If you get less than 8 eggs, you will keep them all yourself and have your treatment as planned.

According to the Human Fertilisation and Embryology Act 1990, you will not be the legal parent of any child resulting from your donated eggs.

You will be required to have counselling about the implications of the proposed treatment.

You can withdraw from the egg sharing arrangement at any time up to the point where embryos created from your eggs are to be transferred to the recipient.  If you withdraw consent you would then have to pay the standard fees for IVF/ICSI and the costs involved in preparing the recipient.  You would not be reimbursed the sharing arrangement fee.

Please note: your treatment can only go ahead if a matching patient who requires egg donation is ready to start her treatment.  This means that you may need to wait for a variable period of time until such a person is available.

Alternative Options: Another way of paying for your treatment is to pay in full.  In such cases you keep all your eggs for yourself and you do not have to wait for the availability of a suitable recipient.

 

 

Commencing Treatment

Following your follow up appointment, you will know which treatment your consultant has recommended for you.    You will be invited to attend one of our group information sessions.  These are held once a month and patients ready to commence their treatment cycles, will attend a presentation which outlines what is involved in a treatment cycle from beginning to end. There will be an opportunity to meet members of the team and also ask questions in a one-to-one scenario or within the group.

You will be issued with a costed treatment plan which outlines the cost involved with the treatment you have been recommended and also outlines the approximate charges involved for the drugs used within the cycle of treatment.   Fees  You will also be issued with a prescription for either Norethisterone or the contraceptive pill and this can be dispensed at the hospital pharmacy on the ground floor of the main tower block hospital.

After the group session, you will be ready to commence your treatment with the period of your choice.

Please see Treatments

Counselling

We offer two sorts of support counselling:  Implications and Support counselling; In addition, some patients are required to have a counselling assessment, to support welfare of the child issues. As part of the contact you will enter into with the counsellor, the exact type of counselling you will have will be made clear from the outset.

Implications counselling

If you are having treatment with donated eggs or sperm, then implications counselling is mandatory.  This is to help you understand the implications of the treatment for you, your extended family and for any child born as a result of treatment.  The counsellor will advise the best ways to tell a child about their origins, and will suggest other resources which may be of help to you with this process. 

Support counselling

All of the staff in the IVF unit can provide you with support.  But occasionally patients want to have access to an independent and confidential support system, specifically if you are having difficulty coping with the stresses of treatment and the effects this may be having on your work, relationships etc.  Patients can access this support system individually, or as a couple.  The IVF Unit would not be made aware of any issues which arose during counselling, unless both you and your counsellor felt otherwise. 

Counselling assessments

When patients requesting treatment have issues which may affect the wellbeing of any child born as a result of treatment, we are required by the HFEA to make an assessment to determine whether or not to offer treatment.  A counselling assessment is carried out, along with a social background report, presented for discussion at the IVF Unit Ethics Committee.  They advise the patient’s consultant whether they think it is reasonable to offer treatment.  The final decision rests with the consultant.

Accessing counselling

Counselling is offered to all patients no matter what treatment you are having.  If we require you to have counselling, an appropriate referral form with be completed.

If you think you would benefit from counselling and wish to make an appointment, please telephone the IVF Unit office on 01482 382648.

The counselling support service is available to you once you have been placed on the waiting list for treatment, as well as during and after. 

For more information regarding accessing treatment as a private or funded patient at the Hull IVF Unit, please contact us on 01482 382648