Initial contact

Initial contact

Patients do not require a referral and can simply contact us to book the pre-treatment tests.


Pre-treatment

Pre-treatment

Preliminary tests and screening

To make the best decision about your treatment in the consultation, your doctor needs the results of some tests. There may be a combination of blood tests and a vaginal ultrasound scan to assess your ovaries, and a semen assessment where appropriate. Whereas you may have had similar tests elsewhere, GCRM strongly recommends having these tests with us to ensure you are on the correct treatment protocol and to ensure we have the most up-to-date results and all parameters are taken into account before your treatment starts.

Fertility Assessment

Initial Consultation

At your first consultation with your fertility doctor, you discuss medical history and the results of your fertility assessment. The doctor will discuss with you their recommended programme of treatment, based on your results and circumstances.

Treatment Protocol


Counselling

Counselling

Counselling is available at any stage of your treatment pathway and three hours of counselling sessions are included in your treatment cost once you have paid for treatment. Fertility treatment is a significant emotional journey for all patients, and counselling provides extra emotional support. It is completely confidential. If you are going to be using donated eggs or sperm for your treatment, then you’ll be required to see the counsellor before starting treatment, to discuss the implications for both you and any children that may be born.

Counselling page


Consents and Planning

Consents and Planning

You need to attend an appointment with a nurse to sign consent forms, and talk through your particular treatment programme. They will explain all the consent forms that you need to sign, and also explain the drugs you’ll be using during the treatment process. Once all the tests and consent forms are completed, you are ready to start your IVF cycle. If you are having treatment as a couple, both of you will need to attend this appointment to sign the consent forms. You will need to pay for your treatment programme at this point.

Consent Appointment


Starting Treatment

Starting Treatment

Your treatment will usually start on Day 1 of your period when you will need to call the clinic. We will then instruct you to start the treatment plan as explained in your Consents and Planning appointment. Often you will take drugs to regulate your cycle; this gives the clinic the ability to manage when you ovulate.


Ovarian Stimulation and Monitoring

Ovarian Stimulation and Monitoring

In general, treatment starts with drugs that stimulate your ovaries. This enables us to collect a number of eggs for insemination, rather than the usual one. The drugs are injections that can be taken at home – you’ll be shown how to do this.

Over a period of around 2 weeks of stimulation, you’re likely to have 1-3 scans, and possibly blood tests, to monitor the development of the egg producing follicles. These are short appointments that last around 20mins, and the results are available later the same day. The timings are different for everyone, because treatment is tailored to suit each patient individually.


Trigger Injection

Trigger Injection

Once your follicles are ready, the stimulation period ends with an injection that matures the eggs in the follicles, ready for egg collection.


Egg Collection

Egg Collection

The appointment to collect the eggs will take place 36-40 hours after the trigger injection. The procedure takes about half an hour, and you will be given drugs to make you sleepy during the procedure. With the help of a scan probe, a very fine needle is passed through the vaginal wall and into the ovary to collect the eggs. Usually, around 80% of follicles contain an egg. You can go home the same day, after a short rest at the clinic. You’ll need someone to pick you up; you mustn’t drive for the rest of the day, because of the anaesthetic.


Providing Sperm

Providing Sperm

If your treatment uses a fresh sperm sample, it will be provided on the same day as the eggs. You provide the sample at the clinic, in one of our andrology (men’s) rooms. If you’re providing the sample via a surgical procedure, this will take place before the egg collection day, and the sample will be be frozen.

If you already have sperm in storage, or have chosen a sperm donor, the sample will be thawed on the same day that the eggs are collected.


Insemination of the Eggs

Insemination of the Eggs

The sperm sample provided is prepared to ensure that the very best sperm are being used for insemination.
In Vitro Fertilisation Cycle – prepared sperm will be added to the eggs in a culture dish.

or

Intra-Cytoplasmic Sperm Injection Cycle – a single sperm will be selected and injected into each egg, then put into a culture dish.

The culture dishes are placed in the incubator to allow fertilisation to take place.

IVF/ICSI page


Embryo Development

Embryo Development

Embryo Development

You

Supportive Drugs

Shortly after egg collection, you may start taking drugs that help prepare your uterus lining to receive an embryo (this is known as Luteal Phase Support).

A-Z luteal phase support

Communication

You clinic will be able to update you on embryo development.

Optional advanced treatments (where offered)

Endometrial Scratch

A further procedure which may help with the implantation of an embryo. This is carried out before the egg collection phase.

Endometrial Scratch

Getting ready for transfer

On-call

During the few days after insemination, you’re effectively ‘on call’, to come in for the transfer appointment when your embryos are ready.

Embryology

Development monitoring

The embryos are carefully monitored in the period after insemination: first to check for fertilisation, then for signs for development which indicate the embryo is growing.

Development monitoring

The embryos are graded as they develop and the monitoring can continue up to six days after egg collection.

Optional advanced treatments (where offered)

Time-lapse Monitoring

Time-lapse monitoring provides more intensive observation of embryo development.

Time-lapse Monitoring

Genetic Screening

Genetic screening (PGD/PGS) detects possible genetic diseases, and can assess embryos for probability of pregnancy success.

Genetic Screening

Getting ready for transfer

Scheduling Embryo Transfer

The decision about when to complete the embryo transfer will depend on the number and quality of your embryos.


Embryo Transfer

Embryo Transfer

The procedure can feel like a smear test, but it takes longer: around 15 minutes. A tiny drop of culture medium containing one or two embryos is carefully deposited in the uterus using a thin catheter.

eSet

If you decided before treatment to store any further good quality embryos for further cycles, you’ll be consulted again, and it will happen at this stage.


The Wait

The Wait

We appreciate how difficult this ‘two-week’ wait can be. Please call us at anytime if you are concerned – no worry is too small. It’s a good idea to make plans for after embryo transfer, to help you feel more in control: try to live life as normally as possible.


Outcome

Outcome

The UK average success rate for an IVF treatment cycle is around 30%. The treatment journey can be made up of a number of cycles and frozen embryo transfers. The good news is that these will add up; the more cycles you go through, the greater your chances of success.

Around 17 days after egg collection you will need to take a pregnancy test.

 

Outcome

Positive Test

If you’re pregnant, we schedule a scan in the clinic at around 6-8 weeks. If everything looks OK, you’re discharged to your GP.

Negative Test

If your period arrives before the test is due, or the test is negative, rest assured you are not alone.

We can meet to talk, review your treatment, and consider what the next step will be on your IVF journey. IVF conception often takes place over a number of cycles. You could be ready for a new cycle within a short time, even a couple of months if you have frozen embryos.