About the Reproductive Medicine Unit
The waiting times vary depending on the clinic, the availability of that clinic and whether your test results are required for booking. If you have been referred to the RMU but have not heard from us for several months, please get in touch with the hospital’s Contact Centre (via the switchboard) so make sure your referral has been processed.
You can help keep our waiting times down by informing us if you are unable to attend an appointment. That way, we can offer it to someone else.
We would always recommend bringing your partner to your clinic appointments. Both partners need to answer questions, have tests etc and it is important that they both understand the treatments, have the opportunity to ask questions and are part of the decision making process. This is often a stressful time for couples, and understanding and support in the relationship is obviously of benefit. If your partner is unable to attend it may delay treatment, for example if they need tests performing another time or if we find something out about their history later on which needs exploring further. We do appreciate that getting time off work can be difficult, and for some appointments (e.g. scans and blood tests) it is less important.
Yes. Our counsellor Carmel Dennehy is available to see all patients undergoing treatment in RMU. A member of the RMU team can refer you, or you can refer yourself by emailing Carmel at: Carmel.Dennehy@uclh.nhs.uk. Once your initial appointment is arranged you need to arrange all your future appointments via the call centre as follows:
(a) Ask the reception staff at the RMU (EGA Floor -1, Clinic 1)
(b) Telephone the outpatients team 020 3447 9759 I 020 3447 9411 I 020 3447 7014 I 020 3447 9393 Please state the clinic code ES1F2.
Here is further information about our RMU counselling Service: https://www.uclh.nhs.uk/our-services/find-service/womens-health-1/gynaecology/reproductive-medicine-unit/counselling-service-information
This can vary depending on the number of referrals made to the unit.
Usually, but it does vary slightly depending on the treatment required, what treatment you have had in the past and also the area in which your GP is based (i.e. which care commissioning group or “CCG” they belong to). Other requirements include things like that the women is under 40 years old, has a BMI of less than 30 and that both partners are non-smokers. If you are not sure if you will qualify for funded treatment your GP should be able to advise you.
Once you have been assessed in clinic, a management plan agreed and you have completed all the appropriate consent forms we will apply for funding from your CCG on your behalf. It may take them up to 6 weeks for them to respond. We cannot start treatment before funding is confirmed.
About fertility investigations
A diagnostic scan is an ultrasound scan performed before about day 5 of the menstrual period. This is a time just as menstrual flow slows down and the ovaries are usually quiet. This scan is performed to evaluate the pelvis. The womb, the ovaries, the number of resting follicles (antral follicles) within the ovaries, the location of the ovaries, evidence of any adhesions (organs sticking to one another from previous infection or surgery), any suggestion of swollen fallopian tubes, endometriosis etc. are evaluated.. It is normally performed vaginally with an empty bladder.
A baseline scan is the scan done at the start of a treatment cycle to check that everything is optimum to start.
We have a mix of highly skilled male and female staff performing ultrasound scans in the RMU. It is not possible to request to be scanned by females only, however a chaperone is always present during the procedure.
The hormone tests are blood tests. The timing of these tests are based on which hormones are being tested. Follicle stimulating hormone (FSH), Luteinising hormone (LH) and oestradiol are often tested together on days 2 to day 4 of the period.
This is because the concentrations of these hormones vary depending on the time of your cycle. The medical staff will advise you on the timing of the tests. Most others can be done at any time of the cycle, but you may want to have them at the same time as FSH and LH so they can all be done at once.
You may be asked to repeat tests if they are more than 6 months old. This is so there is an up to date evaluation, which is important for decisions regarding doses and protocol of treatment. If there was an abnormality or the test was done in another lab it may be necessary to repeat the test.
Women are born with a fixed number of eggs which depletes with time. As this depletes the chances of pregnancy go down and the chances of miscarriage go up. An evaluation of this “ovarian reserve” is performed taking into account the patient’s age as well as assessment of FSH, an ultrasound count of antral follicles (resting follicles) and another hormone called anti-mullerian hormone (AMH).
It is not normal practice to give out results over the phone. This is because appropriate explanation and counselling is difficult over the phone. In exceptional circumstances, the doctor or nurse specialist may call you about your results and advise you on what to do next.
Clinical queries are best discussed in person at consultation. We would not encourage you to use email for any urgent queries as they do not go to the relevant person immediately. Also, the doctor or nurse specialist to whom you are directing your query may for various reasons not be in a position to receive or deal with your query. For an urgent matter, please use the phone.
In general investigations for self-funded treatment should be organised through that clinic. In exceptional circumstances it may be possible to organise some tests through the NHS, but standard procedures and waiting times apply. It is not possible to arrange tests “to fit in” with treatment elsewhere, or tests which we do not offer in this unit.
About the do’s and don’ts of fertility treatment
Paracetamol is safe both during your treatment and during pregnancy. Please do not take any other painkillers without asking us.
There is some evidence that both caffeine (in large amounts) and alcohol may decrease the chances of successful treatment, and increase the risk of miscarriage. Therefore we would recommend both are kept to a minimum
Because of the effect of stimulation on your ovaries (they become enlarged) we recommend gentle exercise only e.g. walking.
It is fine to use normal hair dyes during treatment or pregnancy, and swimming is also fine (but dirty water should obviously be avoided).
Once in treatment you need to be closely monitored, and as such need to be available for scans and blood tests at short notice. It is fine to fly in early pregnancy, but many people choose to wait until after they have had their first scan. The nurses can provide you with a letter explaining your need for needles and syringes.
We recommend a healthy, balanced diet and lifestyle. Criteria for treatment includes no smoking or heavy drinking as both could adversely affect treatment outcome.
About IVF treatment
Usually the first test is the ovarian reserve test (ORT), which involves an ultrasound scan and a blood test. This test is sometimes described as assessing the number of eggs in the ovary. It helps predict how your ovaries will respond to the stimulation part of IVF. It helps to identify those who are at risk of developing Ovarian Hyper-stimulation Syndrome (OHSS – a potentially serious complication of IVF, causing symptoms in up to 5% of IVF cycles) as well as those who may not respond adequately. Having an adequate ovarian reserve test is one of the eligibility criteria for funding for IVF treatment.
You are also likely to be asked to have a dummy (or practice) embryo transfer and a special scan to assess the cavity of the womb, called a 3 dimensional saline infusion sonogram (3D-SIS). These 2 tests are usually done together, in a cycle after the ORT. You will be given written information about these tests when you come to clinic.
You will also be offered an appointment to attend our Patient Information Talk. This is a group session, lasting about 90 minutes, when you will be given more detailed information about IVF and the processes it involves. We also hope that the Talk will help you to understand the potential risks as well as benefits of treatment. The Talk is held once a month and both partners are recommended to attend.
It depends on you individual case and response to the medications, but once stimulation commences most people need scans and blood tests on alternate days for at least 2 weeks. However, it is not uncommon to need to attend every day. Prior to starting the IVF cycle itself you are likely to need several visits for clinics, investigations, information sessions etc.
The length of time varies according to both your individual protocol (decided by your clinician) and your individual response. In general you need stimulation injections for 10 to12 days. After embryo transfer you will start at least 1 other injection, and if you get pregnant this usually continues up until 12 weeks of pregnancy.
Everyone reacts differently to medication. The most common reported reactions are bloating, headache, injection site reactions and abdominal tenderness. Please keep well hydrated throughout your treatment cycle and do not hesitate to seek medical advice if you are concerned.
We encourage frequent ejaculation every 2-3 days prior to the production of the sperm sample (which is on the day of egg collection), but this should be protected sexual intercourse with a condom. After egg collection and during the 2 week wait until your pregnancy test you should abstain from sexual intercourse.
If inserted correctly it probably makes no difference which way it is used, but prior to the embryo transfer we prefer it is given rectally to help keep the vagina clean. Many women find it easier to use vaginally that rectally, and therefore choose this route after transfer.
Spotting after embryo transfer is very common, please continue with your medication and contact the nurses for advice.
If you have good quality surplus embryos you may decide to freeze them for use if the first cycle is unsuccessful, or if you would like to expand your family at a later date. The NHS does not fund IVF for another child within the relationship, and a frozen-thawed cycle is much cheaper, easier and safer than another whole fresh cycle. The success rates of fresh and frozen cycles are similar.
We work with The Centre for Reproductive and Genetic Health so our statistic is reflected in theirs. The most up to date success rates are on the HFEA website.
We normally recommend at least 1 or 2 normal periods before a second cycle. This allows your body (especially your ovaries) to return to normal, and the team to assess your previous cycle to see if anything needs to be done differently the next time around. We would like to see you in clinic to discuss the previous and next cycle, and unfortunately depending on work load there may be a wait for this.
About our other fertility treatments
This is an appointment to see the Clinical Nurse Specialists who organise the ovulation induction (OI) and superovulation (SO) and intrauterine insemination (IUI) treatments. They will provide information about the diagnosis, test results and treatment and ask you to complete some consent forms.
About the Andrology Laboratory
Call the Fertility Laboratory on 0203 447 9436 or email firstname.lastname@example.org. Please have your hospital number available.
The patient must bring a referral form, and abstain from sexual activity for between 3 to 5 days unless otherwise advised by a doctor.
Usual practice is for referral forms to be sent directly to the fertility lab by the doctor treating you. The law requires everybody who stores sperm samples to be tested for viruses such as hepatitis B, Hepatitis C and HIV. These tests are often arranged by your doctor at the time of discussion about sperm storage. Once the Fertility Laboratory has received your referral details and the results of your blood tests, an appointment will be booked for you.
Most appointments will take between 1 and a half to 2 hours. When you turn up to your appointment, you will be asked to fill in a set of consent forms which a member of the lab team will need to go through with you. You will then be asked to produce a sample.
Photo ID will be required and sexual abstinence for a period of 3 to 5 days is needed unless a doctor has advised you otherwise.
You are welcome to produce the sample at home, but it must be brought to the laboratory within one hour of collection. Whether you choose to produce at home or at the lab, you must make an appointment. Failure to do so could mean that your sample will not be processed.
We will return your results to your referring doctor. It is important that your doctor gives you the results to enable you to have a full consultation with the clinician. We regret we are unable to discuss your results with you.
About contacting the Unit
Our phone lines are extremely busy and we understand it can be frustrating when you can’t get through. You can help us return your call quickly by leaving us just one clear message, including your name date of birth and hospital number and the brief nature of your call. If there are times that you are unable to receive a call back, please mention that too. We will call you back as soon as possible; however sometimes it is necessary to prioritise the most medically urgent queries. We try to return all calls in 24 hours, but unless it is urgent please give us up to 48 hours to get back to you. We appreciate your understanding.
To protect the confidentiality of your medical information it is not advisable to discuss clinical information via email. You are welcome to write with a general query, but please note that your message may not be picked up and returned immediately.