Before coming to our clinic for treatment, many patients wish to know what the treatment process involves and what to expect from treatment. We have therefore put together this summary of the average patient journey. Of course every patient is different and as we specifically tailor treatment your experience may be a little different, but the outline below describes the typical route for our patient. Due to our policy of using only the minimum amount of drugs required, the length of treatment is considerably shorter than other clinics at only 2 weeks.
This hour long consultation includes a detailed scan of the female partner and a consultation where full medical histories are taken and a personalised treatment plan created. We believe that diagnosis is very important in devising the appropriate treatment plan. We have therefore invested in training our Doctors to perform advanced ultrasound techniques and we use the most cutting edge ultrasound machines. Our ultrasound scans look at the ovaries and womb, your ovarian reserve and the blood flow to ovaries and womb, as well as using 3D Doppler to check for obstructions such as cysts or polyps. The results of this scan along with the medical history will then inform the doctor as to which treatment is most suitable. They will discuss this with you and answer any questions you may have. The treatments are individualised and tailored to your individual circumstances. They tend to fall into the following categories: IUI (injecting the sperm directly into the womb), Natural IVF (IVF with no stimulating drugs, aiming to collect a single high-quality egg), Natural Modified IVF (IVF with very low doses of stimulating drugs) and Mild IVF (IVF with a short course of stimulating drugs).
This appointment is with a nurse. If you are having treatment with a partner, they will need to attend as well. The nurse will go through the treatment plan with you, and tell you the timings of your appointments for the cycle. They will also dispense any medication that you might need and teach you how to use it. They will also go through any outstanding questions on consent forms and check your screening results are in order. If you are having treatment with donor eggs/sperm, you will fill in a donor matching form and our donor co-ordinator will help to match you with a donor. This is also a great time to ask as many questions as you need to about the treatment process.
Your cycle will be closely monitored with scans and blood tests which will allow doctors to track the maturation of the follicles and tailor your treatment accordingly. Patients ring up on the first day of the woman’s period to arrange the first scan, and most go on to have 2 or 3 over the course of about a week depending on individual circumstances, usually spaced 2 days apart (e.g. day 5, day 7 and day 9). Each scan lasts 20 minutes. The doctor will decide at the scan whether or not you need a blood test. These blood tests check your oestrogen and LH levels, which are hormones that help to assess the maturity of your follicles. By looking at the scans and blood test results, the doctor will be able to keep a close eye on the size of the growing follicles and the lining of womb and determine the right time to collect the eggs.
For those patients undergoing IVF with their own eggs, an egg collection is performed to retrieve the egg(s) from the ovaries. The day and timing of the egg collection depend on the size of your follicles and the rate at which they are growing. This will be carefully scheduled depending on when your eggs are mature and ready for collection, and one of our doctors or nurses will call you and arrange a suitable time for egg collection. You will then take a trigger injection prior to this time (depending on your treatment protocol), to prepare your eggs for collection. The procedure itself takes place in the theatre under sedation, so a friend or partner will need to accompany you home and you will be expected to fast before the procedure. The doctor will pass a transvaginal ultrasound probe and a fine needle through the vaginal wall into your ovary to collect the eggs. The procedure takes around 45 minutes and most patients cannot feel anything during egg collection. You will be told how many eggs were collected as soon as you wake from the sedation.
Following the egg collection, the eggs will be fertilised in the laboratory by our team of embryologists. Usually the eggs and sperm are left in a petri dish to fertilise, but some patients will require ICSI (where the sperm is injected directly into the egg) if there are suspected fertilisation problems, such as male factor infertility or previous abnormal fertilisations. The embryology team will call the day after the egg collection and inform you of how many eggs have successfully fertilised and will grade them depending on quality.
When the embryos are ready, they are transferred back into the woman. Our team of embryologists will liaise with you and choose the highest quality embryos for embryo transfer. This procedure usually occurs around two or three days after egg collection depending on the state of the embryos. It does not require sedation and feels similar to a smear test.
2 weeks after the egg collection, you will have a pregnancy blood test which looks at the level of Beta hCG (a pregnancy hormone) in your blood. One of our nurses will call you with the results, usually later the same day or the next day and if this is positive you will be given an early pregnancy scan 4 weeks later.