Frequently Asked Questions (FAQs) on Fertility

If you have never had any fertility tests/assessments done and you don’t know if you need fertility treatment, then a Couple One Stop will give you information on whether there is an issue as to why you’re struggling to conceive naturally. If you have already had various fertility tests done and know you need fertility treatment, then a new consultation would be the best option for you. A couple one stop would include all tests covered in the female one stop + a semen analysis for men.

1: A Female Mini Fertility is split into a two-part appointment and includes: 

First appointment, 30 minutes in the clinic, includes:

• Anti-Mullerian Hormone (AMH) blood test to check your ovarian reserve

Second appointment (this is booked by the nurse during your first appointment as it will be booked at a specific time of your cycle):

• Ultrasound scan with Antral Follicle Count (AFC) and a 15 minutes consultation with a fertility consultant to discuss your results.

2. A Female One Stop Fertility Assessment package is split into a two-part appointment and includes:

First appointment, 30 minutes in the clinic, includes:

• Anti-Mullerian Hormone (AMH)  to assess your ovarian reserve/inherent fertility
• Rubella – to check if you are immune to Rubella, as the disease affects an unborn child
• Full blood count – to assess your general wellbeing and rule out anaemia
• Urine test for chlamydia and gonorrhoea – easily curable sexually transmitted diseases

Second appointment (This is booked by the nurse during your first appointment as it will be booked at a specific time of your cycle) – Internal Ultrasound scan which includes:

• A detailed 3D Saline Infusion Sonogram (SIS) to assess the uterus
• Antral Follicle Count (AFC) to determine your egg reserve. This together with your AMH will give you an accurate measure of ovarian reserve.
• HyCoSy procedure to check that your fallopian tubes are open.
• We will discuss all your results during a mini consultation at this appointment.

Couple One-Stop Fertility Assessment would include all of the above and a semen analysis. For more information on Fertility Assessments visit: https://hertsandessexfertility.com/treatments/fertility-assessment/

The wait time for a New Consultation is approximately six weeks but could be up to eight weeks depending on the time of year.

1. Call the clinic directly to book your New Consultation on 01992-785060.
2. Pre-assessment – Initially, you will need a pre-assessment appointment with the nurse. At this appointment, we will check your BMI (Body Mass Index) and do a blood test to check your AMH Level (Anti-Mullerian Hormone). The AMH blood test checks your ovarian reserve and can be done at any time in your cycle. A semen analysis, will be done for all men.
3. New Consultation – Once we have performed these initial tests you will then see one of our consultants remotely via Microsoft Teams approx. one week later, to discuss your results and create a treatment plan going forward.
4. TIA – If the consultant has recommended fertility treatment, you will then see one of our fertility specialist nurses for an online Treatment Information Appointment (TIA) via Microsoft Teams. During this appointment, you will need to sign all your consent forms for the type of treatment you are having and plan your cycle of treatment from start to finish.

It takes approximately two to three months from start to finish. A short protocol will take around four weeks in total from starting medication to the pregnancy test result.  See a typical timeline for IVF with ICSI: https://hertsandessexfertility.com/treatments/treatment-journey/

No, the test can be done at any time of your cycle. For more info on AMH see: https://hertsandessexfertility.com/anti-mullerian-hormone-amh-test-demystified/

When someone is providing eggs for IVF, we have a BMI limit of 34 for any patients (male or female) requiring sedation when undergoing egg collection, embryo transfer or surgical sperm retrieval. Ideally, you want to be below 34 at the start of stimulation as it is common to gain some weight during a treatment cycle.

We do not have a BMI limit for IUI. For egg recipients and IUI patients, we advise getting their BMI ideally below 40 to minimise risks of diabetes and hypertensive disorders in pregnancy. However, as there is no anaesthetic involved in treatment, patients can have IUI as long as they have been informed to lose weight (unlike IVF when they strictly have to lose weight otherwise we will not collect eggs.)

We can treat patients with their own eggs up until their 46^th birthday, and with donated eggs up until their 51^st birthday.

Eggs can be donated anonymously up until their 36^th birthday and sperm can be donated anonymously up until their 46^th birthday – as per HFEA guidelines.

With IUI, sperm is introduced into the womb by means of a small procedure at the time of the cycle when the woman is ovulating and then the egg is released naturally from the woman with the hope that the sperm and egg will meet and form an embryo.

With IVF the person providing eggs has to take medication to grow several follicles, the eggs are removed from the body during an egg collection procedure and then fertilised with the sperm in the laboratory. The fertilised egg and sperm then form an embryo which is placed back into the womb a few days later. For a same-sex female couple where the lady has normal fertility levels and patent fallopian tubes, it may be an option to try IUI first as it is less invasive and less expensive.

ICSI is a specific method used in the laboratory to fertilise the eggs. Unlike standard IVF, where the sperm and eggs are mixed together to allow the sperm to fertilise the eggs, in ICSI an individual sperm is injected directly into each suitable egg. ICSI is recommended to patients based on their medical history and test results and would be discussed with you at your new consultation appointment with a doctor.

PICSI is a very similar process to ICSI. There is an additional sperm election method which is used to choose sperm which are most likely to be mature. As with ICSI this is recommended based on your medical history and test results and will be discussed with you at your new consultation appointment with a doctor.

Costs are approximate numbers only and may vary on a case by case basis depending on personal circumstances and individual medical needs. These costs do not include medication.

IUI = £1,150
IVF = £3,800
ICSI = £5,000
PICSI = £5,350

For more detailed information on costs see our price list: https://hertsandessexfertility.com/price-list/

Access Fertility offers patients two IVF funding packages which provide:

• A fixed cost for treatment
• Potential cost of treatment reduced by up to a third
• Up to a 100% refund

These financial packages are offered completely independently of Herts & Essex Fertility and do not affect any clinical decisions or the quality of care that we offer during your treatment. For more info:

https://hertsandessexfertility.com/access-fertility/

FBC, HB electrophoresis, AMH, Rubella, Thyroid profile, Chlamydia & Gonorrhea (urine)

Not necessarily, we would not ask you to repeat certain tests you have already done, depending on the tests or when they were done. The AMH blood test remains valid for one year.

Both, patient and partner will need to be screened before commencing treatment. This is a requirement from the HFEA.

The following screening blood tests are needed for both, patients and partners:

Patient:

• Full Blood Count
• HIV
• Hep B (Core and Surface Antigen)
• Hep C
• Chlamydia
• Gonorrhoea
• Rubella
• Hb Electrophoresis

Partner:

• HIV
• Hep B (Core and Surface Antigen)
• Hep C
• Chlamydia
• Gonorrhoea

These blood tests are valid for three months up until the point of egg collection and then they are valid for two years. If you don’t have an egg collection after this three month period, these blood tests will need to be repeated again.

If you decide to have these blood tests done externally or have had them done at a previous clinic and they are in date, we will need to check that the blood tests have been performed in a UKAS Accredited Laboratory. If they haven’t, then as a clinic we cannot accept them and they will need to be done again. Treatment cannot commence until we have the results from these blood tests in place.

Yes, we would require a repeat semen analysis before embarking on treatment. This is because when assessing semen to determine its suitability for each of the treatment types available at Herts & Essex, we perform additional tests and analyses to a different criteria than is used in a standard semen analysis.

Please don’t panic, place your medication in the fridge as soon as possible if we have advised you to do so and call the clinic for further advice. It all depends on the temperature at the time and where the drugs have been stored – we can offer you further advice and instruction when you call the nursing team.

Once you have started your IVF medication you must make sure to use barrier methods of contraception when you have intercourse. We advise that you continue to use barrier methods throughout your treatment, up until your first scan following embryo transfer.

We have sperm immediately available in our sperm bank for all fertility treatments with the exception of IUI. You can also use sperm from external sperm banks such as London Sperm Bank, Xytex and Cryos. Importing sperm from external banks can take different lengths of time dependent on the bank.

Our waiting list for donor eggs is currently around six+ months.   For more information on egg and sperm donation see: https://hertsandessexfertility.com/donation/

A HyCoSy, HSG and Aqua scan are not the same thing.

Aqua Scan is a Saline Infusion Sonography that assesses the cavity of a patient’s womb. It helps to confirm or exclude things like polyps, cysts or fibroids in the uterus that shouldn’t be there and could potentially affect embryos from implanting.

HyCoSy will assess the cavity of your womb but also your tubal patency. Tubal blockage is the cause of infertility in three out of ten couples.

HSG is usually done in an x-ray department by a radiologist. This is a test to assess tubal patency using a dye which is visible on x-ray. This test is not available at Herts & Essex Fertility Centre.

Yes, we do treat patients with PCOS. For more information visit: https://hertsandessexfertility.com/what-women-need-to-know-about-polycystic-ovary-syndrome-pcos/

Also see the article written by our dietitian, Alex Ballard on PCOS and Symptom Management:

https://www.alextalksdiet.com/_files/ugd/84b348_769b0e29bd7c4e7d940e021c55254959.pdf

Yes, we do treat women with Endometriosis. For more information visit: https://hertsandessexfertility.com/all-about-endometriosis-and-infertility/

No, we don’t use an Embryoscope, however we use undisturbed continuous closed culture, which is the same culture conditions as the Embryoscope.

The current survival rate for frozen embryos is 98% and the clinical pregnancy rate is 38%.

At present only a small number of patients who have frozen their eggs have returned to use them. So we do not have long-term follow-up data, but for those who have returned, we currently have a survival rate of over 80% after thawing, which is in line with published rates from other clinics. (as of 29/09/2022)

Yes, we do. Please call the clinic to speak with one of our egg donation specialists so we can give you detailed information about this. Factors to consider when looking at egg donation and egg sharing are:

• Aged between 18 and 35
• AMH of 15 or above
• Fit and healthy within normal limits of weight and height
• No family history of inherited diseases, genetic disorders or any serious mental health issue

For more information on egg donation and egg sharing visit: https://hertsandessexfertility.com/donation/egg-donation/

Yes, we are now allowing partners to attend appointments with patients but unfortunately no children. However, if they have Covid symptoms or test positive then they should not come into the clinic as with any other viral illness.

No, you no longer need to wear masks or social distance in the clinic.

No, you don’t have to do a Covid-19 test before you visit the clinic.

You can have your hair colored whilst having treatment. You are unable to have your hair dyed once you have had your embryo transfer and through the first trimester of pregnancy.

Yes, you can go to a spa and have a massage whilst having treatment. After egg collection, it would be advisable to avoid these for one week due to the increased risk of infection.

There’s little research on using saunas, Jacuzzis, hot tubs and steam rooms during pregnancy. But it’s advisable to avoid them because of the risks of overheating, dehydration and fainting. You’re likely to feel warmer than normal during pregnancy.

Please check with your therapist as some essential oils used for massage are not safe to use in early pregnancy.

Yes, you can have a tattoo during your treatment. However please bear in mind any procedure like this can increase the risk of infection. We do not advise you to have a tattoo after your embryo transfer.

Once pregnant, although the risk is small, it is recommended that you wait to get a tattoo until after your baby is born. Little information is available about the safety of skin dyes used for tattooing during pregnancy. It is possible that the chemicals in the dye might affect the development of the baby during the first 12 weeks.

As a clinic, we don’t offer advice on complementary therapies such as acupuncture of reflexology. We ask that you do your own research and make an informed decision on whether you think this will help/benefit your treatment.

Should you wish to consider any of these alternative therapies, you could find more information about them on the HFEA website: HFEA Complimentary and Alternative Therapies

Alternatively, if you are particularly interested in acupuncture, you could visit The British Acupuncture Council (BAcC) website and search for a registered acupuncturist using your postcode.