Many years of experience have provided insight into questions you may have at different stages of your journey.
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Is there a finance package available to help with the costs of fertility treatment?
Yes. Bath Fertility offers the Access Fertility package. This offers you a prepay multi-cycle plan (2 cycles) at lower cost than paying for each cycle individually. There is also an IVF refund package, (3 cycles) where eligible patients receive up to a 100% refund if they do not have a baby.
Both plans offer a significant saving compared to paying for treatment as you go if you end up needing more than one cycle to achieve a pregnancy.
Payment plans are also available to Bath Fertility patients through Access Fertility.
How much will my treatment cost and what is included? Am I entitled to be funded by the NHS? And for how many cycles?
You can either call us on 01761 434 464 or alternatively check with your GP surgery on whether you are eligible for NHS funding and how many cycles are covered as this will vary from CCG (clinical commissioning group).
If you are not eligible for NHS funding then please see our comprehensive self-funding price list at http://www.bathfertility.com/costs/ which shows exactly what will be covered in each treatment.
How long should we be trying for a baby before we get referred to an expert?
It is usually recommended that a couple actively try for a family for 12 months before seeking advice or referral from their GP. If there are known factors that could be causing difficulty conceiving or if the female is in the older age range it may be sensible to visit their GP earlier.
I am over 40. Can you help me get pregnant?
We have some of the South West’s highest pregnancy success rates for over 40s. We’ll be completely open and realistic with you about which of our treatments offer you the best chance of success. We will only ever recommend treatment that suits your needs, with complete cost transparency at all times. To find out more, view our page Fertility for over 40s
Do I have to get a referral from my GP to come to you?
Self-funded patients are able to refer themselves directly to Bath Fertility, but we always recommend asking your GP for a referral letter as they are able to furnish us with a detailed medical history. You will need to be referred by your GP if you are wishing to be seen as an NHS patient.
When do I have to pay for the treatment?
You will be invoiced 2 weeks before the start of your treatment cycle and payment is due before treatment can begin.
How do we know you are the right fertility clinic for us?
We have some of the best success rates in the South West. We are a close professional team based in our state of the art medical facilities which we opened in 2013 having moved from our original older premises at the Royal United Hospital.
98% of patients who completed our patient satisfaction feedback would recommend us to friends and family, this includes patients who have not had a successful outcome.
Our team are delighted to answer any questions that you may have either over the phone or please come to one our regular open evenings to meet the team.
How do I come to an open evening and do I have to pay?
We hold regular open evenings which are free to attend. You will have a opportunity to look around the clinic, meet staff and have a ten minutes one-on-one discussion about your particular concerns and the chance to ask any questions you may have.
How long do I have to wait for my first consultation and treatment to start?
There is a short waiting time from calling to make your appointment to seeing a doctor but you are more than welcome to come to one of our open evenings to meet the team during this time. You will then normally start your treatment on your next cycle although in some cases, depending on timing, you may be able to start treatment immediately.
What are the steps in my IVF pathway?
Please see initial steps – what to expect.
How much time do I need to take off work?
We understand the difficulty of fitting IVF treatment in with your work commitments. The initial consultation usually takes one hour which includes a scan.
When you actually start your treatment there will be a minimum of two further scans each of which you should allow about half an hour.
For egg collection you will need a whole day off work as you will be receiving sedation, and if possible you might like the following day off too.
For embryo transfer you will need to be at the clinic for an hour and should take half a day off work.
Do you offer time-lapse monitoring?
Yes, time-lapse monitoring is available at Bath Fertility Clinic and can be used to help identify the strongest embryos for transfer.
We use the Primo-Vision system and have five cameras in the incubators in our laboratory, and these are booked on a first-come, first-served basis. There is a charge for this additional monitoring technique.
Can NHS patients have the extra treatments such as time-lapse monitoring?
Yes, NHS patients are able to have this extra treatments. However they are not covered by the NHS contracts with the CCGs and if you would like them there will be a supplementary charge.
What new technologies are available in your clinic?
We are always keen to offer the latest, proven, technologies and treatments which help us maintain our excellent success rates. We have a range of advanced techniques available including time-lapse monitoring, blastocyst culture, embryo vitrification and laser assisted hatching.
The laboratory procedures are regulated by an electronic witnessing system for safety.
I don’t understand all the terminology – what does it mean?
We appreciate that there are many terms used in fertility treatment that you may not recognise. We have created a Glossary of Fertility Terms to help you.
Do you have any tips to help us cope with our fertility issues?
Approximately 1 in 6 couples may experience challenges when trying to conceive and it can be a very emotional time. We have produced a leaflet “Coping with Fertility Issues” that gives some tips on helping to cope with fertility issues
What happens if my partner is unable to produce a semen sample on the day of egg collection?
Although it is very rare for the partner to be unable to produce the semen to fertilise the eggs on the day of egg retrieval it does sometimes happen. In this case it is possible to perform a surgical sperm retrieval. Usually the process will change from IVF to ICSI as there will be a smaller amount of sperm for egg fertilisation. The other alternative is to freeze the collected eggs and fertilise at a later date.
We can offer the use of Sildenafil (Viagra) if needed, and sometimes it may be appropriate to allow sperm production at home.
Do you treat lesbian couples and single women who wish to become parents?
We believe that everyone should have the opportunity to become a parent and we regularly treat single women and same sex couples.
Can you help me find a surrogate?
Although treatment must be carried out by HFEA-licensed fertility clinics, we are not permitted to recruit surrogate mothers on your behalf, so you must find your own. Contacting the organisations COTS (Childlessness Overcome through Surrogacy) or Surrogacy UK would be a good starting point for advice on how to do this.
Will the donor's identity be known to the recipients of treatment, or to any resulting children?
When fertility treatments involve the use of donor sperm, eggs or embryos, we are required to collect and pass on information about the donor, recipient and treatment cycle to the HFEA, for its confidential register. The purpose of this register is to allow people conceived through donation to find out who the donor was, once they reach 18. The identity of the donor is not released to the recipient(s).
Will the donor be legally responsible for any children born as a result of donation?
Providing the donation is through an HFEA licensed clinic, the person donating will not be the legal parent of any child born, and will have no obligations to or rights over that child. Recipients of donations will become the legal parents.
Can a donor change their mind?
Donors are asked to consent to the use and storage of their donated material, but have the right to change their mind and withdraw from donation at any stage up until embryo transfer or insemination.
How many eggs will I get?
The number of eggs that are collected per cycle can be variable, depending on your age and medical history but we aim to obtain 10 – 12 per egg collection.
Will I feel the egg collection?
The egg collection takes 10 – 15 minutes and you will be given adequate pain relief and sedation.
Temporary amnesia is quite common afterwards as a result of the sedation.
Do I need sedation for the transfer?
No, sedation is not required for the transfer.
When will I have my embryo(s) transfer?
We transfer the embryo(s) 2 – 5 days after egg collection.
How do you know which embryo(s) to transfer into the womb?
All embryos are graded on a daily basis which helps up select those that are making the best progress and therefore more likely to result in a pregnancy.
How many embryos will have transferred back?
We normally aim for a single embryo transfer but older patients or those having more difficulty will be permitted two embryos. Occasionally we can transfer three embryos (the maximum permitted) in women over the age of 39.
Can I take painkillers?
Yes, you may take simple pain relief post procedure. It is also alright to take before treatment. We advise taking only paracetamol.
Can I take hay fever medication?
Yes, it is fine to take hay fever medication.
Do I need a Doctor’s note?
No, you will not require a doctor’s note whilst undergoing treatment.
What exercise can I take?
Pre-egg collection it is fine to take moderate exercise. Post-egg collection you should ease off and avoid swimming but walking is excellent for you to do Any form of exercise that causes breathlessness should be avoided in the run up to egg collection and immediately afterwards.
It is fine to continue to have a normal sex life during the process.
How soon after an IVF failed cycle (negative pregnancy result) could I try again?
Depending on how you are feeling emotionally it is possible to start treatment again on your following menstrual cycle but if you wish to wait for a period of time that is perfectly acceptable.
Is there any risk/side effects of having IVF/ICSI treatment?
As with any medical procedures, there are associated risks. These will be explained to you by your consultant and you will be given information to take home.
Complications are infrequent but you will be advised of the small risk of Hyperstimulation associated with IVF.
What should my BMI be to have fertility treatment?
An ideal BMI would be 18 – 30 .
However, we do not have any restrictions. We would deal with patients case by case.
Does acupuncture/other holistic therapies help/improve my chances of getting pregnant? Would you recommend I should try similar treatment?
Although there are no holistic therapies that we recommend, we would not advise against them as we feel that is very much a personal preference. There is no indication that these therapies affect the success rates of IVF.
We do not recommend Chinese medicine as its effects on IVF have not been validated and the treatments are often unregulated.
What happens if I have a serious cold/infection during or before my treatment? Who shall I talk to?
Having a serious cold/infection during or before your treatment should not affect your treatment plan. If you have any concerns please speak to one of our nurses.
If you have flu, with significant rise in temperature, this can compromise an IVF cycle for both partners.
When flu is prevalent you may wish to consider getting a flu vaccination.
Should I have the flu vaccination whilst receiving fertility treatment or if I become pregnant?
Please click here to see information from The Royal College of Obstetricians and Gynaecologists
Can I return any unused drugs? Can I return the drugs that I haven’t used and be refunded accordingly?
No, we are afraid that this is not possible.
Can I freeze my eggs?
Yes, we offer an egg freezing service for patients who have either a personal or medical reason for requiring this treatment.
We use the latest vitrification technique.
Do you offer Intralipid Infusions in IVF treatment which I read about in the news a while ago?
We don’t currently offer intralipid infusions. Please see our article on this subject.
The Royal College of Obstetricians and Gynaecologists has recently issued guidance warning of the risks of this untested therapy.
What is AMH and how does it indicate a patient’s egg reserve?
Anti-mullerian hormone (AMH) is used in conjunction with menstrual FSH to give a guide to a woman’s ovarian reserve when assessing their fertility potential.
It is produced by the granulosa cells in the small ovarian follicles, the highest amount being produced when the follicles are less than 4mm in diameter. Production of the hormone ceases once the follicles reach 8mm.
With increasing female age, the size of their pool of remaining microscopic follicles decreases. Likewise, their blood AMH levels and the number of ovarian antral follicles visible on ultrasound also decreases.
Women with many small follicles, such as those with polycystic ovaries have high AMH hormone values and women that have few remaining follicles and those that are close to menopause have low anti-Mullerian hormone levels.
The amount of follicles remaining in her ovaries is referred to as “ovarian reserve”.
Unfortunately even if a blood test indicates that the woman has a high level of dormant follicle this does not necessarily mean that the eggs will be of a high quality. Patients with high AMH results tend to respond better to ovulation stimulation for IVF therefore giving us a greater pool of eggs to fertilise which in turn leads to higher pregnancy rates.
However a low AMH does not mean poor egg quality and even if there are fewer eggs, pregnancy can still result.
We can carry out an AMH blood test, if necessary, as part of our investigations at Bath Fertility prior to undergoing IVF to give us some information about the likely response to medication. In many cases however, the ovarian appearance and menstrual FSH give us sufficient reassurance about likely response to therapy.
As there are follicles of varying maturity in the ovaries it means that the AMH test can be done on any day of the menstrual cycle as the levels do not fluctuate.
When should a GP test for AMH?
The test is expensive (£50 per test) and the samples are sent to Glasgow for analysis taking up to 4 weeks for results. We do not recommend that GP’s routinely undertake this test. When an FSH taken in primary care is raised and the comment ‘Recommend prompt referral to the fertility services’, we may undertake an AMH at your consultation.
What areas of the South West do you cover?
Our success rates mean we attract patients from all over the UK.
Where is Bath Fertility?
We are about 5 miles south of Bath on the A367. We are easy to get to and we provide plenty of free parking.
Do you offer weekend and evening appointments?
At the moment we are able to offer appointments during regular working hours and we do have some early evening appointments. We are not currently able to offer weekend appointments.
What percentage of men experience fertility problems?
Up to 20% of men in the UK have either a low sperm count or poor quality sperm so it is far more common than most people assume.
While women may talk about their fertility issues in quite an open manner, men often feel that they can’t discuss their low sperm count in the same way, as many people mistakenly think that this is linked to a man’s virility which is incorrect.
Of the couples who seek medical help to achieve a pregnancy – in one third of cases this will be due to male factor infertility.
We offer on-site counselling to any patient who attends Bath Fertility Centre. Many men find it helpful to be able to discuss their fertility problems with a professional counsellor.
What can Bath Fertility offer to help if I have a low sperm count?
We have helped many men become fathers and can offer the latest advanced procedures including Sperm DNA fragmentation, hormone tests, genetic or chromosomal analysis or surgical retrieval of sperm and chromosomal tests.
Can I help increase my sperm count?
There are various things that you can do to help increase your sperm count. The main two are to give up smoking and cut back on your alcohol intake. Avoid drugs such as marijuana, and other recreational drugs, as these can affect the quality of your sperm and decrease your sperm count.
Use of anabolic steroids is always detrimental to sperm production, and the use of “supplements”, “protein shakes” etc for body building is not always safe, as they are not always “clean”.
You may also take some vitamin and mineral supplements , the main ones being Vitamin C & Vitamin E and Selenium and Zinc. There are a number of proprietary preparations containing these ingredients plus others, which can be helpful.
Frequency of intercourse is also important – essentially there is no upper limit. Regular intercourse is essential for two reasons: firstly to make sure that sperm and egg meet during the short fertile “window”; secondly the quality of sperm improves with regular frequent ejaculation.
Maintaining a healthy body weight and eating well will also help. You may also take some vitamin and mineral supplements such as Vitamin C & E and Zinc as this may help some men improve the quality of their sperm.
Will smoking and drinking affect my sperm count?
It has been shown that drinking excessive amounts of alcohol can affect the quality of your sperm. Government guidelines suggest that you should spread your alcohol intake over a three days or more rather than binge drink and that ideally you should not exceed 14 units per week.
Binge drinking i.e. a stag weekend are notorious for damaging sperm supply for a period of time.
If you smoke you risk reducing the quality and amount of sperm but if you give up smoking this effects are reversible.
Will my age affect my sperm count?
Your fertility will start to diminish from approximately age 40 but you will not be affected in the same way as a woman, whose fertility starts to decline from their early thirties and who is unlikely to become a mother after her mid-forties.
The majority of men are able to become fathers in their 50’s and beyond without any issue.
What happens if I can’t get an erection when I need to produce a sperm sample?
We appreciate how stressful it must be when you know that you have to produce a sperm sample on the day of IVF. It is possible for us to provide you with Viagra if necessary.
I am in the Armed Services - can I freeze my sperm before being deployed overseas?
Yes, it is possible for you to freeze your sperm. There is an annual storage charge. Please see our section Sperm Storage under Treatments.
Can we have sex whilst having IVF treatment?
Many couples find assisted conception treatments stressful. We would not wish to add to this by imposing any restrictions on your current lifestyle. The only important point that we would wish to mention is the length of abstinence from sexual activity. “Saving yourself” for too long before egg collection is not a good idea! Whilst a very short space of time (e.g. one day) between samples can decrease the sperm count, it is important to realise that too long a period of abstinence can decrease sperm motility (the percentage of sperm actually swimming). Sperm are made continually and if they are not produced regularly (a couple of times a week) this may result in a backlog of poor quality sperm.
Is there anything I can do to help my chances of conceiving?
Whilst waiting for treatment to begin many couples want to know if there is anything they can do to improve their chances. A healthy lifestyle, well-balanced diet, stopping smoking and reducing alcohol consumption may all help. Women should also be taking folic acid supplements.
How do I know my embryo(s) are in the right place?
For most patients the uterus is measured at egg collection and the transfer catheter is adjusted accordingly for each individual. Occasionally it is not possible to obtain a uterine measurement and in these cases we use a default setting of average uterine size.
Embryos are tiny at this stage (about a tenth of a millimetre) and during embryo transfer they settle down into one of the small crevices in the endometrium (lining of the uterus). Embryos do not fall out when you stand up and research has shown that bed rest following embryo transfer makes no difference to the chances of pregnancy. The embryo(s) continue to grow and hopefully will implant in a few days’ time (about 7 days after egg collection).
How can we be sure our samples or embryos won't get mixed up?
We use a state-of-the art electronic witnessing system to ensure this. We confirm a person’s identity with them when eggs or sperm are first collected and each dish or tube is labelled with that person’s name, date of birth and clinic number, together with an electronic witnessing tag. The RI Witness system then monitors every instance when sperm, eggs or embryos are transferred from one container to the next and ensures that only one patient’s samples can be worked on at a time. If we were to try and place samples from different patients in the same work area a loud alarm would sound. At embryo transfer the embryologist asks the patient to confirm her identity and check her own Witness ID card, which is electronically matched to the dish containing the embryo(s) for transfer. The culture dish lid is also double-checked by the nurse performing the embryo transfer.
Can I tell if I’m pregnant or not by my symptoms?
Remember that some symptoms like breast tenderness, bloating, tiredness and upset stomach can be caused by the drugs you are taking. You can’t really depend on your body to tell you if you are pregnant or not, so you need to wait for the test. Try not to worry about cramps and twinges – many women get these and they do not affect the chances of implantation.
When can I do a pregnancy test?
You can carry out a pregnancy test 2 weeks after the date of your embryo transfer. Some patients start to bleed before they are due to test, however you should still continue with your medication and test on the recommended day. If you have been drinking large quantities of fluid (more than 2 litres per day) it is possible that your urine may be too weak for a positive result to show, so if you have not had a period 2 days later you should carry out another test. By this time the result will be definite, whether positive or negative (if after this time the result remains negative you should stop taking the luteal support drugs). If you are uncertain about the result please do not hesitate to ring us.
What do I do if the pregnancy test is positive?
If you have a positive pregnancy test you must continue to use your luteal support drugs daily. You will need to contact the clinic to arrange collection of more luteal support drugs and to make an ultrasound scan appointment for 2 – 3 weeks time. At this stage it is best to be cautiously optimistic; miscarriages may occur at any stage in pregnancy, although they are much less common after 12 weeks. For those couples where pregnancy does occur you will need to contact your GP to arrange antenatal care.
Helpful advice about eating, drinking and exercise in early pregnancy can be found on the website www.nhs.uk/conditions/pregnancy-and-baby.
When should I stop luteal support?
If you are not pregnant you should stop taking the luteal support drugs (you should then have a period in the next few days).
If you are pregnant you need to continue with the luteal support until your second scan (approx 9 weeks).
If you have had a frozen embryo transfer with down-regulation you will need to continue with your progesterone and oestradiol until 12 weeks of pregnancy.
What if I start bleeding after a positive test?
You should rest and take things easy. Unfortunately at this stage this is all that can be done, and you need to wait and hope for things to settle. It is still possible for a pregnancy to continue despite some bleeding so you shouldn’t lose hope at this stage. If you start bleeding at night please contact the nursing team on 01761 438585 the next working day. Although bleeding can be very distressing it is not a medical emergency, so please do not call the BFC emergency number.
Do you have any advice regarding the Zika virus
We understand that you may be worried about the Zika virus . Please see here for further advice.
What would the cost implications be if I've had a previous vasectomy or failed reversal?
A previous vasectomy or failed reversal means you have no sperm to ejaculate. Your treatment would involve the surgical sperm recovery.
IVF with ICSI (includes embryo transfer) £4,550
Surgical sperm removal (PESA/TESA) £1,850
Embryo storage £ 500
Drugs (varies £800 – £1700) £1,200
What are the cost implications for women wishing to freeze their eggs for personal reasons or prior to oncology treatment?
We advise that it is best to freeze your eggs before the age of 38 and preferably earlier.
Egg freeze cycle, IVF including egg vitrification (freezing) and first year storage £2,400
Annual storage charge for eggs £ 230
Drugs (varies £800 – £1700) average cost £1,200
Total cost £3,830
Later fertilisation (ICSI required) £800
All eggs will usually be fertilised and embryos cultured to select best one
or two remaining good embryos frozen and stored £500