Information for patients having treatment

Following your review appointment if you are suitable for fertility treatment the consultant or nurse consultant will add you to the waiting list. 

Once you are near the top you will be registered on our online Fertility Consent portal and given access to videos relevant to your treatment. 

You must review the information provided on Fertility Consent and sign the allocated consent forms before we can offer you a date to start treatment.

Please read the section below regarding fertility consent very carefully, to avoid errors in your consent forms. Any errors in your consent forms could lead to delays in starting your treatment.

Fertility consent

Fertility Consent is a UK based company that specialises in providing online consents specifically for fertility clinics. Fertility Consent is a secure online platform, which provides patients with consistent and engaging information about their individual treatment, which they can review in the comfort and safety of their own home before electronically completing and signing their clinic consent forms and, where required, regulatory consent forms.

Newcastle Fertility Centre staff register patients on Fertility Consent through our own secure clinic dashboard. Fertility Consent then allocates each patient’s individual educational videos, clinic information, regulatory consent forms, and clinic consent forms based on their specific demographic and treatment details. 

When you are nearing the top of the waiting list, you will receive a text message directing you to the Fertility Consent platform to review information specific to your treatment and complete the relevant consent forms. If you are having treatment with a partner, you will both receive a text message. When you receive the text message, please log in to review the information videos and complete the consent forms as soon as possible. If you have any difficulties accessing the system or completing the forms, please email the nurses at [email protected]

It is best to complete the forms on a laptop, PC or tablet. Please do not use your mobile phone to complete the forms as they do not format correctly on a mobile phone and the forms will be invalid. Please contact us if you do not have access to a laptop, PC or tablet and we will arrange for you to attend the clinic to use our tablets to complete the forms.

Once you have completed all of the consent forms please email [email protected] to alert us that you have completed your consent forms. You should include your full name and date of birth in the email. If you are having treatment with a partner, you should not email us until you have both completed the forms.

Once we receive your email alerting us that you (and your partner if applicable) have completed the consent forms we will allocate a date to review your forms( you are not required to attend this appointment). If your consents are completed correctly when reviewed, the team will contact you to arrange a scheduling appointment. We will not allocate a scheduling appointment until the consents are completed fully and correctly.

If you fail to complete the forms in one month and have not contacted us for support within this time we may remove you from our treatment list. 

Withdrawing or varying your consent

If you would like to amend your consents or withdraw your consent after you have completed your consent forms please discuss this with a member of the team as soon as possible.

Scheduling appointment 

This is a face-to-face appointment with a member of our nursing team. If you are seeking treatment as a couple both partners must attend this appointment. If you are a single woman seeking treatment, you might find it helpful to have a friend or family member attend the appointment with you.

The nursing team will answer any further queries that you have and make sure you are ready to commence your treatment cycle. If you are happy to proceed to treatment, we will then help you to choose your dates for starting treatment. While we will do our best to accommodate your preference for a specific treatment date it is not always possible.

You will be given a treatment plan listing the medication regime, scan and procedure dates for you to refer to throughout your treatment. The fertility nurse will teach you how to do the injections and you will have a go at practicing this yourself.

During this session, we will provide you with an equipment pack. This includes all the needles, syringes and other equipment that you need for the fertility injections and a sharps disposal bin for your used needles. 

Tests you may have

Hormone test

Women are born with all their eggs and over time, there is a reduction in the number of eggs left in the ovaries. The decline in number is more rapid for women aged 35 and over.

Testing for the level of anti-mullerian hormone helps us to understand a woman’s ovarian reserve. The AMH level is helpful in predicting success from fertility treatment such as IVF, but it does not tell us about the chance of a natural pregnancy.

Full blood count

A full blood count tests haemoglobin levels and identifies if iron supplements are required before pregnancy.

Thyroid hormone

An under or overactive thyroid can impact the chance of a successful pregnancy. All women planning pregnancy will have their thyroid levels checked to see if any additional testing or medication is required.

Vaginal swab and hysterosalpingogram (HSG)

A HSG is an Xray of the fallopian tubes that checks for tubal patency. The Xray is done in the Xray department at the RVI. Anyone needing a HSG must have a vaginal swab to rule out infection (Chlamydia and Gonorrhoea) before the HSG can be arranged. Not everyone will require a HSG, the nurse will explain if it is relevant to you.

Semen analysis

Men will need a semen analysis. Your GP may have already organised this for you. In some cases, a repeat semen analysis is needed to help understand the fertility issue.

The semen analysis includes an evaluation of the number, movement and shape of sperm. Men should abstain from ejaculation for 2-5 days before the semen analysis appointment.

Male factor blood tests

Men with a very low sperm count (less than 5 million) or no sperm (azoospermia) will have additional blood tests to try to identify a cause for their sperm problem. The tests include genetic and hormone tests. The nurse might also refer you to our male fertility specialist for further advice and examination.

Viral screening

Patients who are planning fertility treatment will be checked for HIV, Hepatitis B and Hepatitis C. Male partners will be checked also.

Haemoglobinopathy screening

Hemoglobinopathies are disorders that affects the structure or production of haemoglobin, the protein responsible for carrying oxygen around the body. Some ethnicities are more at risk of haemoglobinopathy disorders so will be tested prior to planning a pregnancy.

Ultrasound scan

The purpose of this scan is to identify any problems with your ovaries or uterus. A narrow probe is inserted into the vagina. The scan should not be uncomfortable. The scan can be performed at any time in the menstrual cycle.

Most scans show normal anatomy but sometimes we detect issues such as signs of endometriosis, adenomyosis, endometrial polyps, ovarian cysts or fibroids. The scan operator will discuss your scan results with you and explain any findings.

Additional tests

Occasionally additional tests not listed above are required. The team will discuss this with you and explain the purpose of the test.

Test results

When your results are available, we will arrange a review appointment with our nurse consultant or one of our doctors to explain your results and plan treatment if appropriate. Some results may take up to 12 weeks to be available.

Interpretation of results with your individualised medical history can be complex and requires a specialist. Therefore, we are unable to discuss results by email or telephone before the review appointment.  

Appointments for treatment

Getting time off work for appointments can be difficult. Some people find it helpful to discuss what is happening with their employer, others don’t. We can provide proof of your appointments if requested.

The minimum number of appointments are as follows. If you are having treatment as a couple then attendance of both partners is essential for the appointments in bold, although partners are welcome to attend at any point

• Scheduling appointment
• starting scan
• monitoring scan(s)
• final scan
• egg collection
• embryo transfer

Please remember that the treatment dates are only an estimate of how your body will respond to the drugs. This means that we may have to alter the treatment dates in response to the scan results to ensure that you have the best chance of a successful outcome. This can sometimes be at very short notice.

Prescriptions

NHS patients will collect their prescription from the outpatient pharmacy at the RVI. You will need to pay the standard NHS prescription charge per item on the prescription. Sometimes there can be multiple items on one script for a cycle of treatment.

Private patient prescriptions can also be sent electronically to the RVI outpatient pharmacy. You can contact pharmacy who will be able to give you the cost of the drugs. You may wish to request a paper prescription to take to your chosen pharmacy. You will need to collect this from the centre. Drug costs can vary significantly so you may wish to shop around. 

Make sure you have collected your drugs before you are due to start the treatment.  Remember to check the expiry dates and storage instructions for each medicine.

Prescriptions sent to the RVI pharmacy must be collected within 7 days.

Injections

The injections you may require to boost your egg supply, and the expected date for you to start this treatment is explained in your individual treatment programme.

This date is flexible, and it’s normal for your cycle not to be exactly times with the treatment programme.

Menopur

• Menopur is a form of follicle stimulating hormone used to stimulate the ovaries to produce eggs.
• Taken at the same time every day (preferably in the morning).
• Kept in a cool, dry place and away from direct heat or sunlight.

Rekovelle

• Rekovelle injections are a form of follicle stimulating hormone and the dose is decided based on your weight and AMH levels.
• Taken at the same time every day.
• Injectable pen and must be kept in the fridge.
• It is fine to have sexual intercourse during treatment however you must use barrier contraception, such as condoms, between starting the injections and the embryo transfer.

Cetrotide injections

• Cetrotide (cetrorelix acetate)is used to suppress ovulation when the follicles have started to develop.
• Taken at the same time every day (preferably in the morning).

You will be asked to take an injection to mature the eggs, this is sometimes referred to a trigger. It is carefully timed to your egg collection and is usually given in the evening. 

Depending on your treatment plan, this may be ovitrelle or buserelin.

How to administer injections

We provide guidance on how to to administer the injections.

It’s simple to learn, and much easier than having to visit your doctor every day. 

The support and training can be found at the links below:

Cetrotide: Support and training information for Cetrotide®

Menopur: Ferring for fertility | Menopur

Ovaleap: Ovaleap Patient Instruction Video | Videos & Movies on Vimeo ) 

Rekovelle: Ferring for fertility | Rekovelle

If you choose not to do your own injections and wish to go to your GP, please make arrangements for this yourself, remembering that some injections have to be given at weekends or evenings.

We will also supply you with the needles and syringes you need. 

We will provide a special container for the disposal of used needles and glass.  Please do not put these in your household rubbish.

Unfortunately, we cannot arrange for injections to be given in the unit. 

Needles and syringes

You can collect needles and syringes and a sharps box from the Newcastle Fertility Centre.  Please return the sharps box and any unused items to the centre for safe disposal.

Counselling

We are aware that undergoing fertility investigations and treatment is stressful and can affect the most personal and private aspects of your life. Counselling can help to lessen potential feelings of isolation and confusion, and encourage you to recognise and understand your emotions and allow you to explore the options that you have available to make the decisions that are right for you.

Research

Our understanding of early human development is constantly evolving and we are actively involved in research to improve current treatments, and to help develop new approaches that may benefit patients in the future.

As part of this work, we may ask you to share your views through surveys about your experiences, your health difficulties, and the treatments you are offered. This helps us continually improve the care we provide.

When you first attend the clinic, we will ask whether you would be willing to donate cells for research purposes. This is entirely your choice.

• If you decide not to take part, your decision will be fully respected
• You will not be asked again
• Your care and treatment will not be affected in any way

If you would like to learn more about our research or what taking part involves, our team will be happy to discuss this with you during your clinic visit.

Social media

We understand that you may wish to share your fertility treatment story on social media.  We know that some of you feel this gives you a network of support and that it can help lessen the stigma you feel surrounding fertility treatment. We respect your choice to do this, but ask that you respect the privacy of our staff and most importantly the privacy of other patients. This means that we would prefer that you do not photograph or record the staff (either in picture or sound) delivering care or speaking with you on the telephone. If you do decide to record yourself attending the clinic this should only be done when staff are not present and when you are in an enclosed room so there is no risk of accidentally videoing other patients. We appreciate that your fertility journey is personal to you and any recordings must remain the same.