Some women have very infrequent periods or no periods at all. This is usually due to an imbalance in the hormones that regulate the ovaries - known as Polycystic Ovarian Syndrome. Although there is no permanent cure for this imbalance, in most cases we can override it either by tablets or injections so that an egg is released. Each case is managed individually depending on your specific circumstances.

The imbalance in the hormones which can regulate the ovary is much worse if you become overweight. It is therefore essential that you achieve a normal weight if you are to give yourself a chance of pregnancy.

What you need to know about IVF

The following information explains briefly the procedures of In Vitro Fertilisation (IVF). This will give you an understanding of the treatments and an outline of methods we use here. We will be happy to discuss any questions you may have about the treatments.

What is IVF?

IVF is the technique of mixing the women’s eggs (ova) with sperm from her partner in a small dish or test-tube in the laboratory to allow fertilisation to occur. Once the ova are fertilised, one or more fertilised eggs (pre-embryos) or developing embryos are replaced into the woman’s womb through the cervix.

Who needs IVF?

Many cases of infertility can be helped with IVF. However, the chances of pregnancy are very variable and depend on the cause of your infertility. When you are seen at the clinic we will discuss the most suitable type of treatment for you and give you an estimate of your chances of becoming pregnant.

For most couples, IVF treatment involves using your own sperm and eggs. Rarely we may recommend using donated eggs or sperm but of course this would never be done without your consent.

What does IVF involve?

The precise details of your treatment will be sent separately and below is a short outline of the steps involved in IVF. These include:

• Stimulation of the ovaries
• Monitoring of egg development
• Egg collection
• Sperm preparation
• Fertilisation
• Embryo replacement
• Pregnancy test and scan
• Stimulation of the ovaries

In a natural menstrual cycle, a woman produces only one egg, but in order to increase the chances of pregnancy in IVF it is desirable to stimulate the ovary to produce several eggs. This is done by giving you medication as a nasal spray or injection for about 3 weeks to control your natural cycle then additional injections are given for about 12 days to make the eggs grow. The eggs need to be exactly “ripe” at the time of their collection and so their development must be carefully monitored. The drug treatment varies slightly to suit your circumstances but this will be fully discussed with you beforehand.

Monitoring of egg development

Development of the eggs is monitored by 2 methods. First, the size and number of egg follicles growing in the ovary are observed by ultrasound scanning. The scan is obtained by passing a small transducer into the vagina and a clear picture of the ovaries can then be seen on a television screen.

The second method of monitoring is by measuring the hormones produced in the ovary. This is done by a blood test. The blood test may sometimes be needed during the 2 weeks before egg collection. At least three eggs must be growing before we can proceed to egg collection. Sometimes treatment will therefore fail at this stage.

If the simulation treatment has been successful, the eggs will be ripe at the right time and a final, different injection will be given to complete the ripening. Egg collection will be planned for about 38 hours after this injection.

On rare occasions a complication of this treatment can occur (Hyperstimulation Syndrome). The ovaries may become large and painful and if severe, admission to hospital may be necessary. This usually only occurs if you become pregnant and gets better within a few weeks.

Egg collection

Eggs are collected from the ovary by suction through a fine needle. This needle is inserted into the ovary through the vagina using the ultrasound picture as a guide. Only a mild sedative is needed and you can go home a few hours later.

We hope to obtain at least 3 eggs; but usually larger numbers are obtained.

Sperm preparation

A fresh sperm sample is needed for IVF so that the sperm are of good quality. The sperm are specially prepared so that only the best, cleaned sperm are put with the eggs.

Fertilisation

After collection the eggs will be put into the incubator for a short time. A relatively small number of sperm are then added to each egg. They will then be kept in the incubator for about 2 days. They are looked at daily and we will keep in touch with you by telephone and advise when to attend for embryo replacement.

Embryo replacement

An opportunity to discuss how many embryos should be replaced will already have taken place. The chances of pregnancy increases with the number of embryos replaced, but so does the risk of multiple pregnancy. There is an increased chance of losing one or all of the babies in a multiple pregnancy and we are therefore anxious to avoid this complication. A maximum of two embryos are replaced except in exceptional circumstances in women over the age of 40 years. The procedure for replacement of the embryos is virtually painless and is little more than an internal examination. You will not need to lie down afterwards and then you can return to normal (but not too strenuous) activity.

In a few circumstances, it may be possible to consider freezing and storing embryos.

Pregnancy outcome

After IVF further injections or pessaries may be needed to support the lining of the womb. We will see you about 2 weeks after egg collection, a pregnancy test will be done. If this is positive, a scan will be performed 5 weeks after egg collection to confirm that this is a good pregnancy and that a baby is growing.

Remember that if 2 embryos are replaced, there is a significant risk of twins (+25%). More problems occur with babies from multiple pregnancies and the risk to the mother is also higher.

Miscarriages can occur in any pregnancy but there is also no increased or decreased risk after IVF/GIFT. There is a small (7%) chance that the pregnancy may stick in the tube (ectopic pregnancy). If this occurs an operation is required to remove the pregnancy and possibly the tube as well.

We see everyone who becomes pregnant regularly at the hospital until we are sure that the pregnancy is growing normally.

Will the baby be normal?

Sadly some babies are born with abnormalities however they are conceived. Many studies throughout the world have looked at babies born after IVF and ICSI.  Recently published reviews of these studies show that the risk of abnormality is the same with both IVF and ICSI treatment. In the UK, about 2-3 babies in every 100 who are conceived naturally will have a major abnormality. After IVF or ICSI this risk is increased and we expect that about 3-4 babies n every 100 will have a major abnormality. At present we do not know whether this is due to the treatment or is related to the cause of your infertility but further studies are continuing.

Disappointments

Clearly, these methods of treatment are complicated and stressful and they may fail at any stage. Sometimes we can explain why it has failed but often it is for reasons which we don’t understand. If you are not successful we will arrange for you both to come back to the hospital to discuss what happened in detail.

If you have any further questions about these treatments, the medical and nursing staff at the Centre are available to answer them. You will be asked to attend for a further counselling/information session at the Fertility Centre before treatment begins which will give you both an opportunity to discuss any problems.

In some circumstances, usually because of very low sperm counts, conventional IVF treatment will be unlikely to succeed because fertilisation will probably not occur. A new treatment is now available which offers you a chance of pregnancy. Pregnancy rates comparable to those of conventional IVF are achieved.

As far as you are concerned, the treatment will be exactly the same as that described in our information about IVF. After the eggs and sperm have been collected, a single sperm will be drawn up into a very small pipette and then injected directly into the middle of the egg. The egg will be looked at the next day to see if fertilisation has occurred and, if successful, we will transfer the embryo(s) to your womb in the usual way. There is a small chance (about 10%) that the egg will be damaged by this injection process and this egg would then not develop.

Many babies have now been born after being conceived by this method and there is no conclusive evidence that they have a higher rate of abnormality than IVF children. It is however a very new technique and the children born have not yet reached maturity. There is theoretically a very small risk that your infertility could be passed on to a male child. We will discuss this in more detail with you in the clinic.

Occasionally, some men produce no sperm at all. We now have a technique whereby sperm can be aspirated directly from the testicle or surrounding tubes using a small needle (PESA). This is done using a local anaesthetic. The sperm would be injected into the egg by the ICSI method to achieve fertilisation. If you need PESA, it will be discussed with you fully at the clinic.

If you have any questions, we would be happy to answer them when you come to the clinic.

Your chances of a successful pregnancy are highest when you have the best first embryos transferred. Although several embryos usually develop with IVF or ICSI treatment, many will be of poor quality and therefore very unlikely to result in pregnancy. In a minority of cases, there will be several good quality embryos remaining after the embro transfer under these circumstances, it is possible to freeze and store these embryos for transfer at a later time. If this option arises for you, you need to understand the following information.

We will advise you if there are embryos suitable for freezing. This final decision will be made by the embryologist based on the quality and number of embryos remaining. We will not freeze poor quality embryos in this unit.

Not all embryos which are frozen will survive the thawing process. Therefore, there is a chance that, when you decide to have frozen embryo's thawed, you may not have any embryos available for transfer.

The success rates from transferring frozen embryos is less than that for fresh embryos.

The Human Fertilisation and Embryology Act requires that you complete consent forms which determine what can and cannot be done with your embryos. You would be asked to sign these forms before we freeze the embryos. The HFEA provide written information about the legal aspects of embryo freezing and this will be made available to you before you sign the consent forms.

Whilst we take every reasonable precaution to take care of your embryos we cannot guarantee against failure of the storage system under all circumstances

It will be your responsibility to keep in touch with us to let us know what you want to do with the embryos. If we are unable to contact you this may result in the embryos being removed from storage. Some patients will need to pay an annual fee for the storage of embryos.

Those couples who have embryos suitable for freezing, have the highest chance of conceiving when they have fresh embryos transferred. If you complete your family with this first treatment, you may have difficulty deciding what to do with your frozen embryos. You can contact us to discuss this at any time if you need help.

You can, at any time, vary and/or withdraw your instructions as to the storage of embryos (including authorisation to destroy them) if you give us notice in writing.

Embryos which you do not wish to use yourself can either be discarded, used to treat another couple or used for research.

It is legally possible to store embryos for up to 10 years. We will ask you to reconsider continuing storage every year.

We cannot guarantee that embryos which have been frozen and stored will be unaffected by that process. The state of medical opinion at the moment is that we do not consider that freezing and thawing of embryos causes any harm that would result in any increased risk of damage to subsequent children born.

All individuals storing either embryos or gametes must now be screened for HIV, Hepatitis B and Hepatitis C. At Newcastle Fertility Centre at LIFE we do not have storage facilities for couples or individuals who test positive for any of these conditions. We would not therefore be able to freeze the embryos in that situation.

Some men produce no sperm in their ejaculate and some only very small numbers or intermittently, whilst for others there may be a physical problem that makes producing a sample of semen impossible. In some of these cases after suitable assessment a sperm retrieval procedure may be offered. The procedures involved allow mature sperm to be collected either from the tubes adjacent to the testis (the epididymis) or from the testis itself. If suitable this sperm can then be used in the IVF process. Sperm injection (ICSI) would be required to fertilise the eggs with the sperm.

PESA (percutaneous epididymal sperm aspiration)

In this procedure a small needle is inserted through the skin of the scrotum into the tubes adjacent to the testis. In men where there is an obstruction these tubes are often swollen and the fluid within them can contain many mature sperm. The quality of the sperm can only be assessed once it has been retrieved, sometimes it can be frozen to avoid a repeat procedure being required.

Testicular biopsy

If no sperm is retrieved from the epididymis or where the diagnosis of a non-obstructive problem, a problem with the sperm making process, is required then a biopsy of one or both testes may be necessary. In this case a small cut is made in the scrotal skin and in the surface of the testis so that a small amount of tissue can be removed. A small dissolving stitch will allow easy healing of these wounds. In this case a small portion of the tissue may be sent for laboratory assessment of its structure and the sperm production process, the rest being retained for sperm retrieval. Although it is less likely, mature testicular sperm can sometimes be frozen for future use.

Is this a suitable treatment for me?

If you have no sperm in your semen (azoospermia) when it is examined then a sperm retrieval procedure may be possible. It does depend however on the cause of the problem. For some men in this situation there is a hormonal problem which may be correctable without resorting to surgery, for others their testes cannot make sperm and an attempt to retrieve sperm would be unsuccessful. In some situations removal of a blockage can be attempted. By investigating the function of your testes advice can be given about the chances of retrieving sperm suitable for IVF treatment upon which you can base your decisions.

How does this fit with my partner’s treatment?

In most cases, in order to take advantage of fresh sperm, the sperm retrieval process is set up to coincide with your partners ovarian stimulation and egg retrieval. Sometimes however it may be preferable to have carried out a diagnostic procedure first to ensure that it is possible to obtain sperm from you in this way. It may then be possible to freeze the sperm for your IVF cycle so that the sperm retrieval doesn’t need to be repeated. All individuals storing either embryos or gametes must now be screened for HIV, Hepatitis B and Hepatitis C. We do not have storage facilities for couples or individuals who test positive for any of these conditions. We would not be able to store sperm in that situation.

Do I need an anaesthetic?

For most men the sperm retrieval procedure is straightforward and can be performed under local anaesthetic. Occasionally a general anaesthetic may be necessary or recommended.

What if no sperm is retrieved?

If the procedure is a diagnostic one performed prior to the IVF process then we will discuss the findings and future options with you in the clinic before you make final treatment choices. If the procedure is being performed in conjunction with your partner’s treatment this would be cancelled prior to egg collection. Some couples prefer to avoid this difficulty by choosing donor sperm to be available as a back-up. This option will be discussed with you and appropriate counselling given before you make your decision. It may not be a treatment option you would want to take up. The use of donor sperm as a back-up however must be arranged well in advance of treatment.

Who needs Donor Sperm?

Donor sperm may be used to produce a pregnancy for a couple when it is inadvisable or not possible to use the sperm of the male partner. This method has been practised for many years and thousands of couples have been able to have a family as a result.

Who are the donors?

Sperm donors may come from all walks of life and are all asked to provide a full medical history so that only healthy donors are accepted. They are screened for infections that can be passed on in semen including tests for the AIDS virus. Semen can only be used when a donor has had a negative AIDS test on at least two occasions, 6 months apart. For this reason only frozen semen can be used. No guarantee of freedom from the AIDS virus can be given, but the risk of a positive donor being undetected and the virus being passed on through donor semen is considered to be very small indeed.

How are donors selected?

The sperm bank provides details of the donor’s physical characteristics ie skin colour, eye colour, hair colour, height, weight and blood group. These are used to match as closely as possible the male partner, or if that is not possible the female partner. If a good match is not available this will be discussed with you before treatment.

Who is the father of the child?

The male partner is considered by law to be the father of the child as he has consented to treatment. He therefore has all the rights and obligations of parenthood, as any father does. The donor has no paternal rights or obligations at all. The child is therefore registered with the male partner named as father.

Who will know about the treatment?

Many couples are concerned that their treatment remains confidential. You can be reassured that no one, including your GP, will be told about your treatment without your written consent. Before being accepted for treatment using donor sperm we will spend some time discussing the many questions you will have. This will include the decisions whether to tell your child of its origin or not. There is no legal obligation to tell the child.

The Human Fertilisation and Embryology Authority, which licences Centres to provide treatment with donor sperm, keeps records about donors and recipients. This includes the name, some background information and sometimes the interests and hobbies of each donor. From April 2005 all newly registered donors must agree to allow release of identifying information by the HFEA to any individual born as a result of treatment using their gametes. Upon reaching the age of 18 (16 if they are planning to get married) anyone has the right to check whether there is information about them on the register, to request information regarding the donor involved and also whether they themselves have a genetic relationship with the person they wish to marry or choose as a partner.

How is the sperm used?

If the woman is ovulating regularly and has normal Fallopian tubes, donor sperm can be used by putting it directly into the neck of the womb (like having a smear test). It only takes a few minutes although we recommend that you rest for about half an hour afterwards. We will monitor your cycle to determine when you are about to ovulate in order to find the best time to carry out the procedure.

If this is not successful after 3 treatments we usually recommend having injections to stimulate the ovaries combined with insertion of the prepared sperm directly into the womb for the next 3 treatments. If this is still not successful, we usually then suggest you consider IVF treatment. The choice of treatments will be discussed with you in detail in the clinic as your treatment progresses.

In 2005 26 babies were born to 22 women as a result of treatment with donor sperm at this Centre.

The more detailed results of treatment provided are given below.

Results of Donor insemination Jan – Dec 2005

Thank you for asking for information about donation of your eggs. This is the first step in a meaningful journey, both for you and at least one other hopeful couple.You can change someone else’s life if you choose to go ahead with egg donation and if after reading this information you are still interested, please contact us on 0191 213 8213. Ask to speak to Egg Donation Co-ordinator, who will take some details from you and arrange for you to attend an informal meeting.

Why Do We Need Egg Donors?

Some women don’t have ovaries of their own due to disease or trauma and some women are born without ovaries. Clearly, without ovaries these women’s only chance of a pregnancy is through donated eggs. Other women reach an early menopause and therefore their ovaries fail to produce eggs. There is also a small group of women who could pass on a genetic disorder if they used their own eggs.

Who Can Donate Eggs?

Women who are between 21 – 35 years of age, preferably in a stable relationship and who have completed their own family. Ideally donors should not be known to the recipients. If you do not fit into this description please discuss this with one of the staff here.

Will I be paid a fee?

No. All of your expenses will be taken care of. We do not pay a fee for your donation as this is done on a voluntary basis only. We will however be able to cover your reasonable expenses.

Will The Donation Be Anonymous And How Is This Arranged?

All donors of gametes (sperm or eggs) or embryos are required to be registered with the Human Fertilisation and Embryology Authority (HFEA). Information both identifying and non-identifying is kept by the HFEA. Following a change in legislation, any donor registered after April 1st 2005 must consent for identifying information as well as general non-identifying information to be available to any child resulting from treatment using their donation. Children born as a result of treatment can obtain this information when they reach 16 years of age, if they intend to marry, or 18 years in other circumstances. Although in general the donor will be unknown to the recipient (identifying information is not available to the parents), we can carry out treatment using known donor’s eggs. Both donor and recipient need appropriate counselling prior to proceeding with treatment. Please ask for more details about this if this is something that you wish to consider. We also have to contact your GP for details of any medical reasons why you should not go ahead with egg donation. Donors who were registered as anonymous donors before April 2005 will continue to have their anonymity protected and only non-identifying information will be available as previously to children born as a result of their donation.

What Information Will The Recipient Be Given About Me?

You will not receive any information about the recipient herself however we are able to tell how many eggs we have collected, how many couples you were able to help and you whether or not a pregnancy has resulted from your donation.

What Information Will I Be Given About The Recipient?

None. We are not allowed to tell you if your donation has resulted in a pregnancy or not. We will let you know how many eggs have been collected and how many couples you have been able to help.

Will I have any legal responsibilities for any resulting Children?

No. The law is very clear (HFEA ACT 1991). You are not the legal parent of any resulting child. At the time of donation you relinquish all legal rights and claims over the resulting offspring. At your consultation you give written consent to confirm this.

Will I Be Held Responsible If A Child Born From My Donation Is Disabled?

No. However, if you know of any genetic or hereditary disease which is present in you or your family you are legally obliged to inform us. Failure to do so is an offence and any resulting affected child would be able to sue you for damages.

What Screening Tests Will Be Done?

You are asked to complete a medical questionnaire about yourself and your family. All donors must be tested for HIV antibody, hepatitis B and C, CMV, syphilis, chlamydia and gonorrhoea. In addition we also check hormone concentrations and genetic analysis including tests for cystic fibrosis. Tests will also be done to check if you are anaemic and to test your blood group and thyroid function. These investigations require blood tests and vaginal swabs. We will give you all the results of these tests.

How Many Visits Will I Need To Attend?

You will have four visits (on average) before starting your planned programme. A further three visits for scans and blood tests will be arranged prior to your admission (for the day) for the egg collection.

What Happens At These Visits?

You will be asked to attend an open information meeting with other interested potential donors where we will explain the content of this information pack in more detail and answer any questions you will have. If you are keen to proceed we will give you an appointment and a medical questionnaire to complete (you will be asked to return this prior to your appointment). You will see our Doctor to discuss your medical history and you will have blood taken at this time. When the blood test results are available we will arrange for you to see the clinic nurse and she will talk a little more about the implications of being an egg donor. More blood will be taken at this visit. If all of these blood tests are satisfactory you will see the Doctor to sign your consent form and explain your drug programme with you.  The next visits are to monitor your treatment programme where scans and blood tests will need to be done. It takes approximately six months from first seeing you to reach the actual egg collection.

What Medication Is Needed?

We need to give you a nasal spray for about five weeks. This drug stops you from growing eggs in the normal way and allows us to control your menstrual cycle. When we have that control you will start a series of injections to stimulate your ovaries to grow eggs. Your nurse will show you how to do this at your appointment with her.

How Are Eggs Collected?

When your eggs are mature we will collect them using a fine needle guided by an ultrasound scan. This is done under sedation and takes about an hour to do.

What Happens To My Eggs After Donation?

We hope to have enough eggs to divide between two couples. The male partner of each couple will provide a sample of semen; this will be prepared and then added to the eggs you have donated. The eggs will be looked at the following day to see if they have fertilised. The next day the resulting embryos will be placed into the recipient’s womb. A maximum of three embryos can be replaced. Spare embryos (if suitable) may also be frozen, with your permission. This may increase the chance of pregnancy from each donation. Two weeks after treatment we will do a pregnancy test.

Will I Have Any Side Effects From The Drugs?

The nasal spray can leave a strange taste in your mouth for a short period after using it. When your own hormone levels drop you may experience hot flushes, headaches and even night sweats. Your own menstrual cycle may be different from normal. Some women experience low moods and irritability. These symptoms are all related to your low hormone levels and these disappear once you start your injections. The injections (follicle stimulation hormone) encourage your ovaries to grow eggs. You may or may not have soreness at the site of injection but this is normally mild and should not bother you too much. You may experience bloating of the abdomen, breast tenderness, increase in vaginal secretions and if you grow a large number of eggs your abdomen can feel quite tender. Most women feel only a slight change and these symptoms disappear completely once you have a period after your egg collection. Some women (about 1%) develop hyperstimulation syndrome. We are very careful and if we think this may develop we may even stop treatment. Hyperstimulation syndrome is characterised by large painful ovaries, nausea and vomiting and fluid retention. If the condition is severe enough you may need to be admitted to hospital in order to monitor the condition and give you some drugs to relieve symptoms. This is very rare but nonetheless you need to be aware that this can happen to you.

Can I Get Pregnant During The Treatment?

You will be very fertile during the later stages of treatment and you must use some form of non-hormonal contraception at this time if you intend to be sexually active.

How Many Times Can I Donate?

This is mostly up to you but will also depend on the quality and amount of eggs obtained at your previous collection(s).

We offer a scheme for those couples who wish to reduce the cost of their own IVF treatment by donating some of their eggs to another couple. This is called egg sharing. Sharing can be an acceptable solution for both couples but there are many potential ethical and practical problems. We will help you to consider these problems in detail.

All the information set out in this section of the page applies to you as an egg sharer, as for any other egg donor. It also gives details of how being an egg sharer will influence your own treatment.You must be aware that the process of counselling and screening will necessarily take some time in order to make sure that you fully understand the implications of treatment and that all the required blood results are available.

How Many Visits Will I Need To Attend?

Your first visit will be to determine the best treatment for you, regardless of whether or not you decide to share your eggs. We usually ask you to sign the consent forms for your treatment at this stage. If you want to be an egg-sharer you will then have a meeting with the counsellor to ensure that you understand the full implications of the procedure. Blood tests and swabs may be taken. At a third consultation with the doctor you will sign the consent forms for egg sharing. A date will then be given to start treatment. You should be aware therefore that being an egg-sharer would delay the start of your treatment.

Will I Have To Pay Anything?

If the NHS is paying for your treatment, there will be no additional costs to you.If you are not eligible for NHS treatment, you will need to pay the initial consultation fee (£250) and the costs of you drugs for treatment (about £600). The recipient of your eggs may be an NHS funded patient or a private patient. The payments for their treatment cover our costs for both your treatments.

How Are The Eggs Shared?

We will agree this in writing before you start treatment. If less than 6 eggs are collected, this would be considered to be an unexpected poor response and we will give them all to you at no additional cost to yourself.If there are 6 or more eggs, but not many more, you may decide that it is in your best interest to have all the eggs for your own treatment. In this case you would need to pay the full cost of treatment.When eggs are shared, they will be allocated randomly between you regardless of quality. If there is an odd number of eggs, you will get the extra egg.

Will Being An Egg-Sharer Alter My Chance Of A Pregnancy?

There is a close relationship between the number of eggs we collect and the pregnancy rate. Obviously, if you give half your eggs away this may reduce your chance of success. If we collect a lot of eggs (~20) and you have good fertilisation, your chance of success will be minimally reduced. If we collect less eggs e.g. 8 eggs, your chance of pregnancy will probably be reduced if you share them. Pregnancy rates are influenced by other factors and we will discuss this with you in detail before you sign the Agreement form to egg share. Receiving donated eggs. During the consultations that you have already had about your fertility problem you have expressed an interest in being an egg recipient.

During the consultations that you have already had about your fertility problem you have expressed an interest in being an egg recipient.

What Does The Treatment Involve?

You will already have been given a separate information sheet describing the IVF process. In your case we will give you drugs to ensure that the lining of your womb is ready for the embryos. This is like taking a mild form of the pill. When the eggs are collected from the donor, your partner will provide sperm that will be used to fertilise the eggs. About 2 days later the fertilised eggs will be put into your womb. A pregnancy test will be done 2 weeks later. More details of these procedures are given below.  If you want to have treatment, the process is summarised below;

STAGE ONE

We will see you to discuss the implications of your treatment for you, your family and the potential child. We will arrange any further blood tests or investigations that may be required. If you decide to proceed with treatment, you will have a further consultation with the doctors to sign the relevant Consent forms.

STAGE TWO

We will arrange for you to have a course of the drugs to prepare your womb. This will allow us to find the best protocol for you before the eggs are ready. This may take about six weeks.

STAGE THREE

You will be advised that a donor is available and you will be given a further programme to follow. If eggs are available and fertilisation occurs, you will also have an embryo transfer.Of course there are many other issues you will wish to consider before starting treatment.

Who Are The Donors and How Are They Selected?

These are usually women aged under 35 years who have completed their own family. Donation is purely on a voluntary basis and no payment is made for this other than expenses incurred.Details of the donor’s blood group, height, weight, hair and eye colour are available so that matching can be made with you. However, as you can appreciate this is not always practical as donors are not available in great numbers, but we try to match on some of your characteristics. Egg donors are screened thoroughly to ensure they are physically fit, free from diseases such as HIV, hepatitis and sexually transmitted disease and that they are not carriers of the Cystic Fibrosis gene.

Egg Sharing

Sometimes couples who are infertile and need IVF themselves, agree to share some of their eggs with couples like yourselves. This would mean that the cost of their treatment is reduced. We would only agree to such an arrangement if we were reasonably confident that the donor will produce good eggs. However, you should be aware that these donors may not have proven fertility. We will tell you if the donor is participating in the egg share scheme.

What Are The Donors Rights?

The donor will have made an agreement with us to donate eggs and has no obligations to you individually. The donor has the right to withdraw from treatment at any stage and for any reason. You may not be told why this decision has been made. If the donor is an egg-sharer, she will have signed an agreement with us regarding how the eggs will be shared between you both. This is an individual arrangement for each patient and you will be informed about the terms of this agreement before treatment starts. You will not be able to influence this agreement. All information about the donors is confidential and, as the law currently stands, you have no rights to information about the donor other than basic details of weight, height, hair colour, eye colour and blood group. The donor does not receive any information about you or the results of treatment. The donor does not have any rights or responsibilities to the child.

Who Are The Legal Parents When Egg Donation Has Been Used?

A consent form is signed by both partners at the clinic visit in order to allow the woman to receive donated eggs and for these to be mixed with her partners sperm. Both partners sign the form and the woman in signing this consent, is regarded in all aspect as the child’s mother.You are the legal parents of any resulting child and your names are entered on the child’s birth certificate.

What Are The Child's Rights?

As the law currently stands your child can approach the HFEA (Human Fertilisation and Embryology Authority) when he or she reaches age 16 if they intend to marry, or 18 years in other circumstances, for further limited information. This includes identifying information if the donor was registered after April 1st 2005.

To Tell Or Not To Tell?

This is something you may want to talk about with the nurse/counsellor within the unit to help you with this decision. There are no rights or wrongs about telling your child of his/her origins and your decision either way does not exclude you from treatment. There are various booklets you can read to help you with this and a support group called “The Donor Conception Network” will be able to supply you with more information.

Confidentiality

This is of utmost importance. Apart from our statutory obligation to inform the HFEA, we do not inform anyone about your treatment without asking you first.

How do I become Ready for Treatment?

Before you are offered eggs we will see you to discuss your drug programme. The programme is designed to suit your individual needs and during this time we will see you to monitor your response to treatment. This response is the basis for your treatment when eggs are available for you. We will discuss this with you so that you will have an understanding of what is happening and how you will feel during this time. We will also give you general advice about how to provide for pregnancy.

What happens if I Do Not Receive The Eggs?

Obviously we cannot make any guarantees that you will receive eggs. This is dependant on a lot of variables, some of which are:- The donor is allowed to withdraw from treatment at any time for any reason. The donor may not respond to stimulation to grow eggs and we may have to stop treatment.The donor may grow too many eggs and there may be a risk to their physical health and we have to stop for this reason. We may not collect the number of eggs anticipated at egg collection. If, in an egg sharing arrangement, there may not be enough eggs available to share.

How are the eggs shared?

Sometimes you may have to withdraw from treatment for unexpected reasons at short notice. Therefore we must make sure that there will always be someone ready to receive eggs when the donor is ready. To ensure this, we usually have more than one couple programmed to receive eggs from each donor. We hope to be able to give you at least 6 eggs and the available eggs will therefore be divided between you to achieve this. It may be that only one recipient will receive eggs. We will let you know whether you are ‘first in line’ or ‘stand-by’. If the donor is an egg sharer, she will have signed a written agreement with us about how the eggs will be shared between you both. This will include the possibility that she may withdraw at any time, either to continue the treatment for herself alone or to stop treatment. If eggs are to be shared, either between more than one recipient or with an egg sharer, they will be allocated randomly between you regardless of quality.

How many times can I have treatment?

Usually twice, but this depends on availability of funding and donors. This will be discussed with you by the Doctor at your initial clinic visit and reviewed each time you have a cycle of treatment.

What happens when I am ready for treatment?

You will be given instructions about your drugs and monitoring during this time. You will be given a time to attend the unit to produce your semen (sperm) sample when the eggs are available. You will be told how many eggs you have. You will be asked to contact the unit to find out if the eggs and sperm have fertilised and formed embryos and you will be given a time to attend for embryo transfer.

When do we come for the embryo transfer?

The transfer usually takes place 2 or 3 days after the egg collection.

What do I do before I Come In?

Have your breakfast as usual then come to the Centre at the time arranged. Please do not wear perfume, strong deodorants and partners should not wear aftershave.

What Happens When The Embryos Are Transferred?

When you go through to the treatment room we will be able to show you your embryos on the monitor screen if you wish. We will confirm with you again the number of embryos you wish to have transferred. The transfer is a simple procedure, similar to a cervical smear test. It lasts about 5 minutes and usually you feel no discomfort at all. You can go straight home afterwards.

Why Do I Need More Medication After The Transfer?

Medication is needed to help support the lining of the womb after the embryos have been transferred. This drug will be a progesterone pessary. Details of the drug will be discussed with you when you see your named nurse. You will still continue your Oestrogen tablets.

What Do I Do Afterwards?

We advise you to lead as normal a life as possible after the transfer without doing anything too strenuous. There is nothing more you can do at this stage to help the embryos to implant. Please don’t hesitate to telephone the Centre if you have any problems. Remember, your nurse is there to help to support you both throughout treatment and even if she is not available, any of the nurses at the Centre will be happy to talk to you.

When Do We Know If The Treatment has Worked?

We will tell you when to return for a pregnancy test, which will be about 14 days after the embryo transfer. Most women do not have a period before the pregnancy test but even if you do you should still attend for a test. Remember that, even if the pregnancy test is positive, we will need to wait another 3 weeks before we do a scan to confirm that a baby is growing.

What Do We Do If The Treatment Fails?

Unfortunately, most couples will not be successful in achieving a pregnancy and we are aware of the great disappointment you may feel. People cope with this in different ways. If you wish to talk to us, please phone at any time and we would be happy to see you. A counselling service is available here even if you feel you are coping. It is good to talk to someone who understands what you are feeling. You will be sent an appointment to come back to the clinic to see a nurse or Doctor to review your past treatment, usually about 1 month later.

At the Newcastle Fertility Centre we are aware that undergoing fertility investigations and treatment is stressful and involves the most personal and private aspects of your life. Counselling can help to lessen your feelings of isolation and confusion and encourages you to recognise and understand your emotions. Counselling can also help you to explore the options that are available, so that you can make the decisions that are right for you. You may also need help to explore your feelings surrounding failure in treatment or possibly the success in treatment. Either situation can have an impact on the rest of your life.

If you would like to talk to one of our counsellors (providing you are registered as a patient here) please contact the centre on (0191) 213 8213 to make arrangements. Counsellors are impartial and anything that you discuss is treated as confidential and not discussed with another member of the team without your express permission. Information is not entered into your medical notes, the counsellor has her own notes that only she has access to. Counsellors have a diploma in counselling and we employ a supervisor who monitors their counselling skills.

Appointments last about 1 hour and a contract can be made with you to attend for more sessions. You can attend together or individually and with or without the knowledge of your partner.

All women who are trying to conceive are advised to take FOLIC ACID 400mcgms daily to reduce the risk of a baby born with spina bifida. It is often cheaper to buy this over the counter at a chemist than on prescription.

Being overweight has serious health implications and can cause complications during pregnancy. If you are overweight we will defer your treatment until you have lost weight. It is important that you maintain your weight loss throughout the time you are having treatment. Certain health authorities will not offer NHS funding if you are overweight.

Research suggests that women who smoke are less likely to conceive following IVF treatment. If you would like help to stop smoking please telephone the NHS Smoking Helpline 0800 169 0 169.

Before you start your treatment you should be tested for rubella immunity and immunised if necessary.

Please inform us if you aware of any conditions or illnesses that exist in your family. This will allow us to investigate any risks to you or any child that you may have and ensure that you receive appropriate advice and counselling. If necessary we may refer you to a genetics specialist.

Sexually transmitted diseases caught at any time may create further problems when trying to conceive. It is also possible that vaginal infections at the time of embryo transfer reduce the chance of IVF working. If you are worried about this at any time we encourage you to visit your local genitourinary medicine clinic.

At the Newcastle Fertility Centre we work closely with our Cancer Specialist colleagues to provide a fertility preservation service for men undergoing cancer treatment that may affect their sperm production and fertility in the future. A sperm storage facility is available for men undergoing such treatment. We are aware that samples may have to be produced and stored at very short notice but whilst we cannot take self-referrals hospital specialists or GPs can phone or fax the centre to ensure that arrangements are made promptly.

For other referrals or for women who wish to discuss fertility preservation, the hospital specialist or GP can make an urgent appointment by ringing or faxing to the Centre. Less urgent cases should be referred to the Young Peoples’ Clinic.

The aim of this clinic is to allow individuals or couples, who know there is likely to be a problem with their fertility, the opportunity to discuss this in detail before they attempt to conceive.

There are many medical problems and conditions that may have an impact on fertility. In this situation it is often helpful to have some knowledge in advance of where the fertility problem lies and what treatment if any may be available to get around it.

Such conditions may be congenital ie something you were born with or something you have developed since. In addition there are treatments for some medical conditions that may affect fertility either temporarily or even permanently. Your GP or hospital specialist can advise you about the risk to your fertility and can refer you to the clinic.

Our hope is that by addressing such issues in advance of an attempt to conceive some of the anxiety surrounding this can be relieved. In addition, an informed individual or couple can receive prompt referral and access to investigation, counselling and if appropriate, treatment when the time is right for them.