Frequently asked questions
Deciding on who to choose for your fertility treatment can be a daunting prospect, and with that in mind we have developed an area which aims to answer as many questions that you may have as possible.
However, if you feel that you require further information, please contact our specialists by email firstname.lastname@example.org or call on 020 7188 2300 and they will be happy to help.
Frequently asked questions before treatment starts
Is there a waiting list for treatment?
There are no waiting lists for NHS funded patients. Most NHS patients will be seen in clinic within six weeks of referral and will commence treatment shortly after.
I have been told that my CCG is not contracted with the
assisted conception unit at Guy's and St Thomas' hospitals.
Is there no way I can have NHS funded treatment?
CCGs contract with specific providers (such as Guy's and St Thomas' NHS Foundation Trust) and provide funding to them. We are happy to receive referrals from all GPs for NHS funded treatment, you can ask your GP to refer to us even if we are out of your catchment area. We will be happy to apply for funding, if you meet your CCGs criteria. However, please note that not all CCGs may agree to fund with us.
Frequently asked questions once treatment starts
How long does a cycle last?
If everything runs smoothly, a cycle takes between four and nine weeks, from the start of a period to when you find out whether the treatment has been successful or not.
Can I travel during a cycle?
If you need to fly whilst you are doing injections we can supply you with a letter to show the airline. Please bear in mind that we may ask you to attend appointments at quite short notice, so it is probably best to avoid any long trips during treatment.
How many times does my partner have to come to the clinic?
Partners are welcome to attend all appointments and we encourage them to do so. As a minimum, they must attend the first doctor's appointment, and again on the day of the egg collection. Please note they will not be allowed to go in with you for your egg collection.
How many cycles will I need?
Everyone is different. Some women will conceive on the first attempt, some need several cycles. After an unsuccessful cycle, we will be able to advise you whether further treatment is appropriate. Please remember that further treatment will not necessarily be funded by the NHS.
Do I need to rest after embryo transfer?
No. You may carry on your daily activities as normal, although we suggest that you avoid strenuous exercise.
Can I bath and swim after embryo transfer?
Yes. This will not cause you any harm, nor reduce the chance of success.
What else can I do to improve the chance of getting pregnant?
Ensure that you are taking a daily 400mcg folic acid supplement. Avoid alcohol. Do not smoke or take recreational drugs. Make sure that you drink plenty of clear fluids.
What if I need urgent advice when the ACU is closed?
A mobile telephone is carried by one of our staff when the unit is closed. You may telephone this number when you need advice urgently. Please remember that the doctor/nurse is unlikely to be in the hospital, and will not have access to your notes.
My treatment hasn't worked - how soon can I try again?
We ask you to have a break of around two to three months before starting another cycle. During this time, you will be offered the opportunity to discuss your treatment with a senior doctor. You may also like to see a counsellor.
Questions our nurses are most frequently asked
How will my scans be performed?
All scans are done vaginally (internally), except when you have embryo transfer where we perform an abdominal scan.
Should my bladder be full or empty for the scans?
For all the internal scans you need to have an empty bladder. For the abdominal scan (during embryo transfer), it is essential that you have a full bladder.
Can I do my own injections?
Most injections can be self-administered. These are done subcutaneously (under the skin) using a very small needle. This makes the injections very easy to do. The nurse will teach you how to administer the injections when you are ready to start them. They will do the first injection with you to ensure that you are confident in administering them.
What happens if I forget to take my nasal spray?
You will need to start taking the nasal spray as soon as you remember. Please inform the nurses as soon as you can.
How soon after treatment do I take the pregnancy test?
You are advised to take the pregnancy test 16 days after egg collection.
What if I bleed before my pregnancy test is due?
Bleeding does not necessarily mean the cycle failed. It is important to do a pregnancy test before you stop taking your cyclogest pessaries and to let the nurses know of the outcome of the pregnancy test.
When are pregnancy scans carried out?
We normally carry out the first pregnancy scan three weeks after a positive pregnancy test and then another two weeks after that. We then discharge you to your GP for your antenatal care.
Frequently asked questions - embryology
What are the risks of ICSI over conventional IVF
Before performing ICSI, the cells surrounding the egg must be removed so it is possible to see whether the egg is mature or not (only mature eggs can be injected with a sperm). This is an additional manipulation of the eggs, but the main additional risk is of damage to the eggs during the injection procedure itself. This can affect up to 10% of the eggs injected.
Current literature suggests that there is no additional risk of any genetic abnormalities in children born from ICSI over that of IVF.
What is the quality of my fertilised eggs?
The day after the egg collection, we will phone you to tell you how many of the eggs have fertilised. At this stage it is very difficult to give any more information on the quality of the fertilised eggs. When they start to divide over the next few days we can gain much more information about embryo quality.
What is a blastocyst?
This is the term used for an embryo on day five of development. The cells develop into two types; trophectoderm and inner cell mass, with a fluid-filled space in the middle.
Why culture to the blastocyst stage (day five)
If we have a good number of good quality embryos on day three (should be at least four embryos at the eight cell stage), we can gain more information about the embryos by culturing them for two more days without risking the possibility of not having any blastocysts available for replacement. We do not expect all embryos to reach the blastocyst stage, so it is a way of refining our selection of the best quality embryo(s) for your replacement.
Is blastocyst culture better than replacing embryos on day three?
Culturing the embryos until day five does not improve the quality of the embryos. It simply gives us more information that may help us select the best quality embryo when we have a number of embryos to choose from. If the embryos reach the blastocyst stage, there is an increased chance of pregnancy as we know these embryos have reached a further stage of development.
What will happen to my spare embryos?
Once we have chosen the best embryo(s) for your transfer, if there are any remaining embryos of good quality we may recommend freezing these embryos. If the embryos are not of good enough quality for freezing, they may be discarded or used for research, depending on your wishes.
How long will the embryo replacement take?
The appointment is for 30 minutes. The embryo transfer is a very simple procedure similar to a smear test, and it is fine to leave the unit and return to your normal routine immediately afterwards, avoiding any heavy lifting.
Why do I need to have a full bladder for the embryo replacement?
There are two reasons: firstly, the full bladder pushes down on the uterus, making the passage from the cervix into the uterus straighter. Secondly, the replacement of the embryos is guided by ultrasound, so the fluid in the bladder enables us to get a clearer picture of the catheter moving into the uterus.
Do I need to lie down after the embryo replacement?
No. Once replaced, the embryos are sandwiched in between the two sides of the lining of the uterus, so will not fall out, even when you empty your bladder.
Is there anything I can do to improve the quality of my sperm?
Your fertility is often a reflection of your overall health. Leading a healthy lifestyle, stopping smoking and reducing alcohol intake may all have a positive impact on the quality of your sperm sample. There may also be some benefit from taking supplements such as vitamin C and zinc. But remember, any effects of a change in lifestyle will not be noticed for at least three months as this is the length of the cycle of sperm production.
Frequently asked questions - preimplantation genetic diagnosis
What is preimplantation genetic diagnosis (PGD)?
PGD is a form of genetic testing available to some couples who are at risk of having a baby with a genetic disorder. It involves IVF or ICSI to help create embryos that can then be tested for the specific genetic condition affecting the family or couple. When the embryos are around eight cells in size one or two cells are removed and tested. It is then possible to tell the difference between affected and unaffected embryos. Usually one (although sometimes two) embryos that are unaffected are transferred to the woman's womb with the hope that she will become pregnant.
For what conditions is PGD available?
We must have a licence from the human fertilisation and embryology authority for every condition for which we offer PGD. Also available soon:
- Von Hippel Lindau
- Autosomal recessive polycystic kidney disease.
How do we arrange a referral?
We are an NHS centre and any couple entitled to NHS treatment may ask to be referred. In the first instance couples must have been seen at their local genetic centre and can be referred by them. We are usually able to offer an appointment within four weeks of receiving the referral letter.
How much does PGD cost and is there any NHS funding?
If we are able to offer a couple PGD we can apply to NHS England for funding. If you are not eligible for NHS funding, please request a copy of our latest price list.
What is the success rate of PGD in our centre?
At the start of treatment overall couples have around a 20% (one in five) chance of having a baby. Couples who reach the point where there are embryos to transfer have a 30% (one in three) chance of having a baby. Most of the couples having treatment have on average had two cycles of PGD and the chance of success per couple is 33% (one in three).
How many babies have been born following PGD in your centre?
Over 600 healthy babies have been born following treatment in our centre. We have followed up those babies at birth, one year and two years where possible. We are not aware of any major problems caused by PGD, but we acknowledge that worldwide PGD is still a relatively new technique and data is not yet available to confirm the long term safety of PGD. We are undertaking a collaborative study at present looking at the health of babies born following PGD.
How long does it take before we can start a PGD cycle?
PGD is complex and requires the expertise of the members of assisted conception unit, the genetics counsellors and the clinical scientists. The testing of the embryos is a very important part of the procedure and we have very robust steps in place to make sure it is as accurate as possible. This does mean that the preparation time for a PGD cycle will take several months although we will aim to move the process forward as quickly as possible.
There are many stages in the process and these are all discussed in detail in the PGD booklet (PDF 538Kb).
If I wish to ask more about PGD is there anyone I can contact?
The PGD coordinator or the genetic counsellors involved with PGD would be happy to answer your queries.
Assisted conception unit
11th floor, Tower Wing
Great Maze Pond
London SE1 9RT
Tel: 020 7188 2300, option 4