Appointments

Your appointment

Most couples come to Guy's Hospital 5 to 6 times per cycle. If you're travelling from a long distance, we can try to arrange some investigations closer to your home. We'll discuss this with you at your appointments.

PGT-M/SR is a complex and timely process. In general, from referral to embryo transfer, it can take from 8 to 18 months.

Once you start a PGT-M/SR treatment cycle, the process will take about 9 weeks to reach embryo biopsy. The most time-consuming part is the preparation before starting a PGT-M/SR cycle. We need to:

• do laboratory testing
• sometimes apply for a licence or funding
• make sure we have prepared you physically for PGT-M/SR

It takes between 6 and 12 months to start treatment.

How to get an appointment

Before attending an appointment to discuss PGT-M/SR, you and your partner must meet with your local clinical genetics service.

If you're not currently under the care of a genetics service, you can ask your specialist or GP to refer you to your local service.

Once your local genetics team has referred you to us we'll review your eligibility for NHS funding.

If we're able to offer you PGT-M/SR, we'll send you a pack with:

• information on PGT-M/SR
• forms for you and your partner (if applicable) to complete
• advice on how to organise your first appointment

We're also happy to apply for NHS funding for single people and for same-sex couples. If sperm or egg donation is needed, there may be an additional fee which is not covered by NHS funding. We can talk about this at your first appointment.

Changing or cancelling your appointment

Phone: 020 7188 1392

Email: [email protected]

Your first appointment

Your first appointment will be with one of our clinical genetics staff. It usually lasts around an hour. We'll talk about:

• a general introduction to PGT-M/SR treatment
• whether or not we'll need to apply for a HFEA licence
• the likelihood of success and the limitations of the procedure
• your general health and reproductive history
• how you might manage emotionally, practically and physically

We'll create a timeline for you. Sometimes we'll need blood or DNA samples from other members of your family. We'll talk about this at your 1st appointment.

After your appointment, we'll send you a letter summarising what we talked about. You're not committed to continue with PGT-M/SR at this point. If you decide you would like to continue, you'll be asked to send us a 'reply form' which will commit you to the PGT-M/SR process.

Depending on the genetic condition, we may then request DNA or blood samples from you and/or other people in your family. Once we have everything that we need, we'll refer you to the assisted conception unit.

Your second appointment

Your second appointment will be with the assisted conception unit. At this appointment, the fertility specialists will talk to you about the treatment. This appointment may include:

• taking a detailed medical history (both partners)
• blood tests (both partners)
• semen analysis (for the male partner)
• taking consent for the PGT-M/SR process (both partners)

If you or your partner have previously had fertility assessments, please bring the results with you.

At this appointment, we'll talk about the treatment in detail, as well as any risks involved. If you agree to continue at this stage, we'll ask you to sign consent forms which gives us permission to carry out PGT-M/SR.

We have a legal obligation to consider the welfare of any children born as a result of treatment. We'll ask you to complete forms asking questions about your background relevant to you having PGT-M/SR. We'll also ask for your written permission to contact your GP and any other doctors involved in your care.

Treatment

Once we have assessed your natural fertility and have everything we need from your family, the doctors at our assisted conception unit will book you in for your treatment. This process is the same as other types of in vitro fertilisation (IVF).

At the fertilisation stage, the eggs are fertilised by a process called ICSI (intracytoplasmic sperm injection). Each egg is individually injected with a sperm.

Once the fertilised eggs (now called embryos) are several days old, the lab will safely remove several cells for genetic testing. Genetic testing can take different amounts of time depending on the condition and the structure of your family. You'll be told in advance how long your genetic testing will take.

If there are healthy embryos at this stage, we'll transfer them to your womb.

After embryo transfer

Around 2 weeks after the embryo transfer, we'll ask you to take a pregnancy test. If you are pregnant, we'll arrange an early pregnancy scan. If all is well, you can continue with routine antenatal care in your local hospital. You won't need to see a specialist unless you have any other health problems.

We appreciate it can be extremely disappointing if you do not become pregnant. We'll arrange another appointment for you to talk about your treatment options.

If there is no medical reason why another round ('cycle') of fertility treatment would not be successful, we can discuss a further cycle. Couples can be funded for up to 3 cycles of PGT-M/SR through the NHS.

We can also arrange for you to meet with our experienced fertility counsellors. Counselling provides support from a trained professional who understands what is involved in your treatment. It can provide you with the time and space to talk over your concerns.