Fertility Centre

This is an unsettling time and we want to provide clarity on our plans over the coming weeks.

Treatments
 All Homerton Fertility Centre patients who are currently in IVF treatment can complete their cycles, however any embryos created from these cycles will be frozen and not transferred. It is with deep sadness that we will have to temporarily postpone all new treatments cycles, (Insemination, IVF and Frozen cycles) investigations and sperm assessments until further notice.

Clinics
We will no longer be able to offer face to face consultations so please do not come to the hospital. For those patients who have appointments in the next few weeks, we will be contacting you by letter or telephone.

We will update our web page on a regular basis and suggest you check for updates on a monthly basis

We ask you to read what guidance Public Health England offers regarding seeking help from neighbours, friends and family, about maintaining good mental health, about ensuring the safety of vulnerable people around you and about ending the isolation after 7 days. More information is available on the NHS website here.

Before your treatment starts

1.How long do I have to wait after I am referred by the GP or another hospital?
We aim to see all patients with in the NHS waiting times criteria.

3. Me and my partner have been investigated already. Will I be on the waiting list sooner?
At Homerton we do some specialised blood tests for both you and your partner which are not avaible through your GP. Hence the waiting times remain the same.

4 .How many cycles of IVF are we eligible for at Homerton Fertility Centre which will be funded by NHS?
Homerton Fertility Centre does not decide the number of cycles that will be funded by NHS. This is pre-decided by the Clinical Commissioning Groups already. (Local health authority). Please contact your GP to know what you are eligible for.
The doctor in the clinic will discuss it furthur in your first appointment. 

5.I have had Private IVF cycle already. Am I still eligible for treatment on NHS?
 Any private attempts of the IVF are    counted towards the NHS cycle. You might still have NHS funded treatment if you are eligible for more than one cycle of IVF through NHS.

6. Am I in the right age to have the NHS funded IVF treatment?
NHS funded IVF treatment is available for the women in the age group of 24 yrs to 42 years. Women between 40- 42 are eligible for treatment if they do not have any previous IVF attempt.
Please note age is not the singular criteria to determine  eligibility.

7. Am I too old to have the IVF treatment?
Every case is individualised to see if the IVF treatment will be beneficial for the couple. However we do not offer IVF treatment to women over 45 completed years.

8. I am a single women. Can I have the NHS funded treatment?
Your CCG will fund IVF treatment if you have a fertility issue and if you fulfil the eligibility criteria

9. I am thinking to go for egg donation. Does Homerton Fertility Services offer Egg donation Services ?
We do offer consultation to guide you about the process and medical aspect of the egg donation. However ,we do not offer the egg donation services.

10.What are the best things we can do as a couple to help our treatment?
Simple measure like stop smoking and  cutting down  alchohol, having plenty of fresh food and vegetables and  some exercise is often enough to help you.
The staff will try its best to optimise your treatment through the latest technology to help you.

11. I am doing the self funded treatment . Can I pay in instalments?
The cost has to be paid in full at the Homerton Hospital Finance Department before the treatment starts.

During the treatment 

1. Do I have to take time off work?
Majority of the women feel well during the treatment and do not need any change in their day to day life. A typical treatment cycle ends between 5- 7 weeks.

2. I do not want anyone to know that I am undergoing the treatment . How will I ensure that?
We take your confidentiality very seriously. Your information is only shared on  need to know basis with the other health care professionals as GP. We ask for your consent that who we can share the information with before we start the treatmen

3. Can I exercise or swim during the treatment?
You can undertake any light exercise during the treatment cycle.

4. Can I have intercourse during the treatment?
We advise you to have no intercourse or protected intercourse during the treatment.

5.Does my partner have to come for every visit?
You and your partner are expected to attend for all consultation visits with the doctor or the nurses  and the day of the egg collection. You can attend alone for your scan appointments alone if you wish.

 6.How am I going to get the medications?
Once we start the treatment all your medications are delivered at the address of your choice, Please bear in mind these medications are very expensive and we request you to store it at the recommended temperature.

 7.Do I have to rest after the embryo transfer for the embryo might fall down if I get up?
Once the embryo is placed in the womb there is no chance for the embryo to fell down as it is safely tucked between the two walls of the womb. All studies suggest that bed rest after the embryo transfer does not translate in improved pregnancy rates.

8. I am spotting after the embryo transfer? Does that mean I am not pregnant?
Many women experience light bleeding and spotting after embryo transfer. You will only know that you are pregnant or not by doing the blood pregnancy test booked for you at blood clinic at the Homerton two weeks after your embryo transfer.

9. I have all the symptoms of pregnancy after the embryo transfer? Does that mean I am pregnant?
You are on plenty of hormones that support the pregnancy and gives you symptoms like breast soreness, nausea etc.

10.How do you make sure that my egg and sperms are not mixed with any-one else’s?
We have two simultaneous systems that the eggs and sperms from various patients  do not get mixed. These are manual witnessing and electronic witnessing. These systems are highly sensitive  and both systems running together ensure that the eggs and the sperms from one patients are not mixed with another patient.

After the treatment

1. My pregnancy test is positive. What do I do?
Please keep on taking the medications which we have advised you to take. You will be invited to come for a early scan at 7-8 weeks to confirm the site and the viability of the pregnancy.

2. Can I have intercourse after positive pregnancy test?
As soon as you feel physically and mentally prepared to resume sexual activity, you can.

3.My pregnancy test is negative. I want to see the specialist immediately to find what went wrong! Can I see the specialist immediately?
We understand that it is a very distressing time for both of you. However we want both of you to settle physically and emotionally before we can talk to both of you about the causes of failure and the next step. Usually you will be seen by the specialist in eight weeks’ time. Counselling services are available free of charge. Please book for a counselling appointment if you feel the need to. 

4. Did I do anything wrong? Is that why the pregnancy test is negative?
You have done your best to achieve a pregnancy. Majority of time it is the chance alone and sometimes it can take more than one attempt to achieve pregnancy.

5. How do I expect my periods to be after a negative pregnancy test?
You can expect to have either an early or a delayed period. It can be heavier than usual before it settles down in its usual pattern. 

6. How soon can I have intercourse after failed pregnancy test?
As soon as you feel physically and mentally prepared to resume sexual activity, you can.

7.Do I have to wait to start the cycle again?
All NHS patients go back on the waiting list again. It helps you to heal physically and mentally.

The Homerton Fertility Centre offers insemination and IVF treatment using donor sperm for couples and single women.

Who needs to use donor sperm for treatment?

• Same sex couples
• Single women
• Heterosexual couples with male factor infertility

What are the legal implications of using donor sperm?
Any child born from donor sperm is the legal child of you and your partner, if you have one. Although the donor is the biological father of the child he will not be the legal parent of the child. The donor has no legal rights or financial responsibility for the child. 

Identifying information about donors is held on the HFEA Register and may be given to any child born from a donation once they are 18 years old.

Consent to parenthood must be in place prior to treatment commencing with donor sperm or embryos; otherwise any child born will not have a second legal parent.

Funding for treatment cycle
If you are having NHS treatment there is no charge for the procedure, scans or medication. NHS funding is dependant on the eligibility of your CCG; this should be discussed at your initial consultation.

For self funding patients please check our price lists in reception. Please be aware the cost of donor sperm is always self funded, even if treatment is NHS funded.

How do I start the process?

1. Referral by GP/other hospital.
2. Consultation at Homerton with a fertility specialist, where a detailed history will be taken and investigations ordered. Both you and your partner (if you have one) will need to attend.
3. Counselling for you and your partner is mandatory before the treatment starts.

I want to start treatment, what happens next? 

1. Appointment for you and your partner to see the counsellor.
2. Ensure sperm is purchased and transferred to Homerton Fertility Centre. 
3. Last stage before starting treatment - Nurses appointment to ensure:

• all consents completed
• that you understand the treatment process
• how and when to contact the centre
• that all necessary investigation have been done and are still valid ( some need to be repeated; normally annually)
• to check the sperm is stored at the Homerton before you start treatment
• answer any queries relating to treatment or funding.

How do I buy a sperm sample?
Donor sperm may only be procured from donor banks. This sperm is screened and quarantined and ready for use when transferred. Sperm can be bought online after matching for your preferred characteristics.

Please do not buy sperm until all the other relevant investigations have been completed and treatment plan finalised. Please check the credentials and license for a sperm bank, especially one outside the UK as this may affect import of the sperm into the UK due to stringent HFEA licensing laws.

Screening the sperm donors
Sperm donors are screened rigorously as per the national guidelines to ensure safety. They are screened at history taking for any medical disorders or family history for a condition which may potentially affect the child.

Similarly blood tests are used to screen for STI and genetic abnormalities. For more information see National Gamete Donation Trust.

When ordering sperm what do I need to know?
It will be very confusing trying to work out what type of sperm to order and how much, below is a basic guide to help 

• Only sperm originating from “open donor/ donors agreeing to indentify disclosure” can be purchased for use within the UK. Do not purchase sperm from an anonymous donor.
• If you order from a recommended bank, one vial or straw will be sufficient for one treatment cycle( very occasionally have we had to use 2). You need to know your CMV status (blood test result) before ordering sperm.
• If you are CMV positive you can choose a donor that is negative or positive.

If you are CMV negative we recommend you only buy CMV negative sperm.

• For Insemination cycles you should choose either an IUI washed sperm sample, with a minimum count of 30 million motile sperm per ml or unwashed IUI sample with a minimum of 60million motile sperm per ml.
• For IVF cycles you can choose a sperm sample with a lower motility and count as we need less sperm for treatment. (these will be cheaper but do not be tempted to use them for insemination cycles as this is a false economy).

Washed or unwashed sperm? If you buy washed sperm you have a guaranteed count in the final thawed sample – if unwashed, we need to prepare the sperm at Homerton; although we do not charge for this, you may find the count reduces with the final preparation.

Dry ice or liquid nitrogen. You can use either to transport your samples to Homerton. We recommend liquid nitrogen as the temperature of dry ice is not as low and if there are delays with transportation, there is a potential for the sample to thaw.

Donor banks we use and can recommend 

• European Sperm bank based in Denmark   
• Xytex international based in the USA  

Sperm bank costs

1. Cost of sperm, they can be bought in either straws or vials. There is no difference in samples, some Centres will have a preference for straws others vials, when freezing sperm. Remember sperm costs will vary according to count and motility.
2. It is not cost effective to buy one at a time unless you are only having one treatment cycle.
3. The sperm banks will charge a transportation fee (courier fee). 
4. Most sperm banks will charge a pregnancy slot .The pregnancy slot is your eligibility to be one of the 10 families that the donor is legally allowed to create. This ensures that the 10 family is not reached whilst you are waiting to start treatment.

More information

Your consent to being a legal parent (PP)
Your consent to your partner being a legal parent (WP)
Legal parenthood leaflet
Legal parenting in the event of your death

Before treatment can take place you will need to complete a number of consent forms. This is because the clinic needs to make sure that you understand and agree to all that is involved in having your treatment.

The consent forms are necessary to protect you and any child you may have from the treatment. The HFEA provides clinics with consent forms for different treatment options and you and your partner will have to sign the forms relevant to the circumstances for the consent to be valid.

Treatments cannot commence legally without the consent of both partners if it is applicable.

Under the terms of the Human Fertilisation and Embryology Act (1990) you are required to give written consent depending on what treatment you are going through. 

A few key points to remember about the consents is

1. You can change your consent any time before the embryo is replaced.
2. If you have stored embryos, it is important to remember both partners involved in the initial treatment, must provide written consent at the time when the embryos are replaced. If your partner withdraws his consent, it will not be possible for us to replace the embryos.
3. We stress strongly that you keep a copy of the consent for future reference.

See the link below to see the consents we use in the clinic for various treatment.

The staff at the centre will help you understand the consent procedure.

You can get the consent form from the HFEA website

Pregnancy success rates 2018

Ageprofile	IVF / ICSI  (per embryo transfer)vc	Insemination cycle using partners sperm (combined stimulated and non-stimulated data)	Insemination cycle using  donor sperm (combined stimulated and  non-stimulated data)	Frozen embryo transfer  (per embryo transfer)
23-34  years old	53%  73/138	12% 5/42 per cycle	25% 5/20 per cycle	60% 170/282
35-37 years old	37%  37/100	7% 2/27 per cycle	33% 4/12 per cycle	58% 87/149
38-39  years old	53%  33/62	25% 2/8 per cycle	25% 2/8 per cycle	49% 50/102
40+ years old	32%  27/84	18% 2/11 per cycle	10% 2/20 per cycle	53% 39/74
		All ages per patient 17%  11/65	All ages per patient 46%  13/28

* Pregnancy data above based on cycles with a positive pregnancy test following treatment.
    For National pregnancy rates please go to www.hfea.gov.uk(success rates) 

We currently fund the services in two ways. 

NHS services

NHS funding is the remit of  Clinal Commissioning Groups (CCG; your local health authority) however, not all CCGs fund fertility treatment and those that do have set eligibility criteria. You can speak to your GP to find out if you are eligible for treatment.

You can also have a look at the eligibility criteria on the following pages as a guide but please note that this can change at very short notice depending on your CCG’s funding availability.

Self Funding Patient
This is where you receive the same service as NHS funded patients but you choose to fund your own treatment if you do not meet the eligibility criteria for NHS funded treatment or do not want to wait for NHS funding to become available.

Self-funding patients are seen for treatment in NHS clinics by doctors and nurses who are on duty at the time of their appointment. If you wish to be self-funding you will still need to have been referred by either your GP or a hospital in order to be seen.

We offer self-funded treatments and do not offer private treatments. 

Treatment prices include HFEA fees but do not include the cost of drugs. Please note prices may change without notice.

Self funding treatment costs from April 1 2018

IVF (In Vitro Fertilisation)	£3,100
IVF egg collection no embryo transfer	£2,790
ICSI (Intra Cytoplasmic Sperm Injection)	£4,000
ICSI egg collection no embryo transfer	£3,600
ABANDONED IVF/ICSI	£1,000
IVF + Elective Embryo Freeze and one frozen transfer (inclusive of 1 years storage fee)	£4,100
ICSI + Elective Embryo Freeze and one frozen transfer (inclusive of 1 years storage fee)	£4,800
FER (Frozen Embryo Transfer)	£1000
Abandoned FER no transfer	£400
Intra Uterine Insemination using partners sperm (IUIH)	£650
Intra Uterine Insemination using donor sperm (IUID) (Excluding sperm; please contact laboratory for exact costing)	£700
IUI abandoned cycle no insemination	£300
Cycle tracking	£300
Private scans (each)	£230
3D Private scan (each)	£275
Private sperm test	£120
Transfer of samples between centres to EU country (admin cost)	£120
Transfer of samples between centres to non-EU country (admin cost)	£170
Embryo freezing	£625
Sperm freezing	£400
Egg, embryo, sperm annual storage	£300

Andrology is the medical speciality that deals with men's health. We are located within the Fertility Centre and offer a dedicated diagnostic service.

Our diagnostic service provides:

• diagnostic semen analysis as part of a routine infertility investigation
• post vasectomy semen analysis to check the success of the vasectomy operation

How to make an appointment

NHS appointments
Tests must be requested by a GP or other specialist doctors using local forms or a brief letter requesting a semen analysis. The GP or requesting specialist may add any additional requests relating to the investigation.

You must have a completed request form or letter from your GP or specialist along with the instruction sheet (available on this website). Please contact the andrology department to arrange an appointment and you must collect a toxicity tested specimen pot from the Fertility Centre reception.

Request forms or letter must be returned by patients on the day of the appointment. We will not accept samples if:

• the request form or letter is incomplete from the referring doctor or GP
• specimen pot is not from the fertility unit
• specimen is produced over one hour when reaching the fertility unit

Private patients
You can refer yourself to the andrology department. You must pay for the test and results. For current charges please check the self-funding treatment costs link in red just above the Andrology link.

Location and contact details

Andrology department     
Fertility Centre  
Homerton Hospital            
Homerton Row         
London E9 6SR

tel: 020 8510 7813
email: huh-tr.homertonivflab@nhs.net

Opening times (by appointment only)

Monday 13.30-17.00
Tuesday 07.00-8.30 and 13.00-14.00
Wednesday 13.30-17.00
Thursday 07.00-08.30
Friday 13.30-15.30

We are not open bank holidays and weekends.

Patient and GP information

Semen analysis guide for patients
Semen cryopreservation for cancer patients
Post Vasectomy Guide for GP Surgery
Vasectomy semen analysis for patients
Semen analysis guide for GP surgery

Homerton Fertility Centre takes research commitment very seriously to further improve patient care and understanding of the various fertility issues from a scientific perspective.

The Research section at the Homerton Fertility Centre was set up in May 2010 headed by Professor Roy Homburg. The aim was to initiate and promote evidence-based research which would enhance the quality of care for the patients while also enhancing the scientific reputation of the centre. Since its inception we have achieved more than 30 publications reporting our research in leading journals, several chapters in books, one textbook and multiple presentations at international conferences. This has been accomplished thanks to a team effort of trainees in reproductive medicine, consultants, nurses, embryologists and administrative staff, all of whom deserve a share of the credit for their enormous enthusiasm. The future is also very promising as a number of large scale studies are presently running to investigate pressing questions for the improvement of patient care, some of them initiated by the Homerton team that are being conducted in several centres throughout the UK. If there are any questions regarding our studies, including requests to participate, please contact huh-tr.fertility.unit@nhs.net

Professor Roy Homburg MB.BS, FRCOG
Affiliation:
Head of Research, Homerton Fertility Centre, Homerton University Hospital, London, UK.

Professor Homburg is an obstetrician and gynaecologist who specialises in reproductive medicine. He has held posts as Professor of Obstetrics and Gynaecology at Tel Aviv University Medical School, as Professor of Reproductive Medicine at the Free University Medical Centre in Amsterdam, The Netherlands and, presently, as Professor of Reproductive Medicine at Queen Mary, University of London.

Professor Homburg now consults in both the UK, as Head of Research at the Homerton Fertility Centre, Homerton University Hospital in London, at the Hewitt Fertility Centre at the Liverpool Womens Hospital and in Malta, as an advisor to the Ministry of Health. 

As a fertility specialist, Professor Homburg has a worldwide reputation having published 200 research articles and chapters in books and has written or edited seven books. He has been invited to lecture in all five continents at frequent intervals and has won prizes for his research at the British Fertility Society (twice), the American Society of Reproductive Medicine, the European Society of Human Reproduction and Embryology (ESHRE) and the Israel Fertility Society (3 times). He has served as an associate editor for Human Reproduction and presently for Human Reproduction Update.

Professor Homburg’s main interests and speciality are the treatment of infertility in general, polycystic ovary syndrome, ovulation induction, ovarian stimulation and IVF.

Priya Bhide
MD MRCOG Associate Specialist

Dr Bhide is an experienced member of the senior clinical team having worked for more than a decade at the Homerton Fertility Centre. She leads the audit programme and is the clinical member of the quality management and clinical governance teams at the fertility unit.

Dr Bhide is research active and has published original research on anti-Mullerian hormone (AMH) and polycystic ovary syndrome (PCOS). Her research interests include reproductive endocrinology, especially AMH and PCOS; and gynaecological ultrasound. She was invited to be a member of the Reproductive Medicine Clinical Studies Group of the Royal College of Obstetricians and Gynaecologists.