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Treatments

We offer a wide range of treatments

At Fertility Exeter we offer a wide range of assisted conception treatments to help you achieve your dream of creating a family.

Science keeps advancing, treatments keep getting better, and more and more babies are being born using techniques such as the ones listed below.

 

Consultation and Diagnostics

Fertility Exeter has a multidisciplinary team of staff consisting of Doctors, Nurses, Embryologists and Counsellors who can help to determine the cause of, and map out the most effective solution to your subfertility. This may include a number of tests and investigations to help with the diagnostic process.

In Vitro Fertilisation (IVF)

IVF is the process of creating embryos in the laboratory and placing them back in a woman’s womb to achieve a pregnancy. Eggs are taken from a woman’s ovaries after she has taken drugs to stimulate egg development. The eggs are mixed with sperm to create embryos (fertilised eggs) which are then replaced in the woman’s womb two to six days after egg collection with the hope of conception. The law relating to IVF limits the number of embryos that can be transferred. If there are high quality embryos remaining after embryo transfer, freezing may be offered.

Intracytoplasmic Sperm Injection (ICSI)

ICSI is an additional process in IVF in which a single sperm is selected from the processed semen sample using a special microscope and advanced micromanipulation equipment. An individual sperm is injected into each suitable egg to create an embryo. This technique is reserved for those couples where sperm function problems significantly increase the risk of a complete failure of fertilisation.

Frozen Embryo Transfer (FET)

If high quality embryos have been cryopreserved after an IVF cycle, an FET can be considered. The lining of the womb is prepared with a series of hormone drugs to optimise the receptivity of the lining of the womb prior to warming of the embryo/s and replacement within the woman’s womb.

Intra-uterine Insemination treatment (IUI)

IUI involves using a catheter to put washed, prepared sperm near the top of the cavity of the womb around the time of ovulation to increase the chance of getting pregnant. This is usually combined with ovulation induction drugs to ensure optimal timing of IUI.

Egg Banking

Egg banking is a process of storing eggs, obtained in a similar way as for conventional IVF, from a female who has reached puberty. The eggs are mixed with a special fluid to protect them from the harmful effects of freezing before being frozen and stored; for short or long periods. Egg banking is used at Fertility Exeter when there are factors likely to affect the future fertility of the female and in the egg donation/egg sharing programme. It is not suitable in certain types of cancer due to the delay in staring cancer treatment.

Semen Analysis

This is a test to check the ‘quality’ of sperm, which gives an indication, although not an absolute assessment, of a man’s fertility potential. It involves looking at a semen sample under the microscope to see how many sperm there are, what proportion are moving vigorously and what proportion have a ‘normal’ shape. A ‘trial preparation’ may be recommended to help decide what type of fertility treatment is most appropriate.

Egg Donation

Eggs can be donated from a fertile donor to a woman whose own egg reserve is reduced for a number of medical conditions. Donors may be egg sharing donors who donate as part of their own treatment or less commonly as altruistic donors who donate all their eggs in a non-treatment cycle.

Sperm Banking

Sperm banking is a process of storing sperm in a deep-frozen state for short or long periods. The sperm are mixed with a special fluid to protect them from the harmful effects of freezing before being frozen and stored. Banking is indicated when there are factors likely to affect the future fertility of a male who has reached puberty such as treatment for cancer or conditions needing drugs known to cause fertility problems or abnormalities in pregnancy. Sperm banking can also be provided for couples needing assisted conception where the man is likely to be absent due to circumstances beyond his control and for cases of male to female gender reassignment although these cases are very unlikely to receive NHS funding.

Donor Insemination (DI)

DI follows the same process as IUI, but uses screened, prepared donor sperm.

Surgical Sperm Recovery (SSR)

SSR is a method for obtaining living sperm directly from the testicles.. It is needed for men who have been born with or who have developed a blockage of the tubes which transport the sperm away from the testicles (including post-vasectomy); and men with disabilities which affect ejaculation. The method used at Fertility Exeter is called Testicular Sperm Aspiration (TESA).

Tubal Patency Testing

Tubal blockage or adhesions affect up to a third of women experiencing a delay in getting pregnant. There are three ways of checking whether a woman’s fallopian tubes are open (patent):

* An operation called a laparoscopy and dye test,

* A contrast tubal patency scan called a HyCoSy scan and

* An X ray procedure called an HSG.

In some cases the woman can have these tests done on the NHS but some women may not be eligible for NHS funding. NHS funding depends on your individual circumstances and the CCG for your GP’s surgery. All of those policies are on your local CCG’s website. If you aren’t eligible for NHS funding or if you want to speed up the process of fertility investigations, you can opt for self-funded tubal patency testing.

At your initial consultation in Fertility Exeter, the doctor will take a clinical history and assess your risk of having tubal disease.

Fertility Exeter can arrange for your blood to be tested to screen for past or silent Chlamydia infection. We can also provide screening with self-taken Chlamydia swabs. If your Chlamydia blood test is negative then your chance of tubal blockage is less than 10% and tubal patency testing with a HyCoSy scan is very reasonable.

If your blood test is positive then your risk of tubal blockage or adhesions may be as high as 60-70% in which case we would recommend considering a laparoscopy and dye test. The advantage of a laparoscopy and dye test is that it is better at diagnosing adhesions and often surgery can be done at the same time to break down adhesions or open the tubes up. The disadvantage is that it is an operation and it carries uncommon but potentially serious complications. None of the doctors in Fertility Exeter undertake private practice but we can refer you on to colleagues who see patients at the Nuffield Hospital or you can explore with your GP whether you can be referred for an NHS funded procedure.

A HyCoSy scan is ideal for women who are at low risk of tubal blockage but who want to check their tubes prior to insemination treatment using either donor or their partner’s sperm. It is also suitable for women who want the reassurance that their tubes aren’t blocked so that they can continue to try to conceive naturally.

A HyCoSy scan is an ultrasound scan done after a small tube (catheter) has been passed through the cervix into the cavity of the womb and then a microbubble mixture is injected through the catheter while a scan is carried out. The procedure also includes a detailed scan of the womb and ovaries. For a more detailed description of the procedure please see our patient information leaflet in the relevant section of our website. If the HyCoSy scan shows any abnormalities then you may be recommended to have an operation to investigate further. This would be explained to you at the time of your HyCoSy scan and a follow up appointment will be arranged for you to discuss the options in detail.

To arrange a HyCoSy scan please contact Fertility Exeter via a GP referral or a self-referral form. Details of the costs of the procedure are in the Costs section of the website.