FAQs

Contact the clinic and tell us what medication you require and the quantity.  A nurse or doctor will review your notes and ensure that more medication is available for you.  We will book an appointment to arrange collection of the medication from the clinic.

If it is the weekend and you need to take medication over the weekend, Wynard Ward (Gynaecology) have an emergency supply of medication.

Please contact the clinic to discuss.  If required, we have emergency stock in the clinic.

If you have waited for four days for your period to arrive and it hasn’t yet come, then it is important that you do not start any injections. This isn’t uncommon so try not to worry. Please inform the clinic and the nurses will adjust your regime.  If necessary, your final scan date will be postponed to allow for the delay in starting FSH. Remember that day 1 of your cycle is always the first full day of bleeding.

The trigger injection will be provided at the scan appointment prior to egg collection or insemination by the nurse or doctor setting up your treatment. This will be in the form of Ovitrelle (hCG) or Buserelin and the dose and time of injection will be confirmed with you. Please bring a frozen cool pack and bag with you to transport the medication home with you as it will need to be kept chilled until you can store it in a refrigerator. It is important that you take the trigger at the time you have been advised, as the timing is crucial in relation to the maturation and release of eggs, and therefore the success of your treatment.

If you experience any of the side-effects that were explained to you during your consultation or planning appointment and find yourself feeling unwell or struggling to cope, then you must contact the clinic to discuss the matter with a nurse. If you are having a serious reaction to a medication including a severe rash, breathing difficulties, swelling of the face or pain in your legs then you must seek emergency medical care immediately as you may be having an adverse reaction to a medication you are taking.

You may be provided with syringes and needles from either the clinic or F2U. From time to time the colour and packaging of these products can change but we will endeavour to keep you informed and will provide injection training at your planning appointment before you are due to start self-injecting.

We recommend the following:

• Buserelin: 1ml syringe with orange safety cap (needle already attached) or 1ml syringe with a yellow or grey needle attached (whichever you have been provided with). You may use the same needle to draw up and administer the medication.
• Gonal-F and Ovitrelle: please use the needles supplied with the medication in its packaging.
• Cetrotide: use the needles and syringes provided with the medication, mix with the larger needle and administer with the small needle.

Buserelin, Cetrotide, and Gonal F are all injected subcutaneously (just under the surface of the skin) and can be injected into either the tummy or front/side of the thigh areas. You will have injection training at your planning visit where a nurse will demonstrate how and where to inject safely.

Cetrotide, Ovitrelle and Gonal-F all need to be stored in a refrigerator. If you are collecting any of these medications from the clinic then please bring a cool bag and frozen ice-pack with you to keep the medications cool on your journey home.

Please return any unwanted or out-of-date medications, including tablets and patches to the clinic where we can dispose them safely for you. If the medications are in date, then you may store them safely in your own home if you are considering future treatment. We can accept your used sharps containers providing they are returned fully closed and not overfilled beyond the line on the box. All needles must be returned within a closed, approved sharp’s container.

We advise that all women trying to conceive take folic acid (400 mcg daily) and vitamin D (10μg/d or 400 IU/d) supplement. Some women might have a higher chance of pregnancy being affected by neural tube defects and should be taking a higher dose of folic acid (5 mg). This may apply if you have a family history of neural tube defects, some medical conditions and raised BMI. If any of this applies to you, please discuss with your GP or a clinic doctor at your initial consultation.

Vitamin A should be avoided in pregnancy. If you wish to take a multivitamin, please ensure that you are taking a supplement designed for those trying to conceive or in pregnancy so that these recommendations are taken into account. Don’t forget a healthy balanced diet should also help to ensure you are getting the right vitamins and nutrients so a multivitamin isn’t essential.

If you are taking any medications, or are prescribed a medication during the course of your treatment then please discuss this with your GP and fertility doctor, it is important that we have a record of what you are taking in addition to your fertility medication in your notes. It is safe to take paracetamol or other mild analgesia for pain relief at its correct dose.

You should be aware that most of homeopathic or herbal remedies will not have been tested in proper drug trials and may interfere with your medication or be contra-indicated in pregnancy. It is important to check that they are safe to take whilst trying to conceive. Clinic staff will not be able to advise you on the safety of unlicensed medication. Your pharmacist should be able to advise you.

If you think you have symptoms of ovarian hyper stimulation syndrome (OHSS), an over-response to fertility medications, then please contact the clinic immediately. Symptoms include feeling bloated, experiencing lower abdominal pain, feeling nauseous, and sometimes, being short of breath. The most efficient way of assessing if you have OHSS is to perform a trans vaginal ultrasound scan.  Therefore, you will need to contact the clinic to discuss and arrange this with a specialist nurse. In mild cases, rest, increasing fluid intake, and taking paracetamol can help but, in more severe cases, an admission to Wynard Ward (gynaecology) may be necessary to assess and manage the situation appropriately.

Out of hours, please leave a message on 01392 40 5051 or email rduh.fertilityexeter@nhs.net

In an emergency, you can call Wynard Ward (which specialises in gynaecology) via the Royal Devon and Exeter Hospital main telephone number 01392 411611. Please only use this number for emergency enquiries and matters which are unable to wait until the next clinic working day. Wynard Ward will not have access to your fertility notes and will be unable to advise on individual treatments.

All enquiries will be prioritised by the nursing staff as they are received.  We will endeavour to contact patients with serious medical conditions as soon as we possibly can. Other urgent enquiries will be dealt with in order of priority, and you can expect a response within 48 hours. If you have called with your day 1 and need a regime, you will receive this in the post/email.  A member of the nursing team might also contact you to arrange scans and appointments.

You can either leave a telephone message (01392 40 5051) or email with your day one to rduh.fertilityexter@nhs.net.

The nurses will then schedule your fertility treatment using the information you provided. You will receive a copy of the regime with the dates and times of your medications for you to follow.  You will also receive, appointment letters for scans and other nursing appointments.

If it is your first treatment cycle, you will be invited to the clinic for a planning appointment to discuss your regime in person and provide injection training prior to you starting any medications.

It is essential that the treatment consent forms  are completed in the clinic and witnessed by a healthcare professional.  Therefore, both partners must be in attendance if undergoing treatment as a couple (IUI and IVF planning appointments).

If you are undergoing treatment without a partner, or if you are in a couple and your partner is unable to attend, you are welcome to bring a friend or relative with you to scan appointments for support.  It is advisable to inform the person conducting the appointment beforehand if there are any confidentiality issues.

For IUI or embryo transfer appointments it isn’t essential to have your partner present but they are very welcome to attend if they wish.

Please note that we recommend you to attend your appointment without any children. If this isn’t possible due to unforeseen circumstances, please contact the team so we can make sure we book your appointment accordingly.

The safety of staff, patients and visitors is important in order for us to provide the best service. We do appreciate that things do not always go as we would wish, potentially leading to difficult conversations. It is essential that all parties remain respectful towards each other and conduct themselves appropriately. There are circumstances where staff are subjected to challenging behaviours and we wish to draw your attention to the Trust Never part of working in NHS poster

Thank you.

We advise that you should take a couple of days off work following your egg collection (in IVF cycles). This is to allow time to recover following your egg collection procedure and to allow time for your body to recover from the effects of ovarian stimulation. This is especially important if you have developed a large number of follicles in response to fertility medications or have symptoms of OHSS as you will need to rest sufficiently. We cannot issue ‘sick notes’ for work purposes, but we can issue you letters for any appointments you have at the clinic.

Your consultant will advise which blood tests are required at your first appointment. Blood tests can be carried out at our clinic or at Wonford Hospital.

Not necessarily, the scan can be booked in between day 10 and 14 of the cycle.  However, the timing will depend on availability of scan appointments. When you contact the clinic a member of the administration team will advise you on when you can book your scan.

Contact the clinic if your period has not arrived by day 42. We will advise you if you need to take any medication to trigger a bleed so you can continue with the next treatment cycle.

If you have started bleeding following an unsuccessful IUI treatment, you will only need a day two scan if the previous cycle was abandoned for over response. Medications for the next treatment cycle will not be supplied until you have called us with your day one of your period.

Current Department of Health advice is that alcohol should be avoided altogether whilst trying to conceive. The advice also states that if you do drink alcohol, to stick to no more than one to two units once or twice a week and not to get drunk. There is good evidence to show consuming alcohol can reduce male fertility so your partner may wish to consider their alcohol intake and cut back if necessary.

A healthy balanced diet is important during fertility treatment to help give you the best chance of conception, and also to prepare your body for a healthy pregnancy and beyond. We don’t advise that you avoid or eat anything in particular, and the odd treat is certainly permitted!

There are no contraindications to having sex during treatment although we do advise two to three days between ejaculates for treatment samples to ensure sperm quality is optimal.  It is best to avoid sex in the two to three days leading up to egg collection or intrauterine insemination. If you are having an endometrial scratch, however, we do advise that you avoid trying to conceive in the cycle you are having the procedure.

It can be a worrying time waiting for the outcome of your treatment cycle. The nursing staff will contact you by telephone approximately a week after your embryo transfer/insemination to enquire about your wellbeing and to discuss any concerns you may have; this call is optional. Regardless of whether you choose to take this patient support call or not, you can call or email the clinic for advice and support during this time.

It is too early to test.  We would advise that you continue taking any medications that you have been prescribed until you know the outcome of your treatment cycle. It is a really worrying time, and if you feel like you need some reassurance, we are at the end of the telephone to discuss any anxieties you have.

If you have performed your pregnancy test on the designated date using a good quality urinary pregnancy test kit and the result is negative, you may discontinue any prescribed medications (if applicable) and inform the clinic of your result.

Following unsuccessful treatment, we will arrange a debrief appointment for you prior to booking further treatment.  If you wish to book further treatment then we would advise that you have a drug free period before commencing any further fertility medications.

If your home pregnancy test is positive, and you have tested on the correct day and not earlier, then contact the clinic to arrange a seven-week pregnancy scan and to collect or arrange a delivery of further medications if required. In the meantime, should you experience a one-sided or severe lower abdominal pain and/or bleeding you must contact the clinic immediately to speak to a nurse.

For both NHS and self-funding patients, you can visit your GP who can make a referral to our service, if appropriate. Self-funding patients may also complete our self-referral form.

Once you have been booked for treatment, you will receive an invoice shortly afterwards. The invoice may be split into two components if you are booking in advance. One will be a deposit to reserve your treatment slot.  The invoice for outstanding amount will be sent nearer the time of commencing the drug regime.

Once you have had a consultation appointment about your treatment choice (an implication appointment), the clinician seeing you can discuss the availability of the month you wish to have treatment in.  Alternatively, the treatment month will be confirmed at your first planning visit with the nursing team.