ACS is licensed by the UK’s regulator of assisted conception treatment (the Human Fertilisation and Embryology Authority) to provide the following services:
Gonadotrophin Ovulation Induction and Intrauterine Insemination (OI/IUI)
Stages of Treatment
Downregulation
OI/IUI starts with the suppression (stopping) of your normal menstrual cycle, and we call this down regulation. To do this we will give you an injection called rostap on a specific day of your menstrual cycle. This may cause some menopausal type symptoms (for example, mild headache, hot flushes, mood swings). Usually, you will have a period around 1-2 weeks later. This period may be heavier than normal.
Stimulation
Around 2 weeks after prostap, we will perform a transvaginal (internal) ultrasound scan to look at your uterus and ovaries. If all is well at this stage, we will give you Follicle Stimulating Hormone (FSH) injections to take at home every day. We will show you how to do these injections yourself.
Monitoring
We will monitor your response to these injections by doing regular transvaginal ultrasound scans and blood samples from day 8 of injections. Each woman’s response to this treatment is different and you may need to take injections anything from 8 to 20+ days. You will attend regularly for appointments to monitor your response while taking the stimulation injections. Depending on the results from the regular tests, we may change the dose of drug in your treatment to help stimulate your ovaries.
Unfortunately, some women may not respond to this treatment which means that none of the follicles in your ovaries grow. In this case we will stop the treatment and review your case. In other cases, too many follicles develop, and treatment is cancelled. This is to reduce the chance of becoming pregnant with more than one baby (Multiple pregnancy | Tommy’s) which has increased risks for mothers and babies.
Once a mature follicle has developed in one of your ovaries, and your endometrium has thickened, you will take an hCG booster injection. This hormone matures the egg and causes ovulation. You will be given this booster 40 hours before having your insemination. Please note that the timing of this injection is critical and it must be done at the exact time specified to you by the ACS staff.
IUI Sperm Sample (for male partners)
On the day of your partner’s IUI you will need to produce a fresh sperm sample. You should ejaculate 2 days before attending to provide your sample. On the morning of the planned IUI we will show you into a private room to produce your sperm sample.
Embryology staff will prepare the fresh sample to be transferred into your partner’s uterus.
IUI Procedure
The procedure is very similar to a smear test. A speculum is inserted into the vagina to pass a catheter through the cervix. Attached to the catheter is a syringe containing prepared (‘washed’) sperm. When the catheter is in the correct position, the operator will depress the syringe, and the sperm will be deposited into the uterus. The catheter is very fine and is normally not felt by the patient.
Please see Frequently Asked Questions – NHSGGC for more information.
Aftercare
After your IUI you will require progesterone to help support the endometrium. This is taken through vaginal pessaries 12 hourly until pregnancy outcome date. After the IUI a nurse will give you the date to do a pregnancy test at home and the email address to let us know the result.
Risks of OI/IUI
The main risk of OI/IUI is becoming pregnant with more than one baby at a time Multiple pregnancy | Tommy’s. We will monitor you closely throughout treatment to try and prevent this.
Ovarian Hyperstimulation Syndrome (OHSS) is a risk for anyone having stimulation of their ovaries with hormones. We will monitor you closely throughout treatment to try and prevent this, but it is important that you know the signs and symptoms. Ovarian hyperstimulation syndrome (OHSS) | RCOG
Intrauterine Insemination
Content coming soon…
In Vitro Fertilisation (IVF)
Before explaining IVF, it is useful to explain the natural fertilisation process (getting pregnant).
Each month an egg (oocyte) is released from a follicle (a fluid filled sac containing an egg) in the ovary and passes down the fallopian tube towards the womb (uterus). Sperm released into the vagina during intercourse swims towards the egg and one sperm will enter the egg, resulting in fertilisation.
This fertilised egg (an embryo) then begins its journey towards the uterus and approximately 5 days later becomes embedded in the thick lining of the uterus (endometrium). This is called implantation and is the first stage of pregnancy.
What is IVF?
IVF involves the collection of eggs directly from the ovaries using a needle. Washed sperm are added to a dish containing the eggs and the sperm are left to swim to the eggs on their own. The sperm and eggs are left in the dish together overnight and the eggs checked for fertilisation the following morning.
The ‘best’ sperm that reaches the egg first should hopefully enter the egg and fertilise it, resulting in an embryo. For more information see In vitro fertilisation (IVF) | HFEA
Who can have IVF?
- Women with blocked or damaged fallopian tubes.
- People with unexplained fertility problems, or who have tried other treatments that were unsuccessful.
- Women who have difficulty with ovulation and who haven’t been successful with other treatments.
- Older women who are less likely to be successful with less invasive treatments.
- At a clinic appointment the nurse or doctor will assess if IVF is the right treatment for you.
Assessment and Tests Required
Depending on which type of treatment you’re having, you will need to carry out some Assessments and Tests. ACS staff will advise which ones are appropriate to you.
The Stages of Treatment
The drug protocol you have been given will explain each step of the treatment which has been recommended for you. Treatment will either start with an injection to suppress your own hormones or will start with your own cycle.
Before starting stimulation injections to stimulate the follicles on your ovaries, you will come the ACS and have an internal scan of the uterus and ovaries. The nurse will give you a supply of medication, explain how to do the injections and your drug regime.
Around day 8-10 of injections, you will return to the clinic for scans and blood test every 1-3 days after, until you are ready for egg collection.
Each woman’s response to this treatment is different. Daily hormone injections can be required for 8-17 days. Some people respond much more quickly while others can take up to 17 days. However, average is around 10-14 days. Depending on the results from the scans and blood tests, the dose of drug used in your treatment may be changed.
Possible side effects from drugs used during the ‘down regulation’ phase may cause hot flushes, headaches, mood swings and vaginal dryness. These symptoms should pass. We carefully and regularly monitor you when drugs are used to stimulate your ovaries. However, in a small number of cases there may be side effects. In mild cases, the ovaries become slightly enlarged which might cause some abdominal cramps. In severe cases, the ovaries become much enlarged, and fluid gathers in the abdominal cavity causing discomfort or pain. There can be vomiting, diarrhoea, abdominal swelling and breathlessness. There may be a feeling of weakness and fainting, and you may not pass much urine. These complications require immediate attention, and you should contact ACS. For more information see Ovarian hyperstimulation syndrome (OHSS) | RCOG
Unfortunately, some women may not respond to this treatment. In this case the treatment will be stopped, and we will review your case. You will be given a clinic appointment to discuss your options.
If you do respond, once an adequate number of follicles (fluid filled sacs some of which contain eggs) are present in your ovaries, you will be given one final hormone injection called the ‘booster’. This helps mature the eggs in your follicles. You will usually be given this booster 36 hours before having your egg retrieval.
Please note that the timing of this injection is critical, and it must be done at the exact time specified to you by the ACS staff.
The Egg Retrieval
The night before your procedure please fast from midnight (do not eat or drink anything), as you will be given sedation.
When attending the procedure:
Give yourself plenty of time to travel to ACS on the day of your appointment. Allow time for traffic delays and finding a parking place which can be time consuming.
Please bring with you a dressing gown and slippers, we will provide you with a hospital gown to wear.
You should not wear nail varnish, perfume, make-up or body lotion.
Do not bring large sums of money or valuable jewellery with you (except your wedding ring).
On the day Please report to the ACS suite. At the ACS suite, a nurse will help you prepare for the retrieval procedure.
A doctor will:
- describe the procedure to you in detail
- take a history of your general health
- answer any questions you may have
- ask you to sign a consent form for the treatment.
An anaesthetist will:
Discuss the procedure and will be present throughout to control your sedation and monitor your wellbeing.
The Procedure
The procedure begins with a needle assembly (called a venflon) being inserted into a vein in your hand or your arm. Your sedation will be given through a tube attached to the venflon. You may feel yourself drifting off to sleep but still be aware of noise around about you and remain sensitive to touch.
Your ovaries are viewed on an ultrasound monitor by gently placing an ultrasound probe into your vagina. Within each ovary, there will be a number of follicles. A fine needle is passed down a specialised guide attached to the ultrasound probe and the tip of the needle is directed right into the centre of each follicle. Gentle suction is applied through the needle, removing the contents of the follicle into a specially prepared container, which is then carefully examined to see if an egg is present.
This retrieval procedure ends when all the follicles have been drained and usually takes about 30 minutes to complete. Afterwards, you will go back to the recovery area to rest until you feel ready to go home, which is usually 1-3 hours later. You should plan for someone to collect you from the ACS Suite and go home with you.
For 24 hours after sedation, you should not drive or operate machinery, drink alcohol, take sleeping tablets or
sign legal documents.
Sperm Collection and the Fertilisation of Your Eggs
Sperm sample (for men) On the day that your partner’s eggs are to be retrieved you will need to produce a fresh sperm sample. Do not have sex or ejaculate for 2 days before your appointment. We will show you into a private room in the Embryology Laboratory to produce your sperm sample.
A fresh sperm sample is prepared to maximise the number of healthy sperm available for mixing with your eggs. There is no guarantee that all of your eggs will be fertilised and very occasionally there will be no fertilisation at all. Any fertilised embryos that do form are left to grow for 5 days in an Embryoscope – NHSGGC. We will contact you the day after your oocyte retrieval to let you know how many of your eggs were fertilised.
Please note that not all patients will have embryos suitable for freezing.
Embryo Transfer
A few days after the retrieval process, the embryo produced will be transferred into your uterus. Please attend the ACS Suite at your appointed time for the embryo transfer.
It will feel similar to having a cervical smear test performed, and you do not usually have to be sedated or anaesthetised. A specially designed tube (called a catheter) is used to place the embryo(s) into your uterus. It would be helpful if you did not empty your bladder before the procedure. After your embryo(s) have been transferred you will continue vaginal progesterone hormone treatment.
Please note that one embryo will usually be replaced, unless double embryo transfer has been discussed. Please see Decisions to make about your embryos | HFEA for more information on why a single embryo transfer is safest for you and any babies born from fertility treatment.
Test Results (Treatment Outcome)
We will give you a date to carry out a home pregnancy test and you should let us know the result via email.
Intracytoplasmic Sperm Injection
Patient Information
This leaflet will give you more information about Intracytoplasmic Sperm Injection (ICS). Before explaining ICSI, it is useful to explain the natural fertilisation process (getting pregnant).
Each month an egg (oocyte) is released from a follicle (a fluid filled sac containing an egg) in the ovary and passes down the fallopian tube towards the womb (uterus). Sperm released into the vagina during intercourse swims towards the egg and one sperm will enter the egg, resulting in fertilisation.
This fertilised egg (an embryo) then begins its journey towards the uterus and approximately 5 days later becomes embedded in the thick lining of the uterus (endometrium). This is called implantation and is the first stage of pregnancy.
What is ICSI?
ICSI involves the collection of eggs directly from the ovaries using a needle. An embryologist then selects a single sperm and injects it directly into a mature egg’s cytoplasm, bypassing the outer layers of the egg. The injected eggs are left in the incubator overnight and the eggs checked for fertilisation the following morning. If the egg fertilises, an embryo starts to develop. For more information see Intracytoplasmic sperm injection (ICSI) | HFEA
Who can benefit from ISCI?
ICSI is a treatment for male infertility and may be offered if:
- It will improve your chance of a successful outcome
- The sperm count is very low
- The sperm are not mobile enough (i.e. They cannot swim properly)
- An attempt at In Vitro Fertilisation (IVF) did not result in fertilisation
- Sperm have had to be removed directly from the epididymis or testicle using a surgical technique.
At a clinic appointment the nurse or doctor will assess if ICSI is the right treatment for you.
Assessment and Tests Required
Depending on which type of treatment you’re having, you will need to carry out some Assessments and Tests. ACS staff will advise which ones are appropriate to you.
The Stages of Treatment
The drug protocol you have been given will explain each step of the treatment which has been recommended for you. Treatment will either start with an injection to suppress your own hormones or will start with your own cycle.
Before starting stimulation injections to stimulate the follicles on your ovaries, you will come the ACS and have an internal scan of the uterus and ovaries. The nurse will give you a supply of medication, explain how to do the injections and your drug regime.
Around day 8-10 of injections, you will return to the clinic for scans and blood test every 1-3 days after, until you are ready for egg collection.
Each woman’s response to this treatment is different. Daily hormone injections can be required for 8-17 days. Some people respond much more quickly while others can take up to 17 days. However, average is around 10-14 days. Depending on the results from the scans and blood tests, the dose of drug used in your treatment may be changed.
Possible side effects from drugs used during the ‘down regulation’ phase may cause hot flushes, headaches, mood swings and vaginal dryness. These symptoms should pass. We carefully and regularly monitor you when drugs are used to stimulate your ovaries. However, in a small number of cases there may be side effects. In mild cases, the ovaries become slightly enlarged which might cause some abdominal cramps. In severe cases, the ovaries become much enlarged, and fluid gathers in the abdominal cavity causing discomfort or pain. There can be vomiting, diarrhoea, abdominal swelling and breathlessness. There may be a feeling of weakness and fainting, and you may not pass much urine. These complications require immediate attention, and you should contact ACS. For more information see Ovarian hyperstimulation syndrome (OHSS) | RCOG
Unfortunately, some women may not respond to this treatment. In this case the treatment will be stopped, and we will review your case. You will be given a clinic appointment to discuss your options.
If you do respond, once an adequate number of follicles (fluid filled sacs some of which contain eggs) are present in your ovaries, you will be given one final hormone injection called the ‘booster’. This helps mature the eggs in your follicles. You will usually be given this booster 36 hours before having your egg retrieval.
Please note that the timing of this injection is critical, and it must be done at the exact time specified to you by the ACS staff.
The Egg Retrieval
The night before your procedure please fast from midnight (do not eat or drink anything), as you will be given sedation.
When attending the procedure:
Give yourself plenty of time to travel to ACS on the day of your appointment. Allow time for traffic delays and finding a parking place which can be time consuming.
Please bring with you a dressing gown and slippers, we will provide you with a hospital gown to wear.
You should not wear nail varnish, perfume, make-up or body lotion.
Do not bring large sums of money or valuable jewellery with you (except your wedding ring).
On the day, please report to the ACS suite. At the ACS suite, a nurse will help you prepare for the retrieval procedure.
A doctor will:
- describe the procedure to you in detail
- take a history of your general health
- answer any questions you may have
- ask you to sign a consent form for the treatment.
An anaesthetist will:
Discuss the procedure and will be present throughout to control your sedation and monitor your wellbeing.
The Procedure
The procedure begins with a needle assembly (called a venflon) being inserted into a vein in your hand or your arm. Your sedation will be given through a tube attached to the venflon. You may feel yourself drifting off to sleep but still be aware of noise around about you and remain sensitive to touch.
Your ovaries are viewed on an ultrasound monitor by gently placing an ultrasound probe into your vagina. Within each ovary, there will be a number of follicles. A fine needle is passed down a specialised guide attached to the ultrasound probe and the tip of the needle is directed right into the centre of each follicle. Gentle suction is applied through the needle, removing the contents of the follicle into a specially prepared container, which is then carefully examined to see if an egg is present.
This retrieval procedure ends when all the follicles have been drained and usually takes about 30 minutes to complete. Afterwards, you will go back to the recovery area to rest until you feel ready to go home, which is usually 1-3 hours later. You should plan for someone to collect you from the ACS Suite and go home with you.
For 24 hours after sedation, you should not drive or operate machinery, drink alcohol, take sleeping tablets or sign legal documents.
Sperm Collection and the Fertilisation of Your Eggs
Sperm sample (for men) On the day that your partner’s eggs are to be retrieved you will need to produce a fresh sperm sample. Do not have sex or ejaculate for 2 days before your appointment. We will show you into a private room in the Embryology Laboratory to produce your sperm sample.
A fresh sperm sample is prepared to maximise the number of healthy sperm available for injecting into your eggs. An embryologist will select one of the healthiest looking sperm from the sample and inject into the eggs. This will be repeated for each mature egg. There is no guarantee that all of your eggs will be fertilised and very occasionally there will be no fertilisation at all. Any fertilised embryos that do form are left to grow for 5 days in an Embryoscope – NHSGGC. We will contact you the day after your oocyte retrieval to let you know how many of your eggs were fertilised.
Please note that not all patients will have embryos suitable for freezing.
Embryo Transfer
A few days after the retrieval process, the embryo produced will be transferred into your uterus. Please attend the ACS Suite at your appointed time for the embryo transfer.
It will feel similar to having a cervical smear test performed, and you do not usually have to be sedated or anaesthetised. A specially designed tube (called a catheter) is used to place the embryo(s) into your uterus. It would be helpful if you did not empty your bladder before the procedure. After your embryo(s) have been transferred you will continue vaginal progesterone hormone treatment.
Please note that one embryo will usually be replaced, unless double embryo transfer has been discussed. Please see Decisions to make about your embryos | HFEA for more information on why a single embryo transfer is safest for you and any babies born from fertility treatment.
Test Results (Treatment Outcome)
We will give you a date to carry out a home pregnancy test and you should let us know the result via email.
Pre Implantation Genetic Testing (PGT)
What is PGT?
This is a special type of fertility treatment which helps couples who are at risk of having a child with a serious genetic condition. Embryos are created outside of the body using Intracytoplasmic sperm injection (ICSI) | HFEA and then tested for the genetic condition. Only embryos not affected are placed back into the uterus.
There are 3 different types of PGT:
- PGT-M (for monogenic disorders):
Used to test for single-gene disorders, such as cystic fibrosis or Huntington’s disease.
- PGT-SR (for structural rearrangements):
Used to test for chromosomal structural rearrangements, like translocations.
- PGT-A (for aneuploidy):
PGT-A is a type of PGT that screens for aneuploidy (abnormal number of chromosomes). Please note, PGT-A is not available as an add-on to NHS IVF/ICSI.
If there is a chance that a pregnancy may be affected by a familial genetic condition, some families wish to take steps to ensure that it will not be affected. Most couples requesting PGT do so to avoid the possibility of terminating a pregnancy following pre-natal testing, or if they already require IVF due to subfertility.
The HFEA regulate which conditions we can test for. Their website contains more information on Pre-implantation genetic testing for monogenic disorders (PGT-M) and Pre-implantation genetic testing for chromosomal structural rearrangements (PGT-SR) | HFEA
All patients having PGT will be seen and followed up by a specialist team including a consultant, nurse and embryologist who work closely with the team at clinical genetics.
Who can benefit from PGT?
- Couples who already have a child affected by a genetic condition or chromosomal rearrangement
- Couples who are not affected by a genetic condition but are both carriers of a gene which can result in them having a child with a genetic condition
- Couples where one partner is affected by a genetic condition, either because they inherited it or it is a new condition, and they risk passing that condition on to their child
- Couples where one partner has a balanced chromosomal translocation which may result in passing on an unbalanced chromosome to a child
Assessments and Tests
Before being seen at the ACS for PGT, you will have had some genetic testing through clinical genetics. Depending on which type of treatment you’re having, you will also need to have some Screening tests and Initial Appointments – NHSGGC and ACS staff will advise which ones are appropriate to you.
The Stages of Treatment
Genetic work-up
Before PGT treatment can begin, we need to wait on the genetics laboratory confirming they are ready to receive samples. This can take around 6 months for PGT-M and 2 months for PGT-SR. Once they are ready, we will arrange your appointments.
Screening and Consent Appointments
See Screening tests and Initial Appointments – NHSGGC for information about your first visits to the ACS.
Starting Treatment
The PGT team will meet and plan a treatment cycle for you.
The drug protocol you have been given will explain each step of the treatment which has been recommended. Treatment will either start with an injection or tablets to suppress your own hormones or will start with your own cycle.
Before starting stimulation injections to stimulate the follicles on your ovaries, you will come the ACS and have an internal scan of the uterus and ovaries. The nurse will give you a supply of medication, explain how to do the injections and your drug regime.
Around day 8-10 of injections, you will return to the clinic for scans and blood test every 1-3 days after, until you are ready for egg collection.
Each woman’s response to this treatment is different. Daily hormone injections can be required for 8-17 days. Some people respond much more quickly while others can take up to 17 days. However, average is around 10-14 days. Depending on the results from the scans and blood tests, the dose of drug used in your treatment may be changed.
Possible side effects from drugs used during the ‘down regulation’ phase may cause hot flushes, headaches, mood swings and vaginal dryness. These symptoms should pass. We carefully and regularly monitor you when drugs are used to stimulate your ovaries. However, in a small number of cases there may be side effects. In mild cases, the ovaries become slightly enlarged which might cause some abdominal cramps. In severe cases, the ovaries become much enlarged, and fluid gathers in the abdominal cavity causing discomfort or pain. There can be vomiting, diarrhoea, abdominal swelling and breathlessness. There may be a feeling of weakness and fainting, and you may not pass much urine. These complications require immediate attention, and you should contact ACS. For more information see Ovarian hyperstimulation syndrome (OHSS) | RCOG
Unfortunately, some women may not respond to this treatment. In this case the treatment will be stopped, and we will review your case. You will be given a clinic appointment to discuss your options.
If you do respond, once an adequate number of follicles (fluid filled sacs some of which contain eggs) are present in your ovaries, you will be given one final hormone injection called the ‘booster’. This helps mature the eggs in your follicles. You will usually be given this booster 36 hours before having your egg retrieval.
Please note that the timing of this injection is critical, and it must be done at the exact time specified to you by the ACS staff.
The Egg Retrieval
The night before your procedure please fast from midnight (do not eat or drink anything), as you will be given sedation.
When attending the procedure:
- Give yourself plenty of time to travel to ACS on the day of your appointment. Allow time for traffic delays and finding a parking place which can be time consuming.
- Please bring with you a dressing gown and slippers, we will provide you with a hospital gown to wear.
- You should not wear nail varnish, perfume, make-up or body lotion.
- Do not bring large sums of money or valuable jewellery with you (except your wedding ring).
- On the day, please report to the ACS suite. At the ACS suite, a nurse will help you prepare for the retrieval procedure.
A doctor will:
- describe the procedure to you in detail
- take a history of your general health
- answer any questions you may have
- ask you to sign a consent form for the treatment.
An anaesthetist will:
Discuss the procedure and will be present throughout to control your sedation and monitor your wellbeing.
The Procedure
The procedure begins with a needle assembly (called a venflon) being inserted into a vein in your hand or your arm. Your sedation will be given through a tube attached to the venflon. You may feel yourself drifting off to sleep but still be aware of noise around about you and remain sensitive to touch.
Your ovaries are viewed on an ultrasound monitor by gently placing an ultrasound probe into your vagina. Within each ovary, there will be a number of follicles. A fine needle is passed down a specialised guide attached to the ultrasound probe and the tip of the needle is directed right into the centre of each follicle. Gentle suction is applied through the needle, removing the contents of the follicle into a specially prepared container, which is then carefully examined to see if an egg is present.
This retrieval procedure ends when all the follicles have been drained and usually takes about 30 minutes to complete. Afterwards, you will go back to the recovery area to rest until you feel ready to go home, which is usually 1-3 hours later. You should plan for someone to collect you from the ACS Suite and go home with you.
For 24 hours after sedation, you should not drive or operate machinery, drink alcohol, take sleeping tablets or sign legal documents.
Sperm Collection and the Fertilisation of Your Eggs
Sperm sample (for men) On the day that your partner’s eggs are to be retrieved you will need to produce a fresh sperm sample. Do not have sex or ejaculate for 2 days before your appointment. We will show you into a private room in the Embryology Laboratory to produce your sperm sample.
A fresh sperm sample is prepared to maximise the number of healthy sperm available for injecting into your eggs. An embryologist will select one of the healthiest looking sperm from the sample and inject into the eggs. This will be repeated for each mature egg. There is no guarantee that all of your eggs will be fertilised and very occasionally there will be no fertilisation at all. Any fertilised embryos that do form are left to grow for 5 days in an Embryoscope – NHSGGC. We will contact you the day after your oocyte retrieval to let you know how many of your eggs were fertilised and have become embryos.
Embryo Biopsy
This will be discussed during your consultation with one of our nurses. Normally biopsies will be performed at day 5 or 6 blastocyst stage of development. The biopsy process starts with the embryologist lasering a small opening in the wall of the embryo. Approximately 5-10 cells are removed from the embryo using a small pipette and then transferred into small tubes.
The embryos will then be cryopreserved (frozen) and stored. The cells that are removed from the embryos are packaged and couriered to the external genetics testing laboratory and the results will be available approximately 4 weeks after biopsy. Our embryologists will call and discuss the results with you.
Embryos that have a low-risk result can be transferred in a frozen embryo transfer cycle. Embryos that show a high-risk result cannot be transferred. Embryos that have been biopsied cannot be transferred in the same cycle with embryos that have not been biopsied, or those that did not yield a result. Embryos with a high-risk result will not be stored or transferred.
Very occasionally (<1% of cases) we may not get a result. We may be able to re-biopsy an embryo, but this will be discussed with you.
We are not allowed to carry out sex selection for social reasons. Sex selection can only be performed when there is a known risk of serious physical or mental illness or disability for one gender, when the other is unaffected. In this case, the unaffected gender will always be selected over an embryo of the affected gender.
Frozen Embryo Transfer
Frozen Embryo Transfer (FET)
When embryos are frozen as part of a treatment cycle, they can be stored for the time period you have consented to. Once you are ready to start an embryo transfer cycle there are a few steps we need to go through to ensure you, and your partner are fully consented and meet the NHS access criteria. Then, to maximise your chance of success, we ensure your endometrium is prepared and ready for the embryo transfer.
When you phone the booking line to book an FET, they will take some information from you and bring your notes the weekly FET scheduling meeting. Due to the high demand for FET cycles, we may not be able to book the 1st time you call. Waiting times for FET cycles can be around 3 months. When you start an FET cycle, we will check your smear is in date and your BMI is 18.5-30. Please ensure you meet both requirements before phoning to book.
In ACS, we have 4 types of Frozen Embryo Transfer (FET) cycles. The doctor will advise which one is most appropriate for you, depending on your menstrual cycle, medical history and any previous embryo transfers.
HRT FET
1st Appointment
If you have a regular cycle, this will be around day 21 of your cycle. If you don’t, we will allocate an appointment based on the treatment cycle. You will both be allocated e-consents to complete before this appointment. Please ensure this is done as failure to do so may delay your appointment or treatment starting.
This appointment lasts 30 minutes and both partners should attend. We will:
- Check e-consents are correct
- Sign off photographic ID
- Check BMI
- Check smear and routine screening is in date
- Administer a prostap injection to downregulate your cycle
- If you don’t have a regular cycle, we will take a blood sample and give you the prostap injection away to administer yourself once the blood result is back
- Answer any questions you may have about the treatment
2nd Appointment
This will be around 2 weeks after your 1st appointment and will last 20-30 minutes. Both partners don’t need to attend as long as all consents have been completed. We will:
- Ask if you have had a period since prostap
- Perform an internal ultrasound to assess the uterus and ovaries
- We may take a blood test depending on the scan result
- Give you medication away to start and explain how to take them
- Make a return appointment for around 2 weeks later
3rd Appointment
We will perform an ultrasound to assess the growth of your endometrium. Depending on what the thickness is, we will advise what to do next.
If endometrium is more than 8mm we’ll give you medication and show you how to administer it. We’ll pass your notes to the embryology team who will be in contact with the next steps.
If endometrium is less than 8mm we’ll arrange for another scan appointment 1-3 days later.
Embryo Transfer
The embryologist will advise when you should stop downregulation medication and start progesterone medication. Timing of this is very important so please follow these instructions carefully.
They will give you a date and time to attend for embryo transfer around 5-6 days after starting progesterone. One adult can accompany you for the procedure but children cannot come into the procedure room.
The embryo transfer is very similar to a smear test. A speculum is inserted into the vagina and an empty catheter is passed through the cervix. Once the empty catheter is in position, a catheter containing the embryo is passed through the empty catheter and the embryo is deposited from the catheter into the uterus. The catheter is very fine and is normally not felt by the patient.
An abdominal (tummy) scan is used for guidance during the embryo transfer procedure. To ensure the best possible view, we ask that you have a comfortably full bladder in preparation for embryo transfer.
Test Results (Treatment Outcome)
We will give you a date to carry out a home pregnancy test and you should let us know the result via email.
See our Frequently Asked Questions – NHSGGC for more advice before and after embryo transfer.
Modified Natural Cycle (MNC) FET
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HMG FET
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Natural FET
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Egg Donation
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Semen Analysis
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Surgical Sperm Retrieval
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Sperm Storage
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Embryo Storage
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Egg Storage
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