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All patients having fertility treatment should have a transvaginal scan (TVS) as part of fertility investigations to assess the health of the uterus and ovaries. It can help identify potential issues like endometrial polyps, uterine abnormalities or ovarian cysts.  It involves inserting a small, lubricated probe into the vagina. The probe emits high-frequency sound waves that create detailed images of the pelvic organs on a monitor. This allows us to see the uterus, ovaries, and fallopian tubes more clearly than with a transabdominal scan. While some individuals may experience slight discomfort, the procedure is usually well-tolerated and not painful. 

It can:  

• check the size, shape, and condition of the uterus and ovaries, checking for abnormalities like fibroids or cysts.  

• assess the number and size of antral follicles, which are small fluid-filled sacs in the ovaries that contain eggs, providing an indication of ovarian reserve.  

Before the scan you will be asked to go into the toilet adjoining the scan room, empty your bladder and remove clothing from the bottom half of your body. You will be given a gown to cover your body. You may also have a TVS as part of a HyCoSy. 

Semen analysis is a routine part of an infertility investigation. A few parameters are examined to determine the quality of semen. This includes the sperm concentration (the number of sperm), motility (how well the sperm are moving) and morphology (the shape of the sperm).  

The results of the analysis help us to determine whether a ‘male factor’ plays a part in the reason why you have not conceived naturally. Several factors can influence the quality of the sample. You may be asked to provide more than one sample if the initial results are not within normal ranges. This is common and helps us to make an accurate diagnosis. 

Initially, you should contact your GP to arrange referral for semen analysis.

Anti-Mullerian Hormone (AMH) is a blood test used to assess ovarian reserve. AMH is made in the ovarian follicles, which contain eggs, and its levels can be checked at any time during the menstrual cycle. Blood levels of this hormone are measured to assess the remaining ovarian reserve (egg supply) in your ovaries.  

How is an ‘AMH’ test result used? 

This result will be used to help decide which treatment protocol you will follow during treatment.  

We will also use it to counsel you on how likely you are to respond to certain treatments, such as hormonal stimulation during IVF.  

If you are between 40-42 years old, AMH will be used as one of the criteria to assess if you are eligible for NHS funding.

A high AMH level raises the possibility that you may over-respond to your treatment (i.e. too many eggs will be produced), increasing the risk of ovarian hyperstimulation syndrome (OHSS). Ovarian hyperstimulation syndrome (OHSS) | RCOG 

A low AMH level raises the possibility that you may respond poorly, or not at all, to hormonal stimulation. This means a low number of eggs, or none, may be produced. 

A full blood count (FBC) test is taken to look for abnormalities such as Anaemia – this means that you have fewer red blood cells than normal or have less haemoglobin than normal in each red blood cell.

This blood test offers Screening for sickle cell and thalassaemia – NHS. If the female partner is found to be a carrier of one of these diseases, the male partner will also be screened.

Cytomegalovirus (CMV) – NHS is a virus which can cause flu like symptoms. If you catch CMV while pregnant there is a risk to the baby. CMV can be present in body fluids, such as sperm. We test patients for immunity to CMV when using donor sperm. If you are immune to CMV, sperm can be used from a CMV positive or negative donor. If you are not immune to CMV the nurse or embryologist will advise on risks of using a CMV positive donor. 

Chlamydia – NHS is one of the most common sexually transmitted bacterial infections and affects both men and women. It often does not cause any obvious symptoms. The disease can be spread during genital contact or unprotected sexual intercourse (including anal and oral sex) with an infected person or from an infected mother to her baby during childbirth. You will either be asked to provide a vaginal swab or sample of urine, depending on treatment type. Should your screening test show that you are infected with chlamydia, you will be offered antibiotic treatment to clear it and encouraged to take precautions to reduce the risks of passing it onto others. 

You will be asked to provide a vaginal swab to test for infections such as thrush, bacterial vaginosis, trichomoniasis and group b streptococcus. 

All women between the age of 25 and 60 are invited to attend for cervical screening. Cervical screening aims to detect and treat abnormal changes in a woman’s cervix (the neck of the womb). If left untreated, this may develop into cervical cancer. It is essential that prior to commencing your treatment you have an up-to-date cervical smear test.  

If you have this done as part of NHS Scotland screening programme, we will be able to access your most recent result and advice. If you have had it done in a different country or privately, please bring a copy of your test result to your first appointment with the nurses. If you are over 25 and have never had a smear test, please arrange to have this done via your GP.  

HIV attacks your immune system eventually stopping it altogether, at which point it becomes difficult to combat serious life threatening infections. The virus can be spread during unprotected sexual intercourse (including oral and anal sex) with an infected person and by sharing needles to inject illegal drugs.  Infected mothers can transmit the virus to their baby before or during childbirth. Should your screening test show that you are infected with HIV, you will be offered treatment(s) designed to reduce the harmful effects of the virus and encouraged to take precautions to reduce the risks of passing it onto others.  

Hepatitis B is a virus that can cause inflammation (swelling and tenderness) of the liver.  It can take a long time for the symptoms to show. The virus can be spread during unprotected sexual intercourse with an infected person and by sharing needles to inject illegal drugs.  Infected mothers can transmit the virus to their baby during childbirth. Should your screening test show that you are infected with Hepatitis B, you will be offered treatment(s) designed to reduce the harmful effects of the virus and encouraged to take precautions to reduce the risks of passing it onto others.

Hepatitis C is also a virus that can cause serious damage to the liver. It can take a long time for the symptoms to show. The virus is mainly spread through contact with the blood of an infected person. Rarely, the disease is passed through other body fluids.  For example, during unprotected sexual intercourse with an infected person or from an infected mother to her baby before or during childbirth. Should your screening test show that you are infected with Hepatitis C, you will be offered treatment(s) designed to reduce the harmful effects of the virus.

Most clinic appointments are being carried out over the phone. At your first consultation a Specialist Fertility Nurse or a Doctor wil phone you, take a detailed medical history from you both and ask for your current BMI. This appointment will last around 30 minutes. They will recommend any further investigations, treatments or advise if you are not eligible for NHS treatment.

If your clinic appointment is in person please attend the ACS unit at Glasgow Royal Infirmary. We may weigh you, do an internal scan and take some blood samples.

Please note that to be eligible for NHS funded treatment you must meet the criteria set by the Scottish Government

• NHS funding | Fertility Network
• Referral Acceptance Criteria – NHSGGC

Each treatment has its own waiting list, so times will vary depending on which treatment you’re having. The nurse or doctor at your clinic appointment will be able to let you know estimated waiting times for you.

When your name reaches the top of the treatment waiting list we will send you a letter with your first ART appointment, around 4 to 6 weeks later.