The Patient Journey

At Complete Fertility Centre we develop a personal treatment plan according to each patient’s individual needs.

A patient’s journey is therefore unique but the patient journey outlined here is a typical one followed by most of our patients having IVF or ICSI.

Patient Journey Flow Chart

Referral

You can be referred to the Complete Fertility Centre by your GP or Consultant Gynaecologist, or you can self-refer if you are seeking private fertility treatment.

Fertility Consultation

NHS referral

Your GP will initially refer you to the NHS fertility clinic on Level E at the Princess Anne Hospital, Southampton. As the region’s largest teaching hospital, you will be seen by a doctor within the fertility team, which consists of consultants and doctors in training. If a decision is made that you require fertility treatment, you will then be referred to Complete Fertility Centre for your assisted conception treatment consultation.

Fertility Nurse Reassuring Patient

Private referral

Private referrals or self-referrals can be made to our fertility team, where you will be seen by one of our consultants at Complete Fertility Centre.

Initial fertility appointment

During your initial appointment either at the NHS fertility clinic or at Complete Fertility Centre, the following will be assessed:

• your fertility history

• the results of the investigations you’ve had with your GP, an ultrasound scan and any additional tests you’ve already had or that are required in order to make a diagnosis

• the pros and cons of each treatment option including the likelihood of success and possible side effects

• your recommended personal conception plan that will give you the best chance of achieving a healthy pregnancy

A decision will be reached in conjunction with you, as to whether you require assisted conception in order to conceive (IUI, DI, IVF / ICSI, donor egg treatment).

Investigations

In general, the following investigations will have been undertaken by your referring GP so that the results are available when you first see the fertility team at your NHS appointment or your Consultant at your private clinic appointment:

• Day 2/3 FSH (follicle stimulating hormone), LH (luteinizing hormone) and oestrogen tests

• Day 21 Progesterone test (if you have a regular 28 day cycle)

• Rubella blood test

• Chlamydia swab or urine test

• Semen analysis

•AMH (this test is not available on the NHS but can be arranged privately at Complete Fertility Centre)

If you have these tests performed in a private consultation, you will be charged. However, your GP could arrange these tests for you under the NHS prior to your appointment, private or NHS.

Fertility doctor answering questions

Counselling

Before starting treatment we encourage all patients to meet with our Counsellor who is a specialist in fertility treatment and will offer emotional support before, during and after treatment.

Up to six sessions of counselling are included in your treatment package whilst you are receiving treatment at Complete Fertility and for up to six months after your last treatment cycle. You can choose when to see your Counsellor depending on your own circumstances. Additional sessions are also available at a cost of £60 per session.

Assisted conception treatment consultation at Complete Fertility Centre

At this point, you will have decided you wish to pursue assisted conception treatment. These include one or more of the following treatments:

IVF / ICSI

• DI / IUI

Egg donation / sharing

Egg recipient treatment

Egg freezing

This appointment will be with one of our doctors to discuss:

• aspects of your treatment and to complete important written consents such as how many embryos will be transferred and will any extra embryos be frozen

• what will happen next and what to expect during your fertility journey

• a personal prescription of drugs for your treatment to give you the best chance of pregnancy but without a hyper response or side effects

• any questions and worries that you have

Nurse Planning Consultation

Your next appointment is with one of our Nurses who will talk though your treatment schedule in more detail and how to administer any medication required.

Starting treatment

Your drugs will be delivered directly to your home ready for you to start your cycle. Treatment will usually take just 4 weeks.

Week 1

Normally you will start your treatment on day one of your period. You will call the Centre and come in for a baseline ultrasound scan. One of our nurses will scan your ovaries and uterus and will look for any structures, such as a cyst, whereby it would be better to wait for them to disappear before starting treatment.

The nurse will then give the go ahead to start injecting FSH to stimulate your ovaries and produce follicles with mature eggs that we will remove during IVF. Usually, you will also be taught to inject a second hormone (depending on the doctor’s instructions) to prevent the eggs from prematurely ovulating.

Week 2

You will have your second scan with a nurse who will see how the follicles are growing. Your drug dose may be adjusted after our daily multidisciplinary meeting involving the doctors, nurses and embryologists responsible for your treatment cycle. If the doses of drugs or any changes to your treatment are decided, the nurse will inform you via a phone call in the afternoon.

Week 3

Normally by this stage your eggs are ready for collection. You will take a trigger injection and 36 hours later you will come into the Centre to have your mature eggs collected.

A Nurse will meet you and you will see your Anaesthetist and Consultant before going under light sedation for a short egg ‘pick up’ procedure. A small needle will be passed into each follicle in your ovary under ultrasound monitoring to suck out the fluid containing the eggs.

The fluid will be passed to our Embryology team who will assess how many eggs have been retrieved. When you awake from the procedure we will tell you how many eggs you have. You will rest in our Recovery room for about an hour and the Nurse will advise when you can go home.

After the egg collection you will start to take another hormone for approximately 2 weeks. It is a gel that goes into the vagina to support early development of your embryo and to support your womb lining.

Your eggs are fertilised in the laboratory using sperm that has been collected from your partner or a sperm donor. The fertilised eggs are cultured in the laboratory incubator before being transferred to the womb. Your Embryologist will advise when your embryo transfer will be.

A blastocyst is an embryo that has developed for five to six days after fertilisation. The additional day’s culture in the laboratory enables the natural selection process to continue and the Embryologist can select the best embryos to transfer. A blastocyst culture is included in your package and your Embryologist will advise if a blastocyst transfer is appropriate in your situation.

Week 4

You will be able do a pregnancy test. If your result is positive you will be offered an early pregnancy scan at our Centre that is included in your package.

If you are not pregnant you should stop taking any further medication and contact Complete Fertility Centre for a follow up appointment which is included in your package for up to 3 months after you cycle.

Summary

Click here to see a summary of the patient journey as a flow chart.