FAQ’s

A: No the BCRM is not a private clinic, but it does allow patient to self-fund if they fall outside the criteria on which the Primary Care Trusts (PCT) base their funding.

A: Your local Primary Care Trust (PCT) provides funding for patients who require fertility treatment. Each PCT has criteria that determine whether patients are eligible or not (e.g. age, smoking habits, weight, etc). Your GP can access the eligibility criteria for you and refer you for funded treatment if appropriate. All information is on the website about the referral process and the eligibility criteria to ensure your GP sends the most appropriate information.

Please note that the BCRM is part of North Bristol NHS Trust and we do not have any control over the funding criteria set by each PCT. Any decisions affecting your funding should be directed to your PCT. Visit www.nhs.uk for more information.

A: On receipt of your referral we will send you a list of any tests you need to have done, sometimes to update previous tests. As soon as you have the results to hand, we will arrange an appointment within 4 – 6 weeks.

A: There is no clear evidence that small amounts of alcohol have any adverse effect on fertility treatment. We advise both partners to restrict their alcohol intake to less than 10 units each week during treatment. As the production time for sperm is up to 100 days, we suggest that men restrict their alcohol intake for about 3 months before treatment. 1 unit of alcohol = ½ pint beer, a small glass of wine or 1 measure of spirit.

A: A referral is required from your GP or Specialist. Their referral letter will include a summary of all tests performed to date and any initial thoughts on diagnosis. Find out more about Referrals.

A: It’s important that both of you are referred with all your details as at consultation we will investigate you together.

A: All referral letters are reviewed on receipt to ensure that relevant blood tests have been done. We will then send you a letter with a date for consultation and instructions about everything you need to do prior to the consultation. Usual requirements are:

• Various blood tests for female
• Various blood tests for Partner
• Semen analysis if appropriate

A: Whilst we do not have research to support the benefits of complementary medicine, we acknowledge that many people may want to use them. We would advise against the use of herbal treatments, which we know can have an adverse effect, such as Agnus Castus, or treatments whose ingredients are unknown. Physical complementary treatments may be more acceptable, particularly if they reduce stress. We cannot accept responsibility for the effects for any of these treatments but advise that, if you are using them, you attend a qualified practitioner and inform us of treatments you are undergoing. We are unable to facilitate complementary medical treatment sessions.

A: Paracetamol used accordingly to the normal dosage instructions is safe, even in pregnancy. If paracetamol does not work we ask that you call us for advice.

A: Once you have been given a diagnosis and treatment options, you may start your treatment as soon as you like. The start of treatment is not determined by whether you’re funded by the NHS or yourselves, there is generally no wait time for treatment.

A: It is important that a semen sample is checked prior to consultation at BCRM. We will be checking if it is suitable for a variety of treatments, not just count of sperm available.

A: Yes, a scan will be performed at consultation, even if you have had one performed before. A scan will be internal and it is important to empty your bladder on arrival at the BCRM.

A: For consultation and treatment planning appointments – yes, as there may be specific issues or consent forms you will both need to consider. Both of you will also need to attend the first monitoring appointment so we can check your wishes and the consent forms for that treatment cycle.

A: It is possible at consultation that further investigations will be required prior to embarking upon the treatment and you will be advised accordingly at that time.

A: Cancellations are sometimes available but please phone the Administration Department on 0117 323 2026 to enquire.

N.B. It is important that all tests are completed where possible prior to consultation so that a full history can be taken, hopefully a diagnosis can be given and treatment options as well. If tests are outstanding it may mean coming back for further consultation when the results are in.

A: At consultation you will be given a treatment request form. You will be required to complete this and return it to indicate you would like treatment. As soon as we receive the request for treatment you will be given an appointment with a nurse to go through your treatment cycle and consent to treat in detail. This is called a planning appointment and is normally offered within 3 weeks of receipt of the letter.

A: HFEA consent forms: We will check with you at every treatment cycle what your wishes are relating to treatment and will only renew any relevant consent forms if you have changed your mind, e.g. relating to freezing of embryos.

‘In house’ consent forms; as some treatment options may vary from cycle to cycle; e.g. assisted hatching, we need to ask for new consent forms each time. We need to be absolutely sure of your wishes, to ensure the correct treatment is carried out.

A: There is no evidence that sexual intercourse in the early stages of your treatment, or after embryo transfer or IUI, has any adverse effect. If anything, the limited information we have is that normal sexual intercourse may have a small beneficial effect. However, we would advise you to avoid sexual intercourse for 3 – 5 days before your egg collection or IUI treatment to improve the quality of the man’s sperm.

A: Up to 8 weeks depending on your menstrual cycle dates and how you respond to the drugs.

A:

• The usual process is to switch your hormones off first with a nasal spray (one spray every 4 hours in the nostril this is twice at bedtime to save you getting up in the middle of the night!). A period when you are on the spray will be followed by a blood test 14 days into the spray to check that it has been effective. It will then be a daily stimulation injection dose to stimulate your ovaries to produce more than one egg. The injection is very simple and you will be given instructions.
• The needle for the injection is very small about the size of a diabetic needle – that means most women would inject themselves.
• When you have grown enough eggs at the right maturity, you will be given one final injection to prepare them for the egg collection.
• After approximately 12 days of injections, the egg collection will take place under sedation so that you don’t feel any pain.
• The eggs will be collected vaginally so you will have no wound but you may have spotting after egg collection.
• Eggs and sperm are mixed on the day of egg collection and embryos or blastocyst will be transferred 2 – 6 days after the egg collection (this will be based on an individual basis).
• After the egg collection you will use vaginal pessaries of progesterone to maintain the lining of the womb. The pessaries are absorbed the first twenty minutes after insertion into the vagina and as they absorb the hormone into your system they will dissolve and you will have a discharge, you may need sanitary protection during this time.
• The transfer of the blastocyst or embryos to the uterus is usually a straight forward procedure which both of you can attend in the procedure room.

A: Yes. There is no evidence that any of these activities can be harmful. However, we would advise women to avoid water-skiing or using water slides during treatment. You should live your life as normally as possible during your treatment. It is important that you are relaxed and comfortable with yourself at this time and during any resulting pregnancy so that if you look back, you have no regrets about anything you might have done. Whilst we may advise a particular activity is safe (for example, to fly), if anything were to go wrong would you blame yourself, despite our reassurance? If you have concerns about any specific activity, please ask us.

A: Any exercise that is usual for you. Treatment is tiring and you may find your stamina and exercise tolerance are not up to your usual level.

A: If you think you have missed a spray please take another one as soon as you remember, occasionally if a nasal spray hasn’t been taken for a significant amount of time it might effect the treatment cycle. However, usually as long as you sniff as soon as you remember there shouldn’t be a problem.

A: Do not attend for your blood test as organised, please inform your nurse when your period does start so alternative arrangements can be made. Keep sniffing the spray during this time.

A: One bottle of buserelin nasal spray will last 2 -3 weeks, 2 bottles are usually required for one treatment cycle. Do not throw away after 1 week (as instructed in the paperwork) please use until the bottle is empty.

A: If you have a cold during your nasal spray, blow your nose prior to the sniff and the spray will work.

A: A pregnancy test is usually taken 2 weeks and 2 days after your egg collection.

A: Sometimes there can be a brownish discharge after the embryo transfer or egg collection which is normal due to having an egg collection and transfer. Please continue to use your pessaries.

Following your treatment cycle, you would normally expect a period 2 weeks after egg collection and sometimes, even though you are on the pessaries you may have a bit of spotting prior to your test. If it is only spotting, continue with the pessaries and take a pregnancy test at the right time. If you have bleeding prior to your pregnancy test, please phone for advice.

A: You would have been advised to drink plenty of fluids (up to 2 litres a day) after your egg collection and take paracetamol regularly. It is important to continue with fluids and take paracetamol on regular basis. If you are short of breath, have nausea, not passing water enough please phone the on-call nurse at the weekend or the doctors out of hours for advice.

A: Patients who are booked for Egg Collections and Embryo Transfers are given a parking permit for these particular days. This is predominantly due to the fact that they are undergoing an operation which usually involves sedation.

A: Generally, our administrators will try and answer patient calls during any part of the day; however, if you wish to speak to one of the nursing team, please be aware that they are usually in clinic/theatre every morning. Therefore, better times to call are in the afternoon on the main nursing number 0117 323 2007. Should your call not be answered, the team will try and contact you by the end of each day.

A: The NHS has a formal compliment or complaints process. Staff within the Trust’s Advice and Complaints Department will be happy to guide you through the process or answer any questions you may have. Out of office hours there is a 24 hour answerphone. Telephone: 0117 340 3741 or 0117 340 3076, telephone/Fax: 0117 340 6646, fax: 0117 340 6561, email: complaints@nbt.nhs.uk or visit www.nbt.nhs.uk/advice-complaints