Leeds Fertility - flipbooks.leedsth.nhs.ukflipbooks.leedsth.nhs.uk/LN004523.pdf · however our staff are here to try to make your fertility journey as smooth as possible. Fertility

© Leeds Teaching Hospitals NHS Trust • 1st edition (Ver 2)

Developed by: Leeds Fertility Clinic

Design by: Medical Illustration Services • M20181107_006/BP

Publication date03/2019

Review date 03/2022

LN004523

Leeds FertilityTransforming lives… building families

nThe Leeds

Teaching HospitalsNHS Trust

www.leedsfertilityclinic.co.uk

Leeds Fertility is a collaboration between Leeds Teaching Hospitals NHS Trust and Genesis Reproductive Healthcare.


www.facebook.com/leedsfertilityclinic

@leedsfertility

@leedsfertilityclinic

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Leeds Fertility

We offer one of the largest and most comprehensive fertility services in the UK, and deliver success rates above the national average.

We understand that beginning fertility treatment is a big decision and there are a lot of things to consider. At Leeds Fertility we will guide you every step of the way.

We undertake around 1500 IVF cycles a year to support individuals and couples to become parents. Since we moved to our state of the art facility at Seacroft Hospital (2010), we have helped to create over 5000 babies.

Leeds Fertility is a collaboration between Leeds Teaching Hospitals NHS Trust and Genesis Reproductive Healthcare, which means we offer both NHS and private treatment. We are a fully licenced, Human Fertility and Embryology Authority (HFEA) regulated clinic.

The services we provide include:• Counselling

• Donation of eggs, sperm and embryos

• Fertility preservation for men and women, including a dedicated service to the trans-community

• Frozen embryo transfer

• Intra-Uterine Insemination (IUI)

• In Vitro Fertilisation (IVF) and IntraCytoplasmic Sperm Injection (ICSI)

• Ovulation Induction (OI)

• Pre-implantation Genetic Screening (PGS)

• Pre-implantation Genetic Tests (PGT)

• Specialist fertility surgery

• Surgical sperm retrieval

• Surrogacy

If you choose to start your fertility journey with us, you will first need to meet with your own GP and ask for a referral letter. There is more on this later in this brochure.

We are proud to be part of The Leeds Way

FairPatient-centred EmpoweredAccountableCollaborative

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What makes us different?

Three key elements make us a market leader in fertility healthcare:

Leading teamWe have an internationally renowned team of leading consultants and doctors who are experts in reproductive medicine and surgery. They are supported by a team of over 25 nurses, two ultra-sonographers, an embryology team, a counselling team and an administrative support team. This means we can provide you with access to total support and care.

For more information about our team please see: www.leedsfertilityclinic.co.uk/about-us

Leading servicesBased on the latest scientific evidence, our team offer the widest range of fertility treatment in the north of England.

We work closely with Leeds Teaching Hospitals NHS Trust, providing us with access to specialist medical services for people with complex health needs. This means that we can offer complete care from before conception, during fertility treatment and then onwards into pregnancy.

Leading resultsWe are one of the most successful clinics in the UK, with a high pregnancy rate and live birth rate (babies born) compared with clinics both locally and nationally. We are:

• 5% above the national average for live birth per embryo transferred (for women under the age of 38)

• 3% above the national average for live birth per embryo transferred in frozen embryo transfer cycles.

87 out of every 100 women under the age of 38 years who undergo treatment with us will have a baby with up to three full cycles of IVF/ICSI treatment, including the use of frozen embryos if available.

For more information visit: www.leedsfertilityclinic.co.uk/patient-information/success-rates

Leading team Leading resultsLeading services

“The decision to have IVF was an easy one for us, as was the decision to use

Leeds Fertility” (patient, 2018)

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Getting started

We are here to help you achieve your goal of having a baby with the best advice, most appropriate tests and personalised caring treatment. We know that trying to get pregnant and not succeeding can be heart-breaking, however our staff are here to try to make your fertility journey as smooth as possible.

Fertility assessmentWhen the time comes to seek advice, your GP can get things started. If you would prefer to see a specialist privately from the start you can contact us directly on (0113) 206 3100 (07:30-18:00 seven days a week), for the options available from our team of consultants.

It is rare that there is one single reason why pregnancy is not happening. The most common causes are:

• blocked or damaged fallopian tubes

• irregular monthly cycles (infrequent or absent egg release/ovulation) e.g. Polycystic Ovary Syndrome

• reducing ovarian (egg) reserve (natural ageing, endometriosis, past surgery)

• sperm problems (quantity and/or quality)

Basic fertility tests for men

• Sperm analysis (you will be asked to provide a sample on site, in a private room, into a small sterile pot)

• Sexual health screening (urine test for chlamydia and gonorrhoea testing)

Basic fertility test for women

• Blood tests (day 1-3 of a cycle, whilst bleeding, to check for certain types of hormones)

• Vaginal examination tests (sexual health screening vaginal swab)

• Cervical screening smear

• Pelvic ultrasound baseline scan (this is performed to make sure there are no interfering factors, and the scan will also assess ovarian (egg) reserve by looking for egg sacs (follicles) that are getting ready to develop mature eggs in the coming months)

For more information on how to start your fertility journey see page 12.

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Fertility treatment

We offer a number of treatments and services which increase a woman’s chances of getting pregnant, now, or at a later time in their lives when they are ready. We also provide services for men who may wish to preserve sperm for a time when they wish to start a family.

We offer:

• Ovulation induction treatment

• Specialist advice for male fertility problems

• IVF & ICSI (In Vitro Fertilisation and IntraCytoplasmic Sperm Injection)

- Pre Implantation Genetic Testing (PGT)

• Frozen embryo treatment

• Receiving egg, sperm, embryo donation

• Fertility preservation

• Support with early pregnancy loss

What you can do to prepare for healthy pregnancy and boost your chances of successIn preparation for any treatment with us, it is important you maximise your own health. By adopting a healthy lifestyle you will give your body the best chance to support the treatment and have a baby. We advise you to:

• stop smoking completely

• reduce alcohol intake, ideally stop altogether

• aim for a normal body weight appropriate to your height (and your partner if appropriate)

• make sure you have been vaccinated against german measles (rubella), or have confirmed immunity (women)

• have a healthy, varied diet and regular physical exercise

• ensure any existing medical conditions are well-controlled

• ensure good, restful sleep.

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“The doctors and consultants we saw along the

way were very knowledgeable and up-to-date with recent research

and advances in the field” (patient, 2018)

1. Ovulation induction treatmentOvulation induction aims to make ovulation happen at the right time in the cycle when it does not happen naturally. The most common cause of ovulation problems in young women who are trying to get pregnant is the hormonal condition Polycystic Ovary Syndrome (PCOS).

Other reasons why ovulation may not be happening at the right time include:

• problems with the master gland in the brain (the pituitary) which controls the monthly cycle. Being underweight and/or exercising too much can affect the pituitary gland

• rarer causes which require more specific treatments

The medicines used include clomifene or letrozole tablets and daily Follicle Stimulating Hormone (FSH) injections.

Patient information leaflets are available online to provide more information:

• Ovulation induction and intra-uterine insemination: http://flipbooks.leedsth.nhs.uk/LN002530P/LN002530.pdf

• Polycystic Ovary Syndrome: http://flipbooks.leedsth.nhs.uk/LN002313

2. Specialist advice for male fertility problems Getting pregnant involves two people, sperm problems are quite common. The quality of the sperm will be an important factor for about half of couples struggling to get pregnant.

Men make new sperm (with fresh genes / DNA) every 90 days, this means men can continue to have children for much longer. Male fertility does decline with age but sperm can still produce healthy babies for men in their 60s and 70s.

Sperm quality is affected by lifestyle. In general, men should aim for a normal body weight for their height. Excess weight gain in men is associated with higher oestrogen hormone levels in the body, rather than testosterone, which is required for good sperm production.

If you think something might be wrong, you should first discuss your concerns with your GP or if you would like to speak to us, we have the expertise of a urology specialist who provides assessment and advice for men with specific issues.

A patient information leaflet is available here: http://flipbooks.leedsth.nhs.uk/LN001117P/LN001117.pdf

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3. IVF - In Vitro Fertilisation IVF has been successfully available for over 40 years. IVF means ‘fertilisation in glass’, or in common language, ‘test-tube baby’ treatment. It involves first stimulating the woman’s ovaries with hormone injections and then a small procedure which is performed under light sedation to collect the eggs from the ovaries. The eggs are then put together with sperm in a dish and so that fertilisation can take place. The fertilised eggs (embryos) are then observed as they develop over the next five days. Usually one is transferred into the womb and any extra embryos can be frozen if they are of good enough quality.

After the embryo transfer, further medicines are taken to give the embryo every chance to attach (implant), and start the journey of pregnancy. A standard urine pregnancy test should be positive after two weeks, if the treatment has been successful. The first pregnancy ultrasound follows about three weeks later. At this stage, the pregnancy sac is large enough to see on the scan, along with a flickering heartbeat.

If you produce more good quality embryos than can be used for one treatment (transfer), they can be frozen and saved for use later on. Human embryos generally cope well with freezing and thawing (90% will survive) and this does not affect their ability to grow into a healthy child, regardless of how long they are frozen.

A patient information leaflet is available here: http://flipbooks.leedsth.nhs.uk/LN003697

4. ICSI - IntraCytoplasmic Sperm InjectionICSI is a type of IVF whereby one sperm is injected into each egg to increase the chance of fertilisation. It is used when the sperm count or quality is reduced. The rest of the treatment is the same as IVF - the only difference is what happens in the laboratory.

This embryo is then separated from the rest and transferred to the woman’s womb in a procedure that feels similar to having a cervical smear test.

How IVF works

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Pre-Implantation Genetic Testing (PGT) There are various reasons why genetic testing can be used alongside your IVF treatment.

We offer two types of genetic testing:

• Genetic testing of embryos created through IVF techniques is used to identify embryos affected by some serious genetic conditions that are known to run in certain families. This helps to prevent a pregnancy that would give rise to a child with a serious health problem that may be fatal at an early age. It increases the chances of a healthy baby being born. This is a technique that allows couples with a particular inherited condition in their family to avoid passing it on to their children.

• Genetic testing of embryos is also possible to screen for the most common genetic problems known as aneuploidies, (Down’s Syndrome is an example of an aneuploidy).


Please note that this test is not a guarantee of a pregnancy.

5. Frozen embryo treatment IVF treatment stimulates the growth of several eggs and can sometimes produce more embryos than can be used in the first treatment cycle. For many decades good quality embryos have been successfully frozen and then thawed to be used to produce healthy babies.

Assisted conception through IVF can be a lengthy process. Unfortunately there is no guarantee of success and treatment can often involve several attempts at embryo transfer in order to achieve the goal of a live-born baby. The ability to use frozen-thawed embryos increases the efficiency of treatment.


or please see: http://flipbooks.leedsth.nhs.uk/LN004204P/LN004204.PDF

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6. Receiving egg, sperm, embryo donationThere are a number of reasons why people may need to use donor eggs or sperm. It may be because there are issues with the quality of their own eggs or sperm. Same-sex couples and single women who want to start a family may also consider using donated sperm.

Donated eggs Some women may be born without ovaries or with ovaries but without eggs inside them. Women are born with all of the eggs they will ever have and there is no treatment to create or multiply them. The eggs are aging with the woman and their quality deteriorates with time. By the time of the menopause, when the menstrual cycle stops, all the eggs have been used up. Most of the eggs available in the ovary do not actually ovulate over a lifetime. They are lost with the day to day turnover of cells like hair and skin. For some women the ovaries age prematurely. This can be as early as the teenage years or in one’s 20’s, long before parenthood is seriously considered for many people. This is called premature ovarian insufficiency. The only way then to conceive is by using donated eggs.

Some women and girls will lose their eggs or whole ovaries as a result of surgery or cancer treatments including chemotherapy and radiotherapy. Unfortunately, unlike hair which regrows, new eggs do not develop.

The most common situation where egg donation is considered is in women whose own ovaries are too weak to try IVF or who have had unsuccessful IVF largely because of the poor quality of their own eggs. This is more common in women over 40 years old and can result in repeatedly unsuccessful treatments or miscarriages.

There are also some rare conditions that are inherited through the female line via the egg genes. Some couples may choose to avoid the risk of having a child with a serious disability, by using an egg from a donor who does not carry the condition in her genes.


Donated spermSome couples need donated sperm in order to have the best chance, or any chance of having a family.

Some men may have problems with sperm production within the testes. Some men and boys will lose their ability to produce sperm or will lose both testes as a result of surgery or cancer treatments including chemotherapy and radiotherapy. Sometimes, sperm production may spontaneously recover in the testes, but when this does not happen, sperm donation may be needed.

Sperm donation is required for fertility treatment for women in a same-sex relationship and for single women.

There are some rare conditions that are inherited through the male line. Some couples may choose to avoid the risk of having a child with a serious disability, by using sperm from a donor who does not carry the condition in his genes.


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Donated embryos Donated embryos may be needed in order for some couples to have the best chance, or any chance of having a family.

Embryo donation is a treatment whereby embryos, that have already been created, are donated and transferred into the womb of a recipient woman to have a baby. The most common reason for this is when both partners are unable to make embryos together, because of difficulties producing healthy eggs and sperm. An alternative would be to consider separate sperm and egg donation treatment (please see egg donation for recipients and sperm donation for recipients patient information leaflets).

Donating eggs and sperm for someone else to use Egg or sperm donation is a remarkable and special thing to consider. It is a voluntary act of kindness to help another woman or couple to achieve their dream of having a family. In the UK donating eggs or sperm is a gift, like blood and organ (kidney, heart etc.) donation.

If you are interested in being an egg or sperm donor, please read our patient information leaflets for more information or get in touch with us for more detail about how your thoughtfulness could help someone else have a family.

7. Fertility preservation Fertility preservation is possible for men and women, girls and teenage boys. There are many reasons why this might be requested:

• if you are an adult (with or without a partner) or a young person (or the adult responsible for a young person), and have been advised to have treatment for a serious condition (such as a cancer), that could affect your ability to have children in the future. You may have been advised to think about ‘storing fertility’

• if you are a woman considering freezing your eggs to give you the option to try to conceive in the future

• if you are transitioning your gender, we can help you make the right decisions for you about preserving your fertility

There are several ways to preserve fertility including the storage of eggs, sperm and embryos. Please get in touch if you are interested in any aspect of fertility preservation.

“If it wasn’t for you and all the wonderful team at Seacroft, we would not be in the

fortunate position we are in today... William brings us so much joy” (patient, 2017)

8. Support with early pregnancy lossThe loss of a pregnancy is always distressing and is devastating if you have been trying to get pregnant for a while. We offer services to help you understand why you have experienced early pregnancy loss, and support you through it with our team. You may find the information below helpful.

MiscarriageMiscarriage is when a pregnancy is lost any time up to 24 weeks of pregnancy. Miscarriage is not talked about very much but is actually very common, more than one in every five pregnancies ends in miscarriage. This is most common before 12 weeks and very often much earlier.

About half of all early miscarriages are caused by one-off genetic faults in the mother’s egg or the father’s sperm, or in how the fertilised egg develops. These pregnancies are not normal and are naturally lost because they are unhealthy.

It is very rare for miscarriage to happen as a result of an action (something you did or didn’t do). Often no specific cause is found and your next pregnancy (if you choose to try again) normally results in a healthy baby.

If you know that you have just had a miscarriage, or suspect that this may be happening, we are here to help. In an emergency, you should contact your GP or local A&E department for assessment and advice. If you have had treatment at Leeds Fertility to conceive this pregnancy, please call one of our nurse specialists for advice on (0113) 206 3102.


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“You helped me get my body right... you helped us through a tough reality

following miscarriages and your care and medical treatment has now given us the thing we wanted the most in the world.

Wilf is brilliant - you and he have changed our lives” (patient, 2018)

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Recurrent miscarriage There are some less common causes of miscarriage. These are usually identified with special tests in women who experience repeated pregnancy loss (three or more miscarriages in a row with the same partner). We have a specialist clinic to offer careful assessment and management of couples suffering this distressing sequence of events, based upon the latest scientific research and evidence.


Ectopic pregnancy Under natural circumstances, the sperm meets the egg in the fallopian tube and fertilisation happens here. The embryo then has about 5-6 days to travel into the heart of the womb where normal implantation should take place, the baby can then grow to full size and deliver successfully. Sometimes a pregnancy can get stuck in the wrong place, such as in the tube. It continues to grow and divide but the tube is too small to contain it and support it properly. This may become a dangerous situation which can lead to the tube bursting and life-threatening bleeding and so may require urgent hospital treatment, either medication or an operation.

Ectopic pregnancies are a specific type of miscarriage and it is normal to feel a similar sense of loss when this happens.


“You were amazing when you treated us following an ectopic pregnancy...

after our first IVF cycle it was refreshing and very much appreciated to be treated with

such compassion and understanding at a very stressful and difficult time...

Louis is just perfect” (patient, 2017)

Your fertility journey

We understand that beginning fertility treatment is a big decision and there are a lot of things to consider. This section details how to start your journey, and where you can find some resources to help you with your decision.

If you would like to read some of our patient stories about their fertility journey, please visit our website: www.leedsfertilityclinic.co.uk/patient-information/patient-stories-and-reviews

ReferralIf you choose to start your fertility journey with us, first of all you will need to meet with your own GP and ask for a referral letter. Your GP will need to carry out some initial tests and include the results with your referral letter to us.

Information for your GP on making a referral is available on the Leeds Health Pathway website: http://nww.lhp.leedsth.nhs.uk/referral_info/detail.aspx?ID=226

It is possible to self-refer directly to one of our consultants through the independent sector hospitals in and around Leeds (including: York, Harrogate, Wakefield / Methley). Although a referral from your GP can be helpful to establish the background to your situation, it is not essential.

You will then receive an appointment to meet one of our doctors or advanced fertility nurse practitioners. You may need further assessments and specialist tests before we can advise you on what fertility options are right for you. If treatment such as IVF is required, you will be given a personalised treatment plan and your treatment could begin within 4-6 weeks of your test being completed.

If you have had tests or treatment elsewhere it is very useful if you bring results, notes and letters with you to your appointment. This helps us get a full picture of what has happened so far and to avoid repeating unnecessary tests.

Patients entitled to NHS-funded treatment will be able to start treatment within 18 weeks of the hospital receiving their referral, in keeping with Department of Health and Social Care targets.

Patients who are not eligible for NHS funding are able to continue their treatment with us as private patients. Private patient services are provided by the same Leeds Fertility consultants.

If you are considering having private treatment, you can complete a private patient enquiry form available from our website: www.leedsfertilityclinic.co.uk/about-us/contact-forms/ private-patient-enquiry

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Sample timeline for IVF treatment

ResourcesWe have dedicated patient information leaflets for all our services. These are available on the Leeds Teaching Hospitals NHS Trust website: www.leedsth.nhs.uk/patients-visitors/patient-and-visitor-information/patient-information-leaflets/fertility

These leaflets are also available in other languages (there is an option to translate them on the website).

To access the patient resources webpage, please scan this code with your phone:

Further information about our clinic, results and patient feedback is available from www.hfea.gov.uk

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Step 1 Contact GP: It could take a few weeks for a referral to reach us.

First Visit: Approx. 40min appointment and two week testing period before second visit.

Second Visit: Discuss results and then start IVF within six week period.

The Next Step: There’s a nurse consultation surrounding medication. You should be ready to start medication/injections approx. up to three weeks from this appointment.

Most women on short protocol have to inject for around two weeks. This is again dependent on individual circumstances.

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Funding and costs Many patients live in areas where the local fund-holding Clinical Commissioning Groups (CCGs) pay for a certain number of assisted conception cycles per year. If you meet certain criteria, the CCG will cover the cycle and medication costs. All CCGs have their own funding policies, so it is worth checking the website of the CCG in your area for more information on their policy. You can also consult with your GP.

If you do not meet the criteria set by your local CCG, you can choose to fund your own treatment with us. You would become a private patient and cover all costs of each cycle of treatment, including the medication.

All our costs can be found here: www.leedsfertilityclinic.co.uk/patient-information/typical-costs

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Our team

To ensure you get the best possible care, we have an outstanding team of internationally renowned consultants including: Professor Adam Balen, Dr Anthony Rutherford, Dr Catherine Hayden, Dr Ellissa Baskind and Dr Harish Bhandari. Together with a dedicated team of nurses, counsellors, a first class embryology team and an administrative support team, we really do put you first.

For more details about all our staff visit: www.leedsfertilityclinic.co.uk/about-us

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Contact us

We provide a fully-licensed facility with the laboratory to support working with eggs, sperm and embryos outside the body. Our consultants are able to assist private patients in all the major local provider hospitals, before and after assisted conception treatment. GP referral of private patients is very helpful but not essential. Please note that most private medical insurers do not cover fertility investigation or treatment. Please get in touch with us and we welcome your questions and feedback.

Telephone number:0113 206 3100 (for general enquiries including appointments)

Opening hours: 07:30am - 18:00pm (please note there is a monitored answering service from 17:30pm) We operate a seven day clinical service

Address: Leeds Fertility Clinic, Seacroft Hospital, York Road, Leeds LS14 6UH

Website: www.leedsfertilityclinic.co.uk

You can find out more information about how to find us or send us a query using the following link: www.leedsfertilityclinic.co.uk/get-in-touch

© Leeds Teaching Hospitals NHS Trust • 1st edition (Ver 2)

Developed by: Leeds Fertility Clinic

Design by: Medical Illustration Services • M20181107_006/BP

Publication date03/2019

Review date 03/2022

LN004523

Leeds FertilityTransforming lives… building families

nThe Leeds

Teaching HospitalsNHS Trust


Leeds Fertility is a collaboration between Leeds Teaching Hospitals NHS Trust and Genesis Reproductive Healthcare.


www.facebook.com/leedsfertilityclinic

@leedsfertility

@leedsfertilityclinic

Cut line

Fold line

440 mm

305 mm

428 mm

304 mm

183 mm

190 mm

Documents

Leeds Fertility - flipbooks.leedsth.nhs.ukflipbooks.leedsth.nhs.uk/LN004523.pdf · however our staff are here to try to make your fertility journey as smooth as possible. Fertility