Fertility

Welcome to Barts Health Fertility Services.

Fertility consultants can be seen at St Bartholomew’s Hospital, Newham University Hospital and Whipps Cross University Hospital. We offer individualised care to women and couples experiencing fertility problems. We investigate the causes of infertility, offer clinical advice, and provide counselling to patients before, during, and after, clinical treatment.

The following treatments are offered:

  • In-vitro fertilisation (IVF)
  • Intra-cytoplasmic sperm injection (ICSI)
  • Fertility preservation (FP)
  • Frozen embryo transfer (FET)
  • Intra-uterine insemination (IUI)
  • Donor insemination (DI)
  • Ovulation induction (OI)
  • Surgical sperm retrieval (SSR)
  • Surrogacy (on application)
  • Reproductive Surgery

HFEA-licensed fertility services are provided at the Centre for Reproductive Medicine, St Bartholomew’s Hospital. Patients may be seen initially at Newham University Hospital or Whipps Cross University Hospital, for a consultation and investigations. If patients require HFEA-licensed fertility treatment, they will be referred to the St Bartholomew’s Centre for Reproductive Medicine.

Download our fertility services brochure [pdf] 3MB

Visiting information

The Centre for Reproductive Medicine
St Bartholomew’s Hospital

2nd Floor
Kenton & Lucas Wing
Little Britain
London EC1A 7BE

St Bartholomew’s Hospital is located in the city of London, close to St Paul’s Cathedral. The nearest Underground stations are St Paul’s, Barbican, and Farringdon. The regular Thameslink service stops at City Thameslink station just around the corner. The new Crossrail service will stop at Farringdon station from 2018. Buses 4, 8, 25, 56, 172, and 242, stop outside, or close to the hospital. There is an NCP car park in West Smithfield.

 

Why choose us

We offer pioneering treatments and first-class clinical support from leading consultants, specialist nurses, embryologists, ultrasonographers, and counsellors. We can call on other specialists within Barts Health Trust and coordinate the process to minimise the number of appointments that you will need to attend.

Our clinical success rates are consistently high. For more information about success rates, please visit the Human Fertilisation and Embryology Association’s website.

We have an HFEA licence to provide fertility treatments, and we are ISO 9001:2008 certified.

The Centre for Reproductive Medicine is based in a prime location in the City of London, in St Bartholomew’s Hospital. It is within walking distance of Barbican, St Paul’s, and Farringdon Underground stations. It is also located conveniently for Thameslink, Liverpool Street, and other mainline rail services.

For patients

If you are interested in receiving fertility treatment, please ask for a referral from your GP or consultant gynaecologist. Once we receive the referral letter, we will arrange an appointment time for you.

Use the links below to navigate to the section you require:

Funding treatment

NHS funded treatment

To qualify for NHS-funded treatment, you need to meet the criteria specified by your Clinical Commissioning Group (CCG). Your CCG is determined by the area in which your registered GP is based. You must fulfil the criteria at the start of each cycle of treatment you undertake.

Self-funding treatment

In you do not meet NHS funding criteria, you may fund part of your treatment. We will still require a referral letter from your GP or a consultant. Once the referral is received, we will send you a price list, paying-patient consent forms and an information pack. Once we’ve received the completed forms, we will raise an invoice and you will be issued an appointment. We will not start treatment until full payment has been received.

Download the price list [doc] 165KB

Self-funded patients must meet the following criteria to receive treatment:
•    Age: you must be under 45 when the treatment commences
•    BMI: your body mass index (BMI) must be under 35

Your referral

All our patients are referred to us by a GP or hospital consultant. You may have had some tests and treatments before having arrived, but we may ask for further information and undertake our own investigations.

Your first consultation

Most appointments are held in an outpatient department or the St Bartholomew's Centre of Reproductive Medicine. We will ask you to undertake tests to help identify the cause of your infertility. Women initially undergo blood tests and a pelvic ultrasound. Male partners undergo semen analysis.

Follow-up consultation

We will discuss your test results and your treatment options with you. We will also provide the relevant information in writing, and you will have the opportunity to ask questions.

As a patient at the St Bartholomew’s Centre for Reproductive Medicine, you can speak to a counsellor to discuss any concerns you may have about your treatment.

If you are a patient at Newham or Whipps Cross Hospital, and you require further fertility treatment, your will be referred to St Bartholomew’s Centre for Reproductive Medicine. The Centre is fully licensed by the Human Fertility and Embryology Association (HFEA).

Pre-treatment information session

All patients at the Centre for Reproductive Medicine must attend a pre-treatment information session. You will receive detailed information on your treatment, including possible side-effects. You’ll also have the opportunity to ask questions, and we will give you instructions on how to administer your medication. We will also ask you to sign a number of consent forms.

If you are being treated as a couple, both partners will need to attend the information session. We are able to provide an interpreter, where necessary.

IVF and ICSI treatment information session

IVF and ICSI information sessions are held every Wednesday at 10am. Afterwards, a fertility nurse will see you individually, so you have the opportunity to ask any questions. The whole process will last approximately 3-4 hours. If you need an interpreter, we can arrange an individual session for you.

IUI/OI/FET information session

Our nurse-led IUI/OI/FET information sessions are held as individual appointments on Thursday mornings. The session will last approximately 30 minutes.

Counselling

The Centre for Reproductive Medicine provides a confidential counselling service. Counselling is available for all patients prior to, during, and after their treatment. Patients who are receiving or donating eggs, sperm, or embryos must discuss the implications with a counsellor prior to treatment, in accordance with HFEA recommendations. You can receive counselling on your own, or with your partner.

Each session lasts 60 minutes.Appointments are available Monday to Friday. Any member of the fertility team can refer you to a counsellor, or you can self-refer by contacting: fertility.counsellors@bartshealth.nhs.uk

Download our counselling information leaflet [doc] 164KB

Our treatments

Our team is committed to offering individualised care in order to help you overcome your infertility, and to identifying which clinical treatment will best suit your needs.
 
We always aim to:
•    Investigate the cause of your fertility problems
•    Offer recommendations and advice
•    Provide a full counselling service
•    Complete our investigations as quickly as possible, minimising the time you need to wait

In-vitro fertilisation (IVF)

Eggs are removed from the ovary and fertilised in a laboratory with the male partner’s (or donor’s) sperm. After 2 or 5 days, one or two embryos are transferred back into the uterus. Excess good quality embryos can be frozen and stored for up to ten years, if you wish.

Intra-cytoplasmic sperm injection (ICSI)

A single sperm is injected directly into the egg in a laboratory, using a fine needle. ICSI may be offered if there are problems with the male partner’s sperm.

Fertility preservation (FP)

Fertility preservation involves freezing and storing eggs, sperm, or embryos for future use. We offer fertility preservation to those undergoing treatment for a medical condition which may affect their future fertility

Frozen embryo transfer (FET)

If available, good quality excess embryos can be frozen and stored after IVF or ICSI treatment. These embryos can be thawed and placed in the uterus (during the course of a natural or hormonally-assisted cycle).

Intra-uterine insemination (IUI)

Prepared sperm are inserted high in the uterus when the female partner is ovulating. This form of treatment may be offered to single women.

Donor insemination (IUI-D)

Women in same-sex couples, or single women, may be inseminated using donor sperm. Heterosexual couples may use donated sperm, if the male partner is unable to produce his own sperm. The CRM has its own in-house sperm donor bank. Alternatively, sperm can be imported from other fertility clinics or from overseas. The CRM also offers donor egg insemination on application, provided the patient has their own donor.
 
Ovulation induction (OI)

Ultrasound scanning and urinary hormone testing identify the female partner’s natural time of ovulation. Either tablets or injections stimulate her ovaries to produce follicles.

Surgical sperm retrieval (SSR)

If no sperm is found in the male partner’s semen sample, it is sometimes possible to extract sperm surgically. This is a day surgery procedure, performed under local or general anaesthetic.

Surrogacy (on application)

Surrogacy is where eggs are removed from the female partner and fertilised by her partner’s sperm, and then the resulting embryos are transferred into the womb of a host surrogate. Surrogacy is a very complex issue: if you have any queries about it, please contact us for more information.

Reproductive Surgery

The Centre offers surgical treatment such as tubal surgery, endometriosis treatment, fibroid removal, and correction of uterine abnormalities. Most of these procedures are performed using minimal access surgery, also known as ‘keyhole’ surgery. Minimal access surgery minimised the recovery time for the patient. All our permanent consultants have subspecialty training in reproductive medicine and surgery.

Frequently Asked Questions

Use the links below to navigate to the section you require. If this page does not answer your query, please contact us directly: fertility.admin@bartshealth.nhs.uk

Pre-Treatment and Investigation Questions

What is meant by Day 1?
Day 1 is the first day of your period, the day that you start to have full flow bleeding. Spotting or discharge is not your day 1.

How do I measure the length of my menstrual cycle?
To measure your cycle length count from day 1 of your period until day 1 of your next period.

I have been asked to have a blood test (hormone profile) carried out on day 1- 3 of my cycle. Can the test only be performed at this time?
Yes, to ensure an accurate assessment of your reproductive hormones this test needs to be carried out within the first 3 days of your period.

Do I need to make an appointment for a blood test?
No appointment is needed for blood tests. These are carried out at the blood test department at Barts, which is located in Clinic 1 on the Ground Floor of King George V Building (KGV). The department is open Monday to Friday, 9am to 5pm. Blood tests can also be done at the Royal London Hospital or Mile End Hospital. You should take your barcode request sticker with you (provided by the doctor or nurse).

I have lost my blood test sticker – what should I do?
Please email fertility.admin@bartshealth.nhs.uk or telephone 0203 465 5050 with your full name, date of birth and also hospital number if you have it, to arrange for a replacement which you can pick up from the Fertility Centre.

How do I book an appointment for a pre-treatment ultrasound scan?
Please book your scan appointment by contacting the Fertility Centre. Telephone 0203 465 5050 or email fertility.admin@bartshealth.nhs.uk. Pre-treatment scan appointments are available on Wednesday, Thursday and Friday afternoons.

How do I book an appointment for a semen analysis?
Telephone 0203 465 5050 or email fertility.admin@bartshealth.nhs.uk. Please ensure you bring your request form to your appointment, so the embryologist knows who your doctor is or who to send the results to.

Click here for information about booking a semen analysis [doc] 115KB 

How do I book an HSG (Hysterosalpingogram) or HyCosy procedure?
Telephone 0203 465 5050 or email fertility.admin@bartshealth.nhs.uk when your period starts to book your procedure. HSG appointments are available on Monday afternoons. HyCosy appointments are on Wednesday and Friday afternoons.

Click here to download the HSG information leaflet [doc] 109KB

Click here to download the HyCoSy information leaflet [doc] 596KB

Why can I not have my HSG (Hysterosalpingogram) procedure carried out after day 10 of my cycle?
The HSG must be performed in the first 10 days of your cycle prior to ovulation (release of an egg) so that there is no possibility of an early pregnancy. As an X-ray is performed during this test, due to Trust policy, it is not permitted to perform this test after the first 10 days of your cycle.

Is it safe for me to have a flu vaccination before or during treatment?
Yes. It is recommended that you have the vaccination if it is offered to you. If you become pregnant you will be more prone to complications from flu which can cause serious illness for both the mother and baby.

Treatment Questions

Is it normal to bleed whilst I am taking Buserelin injections during down regulation?
Yes. Most likely you will have a period whilst taking your Buserelin, before you attend for your baseline scan appointment. However, the period may be different from your normal period. It may be lighter or heavier, or stop and start, it may also not come at the time you were expecting it. This is normal and is nothing to be concerned about.

I am taking Buserelin and experiencing headaches, is it safe to take painkillers?
If you need to take painkillers at any stage during your treatment, it is safe to take a mild painkiller such as Paracetamol 500mg (2 tablets) once every 4-6 hours. Please inform the nurse about your headaches at your next appointment.

Do I still attend for my baseline scan if I have not had a bleed or am still bleeding?
Yes. Please attend for your scan appointment, as you may need some additional treatment based on your scan findings. It may be necessary for you to continue the down regulation for an extra week or two prior to commencing your stimulation. This will also mean that your proposed week of egg collection may be delayed but will not affect the outcome of your treatment.

What preparation do I need to make for my scans?
All scans are done internally. You may eat and drink as usual but you will be asked to empty your bladder when you arrive for your appointment.

Click here to download the transvaginal ultrasound examination information leaflet [doc] 104KB

What is the best time to take my injections?
Buserelin injections should be taken once daily in the morning at a time of your choosing. Gonal F and Menopur should be taken once daily in the evening any time after 6pm. Whatever time you choose for taking your medication please try and stick as near to that time as you can. Cetrotide should be taken once daily, at the same time every day.

I forgot to take my injection – what should I do?
If you forget to take your Buserelin, please take the dose as soon as you remember and have your next dose as normal. If you forget to take your Gonal F, Menopur, or Cetrotide, please take the next dose as soon as you remember, but if it is the next day please also call or email us for advice.

I am taking Crinone gel and am passing clumps of white/brown material
This is normal and. Although it is not very pleasant, you do not need to be concerned and you should continue taking the gel as advised.

Is it safe to fly/travel whilst I am on treatment or following my embryo transfer?
Yes it is safe for you to fly. However, if you are planning to travel whilst in treatment bear in mind that you will need to be available for a number of appointments and that we may have to ask you to attend at short notice, or change your appointment days, depending on how your treatment is progressing.

Please also be aware that the ZIKA virus is affecting many countries around the world. For most people, the virus is not harmful. However, it may have an impact on the safety of your pregnancy. Please let us know if you, or your partner, have recently travelled abroad, or plan to do so in the near future. For more information on the ZIKA virus, see here.

I am waiting to take my pregnancy test and have started to bleed already – what should I do?
Heavy bleeding before your pregnancy test may be a sign that the treatment has not worked, but this is not always the case. We therefore advise you to continue with your luteal support or Crinone gel (or Cyclogest), and await the outcome of the test. Even if you have done an early pregnancy test, we will ask you to do another one on the due date, to ensure the result is accurate. If you wish to speak to one of the fertility nurses for support or reassurance, then please contact the clinic during opening hours.

Post Treatment Questions

I have done my pregnancy test following my treatment, what do I do next?
Please inform the Fertility Nurses of your test result by telephone or email and also let us know if you have started your period or are experiencing any problems. The nurses will try to get back to you on the same day if it is a weekday. If we are not able to contact you on the same day please follow the instructions below and we will telephone or email you the following day.

My pregnancy test is negative – what happens next?
Please stop taking your Crinone gel/Cycloges, if you are taking it. If your period has not already started it should start within the next few days. What happens next depends on the treatment you are having and your individual circumstances. We may ask you to come for an outpatient consultation review appointment with one of the doctors or senior fertility nurses. If your case is straightforward, we may be able to proceed with further treatment without seeing you first. The nurses will contact you to discuss this. You may also find it helpful to arrange an appointment with our fertility counsellors who are here to support you.

My pregnancy test is positive – what happens next?
If you are taking Crinone gel or Cyclogest then please continue to take this along with any other medication we have prescribed for you. We will contact you to book your early pregnancy scan and arrange for you to receive further supplies of your medication. For further information and advice on early pregnancy please see the NHS Choices website.

I am having a frozen embryo transfer cycle, what do I do if I get a positive surge at the weekend?
Please send an e-mail to fertility.admin@bartshealth.nhs.uk or telephone the clinic on Monday morning. We will get back to you on the Monday afternoon to confirm the details of your appointment

I am having IUI treatment, what do I do if I get a positive surge at the weekend?
On Saturdays please arrive at the Centre for 9am with your partner; the insemination will be done on the same day. If you are using donor sperm please also arrive at 9am to inform us. On Sundays please ask your partner to attend at 9am on Monday morning and the insemination will be done later in the day. If you are using donor sperm then please call or email to us on Monday morning and you will be given a time to attend late morning/lunchtime.

Medication and pharmacy questions

How do I obtain my NHS funded treatment medication?
If it is your first treatment cycle the nurse will give you your prescription at your pre-treatment information session appointment so that you can collect the medication from the hospital pharmacy. For any further treatment cycles the nurse will let you know when your prescription is available for collection.

Can I obtain my medication from another hospital or outside pharmacy?
No, NHS funded fertility medication can only be obtained from the Barts hospital pharmacy.

Why is the hospital pharmacy charging me for my medication when I am receiving NHS funded treatment?
You are not being charged the cost of the medication. The payment is the standard prescription charge levied on every prescription item. These charges are payable for all drugs obtained from the hospital pharmacy, unless you are exempt from prescription charges or have obtained a pre-payment certificate. For further information and to get help with prescription costs visit the NHS Choices website.

Click here for information on obtaining medication from the pharmacy [doc] 105KB

I am self-funding my treatment, how do I obtain and pay for my medication?
We will arrange for you to receive a private prescription prior to starting your treatment cycle. You may obtain your drugs either from the hospital pharmacy, an outside pharmacy (these may need to be ordered in for you) or through a homecare delivery company. The most cost-effective of these options is normally the homecare delivery company and the nurses can supply you with the details. The company will arrange for you to make payment directly to them.

How do I obtain needles and syringes to administer my injectable medication?
If you obtain drugs from the hospital pharmacy the Fertility Nurses will give you the supplies and can provide extras if you are running out. Supplies can be collected from the 2nd floor reception of the Centre for Reproductive Medicine. If you receive drugs from the homecare delivery company they will also deliver a supply of needles and syringes and a sharps waste disposal box.

What do I do with my sharps disposal box once it is full/I have finished the treatment?
Please ensure you close the lid firmly and return it to the CRM reception for disposal. We can only accept closed sharps boxes.

How do I store my medication?
It is important that you store your medication according to the accompanying instructions to ensure that the drugs are effective and to prevent wastage as some of the drugs are very costly. The storage instructions for the most commonly used drugs are:

Room temperature

•    Buserelin                         
•    Cetrotide                           
•    Tablets e.g. clomid, dexamethasone, climavel        
•    Crinone gel                        
•    Cyclogest pessaries
•    Antibiotics e.g. doxycycline
•    Marvelon

Fridge

  • Gonal F
  • Menopur Multidose
  • Ovitrelle
  • Pregnyl

Click here for more information on the storage of medication [doc] 112KB

General Questions

Does my partner need to attend all of the appointments?
Partners are welcome to attend for all appointments. However, as a minimum we do require partners to attend the first clinic appointment, the pre-treatment information session and also on the day of egg collection if you are having IVF treatment, or on the day of insemination if you are having IUI treatment using your partners sperm. We also require partners to attend for signing of new consent forms at the first scan appointment for all subsequent IVF and FET cycles.

Can I bring children to my appointments?
Where possible we recommend that you make alternative childcare arrangements for any children you may already have when attending your scan or consultation appointments.

For some appointments children definitely should not attend and you must ensure that you have made adequate arrangements for their care as staff at the clinic are not able to look after them for you. These appointments include: IVF information session, egg collection, embryo transfer, dummy embryo transfer, IUI, HyCosy, Hysteroscopy, and HSG. If in doubt, please ask a member of the clinic staff.

What can I do to increase the chances of getting pregnant?
Have a healthy weight for your height. Being overweight or underweight can affect your chances of conceiving and there is also a higher risk of complications if you do fall pregnant. It is recommended that you eat a healthy balanced diet and take regular exercise to help achieve/maintain a healthy weight, as well as helping to reduce stress levels. Your weight is healthy if your Body Mass Index (BMI) is between 20 and 25.

If you or your partner smoke and/or take recreational drugs you are advised to give these up as they can both reduce fertility for men and women. Note that some CCGs do not fund fertility treatment for smokers. Heavy drinking can also affect fertility. Women should drink no more than one or two units of alcohol, once or twice per week, and men should stick to a daily limit of three or four units.

Take folic acid. Folic acid is important for the development of a healthy foetus, as it significantly reduces the risk of neural tube defects (NTDs) such as spina bifida. It is recommended that all women who are trying to conceive should take a daily supplement of 400 micrograms of folic acid and should continue taking this dose for the first 12 weeks of pregnancy, when the baby's spine is developing. You can buy folic acid tablets either from the pharmacy or the supermarket, or on prescription from your GP. You should take one tablet daily.

Administration and funding

How do I obtain a copy of my medical notes/results?
Please contact the Fertility Administration staff fertility.admin@bartshealth.nhs.uk or telephone 0203 465 5050 for further information on obtaining copies and current charges.

Surgery

I have been booked by the doctor to have an operation, who can I contact to find out details of the date?
Operation dates are booked by the Day Surgery Department. Please contact the Scheduler for Fertility Operations on telephone 0203 594 6244

What do I need to do in order to start my fertility treatment after I have had the operation?
Please contact the Fertility Administration staff on email fertility.admin@bartshealth.nhs.uk or telephone 0203 465 5050. The administration staff will obtain your notes and a copy of your operation report. The doctors will review your notes and decide on a treatment protocol. These will be passed to the nurses who will schedule you for treatment.

For clinicians

Patients’ eligibility for NHS-funded treatment is checked prior to any appointment being issued. If the patient is ineligible for NHS-funded treatment - or if only a part of their treatment is eligible for NHS funding - they will be offered investigations/treatment on a self-funded basis. In this case, a self-funding information pack will be sent out to the patient.

For any patient funding their own treatment we require a referral letter from the GP/Consultant.

For referring to St Bartholomew’s

We accept referrals from GPs for couples/individuals seeking investigations and/or treatment for infertility. Referral letters should be sent for the attention of the appropriate consultant to:

Barts Health Centre for Reproductive Medicine
Second Floor, Kenton and Lucas Wing
St Bartholomew’s Hospital
West Smithfield, EC1A 7BE
Tel: 020 3465 5050
Fax: 020 3465 5099

All new patients are seen within six weeks. Once investigated there may be a short waiting time before we proceed with fertility treatment.

For referring patients to Newham

All referrals must be sent to:

Obstetric and Gynaecology POD
Newham University Hospital
Glen Road
London, E13 8SL
Tel: 020 7363 9015
Fax: 020 7363 8255

We are open from 9am - 5pm, Monday to Friday.
With all new referrals, please include details for patient’s husband/partner.

For referring patients to Whipps Cross

Referral guidelines:

• Semen analysis needs to be arranged by the GP before referral
• Day 2 +/-1 FSH, LH, Oestradiol
• Day 21 Progesterone if regular period cycle
• Rubella test required

If you have any queries, please contact Mr Ismail Wong, Consultant Obstetrician and Gynaecologist and Lead in Subfertility on 0208 539 5522 ext 5498.

Fertility clinics are open from 9am-1pm on Wednesdays and 9am-1pm every other Tuesday.