Fertility Treatments

IVF is suitable for:

• Unexplained infertility
• Tubal Damage
• Male factor problems
• Ovulation disorders
• Older women

What is IFV?

IVF literally means fertilisation ‘in glass’ hence the familiar name of ‘test-tube baby ‘. Eggs are removed from the ovaries and fertilised by sperm in a laboratory dish and the resulting embryos

What does IVF involve?

For Her: IVF involves taking fertility drugs which are tailored to your individual needs. Your own hormone production is temporarily switched off and your ovaries are stimulated to produce more eggs than usual. The production of eggs is monitored by regular ultrasound scans. When eggs are ready to be released, you will have a minor operation to collect them (egg collection). 

For Him: You will be asked to produce a sperm sample at the clinic on the day of egg collection. The sperm are collected in a sample pot and after a short time are washed and spun at high speed to select the best sperm, which are mixed with the eggs. If, for any reason, you are unlikely to be unable to produce a sample on the day, sperm may be frozen in advance. 

What happens next?

The eggs are mixed with sperm in the laboratory and left to fertilise. After two or more days, one or two embryos are placed in your womb. Any good quality embryos may be frozen and stored for future use. 

How successful is IVF?

Success rates depend on a number of factors, but most importantly the women’s age. The chance does not improve as each hurdle in the process is overcome; therefore, it is helpful to know the success rate after egg collection and embryo transfer. We regularly publish success rates, so ask for our latest results. 

What is ICSI?

Intra-Cytoplasmic Sperm Injection (ICSI) is a technique that has been developed to assist fertilisation using very few sperm. If sperm quality is poor, either due to low numbers or because they do not swim very well, or because they are not able to penetrate the barriers surrounding the egg, then infertility can result. ICSI is used successfully to treat these conditions.

Who should have ICSI treatment?

• Men with very low numbers of sperm
• Men with poor quality of sperm
• Men who produce semen in which no sperm is present (see Surgical Sperm Retrieval)
• Couples who have had previous failure to achieve fertilisation in routine IVF, or when very few eggs have fertilised following IVF

What specific tests may be needed before ICSI?

There are conditions associated with severe sperm problems. These include chromosomal abnormalities, cystic fibrosis or a hormonal imbalance. 

1. Chromosomes carry the genetic information from one generation to the next. They are responsible for determining not only what we look like but making sure that everything works normally. We take blood from the man to check his chromosomes.
2. Cystic Fibrosis is a condition affecting the lungs and bowels and is also associated with defects that cause male infertility. The chance that a healthy person may carry a risk factor for this condition is 1 in 20. In men with some types of sperm problem, this risk is higher. If both you and your partner carry the risk factor then there is a 1 in 4 chance that your child may be affected. We take blood to screen for this condition.
3. A hormonal imbalance may be the cause of the abnormal sperm production. Blood is taken to check this.

What does ICSI involve?

For Her: The cycle is the same as for IVF treatment.

For Him: This will depend upon whether a fresh or frozen sample is used, or surgical sperm retrieval is required. 

What happens next?

ICSI treatment involves injecting a single sperm directly into the centre of an egg to assist fertilisation. Once there, the nucleus from the sperm can fuse with the nucleus of the egg, completing the normal fertilisation process. The treated eggs are checked to see if fertilisation has occurred. After two or more days, one or two embryos are placed in your womb. Any other good quality embryos may be frozen and stored for your future use.

How successful is it?

As for IVF treatment, success rates depend on a number of factors, but most importantly, the woman’s age. The chance does not improve as each hurdle in the treatment process is overcome, therefore it is helpful to know what the success rate is after egg collection and embryo transfer. We regularly publish success rates, so ask for our latest results.

If you are not eligible for NHS funding, one way of helping to pay for IVF/ICSI treatment is through egg sharing.

To be an egg sharer, you must be generally fit and healthy, aged 18 to 35 years, a non-smoker, free from any serious medical problems, disabilities, congenital or hereditary diseases, and not severely overweight for your height.

If you want to find out more about compensated egg sharing, please contact us at the Birmingham Women’s Fertility Centre.

What does 'treatment with donor eggs' mean?

Eggs from a donor are fertilised with your partner’s or donor sperm and transferred to your womb.

Where do donors come from?

We recruit egg donors, but there is high demand, and you may need to wait up 18 months for a suitable donor who matches your characteristics. This may be longer depending on your specific requirements.

Alternatively, you may ask a friend or relative to donate their eggs, either directly to you or anonymously to someone else on the waiting list. You will then automatically go to the top of the waiting list for the next suitable anonymous donor.

Treatment with donor eggs

The fertility tests that we do include tests to check on the ovarian egg store. You will be offered a follicle-stimulating hormone (FSH) test, which measures the amount of FSH in a blood sample and in addition, you may be offered an anti-mullerian hormone (AMH) test to check on your store of eggs. If the egg store is low, then donor egg treatment may be an option for you. We have a specialist team to remove the complexities of donor egg treatment and guide you through a step-by-step and effective treatment pathway.

Egg donation may be suitable for women who:

• Have had an early menopause
• Have no ovaries or have had them removed
• Have had cancer treatment, which has damaged the ovaries
• Are producing few or low-quality eggs
• Have a high risk of passing on an inherited disorder

Donor sperm is needed for a variety of reasons:

• Where a couple’s cause of infertility is due to a lack of sperm, or a very low sperm count, not suitable for ICSI
• Where the male partner has a heritable disease and pre-implantation genetic diagnosis is not suitable
• For single women and same-sex couples.

Sperm donors are recruited from a wide range of backgrounds. They are required to be fit and healthy, with no family history of hereditary disease. Donors are screened for a variety of infectious conditions, including HIV and hepatitis, and for some genetic conditions, according to national guidelines.

As far as possible, we try to match donor characteristics to the patient’s requirements - ethnicity, skin, hair/eye colour, height etc.

The Centre believe in the importance of UK policy around family limits and respect the UK and ESHRE best practice guidance around clear information for patients. We therefore will not import sperm from centres where these requirements are not met. We encourage all patients, via engagement with our counselling service, to understand the potential negative impact of unregulated family size on their potential child.    

Donor sperm can be used in conjunction with artificial insemination, IVF or ICSI.
At our centre, all donors and patients receiving donor gametes must have implications counselling.

Sperm donors are recruited from a wide range of backgrounds. They are required to be fit and healthy, with no family history of hereditary disease. Donors are screened for a variety of infectious conditions, including HIV and hepatitis, and for some genetic conditions, according to national guidelines.

As far as possible, we try to match donor characteristics to the patient’s requirements - ethnicity, skin, hair/eye colour, height, etc.

Donor sperm can be used in conjunction with artificial insemination, IVF or ICSI.

Surrogacy involves the transfer of embryos created using the eggs and sperm of a couple undergoing treatment (the commissioning couple), into the womb of another woman, the 'surrogate' and is carried out when, for some reason, a woman cannot carry a child herself. Surrogacy is never funded by the NHS. 

The centre is currently are not offering surrogacy, but will be happy to guide you towards other sources of information and providers. 

Ovulation induction is a treatment for women who, for some reason, do not ovulate (release an egg) every month. By stimulating the ovaries with mild type fertility drugs and monitoring the effects with ultrasound scans, ovulation can be induced. The couple are then advised to have sexual intercourse over the next three days.

This is a technique that is used for couples with ‘unexplained’ infertility. The procedure is carefully coordinated with a woman’s cycle. The correct day for insemination is determined by using mild fertility drugs and ultrasound scans to predict the day when ovulation will occur. The husband/partner is asked to produce a fresh semen sample on the day of treatment. This is prepared by the embryologist, which can take up to 2 hours. The woman then attends the clinic later on the same day. The insemination procedure itself is a simple one, similar to having a cervical smear test.

When there are no sperm in the ejaculate, sperm can sometimes still be recovered from the testicles by an operation. There are a variety of techniques:

• PESA (Percutaneous Epididymal Sperm Aspiration- A fine needle is inserted into the epididymis (the sperm reservoir) at the upper area of the testicle and any sperm will be drawn through the needle into a syringe.
• TESA/TESE (Testicular Sperm Aspiration/ Extraction)- A fine needle is inserted into the testicle and tubules and sperm are drawn through the needle into a syringe.
• Open Testicular Biopsy– if few or no sperm are obtained from the above procedures a biopsy (tissue sample) is taken from the testicle through a small incision. After the procedure 2-3 stitches are placed in the skin, these will dissolve after about 10 days.

These procedures are carried out either under local or general anaesthesia. The sperm can be used either for diagnosis, immediate treatment, or frozen for use in future treatments. Sperm obtained from this procedure normally need to be used for ICSI treatment.

Who needs egg freezing?

Egg freezing is available to women whose capacity to produce eggs is becoming limited, other than from the natural ageing process. Some treatments for cancer and other serious conditions may affect the store of eggs in the ovaries or the function of the ovaries themselves. Egg freezing before such treatment takes place may make it possible for women to have children using their own eggs*.

Women who suffer from any condition that may lead to premature ovarian failure, and as a result infertility, may also consider egg freezing.

Finally, egg freezing may be used as an emergency procedure for couples undergoing IVF, if the male partner is unable to provide sperm at the time of treatment.

What does egg freezing involve?

In order to collect enough eggs to freeze, women must undergo drug treatment to stimulate their ovaries, in the same way as women undergoing IVF treatment. This takes two to five weeks.

The eggs are then collected under general anaesthetic or sedation. Only eggs that are mature and ready to be fertilised, can be frozen.

When the eggs are required for treatment, they are thawed and fertilised using ICSI in order to give the maximum chance of fertilisation. However, you must bear in mind that freezing eggs does not guarantee future successful fertility treatment.

How long can eggs be stored?

You may legally store your eggs for ten years, but under certain circumstances this can be extended to 55 years.

It is necessary to stimulate the ovaries so that enough eggs develop for freezing. In some cases there is a risk that the drugs involved will make the cancer worse, in which case egg freezing would not be possible.

Funding for egg freezing

In some areas, funding is available for fertility preservation. Your GP or oncologist should be able to discuss this with you. However, you need to be aware that even if funding is available for egg freezing, there is no guarantee that funding will be available for treatment using those frozen eggs.

Who needs sperm freezing?

Men who are having treatment that might impact their future fertility, for example, chemotherapy or radiotherapy, urological surgery or undergoing a vasectomy.

Men with low sperm counts whose partners are going to have ICSI treatment may be advised to freeze sperm in case they are unable to produce sufficient sperm on the day of egg collection.

How long can sperm be stored?

Sperm are initially stored for ten years, but storage may be extended to 55 years in certain circumstances.

How do I use my sperm in the future?

Frozen sperm is usually used in conjunction with IVF or ICSI, depending on the quality and post thaw survival.

Donors are people from all walks of life and ethnicities – there is no such thing as a ‘standard donor’. What they all have in common is their desire to help people and make a real difference in someone’s life.

Sperm Donor Information Leaflet

Why are sperm donors needed?

Some men are infertile. This might be because of:

• Inherited disorders in the family
• Poor sperm production
• Cancer Treatments
• Same-sex couples and single women also require donated sperm to undergo fertility treatment.

In the UK, there is a shortage of sperm donors with many couples having to wait over a year for treatment. Donors are required from all nationalities, religions, ethnicities and cultures.

Become a sperm donor

To become a donor, you need to be aged between 18-46, generally fit and healthy. You may not be able to donate if you have had a serious medical problem, disability, infection with genital warts/genital herpes or a family history of a hereditary (inherited) disease.

You will need to be willing to attend the clinic for initial tests and then regularly to make donations and finally attending the last screening appointment six months after your last donation.

Sperm donation process

We start with a brief telephone questionnaire, asking a few individual questions and also offer you a screening appointment.

At the first appointment, we will explain the whole donation process, ask you to complete a questionnaire and also provide a semen sample for analysis/test freeze. We will also ask for your consent to contact your GP to check your medical history.

The next appointment will be with our counsellor, who will be able to discuss the implications or any private and confidential questions you may have about the process. We will also arrange for blood and urine samples, to screen for various diseases. You will also be asked to undergo a physical examination.

When the screening checks are complete regular appointments can be made for you to make donations. This normally involves making around 10-15 visits.

Sperm donation law

In a legal and social sense, the people who receive your donation will be the parents of any child that is born. But the child will inherit your genes and therefore they will be genetically related to you.

As the law now stands, once any children born from your donations reach 18 years of age they will be able to find out who you are, and may want to get in touch. You have no legal obligations to any child created from your donation. The person who received your donation (and their partner) will be the child’s legal parents. You cannot be named on the birth certificate and have no rights over how the child is brought up, nor will you have any responsibility to contribute financially.

As a donor you would have a statutory right to request information on the number, sex and year of birth of children born as a result of your donation. This information may be obtained from the clinic or from the Human Fertilisation and Embryology Authority, (the UK’s independent regulator of fertility treatment and research using human embryos).

In addition, the Human Fertilisation and Embryology Authority is expected to contact and forewarn you if ever a donor-conceived person requests identifying information about you.

Can you give the gift of life?

You will be paid a total of £45.00 for every sperm donation you make. This is paid at £30.00 cash per donation visit (after initial screening has been completed) with the remaining £15.00 from each visit paid in a lump sum at the final screening appointment.

For enquiries relating to donor sperm or becoming a sperm donor please email bwc.sperm.bank@nhs.net or call 0121 335 8272.

Donors are people from all walks of life and ethnicities – there is no such thing as a ‘standard donor’. What they all have in common is their desire to help people and make a real difference to someone’s life.

Why are egg donors needed?

Some women are unable to produce their own eggs. This might be due to:

• Cancer treatments
• Premature menopause
• Inherited disorders in the family
• Poor response to IVF with their own eggs
• Age-related infertility

Can I help?

Potential donors should be generally healthy, aged 18-35 years, free of any serious medical problem, disability, congenital, family or hereditary disease and who are not severely overweight for their height. We need donors of all ethnicities.

We pay £750.00 per completed egg donation cycle. This will be paid to the donor after egg collection. This compensation level will increase soon in-line with an HFEA update.

General health assessment

This can be done by a nurse or a doctor, over the telephone or at an appointment in the clinic. We will take a full personal medical and family history, in the form of a detailed health questionnaire. It is essential that the potential donor gives accurate information and ensures that the Fertility Centre is aware of any relevant medical conditions. We will also ask for your written permission to contact your GP in order to confirm your health status.

Counselling

All potential donors will meet the counsellor and the effects of this procedure on the donor, her family and children are discussed. We also like to ensure that the donor’s partner is in agreement before we begin the donation process.

We encourage all donors to discuss their donation with their children when appropriate to their age. We make sure that the welfare of any potential children born from your donation is carefully considered during counselling with the recipient couple.

Screening and consent

At this appointment, you will see a nurse and it will take approximately one hour.

You should bring a form of ID such as a passport or driving licence as we will need a copy for our records.

All details needed to register you as a donor with the HFEA (Human Fertilisation and Embryology Authority) will be taken and you will be asked to provide a brief description about yourself (you can take this part away with you to complete).

The paperwork and consent forms needed for the process will be explained and completed.

Blood samples will be taken for infective disorders, genetic disorders and to check that your ovaries are working well.

Vaginal swabs are also taken to test for infections such as chlamydia and gonorrhoea. The implications of having these tests are fully discussed before samples are taken. The results of the tests are confidential and the results are made known only to the donor. Without written permission, not even your GP can be informed.

Final appointment (before treatment begins)

This appointment will also last about one hour and is again with a nurse. The results of all tests will be discussed. The process of actually donating your eggs will be fully explained and further paperwork will be completed.

Start of treatment

You can decide which month to start the process of donating your eggs. Remember that the process will take approximately six weeks across two menstrual cycles. The process begins on day 21 of your menstrual cycle. This involves daily injections for two to three weeks to 'switch off' your own hormones, followed by approximately two weeks of further injections to stimulate your ovaries to grow eggs. All injections are given into the fat layer just under the skin. We will teach you to do these injections yourself. The nurses will do vaginal ultrasound scans to monitor your progress. You will then have a minor operation under general anaesthetic or sedation to collect the eggs. This takes place in our department and only takes approximately half an hour.

This completes the process. You will then go home when feeling well enough for a well-earned rest! You will need to organise for a friend or relative to take you home and be with you for 24 hours until you are fully recovered from the anaesthetic.

Egg donation law

Any child born as a result of egg donation will be the legal child of the recipient, not the donor. The HFEA keeps a register of all egg donors as well as all treatments using donated eggs. As the law stands, the identity of a donor remains confidential as far as the parents of donor-conceived children are concerned.

However, at the age of 16, children born as a result of donated eggs will be legally entitled to non-identifying information about the donor and other donor-conceived children to whom they are genetically related. Young people aged 16 who are entering a relationship may also find out whether they are genetically related. At the age of 18, they will be entitled to identifying information about the donor. They may also be given identifying information about donor-conceived genetic siblings if both sides consent.

Parents of children conceived using donated eggs are provided with non-identifying information about the donor. They may also ask the HFEA for information about the number, sex and year of birth of other children born from the same donor.

The donor is entitled to non-identifying information about their offspring, specifically the number, sex and year of birth.

Under regulations, donors may help to produce children for a maximum of ten families. However, women who donate in this clinic will be donating to a maximum of two couples in the process of one cycle.

Withdrawal of consent

It is important that donors only proceed if they are completely happy with the procedure and the possible consequences. Our counsellor is available to discuss any concerns and any such discussions are completely confidential. However, donors are free to withdraw consent at any time up until their eggs, or the embryos created using their eggs, are used in treatment (transferred into the womb of the recipient). If eggs or embryos have been frozen for future use, the donor may withdraw her consent to storage and future use at any time.

Can you give the gift of life?

For further information, email us at bwc.eggdonation@nhs.net or call us on 0121 335 8270.