Sunday, 24 January 2016

Guest Post - Choosing your IVF clinic

A while ago we wrote a post answering some of the more common questions around same sex conception, in particularly IVF.
Obviously we answered the questions from the perspective of a lesbian couple who have successfully gone through the process, so we are now publishing a post from the perspective of a clinic.

Professor Dr Geeta Nargund, Medical Director at CREATE Fertility clinic in Birmingham was kind enough to answers questions on finding the right IVF clinic for your treatment, and what questions you should be asking your clinic.

"The IVF process for same sex couples can be both daunting and emotional. Therefore finding the right clinic for you and understanding the treatments available are crucial steps in your fertility journey. Here are the top questions that I would recommend asking any clinic to ensure they are right for you.

What makes your clinic suitable for same sex couples?

The treatments that clinics offer will depend on their expertise and the resources available. Not all IVF clinics in the UK will offer every kind of treatment, so it is crucial to ask upfront how they can meet your needs. It is worth visiting a few different clinics to get a range of options and a feel for the clinic’s ethos.

You must make sure that any prospective clinics cater for same sex couples hoping to conceive through IVF, and offer treatments such as:

Sperm donation: sperm is donated through a clinic or sperm bank, and chosen by the couple or woman undergoing IVF treatment. Donation is considered ‘semi-anonymous’. The recipient is not aware of the identity of the donor, however, after the law changed in 2005, anyone conceived using donated sperm is entitled to ask the Human Fertilisation and Embryology Authority for identifying information about the donor once they reach 18 years old.

Intra-Uterine Insemination: is the process whereby sperm is inserted into the woman’s womb at the most fertile point of her cycle; no eggs are extracted or fertilised outside the body.

What kinds of IVF treatments are available to same sex couples?

Following the growth and diversification of the IVF industry, there are different types of treatments available with many moving away from traditional methods of high stimulation IVF treatment. The following low or no drug treatments are now offered by clinics throughout the UK:

Natural Cycle IVF: aims to collect the single egg that has been naturally selected by the body. This is carried out without the use of any fertility drugs, and the egg is fertilised in the lab before being placed in the womb.
Modified Natural Cycle IVF: is a type of Natural Cycle IVF in which spontaneous ovulation is blocked through taking medication for just 3-4 days. Small doses of stimulation hormone are given to keep the follicles healthy and growing.
Mild Stimulation IVF: occurs within the natural menstrual cycle and a minimal amount of fertility drugs are used within the process. Stimulating medication is given for only 8-10 days, compared to 4-5 weeks of medication in conventional IVF.
In Vitro Maturation (IVM): is a process that involves the collection of immature eggs from the ovaries which are then matured in the lab before being fertilised. IVM maintains the benefits of IVF but provides an opportunity for more than one embryo to be created and frozen for later use.

Are IVF treatments tailored to each patient?

IVF treatment should be a personal process, dependent on whether you have undergone IVF previously, your test results and any existing conditions you may suffer from. Areas that your chosen clinic specialises in will also be a key factor in determining which treatment they recommend for you.
Clinics will often offer a blanket IVF treatment to patients that is intended to be suitable for all, however a one-size-fits-all treatment may not be suitable for all patients. In particular, women with endometriosis or Polycystic Ovary Syndrome (PCOS) will respond better to specialised treatment and you need to ensure your preferred clinic offers this if you suffer from these conditions.

Are there any tests you advise having prior to, or during, treatment?

Your chosen clinic should undertake some diagnostic investigations and take a full history on you and your partner before you begin any kind of treatment. This process is essential and can identify any fertility issues you may have upfront, so ensure you give a wide berth to clinics that do not offer these.
A simple fertility MOT can help to highlight cases of infertility and may mean less invasive, and therefore more affordable, treatments are suitable for you. During treatment, clinics tend to offer vaginal ultrasound scans in order to monitor your ovaries and regular blood tests as well.

How many patients have been admitted to hospital during treatment?

Complications of IVF treatment or reactions to the drugs administered, such as Ovarian Hyper Stimulation Syndrome (OHSS), may result in patients being hospitalised. OHSS affects the ovaries of some women who have undergone conventional, high stimulation, IVF. Mostly the effects are mild, causing nausea, abdominal bloating and vomiting although
in rare cases the condition can be fatal. It is important to check that the clinic’s approach to IVF suits you and your needs as OHSS admissions can indicate that a clinic favours a high drug approach. If milder, gentler methods are used, OHSS can be largely avoided.

What are your success rates and how are they measured?

Success rates of IVF clinics should be viewed with considerable care. Not all clinics measure success rates in the same way; some will only accept younger women to increase their rates. It is important to note that not every clinic will accept women with conditions such as low AMH (low egg reserve) in order to avoid risking their success rates. This is unfair, but it happens and you should ask your clinic this upfront if you are affected by either of these conditions or any others. This also makes it very difficult to compare different clinics’ success rates, because they may be treating very different patients. Any woman considering IVF should know exactly how their clinic measures success rates, especially in relation to the treatment you are considering.

How much will treatment cost?

The IVF journey is an expensive one, with the cost often being a major factor for many couples. Medication, blood tests and supplementary tests are usually charged additionally by clinics so make sure you check your clinic’s information on pricing, and ask for a clear indication of what the total cost of your cycle is likely to be before you begin your treatment."

We wholeheartedly agree with Geeta's information. Success rates, aftercare, support, tailored treatment are all important, as well as costs. The cost of treatment often doesn't include sperm, extras, or the expensive medication needed throughout, all of which can run into extra hundreds or thousands. The general feel of the clinic is also important - we chose ours as the staff were lovely, and we just got a lovely calm feeling when we visited. IVF is a huge decision and is financially, emotionally, and physically one of the hardest things you will go through - plus a positive result will change your life! As always, we are happy to answer any further questions our readers have, and thank you again to Geeta for her great advice! 

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