Prior to starting treatment
When we receive a referral letter from your doctor, we will send you a letter of acknowledgment requesting some important information regarding your partner. When we are able to offer you an outpatient appointment, we will write to you and give you:
- a date and time approximately 4-6 weeks later for you both to attend for your first appointment at ACS
Since the results of your partner’s semen test will influence which treatment is most suitable for you, it is most important that your partner has had a sample analysed prior to your appointment. This should be arranged with his General Practitioner. Please note that:
- if, despite this request, your partner does NOT supply a semen sample as instructed, your first visit to ACS will be cancelled and you must contact us to arrange another appointment.
Your first visit
At your first consultation (which will take about 30 minutes) you will meet with a Specialist Fertility Nurse or a Doctor. They will go through a detailed medical history with you both. You will also have your height and weight measured (to calculate your BMI), carbon monoxide screening (to check if you smoke) and you may also need an ultrasound scan of your ovaries.
We require all patients starting a cycle of treatment to have 2 MMR (Measles, Mumps & Rubella) vaccinations. If you have already provided us with paperwork to confirm this, you do not need to do so in subsequent cycles. If you need to check if you have had 2 MMR vaccines please check with your GP in the first instance.
Please note that to be eligible for treatment offered by ACS you must meet the following criteria (the first two apply to the female partner only):
- eligible patients must be screened before the female partner’s 42nd birthday
- the female partner must have a BMI above 18.5 and below 30. Couples should be aware that a normal BMI is best for both partners.
- both partners must be non-smoking (nicotine free) for at least three months before treatment and couples must continue to be non-smoking during treatment. This includes patches, gum and e cigarettes
- couples where only one partner has legal parenthood of a child (or a biological child) can access NHS funded treatment as long as all other access criteria are met in full
- same sex couples will not be eligible if they already have a child in the home and both have
consented to legal parenthood of that child. - neither partner to have undergone voluntary sterilisation or who have undertaken reversal of sterilisation
- couples must have been cohabiting in a stable relationship for a minimum of two years
- both partners must abstain from illegal and abusive substances
- both partners must be Methadone free for at least one year prior to treatment
- neither partner should drink alcohol prior to or during the period of treatment
Possible investigations
Provided you are eligible for treatment at ACS, the most likely outcome of your first visit is that we will be able to recommend a treatment appropriate for you. Should you decide to proceed with that treatment, your name will be placed on the appropriate waiting list.
However, sometimes it will be necessary for you to make several visits to ACS before we can recommend a treatment appropriate for you. Here are some examples of reasons why that might be the case:
- blood tests need to be carried out but cannot be done during your first visit as they need to be taken at a particular time in your menstrual cycle.
- an x-ray or scan needs to be carried out to see whether your fallopian tubes are blocked.
- your partner needs to provide another semen sample to confirm the results from his first sample.
- your BMI needs to be reduced to less than 30 or increased to greater than 18.5
Reaching the top of the waiting list
When your name reaches the top of the treatment waiting list (which may take up to 12 months from the date of your referral to ACS), we will send you a letter giving you your next two appointment dates.
The first of these appointments (ART appointment) will be dated 4 to 6 weeks after the date of the letter you received, and the second appointment (Post Screen appointment) 2 to 3 weeks after that.
ART Appointment
At the ART appointment (which takes about 30 minutes to complete) You will meet with a Specialist Fertility Nurse who will:
- take samples for tests that are required (e.g. high vaginal swab, Anti Mullerian Home etc.)
- give you some registration forms to complete prior to your next appointment.
- you will also be given some Human Fertilisation and Embryology Authority consent forms. It is important that you and your partner read over these forms and discuss the relevant issues that require consent, such as using your eggs and sperm to create embryos for treatment, freezing embryos, research and training. All of these issues can be discussed further with the specialist fertility nurse at your next appointment should you have any questions.
Post Screen Appointment
At the Post Screen appointment (which takes about 1 hour to complete) You will meet with a Specialist Fertility Nurse who will:
- review your medical history
- discuss your test results
- discuss in detail your recommended treatment cycle
- complete your consent forms (both treatment and HFEA)
- review the forms that you have completed
- discuss arrangements for you to start treatment
Depending on when you have your period, your treatment will begin 5 to 8 weeks later.