Treatment

Funding

We can offer treatment which is funded by the NHS. In some areas, waiting lists for treatment can be extensive. The criteria you must meet in order to receive treatment can also vary. All patients have the right to be referred by their GP to a Fertility Specialist in an NHS clinic for their first investigation. Your GP will be able to analyse whether or not you are eligible for NHS treatment.

As an alternative, you may wish to consider private treatment, which the Countess of Chester can also offer. However it should be taken into consideration that private treatment for infertility can be very expensive, and as with NHS funded treatment, there is no guarantee that it will be successful. As with our NHS treatment, our private treatment is licensed by the Human Fertilisation and Embryology Authority (HFEA).

Fertility Drugs

Fertility medication can often be the initial treatment for women who aren't successfully ovulating. The drugs work in a similar way to the body's hormones, which encourages the ovaries to release eggs. This type of treatment is known as Ovulation Induction, and if the course of medication is successful, it can result in conception after a few months without any further intervention.

These drugs - in addition to others that will help to control the menstrual cycle or thicken the lining of the womb - are sometimes also used as part of more complicated reproduction treatments, such as In Vitro Fertilisation and Intrauterine Insemination.

Premenstrual symptoms such as nausea, headaches and an increase in weight, as well as hot flushes and swollen breasts, are among the possible side effects associated with fertility drug treatment.

 

Assisted Reproduction

Intrauterine Insemination (IUI)

Intrauterine Insemination, also commonly referred to as 'artificial insemination', involves the womb being inserted with sperm at the time of ovulation, using a catheter (thin soft hollow tube). As mentioned earlier, in order to stimulate egg production, the woman may also need to combine this treatment with drugs. The sperm used can be either a partner's, or a donated sample.

Used to treat unexplained infertility, premature ejaculation, and erection problems, Intrauterine Insemination has an approximate success rate of fifteen per cent, per cycle.

In Vitro Fertilisation (IVF)

The embryo is transferred to the womb after the eggs and sperm are collected and fertilised in the laboratory. Fertility drugs are used to stimulate egg production. Once the eggs are mature, they are collected by ultrasound guidance. The man's sperm and woman's eggs are put into a Petri dish and left for a few days to allow fertilisation to take place. If a healthy embryo is produced, it is transferred into the womb using a catheter. Any remaining embryos can be frozen for future use. The sperm and/or eggs can be the couples, or a donation.

Used to treat unexplained infertility, blocked fallopian tubes, endometriosis, and PCOS (an ovarian disease), In Vitro Fertilisation has a success rate of approximately twenty-five per cent, per cycle.

It is also possible that some of the remaining embryos may be frozen/cyropreserved and stored for future use.

Intracytoplasmic Sperm Injection (ICSI)

For Intracytoplasmic Sperm Injection (ICSI), a single sperm is injected into the centre of the egg. This is then put into the woman's womb using a catheter.

Used to treat male infertility, such as low sperm count, poor sperm movement and abnormally shaped sperm, Intracytoplasmic Sperm Injection has a success rate of approximately twenty-five per cent, per cycle. ICSI may also be used as an alternative to previously unsuccessful attempts at fertilisation using IVF.

Gamete Intrafallopian Transfer (GIFT)

Using the same method as IVF, eggs and sperm - known as Garmetes - are collected. Rather than mixing sperm and eggs, they are transferred to one of the woman's fallopian tubes immediately, so fertilisation takes place inside the body. Due to the need for general anesthethsia and advances in IVF this technique is very rarely used.

Used to treat unexplained infertility, GIFT has a success rate of approximately twenty five per cent, per cycle.

Sperm Extraction

This is a small operation that extracts sperm from the epididymis - the tube where sperm matures in the man's body - or the testicles, for use in ICSI or other treatments. There are a number of sperm extraction methods. They are;

• Percutaneous Epididymal Sperm Aspiration (PESA) - Involves using a small needle to draw out fluid containing sperm, from the epididymis.
• Testicular Sperm Extraction (TESE) - Uses the same method to remove tissue from the testicles.
• Microsurgical Sperm Aspiration (MESA) - Uses a small needle to extract mature sperm from the epididymis.

 

When the cause of no sperm in the ejaculate is due to a blockage (obstructive azoospermia) such as that due to previous vasectomy the success rates for retrieval are approx 100%. If the cause of no sperm is due to a lack of production in the testis (non obstructive) success rates are around 50%. The retrieved sperm can then be used in IVF/ ICSI with no significant reduction in pregnancy rates from these treatments.

Embryo Freezing

The HFEA states that only two embryos may be transferred to the womb at one time during fertility treatment. As IVF often creates more embryos than can be transferred in a single cycle, any remaining healthy embryos can be frozen for future IVF treatments.

Used to avoid the need for fresh IVF cycles involving multiple egg collections, approximately sixty per cent of embryos survive the freeze/thaw process. Embryos that do survive have only a very slightly lower pregnancy rate than fresh embryos (see tables on results), as the result of a slightly lower rate of implantation.

New Treatments

The Countess is continuously developing new and innovative methods of fertility treatment. Two new techniques in particular can enhance the chances of pregnancy in certain patients

Blastocyst Transfer

Used following unsuccessful IVF treatment when the embryos fail to implant in the womb, Blastocyst Transfer treatment consists of the embryo being allowed to develop for around a week, before being transferred into the womb.

This method draws on the fact that the embryo is more developed and transfer occurs nearer to the time that implantation would occur naturally. As a result, the pregnancy rate is usually higher. However, as some embryos die in the laboratory, the number of embryos available for transfer is reduced.

Due to the above, this treatment is only usually offered to women who produce a significant number of healthy embryos.

Assisted Hatching

An embryo has to break out from a gel-like membrane -known as the Zona Pellucida - before attaching itself to the wall of the womb. Some fertility experts think that the thickness of this membrane may prevent implantation of the embryo in the womb. The embryologist can make a small hole in the membrane before it's transferred, which assists the hatching process.