IN VITRO FERTILISATION (IVF)

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2 IN VITRO FERTILISATION (IVF) Pre Treatment - first cycle 785 Medical Consultation 225 Nurse Planning 235 Baseline ultrasound scan of uterus and ovaries HIV, Hep B antibodies, Hep B antigen, Hep C blood test Included Semen Analysis per patient IVF Treatment Cycle 4,495 IVF cycle Includes all ultrasound scans & oestrogen blood tests, egg collection under sedation, laboratory costs, embryo culture to day 3, embryo transfer, HFEA fee where applicable, one pregnancy scan, follow up medical consultation if within 3 months, one counselling session. IVF cycles with Genetic Testing do not include embryo transfer & pregnancy scan see Embryo Storage Cycle 3,920 the IVF cycle cost, but will be refunded should culture to day 5 not be achieved. Does not include drugs (approx ,250) Intracytoplasmic Sperm Injection (ICSI) Treatment Cycle 5,725 IVF cycle Includes all ultrasound scans & oestrogen blood tests, egg collection under sedation, laboratory costs, embryo culture to day 3, embryo transfer, HFEA fee where applicable, one pregnancy scan, follow up medical consultation if within 3 months, one counselling session. IVF cycles with Genetic Testing do not include embryo transfer & pregnancy scan see Embryo Storage Cycle 3,920 ICSI 1,230 the IVF cycle cost, but will be refunded should culture to day 5 not be achieved. Does not include drugs (approx ,250) Price List April 2018 (V1) 2

3 Embryo Storage Cycle 4,495 IVF cycle - No transfer Includes all ultrasound scans & oestrogen blood tests, egg collection under sedation, laboratory costs, embryo culture to day 3, HFEA fee where applicable, follow up medical consultation if within 3 months, one counselling session, freezing of all embryos. 3,920 the IVF cycle cost, but will be refunded should culture to day 5 not be achieved Does not include drugs (approx ,250) Does not include the fee for ICSI if required Does not include storage fees. Embryo Freezing 820 Embryo freezing 510 One year storage fee 310 IN VITRO MATURATION (IVM) IVM Treatment Cycle 3,295 IVM Cycle Includes all ultrasound scans & oestrogen blood tests, ICSI, egg collection under sedation, laboratory costs, embryo culture to day 3, embryo transfer, HFEA fee where applicable, one pregnancy scan, follow up medical consultation if within 3 months, one counselling session. Please note specific eligibility criteria apply 2,720 the IVM cycle cost but will be refunded should culture to day 5 not be achieved. Does not include drugs (approx ) Price List April 2018 (V1) 3

4 FERTILITY PRESERVATION Pre Treatment - first cycle 785 Medical Consultation 225 Nurse Planning 235 Baseline ultrasound scan of uterus and ovaries included HIV, Hep B antibodies, Hep B antigen, Hep C blood test 130 per patient Semen Analysis 195 Egg Storage Cycle 3,920 Egg freezing cycle Includes all ultrasound scans & oestrogen blood tests, egg collection under sedation, laboratory costs, HFEA fee where applicable, follow up medical consultation if within 3 months, one counselling session, freezing of all eggs, one year s storage fee. 3,920 Does not include drugs (approx ,250) Embryo Storage Cycle 4,495 IVF cycle - No transfer Includes all ultrasound scans & oestrogen blood tests, egg collection under sedation, laboratory costs, embryo culture to day 3, HFEA fee where applicable, follow up medical consultation if within 3 months, one counselling session, freezing of all embryos. 3,920 the IVF cycle cost, but will be refunded should culture to day 5 not be achieved Does not include drugs (approx ,250) Does not include the fee for ICSI if required Does not include storage fees. Sperm Freezing 455 Sperm freezing (per sample) Does not include semen analysis 145 Annual storage fee 310 Surgical Sperm Retrieval (SSR) Surgical sperm retrieval (SSR) if required includes sedation Does not include freezing and storage fees 1,200 Price List April 2018 (V1) 4

5 EGG DONATION Egg Recipient Treatment Cycle 9,530 Egg recipient cycle Includes all ultrasound scans and oestrogen blood tests, laboratory costs, embryo transfer, HFEA fee where applicable, one pregnancy scan, one counselling session. 8,955 the cycle cost, but will be refunded should culture to day 5 not be achieved. Does not include recipient drugs (approx ) Does not include the fee for ICSI if required Egg Sharing Treatment Cycle 655 IVF cycle Includes all ultrasound scans and oestrogen blood tests, drugs for the IVF cycle, egg collection under sedation, laboratory costs, embryo culture to day 3, embryo transfer, one pregnancy scan, follow up medical consultation if within 3 months, one counselling session. No Charge the cycle cost, but will be refunded should culture to day 5 not be achieved. HFEA fee 80 Egg Sharing ICSI Treatment Cycle 1,885 IVF cycle Includes all ultrasound scans and oestrogen blood tests, drugs for the IVF cycle, egg collection under sedation, laboratory costs, embryo culture to day 3, embryo transfer, one pregnancy scan, follow up medical consultation if within 3 months, one counselling session. No Charge ICSI 1,230 the cycle cost, but will be refunded should culture to day 5 not be achieved. HFEA fee 80 Does not include drugs (approx ,250) Price List April 2018 (V1) 5

6 EMBRYO RECIPIENT Embryo Recipient Cycle 2,925 Embryo cycle Includes all ultrasound scans & oestrogen blood tests, laboratory costs, embryo replacement, one pregnancy scan, HFEA fee where applicable, follow up medical consultation if within 3 months, one counselling session 2,925 Does not include drugs (approx ) FROZEN EMBRYO REPLACEMENT AND EGG THAW Frozen Embryo Replacement (FER) Cycle 1,850 FER cycle Includes all ultrasound scans & oestrogen blood tests, laboratory costs, embryo replacement, one pregnancy scan, HFEA fee where applicable, follow up medical consultation if within 3 months, one counselling session 1,850 Does not include drugs (approx ) Egg Thaw ICSI Cycle 4,005 IVF cycle - Egg thaw Includes scans, blood test, egg thaw, laboratory costs, embryo transfer, pregnancy scan, follow up consultation if within 3 months and first counselling session 2,200 ICSI 1,230 the cycle cost, but will be refunded should culture to day 5 not be achieved Does not include drugs (approx ) Price List April 2018 (V1) 6

7 INTRA-UTERINE INSEMINATION (IUI) Pre-treatment - first Cycle 785 Medical Consultation 225 Nurse Planning 235 Baseline ultrasound scan of uterus and ovaries included HIV, Hep B antibodies, Hep B antigen, Hep C blood test 130 per patient Semen Analysis 195 Intra Uterine Insemination (IUI) 1,430 IUI cycle Includes scans, blood test, preparation of sperm, insemination, pregnancy scan, follow up consultation if within 3 months and one counselling session Does not include drugs (approx ) 1,430 Donor Insemination (DI) 2,280 IUI cycle Includes scans, blood test, preparation of sperm, insemination, pregnancy scan, follow up consultation if within 3 months and one counselling session 1,430 Donor Sperm for IUI cycle 850 Does not include drugs (approx ) OVULATION INDUCTION (OI) Ovulation Induction (OI) 530 Ovulation Induction cycle Includes all ultrasound scans session Does not include drugs (approx ) 530 Price List April 2018 (V1) 7

8 ADDITIONAL SERVICES Annual Storage Costs for Embryos, Eggs, and Sperm Annual storage cost 310 Additional Treatments Counselling - first session free if in active treatment 110 Medical Consultation 225 Cyst Aspiration under sedation 300 Embryo transfer under sedation 300 Embryo Glue 200 Endometrial scratch 300 Endometrial scratch under sedation 540 Embryoscope 445 Natural Killer Cell test with Endometrial Scratch 715 IMSI 510 PICSI 260 Assisted Hatching 570 Intralipid Infusion (per administration) 275 Donor Sperm 850 Egg Freezing (does not include storage) 510 Egg/ Embryo Recipient Registration fee (non-refundable) 260 Egg Recipient Trial Cycle 610 Additional Scans Saline Ultrasound Scan 450 Gynaecological or Early Pregnancy Scan 210 HyCosy 450 Genetic Testing Recombine Test per couple 900 Sperm DNA Fragmentation Analysis (Comet Assay) 320 Sperm DNA Fragmentation Analysis (SSR/Oligo Sperm) 420 Sperm DNA Fragmentation plus Semen Analysis 410 Y-Chromosome Micro-Deletion blood test Pre-natal Testing and Analysis of Miscarriages Non-invasive prenatal testing (NIPT) for aneuploidy price on application price on application Products of conception (miscarriage) analysis 620 Price List April 2018 (V1) 8

9 PRE-IMPLANTATION GENETIC SCREENING (PGS) PGS using Next-Generation Sequencing (NGS) PGS with NGS for up to 5 embryos Includes freezing of embryos, biopsy, analysis of up to 5 embryos and storage of embryos for an initial 3 months (storage beyond 3 months will incur the annual storage cost). Additional analysis (per embryo) If more than 5 embryos are to be tested, then each additional embryo will be charged individually. Does not include the cost of the IVF cycle to create embryos or any subsequent replacement cycles. 2, PRE-IMPLANTATION GENETIC DIAGNOSIS (PGD) PGD for Single Gene Defects PGD using Karyomapping for up to 5 embryos Includes freezing of embryos, biopsy, analysis of up to 5 embryos and storage of embryos for an initial 3 months (storage beyond 3 months will incur the annual storage cost). Additional analysis (per embryo) If more than 5 embryos are to be tested, then each additional embryo will be charged individually. Does not include the cost of the IVF cycle to create embryos or any subsequent replacement cycles. PGD for Chromosomal Translocations PGD using NGS for up to 5 embryos Includes freezing of embryos, biopsy, analysis of up to 5 embryos and storage of embryos for an initial 3 months (storage beyond 3 months will incur the annual storage cost) Additional analysis (per embryo) If more than 5 embryos are to be tested, then each additional embryo will be charged individually. Does not include the cost of the IVF cycle to create embryos or any subsequent replacement cycles. 4, , Thaw / Re-freeze Thaw / Re-freeze of embryos 370 Further information to be aware of: Additional frozen embryos (untested) can be included for analysis and will be charged accordingly. The Thaw / Re-freeze cost will also be incurred in addition to the analysis fee. If analysis is carried out on less than 5 embryos the cost remains the same. Once the analysis has been completed we cannot then retrospectively include embryos created in subsequent cycles within this fee. If less than 5 embryos are available, you may choose to delay analysis until embryos are available from further cycle(s) to be analysed together. This option will also incur the Thaw/Re-freeze cost above in addition to the analysis fee. Price List April 2018 (V1) 9

10 BLOOD TESTS Blood Tests Female Hormone Profile (FSH, LH, Testosterone, Prolactin, TSH, AMH) 195 Male Hormone Profile (FSH, LH, Testosterone, Prolactin, TSH) 125 FSH 50 LH 50 AMH 50 TSH 50 Prolactin 50 Oestrogen 50 Progesterone 65 Testosterone 50 Female Thrombophilia 625 Beta hcg 50 HIV, Hep B (all) & Hep C 130 Hepatitis B antigen 85 Hepatitis B core antibody 70 Hepatitis C 75 HIV 50 CMV 85 Rubella 50 Syphilis 50 Karyotyping 285 Thyroid Antibodies 95 Cystic Fibrosis 200 Blood Group/Rh 50 Zika Virus 150 Other Services Administration costs for gamete/embryo transport (within UK) excl. courier costs Administration costs for gamete/embryo transport (International) excl. courier costs Price List April 2018 (V1) 10

11 REFUND INFORMATION Occasionally, patients choose to delay the start of their treatment. If this happens, then we will make a refund of any treatment costs minus a cancellation fee. You may, however, incur additional costs should any tests already undertaken need to be repeated when you resume your treatment. If you should decide not to go ahead at all or if, unfortunately, it is necessary to discontinue treatment for medical reasons i.e. due to poor or excessive response to the treatment drugs, or a coincidental development of a medical condition during the treatment, a cancellation fee will apply. Full details of the cancellation fees per treatment type are given in the table below. Cancellation Fees Cancelled IVF or ICSI cycle before medication is started 250 Cancelled IVF or ICSI cycle after one treatment scan 500 Cancelled IVF or ICSI cycle before egg collection 800 Cancelled IVM before egg collection 525 Cancelled IUI cycle prior to insemination 350 Cancelled FER cycle before cycle / medication is started 150 Cancelled FER cycle before thawing of embryos* 500 Cancellation of PGS or PGD before biopsy 525 Cancelled Egg Sharer Cycle (If egg sharing does not proceed) 1,180 * When embryos are thawed in a FER cycle, should they fail to thaw successfully, there will not be a refund. Annual Storage for Embryos/Eggs/Sperm Once you have consented to store your frozen embryos, eggs or sperm, every twelve months you will be asked to pay for continued storage. You will receive a letter asking for you to tell us if you want your samples to remain frozen and your agreement to pay for a further year of storage. If you decide to dispose of your frozen gametes, you must indicate this by completing the correct section, signing and returning the form so that it is received before the invoice is due. It is very important that you let us know if your contact details change at any time if you have gametes in frozen storage. HOW TO PAY Payment can be made by credit/debit card or by direct transfer to our bank account. We still accept cash or card payment at the clinic but cannot accept personal cheques or American Express card payments. PAYMENT TERMS Please note that we will invoice in advance for your treatment cycle. Payment is required in full before commencing any treatment and we reserve the right to cancel treatment if payment has not been received. Price List April 2018 (V1) 11

12 ONE STOP FERTILITY ASSESSMENT We have designed a range of Fertility Investigation packages to suit a range of circumstances. These provide fast, reliable and thorough investigations together with a review by one of our fertility specialists who can then give appropriate advice or treatment. You do not need to see your GP to refer you. Just contact us for advice on which package will best suit you. Most of the packages shown below require just 1 or 2 visits to the clinic to complete all investigations and consultation, all in a fraction of the time normally needed when undertaken through a GP. Call us on or onestop@oxfordfertility.co.uk to book an appointment. Fertility Assessments Couple: Comprehensive Fertility Assessment Single Women, Women in same-sex relationship or with recent/past diagnosis of cancer Couple: Mini Fertility Assessment HyCoSy Single Men, Men in samesex relationship or with recent/ past diagnosis of cancer Anti-Mullerian Hormone (AMH) Ovarian reserve blood test Progesterone Ovulatory Blood Test Rubella Immunity Blood Test Semen Analysis (Sperm Test) Ultrasound examination of pelvis Antral Follicle Count (AFC) Ultrasound Test of Ovarian Reserve HyCoSy (Ultrasound Test for Fallopian Tubes Patency) * Follow Up Review with Fertility Doctor (30 minutes) LH / FSH/ Prolactin/ TSH/ Testosterone 1, Price List April 2018 (V1) 12

13 ONE STOP FERTILITY ASSESSMENT Ovarian Reserve Assessment Full Ovarian Reserve with doctor review Full Ovarian Reserve without doctor review AMH with doctor review AMH without doctor review Anti-Mullerian Hormone (AMH) Ovarian reserve blood test Ultrasound examination of pelvis Antral Follicle Count (AFC) Ultrasound Test of Ovarian Reserve Follow Up Review with Fertility Doctor (30 minutes) Summary letter Price List April 2018 (V1) 13