Brochure

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1 Brochure

2 The Fertility & Gynaecology Academy Introduction The Fertility & Gynaecology Academy London s leading fertility clinic for infertility treatments The Fertility & Gynaecology Academy is an established Assisted Conception Unit in central London that offers infertility treatments. Established in 2004, it is a progressive clinic consisting of a highly dedicated team, experienced in the treatment of male and female fertility problems. The Fertility & Gynaecology Academy offers comprehensive fertility services including gynaecology, pelvic ultrasound and endoscopic surgery. We run the most comprehensives Reproductive Immunology Programme in UK if not in Europe, including uterine NK cells, LIT, KIR test, G-CSF therapy, etc. We recognise that undertaking infertility diagnosis and treatment can be extremely stressful due to the inherent emotions and financial cost involved. We pride ourselves in offering you not only the most advanced techniques available in Assisted Conception, but also personalised direct support from our consultants. We ensure that every patient feels educated, comfortable and fully supported throughout their treatment. Our costs are reasonable and we also offer an exclusive IVF / ICSI package at an extremely competitive price. All this coupled with consistently high success rates, especially for women with complex fertility problems, makes us an ideal choice for women and couples seeking to start a family via assisted conception. Please note that currently all fertility treatments that require a license by the HFEA (including IVF, ICSI, IUI, donor insemination, storage of gametes or embryos) are carried out by Dr A Gorgy at City Fertility, 16 St John Street, London, EC1M 4NT. 2

3 Brochure 2013 Our Consultants DR A Gorgy, Fertility Consultant & Co-Director MBChB, MSc, FRCOG Dr Gorgy has been practising in the field of Fertility and Assisted Conception since He founded The Fertility & Gynaecology Academy in 2004 with Dr Eskander and is co-director. He was the Clinical Director of the London Fertility and Gynaecology Centre for over four years. Here he created all the clinical protocols for the unit. He contributed to the development and improvement of new techniques e.g. Micro-surgical Sperm Retrieval (PESA and TESA), Assisted Hatching and Blastocyst Transfer. Through hard work and dedication to his patients, he improved and maintained good results of the unit during his directorship. He was then approached by the Assisted Reproduction and Gynaecology Centre (ARGC) to work as a Consultant Gynaecologist and Deputy Director from 2000 to In this role he contributed to the outstanding results of the unit and to the introduction of new developments, including Pre-Implantation Genetic Diagnosis (PGD), Reproductive Immunology and egg freezing. Dr Gorgy also worked alongside late Dr Alan Beer, when he treated patients with Reproductive Immunology problems in the UK. Dr Gorgy s name is mentioned as an Associate with the Beer s Institute in Dr Beer s famous book Is Your Body Baby-Friendly? During his career, he also set up a very successful Assisted Conception Unit at Alsalam Hospital, a prestigious hospital in Cairo. He is still very committed to this unit in a consultancy and professional advisory capacity. Dr Gorgy is an active member of the European Society of Reproductive Immunology (ESRI) and is well connected to the American Society of Reproductive Immunology (ASRI) and International Society for Immunology for Reproduction (ISIR). Dr Gorgy is today one of the most respected fertility consultants in the UK. Working from The Fertility & Gynaecology Academy, he consistently forms a close and meaningful bond with all his patients as a result of his empathetic, non-judgemental and compassionate approach towards each individual case. Over the years, Dr Gorgy has dealt with patients from all corners of the world, allowing him to understand and meet the needs of patients with varied cultures, customs and backgrounds. DR A Eskander, Consultant Gynaecologist & Co-Director MBChB, FRCOG Dr Eskander is a well known leading gynaecologist with a special interest in the field of assisted conception. Along side Dr Gorgy, he is the co-founder and co-director of The Fertility & Gynaecology Academy. Dr Eskander complements Dr Gorgy by providing a one-stop gynaecology care service for women. He is able to utilise his wealth of experience to diagnose and treat women for all kinds of gynaecology problems, often in a single visit. Dr Eskander was admitted as a distinguished Member of the Royal College of Obstetrician and Gynaecologists in 1977, and by 1983 he was acknowledged as one of the few obstetricians and gynaecologists in the world who could make an accurate and confident diagnosis of fetal abnormalities and gynecological problems using ultrasound. In 1989 he moved overseas to help organise the obstetric unit at the prestigious teaching hospital in Bahrain, one of the first hospitals in the middle east to introduce IVF. Since returning to the UK in 1993, Dr Eskander has gained a reputation as one of the pre-eminent gynaecologists working in London. He has had a special interest in Assisted Reproduction since 1989 and in immunology since He has used Saline Installation Hysterography (SIS), or Aqua Scan for evaluation of the uterine cavity since Dr Eskander is also a consultant in the field of assisted conception. He has recently been awarded a mini fellowship in Reproductive Immunology from Rosalind Franklin University in Chicago, USA. 3

4 The Fertility & Gynaecology Academy Infertility Treatments The Fertility & Gynaecology Academy offers a comprehensive set of treatments for male and female infertility problems. Our consultants will thoroughly investigate your circumstances and medical history before advising you on the most appropriate fertility treatment. A list of some of the treatments offered at The Fertility & Gynaecology Academy is provided here. Starting a family is one of the biggest decisions we make in life, yet having a baby isn t always easy. As one of the UK s leading centres for fertility diagnosis, support and treatment, The Fertility & Gynaecology Academy is dedicated to giving you the best possible chance of having a baby. Your fertility specialist will investigate all possible causes of infertility before any treatment begins. These investigations will include compiling a medical history for you and your partner, hormone tests for the woman (including ovarian reserve) and sperm tests for the man. We then take you through all possible treatment options and outline the one best suited for you. Our close-knit team of doctors, staff and therapists provide full patient support throughout the entire process, thereby ensuring that all treatments are carried out to the highest professional standards. IVF / ICSI / PICSI Two of the most widely known treatments for male and female infertility are In-Vitro Fertilisation (IVF) and Intra-cytoplasmic Sperm Injection (ICSI). At the Fertility & Gynaecology Academy, we have the experience of using both these procedures successfully to help couples achieve conception, and have consistently achieved impressive results. The aim of an IVF cycle is to produce several eggs which are collected and fertilized in the laboratory. The best embryos are then selected and returned to the uterus. There are various protocols used, some of which start with the administration of drugs to down-regulate your own hormones (and to prevent ovulation). FSH (and sometimes LH) hormone is then administered by daily injections to stimulate your ovaries to produce a number of eggs. Frequent ultrasound scans and blood tests are needed during stimulation to monitor your response and to tailor your treatment to produce the optimum number and quality of eggs. The stimulation part of the treatment usually takes 8-14 days. At the optimum time, you will be instructed to discontinue the stimulation drugs and to inject a trigger medication which ripens the eggs (HCG). 36 hours later, the eggs are recovered from your ovaries under light sedation using a fine needle that is passed through the wall of the vagina into the ovary using ultrasound guidance. Your partner will provide a sample of sperm to fertilise the eggs. When you have recovered from the sedation you will be able to return home accompanied by an escort (but will not be permitted to drive for 24 hours). The fertilisation of the eggs and the development of the embryos will be monitored by the embryologist to advise on the best day to return the embryos to your uterus. This is usually 2, 3 or 5 days after Egg Collection. Women under 40 years old are permitted to have a maximum of 2 embryos transferred under the HFEA rules. Women over 40 are permitted to receive a maximum of 3 embryos. Decisions on whether to limit the transfer to 1 embryo are taken on the basis of the patient s preferences and on our assessment of the likelihood of multiple pregnancy for that particular patient. The treatments described are mainly for information purposes and should not be considered a substitute for medical advice. 4

5 Brochure 2013 Embryo Transfer usually requires no sedation and is performed by passing the embryos through the cervix up into the uterus using a narrow catheter. You will be able to go home as soon as you feel ready. Excess good quality embryos can be vitrified (frozen) for a subsequent transfer, but not all embryos will merit freezing as only good quality embryos are likely to survive the defrosting process and give a reasonable chance of pregnancy. Frozen embryos can usually be stored for up to 10 years (55 years in specific circumstances). There will be an additional charge for vitrification and an annual storage charge. In conventional IVF, a large number of sperm are placed with each egg, so that the sperm compete naturally to fertilise the egg. In ICSI-IVF, individual sperm are selected by the embryologist and injected into each egg. ICSI may be the only option where sperm numbers or quality are sub-optimal, but it may also be suggested in other circumstances e.g., where antisperm antibodies, thickened zona (shells of the egg) or other factors are likely to cause failure to fertilise without ICSI. PICSI is a method of selecting the best possible sperm for fertilisation in the IVF protocol. Please visit our website for more information on IVF, ICSI and PICSI. Ovulation Induction With this technique, monitoring of the natural cycle is undertaken through hormone assessments and ultrasound scans, which may be advantageous in helping couples to identify the optimal time of intercourse, giving the highest chance of natural conception. If ovulation is not occurring, medications such as clomid or other fertility drugs are administered, to stimulate the follicles in the ovaries, resulting in the production of multiple eggs. Alternatively, a low dose of FSH may be used. Fertility drugs are available in both tablet and injection forms and are normally given within the first few days of the cycle, with an injection of HCG when the follicle is mature. The medications also control the time you will release the eggs, enabling the scheduling of sexual intercourse, IUI (Intrauterine Insemination) or IVF procedures at the optimal time to achieve pregnancy. It is recommended that you take folic acids and vitamins to improve your nutritional intake status, and reduce the risk of neural tube defects as with natural pregnancy. 5

6 The Fertility & Gynaecology Academy Risks of IVF / ICSI / PICSI and Ovulation Induction Fertility treatments increase the chance of multiple pregnancies, which in turn increases the risk of pregnancy complications e.g. preterm labour, pregnancy induced hypertension and pre-eclampsia. All pregnancies carry a risk of being ectopic (located outside the uterus) and we recommend an early pregnancy ultrasound scan to confirm the location of the pregnancy. Ectopic pregnancies can be life-threatening and if necessary we can provide the most appropriate treatment to reduce the risk of tubal rupture. All treatments involving ovarian stimulation carry the risk of Ovarian Hyperstimulation Syndrome (OHSS), symptoms may include abdominal discomfort, bloating, breathlessness and difficulty in urinating. Early treatment is vital as, in rare cases, OHSS can become life threatening if not treated. Any patient who feels unwell during ovarian stimulation or shortly afterwards is requested to call the clinic without delay or, if necessary, see their local A&E department. In some cases, where an over-response to the stimulation drugs is apparent, it may be necessary to reduce the dose of stimulating drugs or stop them while monitoring the oestrogen level every day (coasting), freezing all the embryos or even abandon the cycle for the patient s safety and restart on a lower dose of medication at a later date. The optimal starting dose of stimulation drugs is carefully evaluated based on patient hormone profiles, antral follicle counts, previous responses, body weight and other factors, taking into account the risk of over-responding. However, some patients may have a lower than expected response to the stimulation medications. In some cases, the cycle may still proceed to Egg Collection/ovulation with an increased dosage. In a very few cases, we may recommend cancelling the cycle to restart on a higher initial dose of medication at a later date if that is more likely to be successful. There are some risks associated with the fertility drugs used in Ovulation Induction. These include a slightly higher chance of twin pregnancy and development of ovarian cysts. Intrauterine Insemination (IUI) In this procedure, the semen sample is washed and prepared for injection into the womb using a specially designed ultra-thin catheter. The catheter places the sperm near the uterine entrance of each fallopian tube, thereby providing it a shorter distance to swim to reach the eggs. The combination of Ovulation Induction or controlled ovarian stimulation and IUI results in higher chances of achieving pregnancy than natural or timed intercourse. Genetic Testing Screening of embryos (PGS) prior to transfer for chromosomal aneuploidy (extra or missing chromosomes) is available. PGD is also undertaken to exclude embryos that inherited chromosomal translocations or gene mutations from either parent. Frozen Embryo Replacement (FER) Couples who undergo In-vitro Fertilisation (IVF) or Intra-cytoplasmic Sperm injection (ICSI) may produce a number of unused embryos. We can provide you with an option to freeze and store the good quality unused embryos, so that you may use them in a future cycle without having the need to undergo egg collection. Egg Freezing & Sperm Freezing Freezing your eggs at a stage in your life when the ovaries are capable of producing high quality eggs is an option available for fertility treatment in future years. This freezing process is performed by a quick cooling method known as vitrification. The Fertility & Gynaecology Academy also offers a comprehensive sperm freezing service. Egg Donation & Egg Sharing The Fertility & Gynaecology Academy runs a successful egg donation programme. In addition, The Fertility & Gynaecology Academy runs an eggsharing programme in which a couple that requires IVF can donate half of their eggs to another recipient couple. In return the donating couple s IVF cycle will be free of charge. Surrogacy Surrogacy is the act of one woman, known as the surrogate host, bearing a child for another, the commissioning mother. Two types of surrogacy treatment are offered at The Fertility & Gynaecology Academy. The first is host or full surrogacy where the surrogate host receives an embryo that does not belong to her genetically. The second type is partial or straight surrogacy where the surrogate host supplies her own eggs. In this technique, the surrogate host becomes both the carrying and genetic mother. The Fertility & Gynaecology Academy offers surrogacy treatment but is not involved in recruiting surrogate mothers. For more information on all Infertility Treatments, please refer to our website. Surgical Sperm Aspiration (PESA / TESA) Where semen analysis reveals no viable sperm, it may still be possible to extract viable sperm for ICSI-IVF from the epididymus (PESA Per-cutaneous Epididymal Sperm Aspiration) or directly from the testes (TESA Testicular Sperm Aspiration). These procedures are carried out under local anaesthetic or light sedation and the patient is normally able to go home shortly after the procedure and resume normal activity the following day. Samples obtained may be frozen for later ICSI or may be obtained on the day of Egg Collection for immediate use. Blastocyst Transfer The success rate of IVF and ICSI treatment is improved by delaying the embryo transfer until 5-6 days after egg collection, to allow natural selection of the strongest on-going embryos. Such an embryo that has developed 5-6 days after fertilisation is called a blastocyst. This procedure involves the transfer of the blastocyst into the uterus (womb) using a flexible catheter with its passage monitored through an ultrasound scan. The transfer procedure does not need patient sedation and any discomfort the patient feels is only as a result of the full bladder. 6

7 Brochure 2013 Recurrent IVF Failure & Recurrent Miscarriage If you are trying to conceive and have experienced recurrent IVF failure or worse, recurrent miscarriage, it can be a frightening and emotionally draining experience. At The Fertility & Gynaecology Academy we understand the frustration of couples who have experienced repeated IVF failure and have not been able to find out why it has happened or what can be done differently next time. Our clinic offers a full range of tests which aim to isolate the problems causing implantation failure, or preventing you from successfully carrying a baby to term. These tests can be broadly grouped into four categories: Immune Testing for Infertility There is currently much on-going debate in the scientific community about the role of the immune system in promoting or preventing a healthy pregnancy. There is a view pioneered by late Dr Alan Beer that the products of an activated immune system could damage the placenta and cause miscarriage, as well as damage the embryo and cause implantation failure. Natural killer cells, which help to keep the body from developing cancer, can overpopulate the uterus or exist at too high levels within the blood stream. These cells then go overboard, killing the embryo or interfering with the endocrine system that produces the hormones that are essential for pregnancy. At The Fertility & Gynaecology Academy we carry out a comprehensive group of tests to check different aspects of your immune system and related thrombophilia. These include testing for: Antibodies, Natural Killer Cell Assay, TH1/TH2 Intracellular Cytokine Ratio, Leukocyte Antibody Detection (LAD) or Paternal Leukocyte Antibodies (PLA), DQa genes, Killer-cells Immunoglobulin-like Receptors (KIR), clotting factors and Gene Mutation of Factor II, Factor V and MTHFR. Once we have identified the problem, we can provide relevant supportive immune therapy: Steroids, Clexane, IVIg, Intralipids, Lymphocyte Immune Therapy (LIT) and G-CSF (Neupogen). Infection Screening Infections particularly Chlamydia, mycoplasma and ureaplasma can last and recur for years. Such infections make it unsuitable for the embryos to implant or the pregnancy to continue. They can also agitate your immune system and make it over-reactive i.e. increase your natural cell and other immune components activity. The latter will make the environment in you uterus hostile for the embryos and the pregnancy. We undertake screening tests for infections via a vaginal swab, menstrual blood and semen, and offer treatment. Uterine Cavity Assessment Implantation failure or miscarriage can happen because of an abnormality in the uterine cavity e.g. polyps, adhesions, scar tissue or maybe even a septum you were born with. Even minor abnormalities can cause problems and dealing with them would improve your chances of success. We can explore the uterine cavity by saline hysterography; also known as Saline Installation Sonography (SIS) or Aqua Scan, and if any such abnormalities are found, perform a hysteroscopy for its treatment. Karyotyping We check the chromosome set of both partners to exclude the possibility of underlying chromosomal rearrangement problems. If this is identified, we can test the embryos and only select the normal ones for transfer. You can read more about the tests outlined here on our website. While there are no guarantees, if you are ready to ask for assistance, we believe that at The Fertility & Gynaecology Academy we can improve your chances of a successful pregnancy. Our experience, close monitoring of the patients and personalised treatment can give you the extra help you need to safely navigate the obstacles keeping you from your dream of having a baby. 7

8 The Fertility & Gynaecology Academy Success Rates Having decided you wish to proceed with assisted conception, choosing a clinic can be a daunting prospect involving a number of different considerations, not least IVF success rates. While the comparison of success rates can never be considered an exact science (due to the different patient diagnoses various clinics treat and so on), they can be a useful tool in deciding if you want to proceed further with a clinic. Here at The Fertility and Gynaecology Academy, our success rates are among the very highest in Britain. Indeed, our positive pregnancy rate for women under 40 in 2011 was 51.6%. We are particularly proud of this figure considering that our specialism is treating complex cases of recurrent IVF failure (IVF treatment that has been repeatedly unsuccessful at other clinics for whatever reason). We have provided a table of recent success rates below. Since fertility declines with age, we have divided the information into appropriate age brackets. Positive Pregnancy Rates (per embryo transfer) for fresh IVF/ICSI Cycle for Year 2011 Women under 35 years old Women under 40 years old Women 40 or above 60% 51.6% 33.3% Live Birth Rate per fresh IVF/ICSI Cycle for Year 2011 Women under 35 years old Women under 40 years old Women 40 or above 45.7% 37.5% 16.7% Egg Donation Outcomes for Year 2011 Positive Pregnancy Outcome Live Birth Outcome 71.4% 71.4% It s worth comparing the National Average for fresh IVF/ICSI Live Birth Rate in women under 35 in 2010, which was 32.2%, against our clinic s 2011 success rate of 45.7%. At the Academy we offer not only the most advanced techniques available in assisted conception, but also personalised direct support from our specialists. Our consultants are leaders in their field and they will always ensure that you feel educated, comfortable and fully supported throughout your treatment with us. 8

9 Brochure 2013 How Fertile Am I? At The Fertility and Gynaecology Academy we make things as simple as possible, offering our patients a comprehensive Fertility Check to make sure all is well. For one upfront fee, you will receive a comprehensive assessment of your fertility potential, and, if any potential stumbling blocks are discovered, we ll guide you around the next steps. Women s Fertility Check 1. In an Initial Consultation with one of our esteemed fertility experts, we ll talk you through the whole series of necessary tests, through which you ll have an expert consultant as your port of call. You ll also have the chance to have your questions answered. 2. A Transvaginal Ultrasound Scan is an important means of checking for any possible causes of infertility. It is a pain free procedure that looks at the female reproductive system and is a common test for women experiencing problems getting pregnant. The scan involves assessment of the uterus, ovaries and fallopian tubes, and is a more accurate means of making these assessments than an abdominal ultrasound. It does not require a full bladder. 3. Saline Hysterography, also called Saline Installation Sonography (SIS) or Aqua Scan: for integrity of uterine cavity and patency of the tubes. In this investigation, a sterile saline is placed into the uterine cavity through a fine catheter. The integrity of the uterine cavity is then examined by an ultrasound scan. Implantation failure or miscarriage can sometimes happen due to blocked fallopian tubes filled with potentially infectious fluid (Hydrosalpinx), or uterine abnormalities. such as polyps, adhesions or scar tissue, or even a septum that you were born with. An Aqua Scan provides a better visualisation of the uterine cavity and fallopian tubes for potential obstructions. 4. The AMH blood test measures your levels of a hormone known as the Anti-Mullerian Hormone. This hormone is produced by follicles in the ovaries and levels of AMH are associated with a woman s ovarian reserve. Generally as a woman ages her levels of AMH decline, reaching undetectable levels in post-menopausal women. Therefore AMH levels reflect the function of the ovaries and so generally, the lower your AMH levels, the lower your ovarian reserve is taken to be. The AMH test can be done at any time of the cycle. The level is fairly consistent regardless the time of the cycle and in different cycles. 5. A Consultation to explain the results follows. Here at the Academy we take the proper time and care to ensure that you are informed and fully understand the implications of any test results. You will have the opportunity to ask any questions and receive comprehensive answers in plain English so you re never kept in the dark. 6. A detailed written report with a conclusion and advice is provided, presenting all our findings and recommendations. It is important that you come out of this process not only with a good sense of what may be causing any problems with conception, but what can be done about it. Our experts are among the best in their field, you can rest assured you ll leave with advice you can trust. Having a report in writing also enables you and your partner to revisit this detailed information as many times as you need to, as you consider your options. Couple s Fertility Check Male problems account for around half of all infertility issues and may include: Abnormal sperm, lack of sperm itself or low sperm count, low semen volume, problems with sperm motility, increased semen viscosity, genital tract infection, or simply a natural decline in fertility. The Couple s Fertility Check includes all the female investigations and reports as detailed above, with the addition of a semen analysis investigation. A semen analysis is non-invasive. After collection, the semen will be assessed to establish the mobility and shape, as well as the number of sperm and overall content of the seminal fluid. These packages should be booked ahead and paid for in advance. A Fertility Check can help you and your partner achieve clarity as to where you are in your journey towards conception, as well as straight answers as to what, if anything, needs to be done to help you along. Here at The Fertility and Gynaecology Academy, we have years of experience in helping couples to create the family they ve always dreamed of. 9

10 The Fertility & Gynaecology Academy Fees CONSULTATIONS AND ULTRASOUND Initial consultation 190 Up to 45 min with a qualified consultant and fertility specialist. This involves full history, possible diagnosis and treatment plan. Follow-up consultation 140 To discuss test results, their implications and possible treatment plan. Initial telephone consultation 190 Follow up telephone consultation 140 Nurse consultation during the treatment Free Follow up consultation following unsuccessful treatment cycle (within 1 month) Free Baseline ultrasound 170 By consultants, necessary and important for all new patients. Allows assessment of the uterine cavity to exclude developmental abnormality, fibroids and polyps. It also permits assessment of the ovaries and ovarian egg reserves. Saline sonohysterography/ HyCoSy/ Aqua scan 400 Injecting saline into the uterine cavity to exclude abnormalities, fibroids and polyps and a tube test if necessary. Gynaecological ultrasound by consultant 170 Obstetric ultrasound: Early for Dating and viability 170 Fetal anomaly scan, weeks 300 Fetal sex scan (between 12 and 16 weeks with 98% accuracy) 500 Fetal sex scan (after 16 weeks with 99% accuracy) 240 FEMALE FERTILITY TREATMENTS Female Fertility Assessment (Ultrasound ovarian reserve and AMH) 275 Intrauterine insemination 800 Includes ultrasounds, consultations during the treatment cycle, and laboratory sperm preparation and intrauterine inseminations IVF (in vitro fertilisation) 2,750 Includes consultation and ultrasound during the treatment cycle, egg collection, surgeon fees and embryo transfer. It does not include the price of drugs, blood tests and sedation. ICSI surcharge 900 IVF / ICSI (intracytoplasmic sperm injection) 3,650 All inclusive package IVF / ICSI 5,000 The following conditions apply: The patient should be less than 35 years old and have an optimum AMH. This should be her first IVF cycle or she should not have any previous unsuccessful cycles. The package does not include initial consultation, scan, mock ET or any other initial investigation costs. Extended in-vitro culture of embryos to day, embryo freezing and storage will incur extra cost. Egg freezing treatment cycle by vitrification 2,400 excluding drugs, blood tests, HFEA fees and storage, and ICSI using frozen eggs ICSI using frozen eggs 2,200 HFEA fees for IVF cycle 75 Cancelled IVF cycle 700 Sedation for any procedure if necessary 250 Specialized semen analysis + MAR test 175 Specialized semen analysis + MAR test + Sperm survival assessment over 24 hours

11 Brochure 2013 Surgical sperm retrieval PESA / TESA (including local anesthesia or IV sedation) 1,200 Cycle monitoring or timed sexual intercourse 500 TEST Cx Smear test 100 Chlamydia in menstrual blood by PCR 200 Chlamydia and ghonorhea tests (cx swab/urine/semen) 75 AMH 120 Chlamydia, Mycoplasma and Ureaplasma in menstrual blood by PCR test for DNA microorganisms in menstrual blood including Chlamydia, Mycoplasma and Ureaplasma by PCR test for DNA 500 Female fertility assessment (Ultrasound and AMH) 275 Women s Fertility Check including initial consultation, AMH, vaginal ultrasound scan, Saline Hysterography and F/U consultation to discuss the results with a report. 625 Couple s Fertility Check including initial consultation, AMH, vaginal ultrasound scan, Saline Hysterography, specialised semen analysis and F/U consultation to discuss the results with a report. 750 EMBRYOLOGY Assisted hatching 400 Extend in vitro culture to day 5 and blastocyst transfer 400 Frozen embryo transfer treatment cycle 1,200 Embryology Freezing (including one year storage) 500 Semen freezing 220 Annual storage fee for sperm, eggs or embryos (paid directly to the IVF Lab) 300 Time Lapse Imaging (Embryoscope) 400 Donor sperm 900 HFEA fee for donor sperm IUI 37.5 PGS (Preimplantation Genetic Screening) by CGH 2,500 not including blaastocyst culture 400 PGD (Preimplantation Genetic Diagnosis) for Chromosomal Rearrangement 3,250 not including blastocyst culture 400 PGD (Preimplantation Genetic Diagnosis for Single Gene Disorder) 3,700 Including blastocyst culture 400 N.B This price includes biopsy of up to eight embryos, thereafter a charge of 200 per embryo will apply. IMMUNE TESTING Natural killer cells panel screen 465 TH1/TH2 intracellular cytokine ratios 360 Natural killer cells panel TH1/TH2 intracellular cytokine ratios 750 Natural killer follow-up 400 Leukocyte antibody detection (or paternal leucocyte antibodies, blood sample from both partners) 220 Gene mutation test for factor II and V, MTHFR 250 DQα Genotype (for both partners) 220 Killer Cell Immunoglobuline-like Receptors (KIRs) 220 Endometrial Biopsy for NK cells 450 Thrombophilia (comprehensive including gene mutation for clotting factors) 550 IMMUNE THERAPY IVIG 25 Gms (IV drip) 1,400 IVIg 30 Gms (IV drip) 1,650 Intralipid 20% 100 ml (IV drip) 275 N.B. For the latest prices please refer to the website: 11

12 Appointments and enquiries The Fertility & Gynaecology Academy 57A Wimpole Street London W1G 8YP Phone: Fax: Website: All appointments must be booked and confirmed by phone. Opening hours Monday to Friday: 8am to 6pm Saturday: 8am to 12pm Getting to our clinic Our clinic is within easy walking distance of Regent s Park, Oxford Circus, Great Portland Street, Bond Street and Baker Street underground stations. On street car parking is available in Wimpole St and the surrounding area and is payable by credit card using the phone numbers displayed on signs.