FEE SCHEDULE (Effective 1 September 2018)

Transcription

1 Fee Schedule for In Vitro Fertilisation and Intracytoplasmic Sperm Injection (IVF / ICSI Treatment): Please note that charges for abandoned cycles apply see page 10 Fee Paying HFEA Fees 80 IVF (In Vitro Fertilisation) including natural cycle IVF (exclusive of drugs) 2,800 (+ 80) = 2,880 ICSI (Intracytoplasmic Sperm Injection) including natural cycle ICSI (exclusive of drugs) 3,250 (+ 80) = 3,330 Egg Freezing IVF 2,750 ICSI for Thawed Eggs 1,300 Frozen Embryo Replacement (without sedation) 980 (+ 80) = 1,060 Frozen Embryo Replacement (with sedation) 1,180 (+ 80) = 1,260 Sperm Freeze (including first year of storage) 300 Testicular Tissue or PESA Freeze (including first year of storage) 300 Annual Storage Charge for Egg/Sperm/Embryo 200 Assisted Hatching 250 Embryoscope 390 Endometrial Scratch (without sedation) 180 Endometrial Scratch (with sedation) 380 Counselling Free providing the issues relate to current fertility, treatment and donors Document Location: QM computer, I drive (patient info), website, printing (egg donation/info session recip and sharer and ed clinic) 1/10

2 Fee Schedule for Intra Uterine Insemination (IUI) and Donor Insemination (DI) Please note that charges for abandoned cycles apply see page 10 Fee Paying HFEA Fees IUI using partner s semen (scan monitored cycle) per cycle IUI using donor sperm (sperm not from CRM) per cycle Administration costs for transfer of gametes/embryos to/from overseas Administration costs for transfer of gametes and embryos to/from UK Approximate cost for 1 vial of donor sperm from overseas donor bank (cost is dependent upon Centre). Includes shipping ( ) = Document Location: QM computer, I drive (patient info), website, printing (egg donation/info session recip and sharer and ed clinic) 2/10

3 Fee Schedule for Fertility Assessment Fee Paying New Consultation 200 Follow up Consultation 170 Ultrasound Scan 150 Semen Analysis 100 HyCoSy 330 FSH, LH, E2 90 AMH 80 FSH, LH, E2, TSH, Prolactin 130 Monitored Cycle (per cycle) 400 Complete Hormone Profile (FSH, LH, E2, Prolactin, Thyroid Function Tests, Testosterone, SHBG, Androstenedione) 225 Ovarian Reserve Tests (FSH, E2, AMH, Pelvic Ultrasound Scan) 260 Progesterone 30 Full Blood Count 15 Haemoglobinopathy 50 High Vaginal Swab and Chlamydial Swab 60 HIV, Hepatitis B, Hepatitis C 100 HIV, Hepatitis B, Hepatitis C, CMV, IgG, IgM, VDRL 150 Rubella 25 NK Cell Testing 540 Pregnancy Test (urine) )this is included in the cost of IUI, DI, IVF and ICSI treatment) 20 Beta HCG (if clinically indicated) 25 Sperm DNA Fragmentation To be confirmed Zika Test 250 Document Location: QM computer, I drive (patient info), website, printing (egg donation/info session recip and sharer and ed clinic) 3/10

4 * If you have a GP or Consultant referral letter, your first consultation and the following investigations will be free of charge. * Any additional or repeat investigations will be charged refer to the price list. Exclusions: Women age 40 or over Egg recipients Known egg donors (but not shared egg donors and altruistic donors) Surrogates Document Location: QM computer, I drive (patient info), website, printing (egg donation/info session recip and sharer and ed clinic) 4/10

5 Investigation Packages If tests are taken individually, please refer to the price list. Full blood count Haemoglobinopathy HVS / Chlamydia Rubella FSH / LH / E2 / TSH / Prolactin Scan HyCoSy Semen analysis Full blood count Haemoglobinopathy HVS / Chlamydia Rubella Complete Hormone Profile (FSH, LH, E2, Prolactin, TSH, Testosterone, SHBG, Androstenedione, DHEAS, 17AHP) Scan HyCoSy Semen analysis Actual cost of investigation package = 835 Cost to patient if purchased as a package = 650 Actual cost of investigation package = 930 Cost to patient if purchased as a package = 750 All patients undergoing IUI, IVF, ICSI will also be offered HIV, Hepatitis B, Hepatitis C on both partners and, if required, chromosome karyotyping at NO additional cost. Document Location: QM computer, I drive (patient info), website, printing (egg donation/info session recip and sharer and ed clinic) 5/10

6 Fee Schedule for Egg Donors, Egg Recipients and Egg Sharers Please note that charges for abandoned cycles apply see page 10 Fee Paying Embryo Donation 2,650 (+ 80) = 2,730 HFEA Fees 80 Egg Recipient Consultation 180 Egg Recipient and unknown egg donor Egg Recipient Administration 310 Unknown donor Egg Recipient Cycle IVF (includes donor and self drugs, donor screen and IVF) Unknown donor Egg Recipient Cycle ICSI (includes donor and self drugs, donor screen and ICSI) 6,100 (+ 80) = 6,180 6,550 (+ 80) = 6,630 Egg Sharer (Egg Provider) Egg Sharing (egg provider) IVF ( 80) = 380 Egg Sharing (egg provider) ICSI ( 80) = 850 Egg Sharer screening Free Standard package of medication Egg Sharer drugs included Known Egg donor and known Recipient (Initial consultation and scan for both donor and recipient and screen for recipient and SA are chargeable) Known donor egg recipient IVF (includes donor and self drugs, donor IVF) 5,600 (+ 80) = 5,680 Known donor egg recipient ICSI (includes donor and self drugs, donor ICSI) 6,060 (+ 80) = 6,140 Known egg donor consultation 180 Known egg donor screening 530 Standard package of medication Known egg donor medications included Document Location: QM computer, I drive (patient info), website, printing (egg donation/info session recip and sharer and ed clinic) 6/10

7 Surrogacy Host screening Host surrogacy IVF Host surrogacy ICSI Host surrogacy using frozen embryos 555 5,850 (+ 80) = 5,930 6,450 (+ 80) = 6,530 2,050 (+ 80) = 2,130 Sharer/Donor Medications Standard Package: 3 bottles of Buserelin (5.5 ml) 1 x Ovitrelle 150 iu of stimulation for 12 days 400 mg x 36 Cyclogest Recipient Medication Standard Package: 3 bottles of Buserelin (5.5 ml) Cyclogest 400 mg (36 pessaries) 100 Progynova tablets Document Location: QM computer, I drive (patient info), website, printing (egg donation/info session recip and sharer and ed clinic) 7/10

8 Investigation Package for Egg Donors and Surrogates If tests are taken individually, please refer to the price list. Scan Full blood count Haemoglobinopathy HVS / Chlamydia Rubella FSH / LH / E2 / TSH / Prolactin Chromosome/Karyotyping Infectious Profile (including HIV, Hep B, Hep C, CMV, VDRL) If required, Complete Hormone Profile (FSH, LH, E2, Prolactin, TSH, Testosterone, SHBG, Androstenedione, DHEAS, 17AHP) Actual cost of investigation package = 850 Cost to patient if purchased as a package = 600 Investigation Package for Egg Recipients If tests are taken individually, please refer to the price list. Scan Full blood count Haemoglobinopathy HVS / Chlamydia Rubella FSH / LH / E2 / TSH Chromosome/Karyotyping Infectious Profile (including HIV, Hep B, Hep C, CMV, VDRL) Actual cost of investigation package = 745 Cost to patient if purchased as a package = 550 Document Location: QM computer, I drive (patient info), website, printing (egg donation/info session recip and sharer and ed clinic) 8/10

9 Egg Recipients Abandoned Treatment Costs (prior to egg collection) Recipient Type Unknown Recipient Known Recipient Treatment Treatment Cost Abandoned Fee Cost of drugs already used Refund Due IVF 6, ,210 ICSI 6, ,660 IVF 5, ,710 ICSI 6, ,170 Fee Schedule for Surgical Procedures Fee Paying Surgical Sperm Retrieval (SSR) Surgical Sperm Retrieval (SSR) PESA / TESE Please note: A deposit of 300 is required to be placed on the SSR waiting list. Payment is required as follows: 1, deposit treatment cost to be paid before procedure reimbursement if no sperm retrieved Document Location: QM computer, I drive (patient info), website, printing (egg donation/info session recip and sharer and ed clinic) 9/10

10 Fee Schedule for Abandoned Treatment Reason Under Response / Over Response No Viable Eggs (inc natural cycle) Treatment (see cost as stated) Charge if abandoned ICSI 850 2,480 IVF 850 2,030 IUI FET ICSI 2,250 1,080 IVF 2, Refund due to patient Failed Fertilisation (inc natural cycle) ICSI 2, IVF 2, Failed Blastocyst Culture (inc natural cycle) ICSI 2, IVF 2, Failure to produce semen sample ICSI (freeze eggs) 2, IVF (freeze eggs) 2, IUI Failed Thaw FET Failed Blast Culture FET Miscellaneous (Charge to be confirmed on an individual basis) Document Location: QM computer, I drive (patient info), website, printing (egg donation/info session recip and sharer and ed clinic) 10/10