Gateshead Fertility Unit – General Information

1. Unit Information

Gateshead Fertility Unit is a purpose-built unit situated on the 3^rd floor of the Jubilee Wing in the Queen Elizabeth Hospital. The centre was designed to provide patient centred care on a single site by a dedicated team of clinicians, nurses, and scientists.

We offer a broad range of services for the investigation and treatment of couples with fertility problems including: –

• Diagnostic andrology
• Ovulation induction with or without ultrasound monitoring
• Intra-uterine insemination (IUI) with partners sperm
• Donor Insemination (DI)
• In-vitro fertilisation (IVF)
• Intracytoplasmic Sperm Injection (ICSI)
• Egg Donation (using a known donor)
• Embryo freezing
• Frozen Embryo cycles
• Surgical Sperm Extraction
• Sperm freezing

The service is available for NHS funded couples from the Gateshead, South Tyneside, Cumbria, North of Tyne, and County Durham areas according to the eligibility criteria.,

Self- funding patients are treated on an individual basis.

Referrals

We will be pleased to see any couple following referral by their GP or consultant. Couples who request a private appointment may contact the Unit directly on 0191 445 2768 to make an appropriate appointment with a consultant.

Waiting Times

The waiting times for treatment can vary, we will be happy to discuss times with you on an individual basis. NHS funded treatment does fall in to the 18-week pathway so your first appointment will be within 18 weeks from referral date to the unit. (However, Covid has had an impact on waiting list and has caused a larger wait time of up to 24 weeks).

2. Human Fertilisation and Embryology Authority

The Human Fertilisation & Embryology Authority (HFEA) was created by the Human Fertilisation and Embryology Act of 1990 and is an executive non departmental public body.

They have statutory responsibility for the regulation of assisted reproductive technology (ART) and human embryo research within the UK.

The HFEA’s principal tasks are to license and monitor centres that carry out in vitro fertilisation (IVF), donor insemination (DI) and storage of gametes (sperm and eggs) and embryos. The HFEA also regulates human embryo research.

The HFEA’s other statutory functions include

• Producing a Code of Practice which gives guidelines to centres about the proper conduct of
• licensed activities.
• Keeping a formal Register of information about donors, treatments and children born from those treatments.
• Providing relevant advice and information to patients, donors, and centres
• Keeping under review, information about human embryos and any subsequent development of such embryos, and the provision of treatment services and activities governed by the Human Fertilisation and Embryology Act, and, where appropriate, advising the Secretary of State on relevant developments.

Underlying all its activities is the HFEA’s determination to safeguard the interests of patients, children, service providers, scientists, the wider public and future generations.

The HFEA have an excellent website that you may find useful www.hfea.gov.uk

HFEA Register

The HFEA keeps a confidential register of information about patients, donors, and treatments. This register was set up in 1991 and contains information on children conceived from licensed treatments from that date onwards.

As from 2008, people over 16 years old (if considering marriage) or 18, who ask the HFEA, will be told if they were born as a result of licensed assisted conception treatment, and if so, will be informed if they are related to the person they wish to marry.

3. Information about Treatments

It is very important that you feel fully informed about your treatment. We hope you find the written information helpful and also the information given to you at the information evening/ individual consultation.

If you do not understand anything or would like further explanation please don’t hesitate to contact a member of the team.

The following information should be discussed with you at the information evening and your individualised consultation.

• The limitation and possible outcomes of the proposed treatment
• The possible side effects and risks of the treatment
• The possible disruption to your domestic life the treatment may cause and the length of time before the treatment begins
• The techniques involved
• Other treatment options available to you
• The availability of counselling
• The legal duties that the fertility unit has to take into account including the welfare of any child born as a result of fertility treatment and also the welfare of any existing children
• The advantages and disadvantages of continuing treatment in cases of an unsuccessful outcome

There are a number of consent forms that legally need to be completed for your treatment, ensuring you understand the process is vital for you then to be able to give your consent to the proposed treatment.

The consent forms include:

• Consent to treatment – you will be asked to consent to the procedures involved in the fertility treatment
• Consent to disclosure of information – by law, we will ask you to consent to disclose information about your treatment to your GP and other medical staff, this includes entering your details onto the hospital patient system
• Disclosure consent also includes a section for Research (contact and non-contact), this consent allows the HFEA to release non identifying information to a third party who are researching fertility treatments
• Consent to use and storage of gametes and embryos – patients having IVF/ICSI only

Please see separate information leaflet on HFEA consent forms.

You can change or withdraw your consent to the above at any time. You will be fully counselled about the consent forms before completion.

If partner A withdraws their consent to the use of their gametes or embryos then treatment will not continue. Partner B will not be able to use the gametes of partner A, even if embryos have been created together.

If there is anything you do not understand regarding consent forms please do not hesitate to ask at any time.

4. Witnessing Laboratory Procedures

The majority of stages in your treatment cycle are double checked by a state-of-the-art computer software system called IVFWitness. This system ensures the identity of your eggs, sperm, and embryos whilst they are stored and processed and documented evidence of this is available on request. This electronic system has been approved by the HFEA.

We will also ask you to identify yourself before any procedure and certain key steps will be double witnessed by two members of staff. These strict protocols aim to minimise any errors.

If you have any queries regarding this matter, please approach a member of staff.

5. Pregnancy and Success Rates

If your treatment is successful and you become pregnant, we will arrange an ultrasound scan to be performed on the unit. This will take place at six weeks gestation (four weeks after your treatment, two weeks after your pregnancy test). This scan will hopefully confirm that the pregnancy is progressing normally. If the baby’s heartbeat can be detected this is called a clinical pregnancy and a further scan will be arranged two weeks later.

Providing your first scan is normal you will be advised to see your GP and arrange your antenatal care. You will receive a scan picture and a copy of your scan report at both scans.

Success Rates

The Human Fertilisation and Embryology Authority keep a record of all cycles performed in the UK and annually publish success rates for each fertility unit.

Our most recent results are shown on the separate RESULTS SHEET. It is important to remember that these statistics reflect the general success rates, and it is important to discuss your individual case with the consultants.

6. Welfare of the Child

Before you begin treatment we have to by law & the HFEA consider the welfare of any child resulting from fertility treatment and the welfare of any existing children within the family unit.

The HFEA states that people seeking treatment are entitled to a fair and unprejudiced assessment of their situation and needs. The assessment taken from you will cover:

• Your commitment to having and bringing up a child
• Your ability to provide a stable and supportive environment for any child resulting from treatment
• The medical history of yourself and your family
• Your health and ages, and consequent future ability to look after a child’s needs
• Your ability to look after a child’s needs, including the implications of multiple births
• Any risk of harm to the child including the risk of inherited disorders or transmissible diseases, problems of pregnancy and of neglect or abuse
• The effect of a baby or babies upon any existing children in the family

We assess all ‘welfare of the child issues’ including medical and social information with yourself and ask you to complete a Welfare of the Child form. All information that you give us is treated with the strictest confidence. We will consider all cases carefully and only arrive at a decision after extensive discussion within the unit and, with your permission, any other appropriate person e.g., you family doctor. Some cases may be taken to an ethical committee where an independent decision about treatment can be given. Our main concern is the welfare of any potential child/children and there are no ideal circumstances that have to be met before treatment is offered.

7. General Advice Prior to Conception

Obviously it is very important that you approach a pregnancy in good health.

SMOKING

We do know that smoking can restrict your chances of the treatment working. Also, in pregnancy it may harm the baby causing growth problems and early labour. This applies to both partners.

NHS eligibility for treatment now requires that you must have stopped smoking before treatment begins.

We therefore request that you both stop smoking- your GP will be able to offer support for this If you would like more information, please contact staff who will be happy to help.

ALCOHOL

Drinking alcohol in excess can affect your health. Government guidelines are to restrict your alcohol consumption to a maximum of 14 units of alcohol per week for a woman and 21 units for a man. However, it is recommended to reduce your alcohol consumption as much as possible before and during treatment. Excessive drinking can lead to sperm problems and in pregnancy, alcohol can affect the baby. The latest guidance recommends that having NO alcohol is the safest.

DIET

A well-balanced diet provides all the essential nutrients to maintain good health both before and after pregnancy.

For women it is very important to have a good intake of FOLIC ACID as this helps to reduce the risk of Neural Tube Defects including Spina Bifida.  Please commence folic acid prior to your treatment; the medication is available to buy over the counter at any chemists. We also recommend commencing Vitamin D.

WEIGHT

Ideally to help with the success of your treatment and subsequently during pregnancy it is important to be within a healthy weight range. We know that being very overweight can have a detrimental effect on treatment and can make problems in pregnancy exacerbated.  If your treatment is being funded by the NHS, they require your BMI is 30 or less. Please feel free to check your BMI against the NHS BMI calculator. We will actively encourage all women to reach a BMI of 30 or below before treatment can commence. Treatment will be delayed if your BMI is 35 or above.

We are happy to offer support, advice, and encouragement to help you reach your goal.

If you would like further advice or support about this please discuss it with one of the clinicians or nurses

SMEAR TEST

It is important to have an up-to-date smear test result. If your smear test is due please ensure this has been performed prior to your appointment. If a result is not available this will delay your treatment.

ZIKA

You may be aware of the current concerns regarding Zika virus infection and the harm it may cause to a baby during pregnancy. In the UK, current advice is that women who are pregnant or planning to become pregnant should consider avoiding travel to countries where Zika outbreaks are ongoing, in order to reduce the risk of fetal microcephaly. Almost all cases of Zika are acquired via mosquito bites. However, a small number of cases of transmission following intercourse have been reported, and in a limited number of cases, the virus has been shown to be present in semen. Please contact us if you are planning to travel or have travelled to a ZIKA county.

EBOLA

Ebola mainly affected three countries in West Africa: Guinea, Liberia, and Sierra Leone. Some cases also occurred in parts of central Africa. There is still a small chance occasional cases of Ebola may occur in Africa as the virus is present in several countries there. Gamete use or donation from people who have been in an area infected with Ebola virus is two years after leaving the affected area.

8. Counselling

Fertility treatment can be a very stressful and emotional process. It is often the culmination of many years’ waiting and investigations. All patients will be seen by our experienced fertility nurses and clinicians and undergo full information and implications counselling. At various stages of fertility treatment, you will encounter the whole team and we aim to provide support throughout your treatment.

All counselling is free of charge (up to six sessions)

Our independent counsellor is available to speak with individuals or couples who may wish to discuss certain issues emotional or otherwise, with someone outside the fertility unit. The role of the counsellor in this context is to offer emotional and psychological support and help you to work through difficult times. This is a confidential service and is entirely independent of your fertility treatment.

Counselling prior to making decisions about your proposed treatment has been found to be beneficial and is recommended by HFEA.

You can request to see the nursing or clinical staff at any point, either as a couple or individually, by telephoning the unit on 0191 445 2768.

9. Complaints or Comments

Should you have any complaints or comments about our service or your experience at the unit, we would be happy to discuss them with you. Feedback is important in the development of the unit, and we welcome any comments.

However, if you feel that your complaint or comment has not been satisfactorily dealt with by a member of the fertility team please contact the following:

We welcome all suggestions or concerns that you may have about your treatment and experience at Gateshead Fertility Unit.

10. Treating People Fairly

Gateshead Fertility Unit want to ensure, that during all contact with ourselves, that you feel you are treated fairly and are not discriminated in anyway.

If you feel that there are circumstances which you would like to discuss regarding any aspects of your treatment please discuss these with staff so that these needs can be accommodated appropriately.

If you require any further information please do not hesitate to ask. We are all happy to help and advise you regarding all matters related to your treatment.

GOOD LUCK!

11. Contacts