Selection Criteria & First Steps
The Unit has selection criteria to ensure that patients who we are treating have a realistic chance of success, specifically as all treatments are not without risk.
The success rates of fertility treatments using a lady’s own eggs, are very poor once a woman is aged 40 years or over. We may only offer to treat women over 40 years of age following counselling and tests to ensure the ovaries are functioning satisfactorily. Subject to the Medical Director’s discretion, we are able to commence treatment up until the date of the lady’s 46th birthday. We are not able to offer treatment to anyone under the age of 18, unless this is for the purpose of fertility preservation. Women over the age of 44 are not accepted onto the waiting list for donated eggs in case we are unable to get eggs prior to the lady’s 46th birthday.
When considering offering treatment, the Unit has a legal obligation to the welfare of existing children, and any child born as a result of any treatment, and must decline treatment if doubts about such welfare exist. In order to assess the welfare of the child we will give you a letter to take to your general practitioner, who will sign it to indicate to us that he/she knows no reason why you should not be treated. We will also ask each partner to complete a questionnaire from the HFEA.
Female Body Mass Index (BMI) –BMI is a measure of body “fatness”. The IVF Unit does not treat any new patient with a body mass index greater than 35 at the time of treatment.
BMI is calculated by dividing your weight in kgs, by your height in metres squared. Weight (kg) / [height (m)]2
Normal Range: 18.5 – 25: Overweight: 25 – 30: Obese:>30
The reason for this restriction is that an increased BMI is associated with a decreased pregnancy rate – and an increased risk of miscarriage and other complications if pregnancy is achieved. If you have problems calculating your BMI before we see you, you could ask the practice nurse at your GP surgery to work out the BMI for you or use an online BMI calculator.
For NHS funding a BMI of <30 is usually required.
Single women who wish to be considered for treatment may require counselling, a Welfare of the Child assessment, a social work report and agreement at the Ethics Committee that treatment should be offered.
The First Step
Is there a problem?
We take the view that you have a problem when you think you have. We can provide you with reassurance if that is all you need.
It is generally accepted that if you have been trying for two years, then you should have investigations. However, there may be significant previous medical problems which may affect the fertility of either partner, and which suggest that you should have investigations before you have been trying for 2 years.
If you are troubled by any of the following, please ask your GP to intervene earlier than would normally be the case. If there is an issue investigating you, we will be happy to advise.
You can remind your GP that the criteria for NHS funding do not apply to the investigation of any couple, but only to treatment.
Both partners:
A history of treatment for cancer.
Female Partner: A history of the following:
Your mother having a menopause prior to 45 years of age.
A family history of late onset diabetes, usually treated with diet and/or tablets (this may be your grandparents).
Irregular periods.
Previous history of a pelvic infection, which may have been pelvic inflammatory disease, or related to e.g. appendicitis.
A history of a laparoscopy to investigate pelvic pain, which revealed endometriosis.
Recurrent miscarriage (3 or more consecutive pregnancy losses).
Male Partner:
Any testicular surgery or injury, even as a child.
Vasectomy and reversal, which may result in a good sperm count on a simple semen evaluation, but reveal a significant level of antisperm antibodies if a more detailed assessment is performed.
Erection or ejaculatory problems.
General Advice:
We suggest any couple trying to achieve a pregnancy to have intercourse 3 times a week. If you do this there is no need to time the cycle, which we believe isn’t beneficial, and can affect relationships. We do not encourage the use of ovulation prediction kits, which are expensive, and not necessary if intercourse is occurring as above.
You can improve your chances of conceiving if you eat a healthy diet, exercise and stop smoking and reduce alcohol intake to within advised limits. Please note that recent advice suggests using tobacco substitutes such as vaping may also affect sperm quality.
If the female partners BMI is less than 30 this will significantly improve your changes of a successful pregnancy.
Caffeine should be stopped by the female partner wishing to conceive.
All ladies wishing to conceive should take folic acid 400 ug daily, and vitamin D, and we also support the use of L-carnitine which may improve embryo quality. We suggest a supplement called “Proxeed” which has the formulae for male and female partners, and can be obtained on-line or from the IVF Unit office.
Please note some ladies taking anti-epileptic drugs may need to take Folic Acid in a dose of 5 mg. Please ask if you are unsure.
Do you wish to make an appointment?
Should you meet the selection criteria, the next step in your patient journey is to attend an initial consultation here at Hull & East Riding Fertility. We prefer you to have a referral letter either from your GP or the consultant looking after you. This is so they can be kept up to date with your progress, and are able to recognize any problems relating to your treatment, if they see you. We have devised a private patient referral form that you can download and take to your GP to complete. private patient referral form Once completed by your GP this can be returned directly to us at the IVF Unit or given to you to bring to your appointment.
We are able to make you an appointment over the telephone.
Once an appointment is made we will forward you an appointment pack, enclosing the appointment date and time and paperwork which will need to be completed by you, and your partner if applicable. We will also ask for a form of photo-ID, i.e. a photographic driving license or a passport.
If we do see you without a referral letter, we will ask to write to your doctor once you have been seen.
Following is a list of the investigations which your CCG will fund on the NHS for all patients with subfertility problems.
Prolactin, Progesterone (D21) 7 days before period, Rubella antibodies, serum chlamydia antibodies, Hepatitis C antibodies, Hepatitis B core antibodies, Hepatitis B surface antigen, cervical smear and basic semen evaluation,
Note, you do not need to meet the criteria for treatment to have investigations carried out.
Page Last Modified: 23rd September 2024