Consultations & other investigations

Transcription

1 Pricelist Please note as part of pre-treatment consultations, you may be required to have blood tests performed, the costs of which are not included in the treatment cycles. These costs are outlined below. Consultations & other investigations Initial Doctor Consultation 160 Review Consultation (within 1 year) 120 General Nurse Consultation 50 Review consultation following IVF/ICSI/FET No charge Trans-vaginal Ultrasound Scan 100 Semen Analysis (including full preparation) 140 Repeat Semen Analysis (within 1 year) 120 Morphology testing 40 Culture and sensitivity 40 Retrograde testing 150 DNA fragmentation testing 350 Summary of care letter 20 Surgical Sperm Retrieval (SSR) 850 Partial cost can be reclaimed through medical insurance (Code 0740) Cyst Aspiration 200 Fetal Heart Scan 100

2 Saline Ultrasound Scan 200 HVS Swab 20 Endometrial Scratch 250 Decapeptyl Injection 20 First Step Fertility Check 400 This includes the following full package, Planning and co-ordination, Semen Analysis, Ultrasound scan, AMH blood test, Progesterone blood test and consultation with one of our fertility specialists. Ovulation Induction (OI) / Intrauterine Insemination (IUI) Follicle tracking 260 This includes planning and co-ordination and all ultrasound scans required for the cycle. OI/SO with Clomid 260 This includes planning, co-ordination and all ultrasound scans required for the cycle. OI / SO with FSH 475 This includes planning and co-ordination, all ultrasound scans required for the cycle. IUI Natural cycle or Clomid 520 This includes planning and co-ordination, all ultrasound scans required for the cycle and IUI procedure. IUI and FSH 720 This includes planning and co-ordination, all ultrasound scans required for the cycle and IUI procedure Nurse Consultation prior to starting OI/IUI treatment 75

3 Rebate schedule OI/IUI Follicle Tracking/OI/Superovulation with Clomid 160 (Cancellation at baseline stage) OI/Superovulation with FSH 375 (Cancellation at baseline stage) IUI Natural/IUI Clomid/IUI + FSH 250 (Cancellation at stage where IUI does not take place) IVF/ICSI Treatments In-Vitro Fertilisation (IVF) 4,500 This includes planning and co-ordination, treatment cycle scanning, IV sedation, egg collection, embryo transfer up to day 3, pregnancy blood test, pregnancy scan, early pregnancy care and a review consultation if required. Intra-Cytoplasmic Sperm Injection (ICSI) 4,900 This includes planning and co-ordination, treatment cycle scanning, IV sedation, egg collection, embryo transfer up to day 3, pregnancy blood test and a review consultation if required. This does not include Pre-IVF consultation, Blastocyst Culturing, Embryo storage or the use of Embryoscope. *A non-refundable booking deposit of 500 will apply *Balance to be paid on the day of baseline scan. Please note that fees do not include the cost of drugs. Pre-IVF/ICSI Consultation 160 Embryoscope 500 Blastocyst Culturing (additional culturing of embryo to day 5)* 750 Embryo Cryopreservation (includes storage for 1 year) 600

4 Rebate fees for IVF Cancellation during stimulation phase up to hcg 3700 Cancellation after oocyte retrieval (embryos fail to fertilise) 500 IVF converted to IUI 2,950 Rebate fees for ICSI Cancellation during stimulation phase up to hcg 4,100 Cancellation after oocyte retrieval (embryos fail to fertilise) 500 ICSI converted to IUI 3,350 Frozen Embryo Transfer (FET) 1,100 This includes planning and co-ordination, ultrasound scans and embryo transfer. This does not include blastocyst stage. Frozen Embryo Transfer to blastocyst stage 1350 This includes planning and co-ordination, ultrasound scans and embryo transfer. A non-refundable booking deposit of 500 will apply. Balance is to be paid ahead of 1 st scan appointment please. In the event whereby a freeze all cycle is required due to OHSS, no fee is required for the first FET cycle. Rebate schedule FET Cancellation at pre thaw stage 800 Cancellation at post thaw stage 500 Satellite Monitoring (Overseas clinic-treatment using donated eggs, embryos or sperm) Monitoring of Stimulation Cycle for IUI Cycle (per visit to MFC) 150

5 Monitoring of IVF/ICSI Stimulation Cycle 200 Satellite Donor Egg Service 800 Cryopreservation Services Semen Cryopreservation (up to 3 P.A) 350 Annual charge for storage of sperm 250 Semen Cryopreservation (annual charge) 250 Annual charge for storage of embryos 300 Merrion Diagnostic Laboratory Services (MDLS) Pricelist Pathologist Accounts Office, National Maternity Hospital, Dublin 2. Blood tests HIV, Hepatitis B & C, Rubella No charge FSH 30 LH 30 Testosterone 30 Androstenedione 40 SHBG 40 DHEAS 40 HbA1c 30 Free Testosterone Index 30 Prolactin 35 Progesterone 35 Chlamydia screen 75 Chromosome Testing TSH 30 T4 30 TPO Antibodies 40 E2 40 Full Blood Count (FBC) 30 CA Pregnancy test (bhcg) 40 Anti-Mullerian Hormone (AMH) blood test 75

6 Payment Methods MDLS Payment for blood tests and contact details. Please note that following the receipt of a postal invoice for blood tests, payment for such can be made by contacting Mount St Diagnostic Laboratory Services (MDLS) located in Lower Mount St, Dublin 2. Telephone: between 9.00am 2.00pm to make payments using credit Cards /debit cards/cheques payable to MDLS. MFC Rebate fees All rebates relate to medically indicated cancellations by the clinic. Rebates are not payable for patient self-cancellation. MFC Payments Patients are asked to note that payment is due prior to each treatment cycle with the balance being paid in full the day of baseline scan. Payment can be made by debit card, credit card, cheque, bank draft, postal order or cash. A 2.00% surcharge applies to credit card payments. Med 1 Forms for claiming tax relief on Medical Expenses may be downloaded on This fee schedule is effective from February 2015 and supersedes all previous fee schedules. Prices are subject to change without prior notice. MFC Bank transfer details Bank Name: Bank of Ireland Address: Lower Baggot St, Dublin 2 Sort code: Account number: IBAN: IE55 BOFI SWIFT: BOFIIE2D Payment reference: Patient name or PID number