University Hospitals Coventry and Warwickshire NHS Trust. Centre for Reproductive Medicine. We Care. We Achieve. We Innovate.

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1 University Hospitals Coventry and Warwickshire NHS Trust Centre for Reproductive Medicine We Care. We Achieve. We Innovate.

2 Introduction We were the first NHS Hospital in the West Midlands to set up a successful IVF programme. Since 1990 our services have developed considerably, several thousand children have been born and we are one of the leading reproductive medicine services in England. The service is provided by a knowledgeable and friendly team who together bring considerable experience and expertise in the field. We hold combined clinics with allied medical specialties such as Endocrinology, Urology and Andrology. The team works closely with other experts in the related areas of gynaecology, early pregnancy and obstetrics to provide a seamless service to women right from the time of conception until after the delivery of their baby. Safety and quality are our absolute priorities and as part of a major teaching hospital we have a range of state-of-the-art facilities very close at hand. Our outpatient clinics and diagnostic services are provided as NHS services. Approximately half of the IVF and ICSI treatments we undertake are NHS funded but we also provide treatment to self funding patients. 2 Centre for Reproductive Medicine

3 Meet the Team Mr Stephen Keay Clinical Director for Women and Children s and Consultant in Obstetrics and Gynaecology Dr Rina Agrawal Consultant in Gynaecology / Obstetrics and Specialist in Reproductive Medicine, Hon. Associate Professor Warwick University Mr Tarek Ghobara Consultant Gynecologist and Subspecialist in Reproductive Medicine and Surgery Mr Richard Kennedy Consultant in Obstetrics and Gynaecology Professor Geraldine Hartshorne Scientific Director, Professorial Fellow at Warwick Medical School Professor Siobhan Quenby Professor of Obstetrics, Honorary Consultant Obstetrician Professor Jan Brosens Professor of Obstetrics, Honorary Consultant Obstetrician Ben Lavender Head of Embryology and Andrology Teams University Hospitals Coventry and Warwickshire NHS Trust 3

4 Treatments available at the Centre Coventry include: Ovulation Induction (OI) If a woman is not ovulating by herself then ovulation induction may be required. The most common causes of failure to ovulate are stress, weight fluctuations and Polycystic Ovarian Syndrome (P.C.O.S.). Other causes may include disorders of the pituitary gland, thyroid gland and raised prolactin levels. Intra-Uterine Insemination (IUI) This treatment is often recommended as the first line treatment in unexplained infertility and is used as part of donor sperm treatment. It may also be used in cases involving: mild endometriosis infertility related to sexual problems mild sperm abnormalities IUI involves the introduction (insemination) of sperm from the husband, partner or donor into the woman's womb via the neck of the womb. In vitro fertilisation (IVF) IVF literally means fertilisation of the egg and sperm outside the body. IVF was originally used if the fallopian tubes were blocked, absent or damaged, but is now used to treat infertility caused by a number of other conditions such as endometriosis, male factor infertility, ovulation problems that are difficult to treat by simpler means, or a combination of infertility factors. IVF is also used to treat infertility for which no cause has been found. 4 Centre for Reproductive Medicine

5 for Reproductive Medicine in Intracytoplasmic Sperm Injection (ICSI) ICSI involves injecting a single sperm directly into the egg, bypassing many of the egg's natural barriers. ICSI is used when sperm quality is poor and fertlisation is unlikely without direct injection of the sperm. Surgical Sperm Retrieval (SSR) Surgical Sperm Retrieval may be a treatment option for men with: An obstruction preventing sperm release due to vasectomy, injury, infection or congenital absence of the vas deferens. Absence of sperm without obstruction - the testicles are producing such low numbers of sperm that they do not reach the vas. This may be of unexplained nature or can be the result of previous infection of the testes. Embryo Cryopreservation (Freezing) Treatments such as IVF, ICSI and Egg donation sometimes generate embryos that are surplus to the immediate requirements of the treatment. If these 'spare' embryos are of sufficiently good quality they can be frozen and placed in storage for your future use. Frozen Embryo Transfer Frozen Embryo Transfer (FET) consists of the thawing of embryos which were frozen during previous IVF or related treatment and then replacing them in the uterine cavity at the appropriate time of the menstrual cycle. Depending on a woman s menstrual pattern, medications may be used to prepare the lining of the womb. University Hospitals Coventry and Warwickshire NHS Trust 5

6 Egg Share Programme Egg Sharing is a process in which a woman (the sharer or donor) going through IVF treatment (because she needs IVF to get pregnant), elects to give away (donate) half of her eggs to another woman who needs donor eggs because she is unable to produce her own. By doing so both the donor and recipient benefit. The recipient receives the eggs to become pregnant and the egg sharer benefits by receiving her treatment at a reduced cost. Egg Donation Egg Donation is a process in which one woman donates her eggs to help another woman who is unable to produce her own eggs. Donors may be a relative or a friend known to the recipient receiving the eggs, or can be an altruistic anonymous egg donor. Donor eggs are a very precious and important gift. Providing donor eggs may enable a couple to have a child that would otherwise have been impossible. If you are interested in donating eggs or require an egg donor our staff will be happy to answer any queries you may have about this process. Sperm Donation For some couples in whom the male partner is producing no sperm or very few sperm, using sperm from a donor may be an option for treatment to enable the female partner to bear a child. We provide donor sperm from our own bank or facilitate the use of donor sperm imported from large banks in the UK or oversees. Single women or female couples without a male partner may also be treated using donor sperm. Reproductive Surgery Our specialists provide expertise for the laparoscopic and hysteroscopic surgical treatment of a range of complex gynaecological problems including fibroids, endometriosis, tubal surgery and uterine septum. 6 Centre for Reproductive Medicine

7 Counselling and Support Difficulties in conceiving occur frequently and may be highly stressful for those affected. The treatments available may be complex and take a long time, adding to the stress experienced. There may be difficult decisions to take and sometimes coming to terms with a situation can be challenging. Our counselling team is available to provide support at all times during and after treatment. They also offer guidance on the implications of specific treatments such as those using donor sperm or eggs, and alternative options such as adoption. To find information about becoming a sperm or egg donor please visit: Our Results The CRM reports its pregnancy and live birth rates to Human Fertilisation and Embryology Authority (HEFA). Our results are regularly updated and our latest success rates can be found on our website: If you have any questions, please do not hesitate to contact us. University Hospitals Coventry and Warwickshire NHS Trust 7

8 How to find us If you would like to find out more about our services please do not hesitate to get in touch. You can talk to our friendly staff by telephoning us on the following numbers. Reception: (for general enquiries) Secretaries: Andrology: Emergency out of hours telephone number: Fax Number: You can the centre direct on: Opening hours: Monday - Friday 8.00 am pm (Telephones answered 9.00 am pm) Saturday 9.00 am am for emergency/ essential appointments only. Address: Centre for Reproductive Medicine University Hospitals Coventry and Warwickshire NHS Trust Clifford Bridge Road Coventry CV2 2DX (Near Junction 2 off the M6). print solutions (europe) ltd :