Fertility and Reproductive Endocrinology
1 in 6 couples experience difficulty conceiving and might require assistance to achieve their dream of a family. It is advisable to have tried to conceive for at least 12 months before seeking our help, except if one of the partners is known to have a condition that is known to delay/prevent conception.
When trying to conceive, it is best to have intercourse regularly (2-3 times each week) rather than concentrating intercourse around the time of ovulation. We do not recommend temperature charts and other ovulation test kits as they add further strain to the couple at an already difficult time and do not improve the chances of conception if the couple are having regular intercourse.
We provide the full range of services to assist couples when they experience a delay in conceiving. Couples will need to be referred to us by their GP or other healthcare practitioner to access our services; this can be done online on this website. We provide the following services:
Full baseline investigations of both partners
These are performed over 1-2 menstrual cycles and include assessment of female ovulation using blood tests for FSH, LH and Progesterone; assessment of fallopian tube patency using ultrasound or x-ray; and assessment of sperm function by two sperm tests performed six weeks apart. Women who do not have regular ovulation or periods will be required to have additional blood tests (for prolactin and androgens)
Outpatient tubal patency testing (HyCoSy)
We prefer to check normality of the fallopian tubes using an ultrasound based test called HyCoSy. This is a straightforward outpatient procedure that takes about 30 minutes. Some women (because of either high BMI or presence of pelvic masses) are best suited to x-ray tests of tubal patency.
Female fertility profiling (ovarian reserve testing)
These tests help us to estimate the functional age and so fertility potential of a woman’s ovaries. We undertake both blood (anti-mullerian hormone – AMH) and ultrasound (antral follicle count) tests of ovarian reserve.
Ovulation induction and follicle tracking
We induce ovulation in women who do not ovulate on their own using tablets (Clomid) or injections (Gonadotrophins). Women undergoing this treatment are closely monitored by blood tests and ultrasound scans to ensure optimal response to stimulation.
Ovarian drilling (for polycycstic ovary syndrome)
We undertake laparoscope ovarian drilling for women with polycystic ovary syndrome who do not respond satisfactorily to Clomid/Gonadotrophins. We do this before or after gonadotrophin treatment before considering IVF.
Intrauterine insemination (IUI) with partner sperm
IUI can improve the chances of conceiving in couples with unexplained infertility or mild sperm abnormalities. It is much cheaper and less complicated than IVF. We offer the choice of 4-6 cycles of IUI in suitable couples before IVF.
In vitro fertilisation (IVF)
IVF involves stimulating the female to produce a large number of mature eggs and collecting and mixing these with sperm from her partner or a donor. The best 1-2 eggs that fertilise are then replaced back into her womb.
Intra-cytoplasmic sperm injection (ICSI)
ICSI is a form of IVF that involves stimulating the female to produce a large number of mature eggs and injecting these with sperm from her partner or a donor. The best 1-2 eggs that fertilise are then replaced back into her womb.
Donor insemination (DI)
Donor insemination involves introducing washed donor sperm into the womb of women at the time of ovulation (either natural or induced). This treatment is beneficial for couples where for some reason the male partner does not have any sperm of his own.
IVF/ICSI with donated gametes
This involves performing the procedure of IVF or ICSI using donated eggs or sperm. This treatment is beneficial for couples where the female and/or male partner(s) do not have any eggs and/or sperm of their own.
IVF/ICSI with egg sharing
This involves performing the procedure of IVF or ICSI using donated eggs from a woman (the donor) who is having IVF treatment in the same cycle. This treatment is beneficial in situations where a female with good ovarian function who cannot afford to pay for IVF/ICSI treatment is paired up with another female (the recipient) who can afford to pay for treatment but has poor ovarian function. The recipient effectively pays for the treatment and the eggs retrieved from the donor are divided up between donor and recipient using a previously agreed formula.
Epididymal sperm aspiration (PESA)
This procedure is used to get sperm from the bag around the testes of men who ordinarily do not produce sperm by themselves for use in IUI or IVF/ICSI.
Testicular sperm extraction (TESE)
This procedure is used to get sperm from the testes of men who ordinarily do not produce sperm by themselves for use in IUI or IVF/ICSI.
We provide a sperm and egg freezing service for clients who require this. This is beneficial for people who need to store their gametes for future use, for instance before undergoing treatment that has the potential to render them infertile.
We recommend and provide counselling for couples going through fertility assessment and treatment in recognition of the stressful nature of this condition. Please ask us how we can help you with this.
NWG doctors providing Fertility services:
Dr Kingshuk Majumder is a consultant gynaecologist and specialist in reproductive medicine and surgery. He completed a fellowship in advanced minimal access surgery at the King Edward Memorial Hospital in Perth, Australia. He has been a consultant Gynaecologist at St. Mary’s Hospital Manchester since 2011.