The IVF Pathway The Nurse Consultation Lasts about 1 hour Both partners need to attend Remember to bring with you any test results and your consent forms TASKS Consent forms and HFEA Registration Prescription and medication injection teach Planning your treatment dates Settlement of invoice The nurse consultation takes about one hour and requires both partners to attend. Your consent forms will be reviewed and checked. Your signatures will be witnessed. Your personalised diary plan will be provided and explained. Please make sure you refer to this throughout your treatment and bring it with you to every appointment. If you are self-funding, you will be required to settle your invoice by this date. The Embryoscope (time-lapse imaging facility) will be explained shortly. This also needs to be booked and paid for by the time of Nurse Consultation. Important: Please bring your treatment diary to every visit

The IVF Pathway The Nurse Consultation PRESCRIPTION Private Patients: Stork dispensary service NHS Patients: Healthcare @ Home dispensary service / hospital pharmacy (NHS prescription charge payable per top-up item) INJECTIONS Need to consider: Self /partner injection GP / practice nurse Daily attendance to: LCRM / Gynaecology ward at St. James’s Hospital SETTLING YOUR INVOICE Credit card (2% added – bank-imposed charges) Over the telephone prior to nurse consultation 0113 2063157 Or In person on the day of LCRM Business Support Team Prescriptions… Home delivery service will deliver to an address of your choice. You need to make sure you will be in to receive the medicines, and that there is a fridge handy as some of the medicines need to be stored in a fridge. The woman will be using medicines on a daily basis, some by injection. We will teach you how to do this properly. Quite often this is the biggest worry!, but most people get the hang of it very quickly Payment… In an emergency, gynae ward can help out

The IVF Pathway The Nurse Consultation Planning your calendar: TREATMENT PROTOCOLS Each cycle is personalised to suit the needs of every couple All types of cycle involve: Suppression of natural cycle Stimulation of the ovaries to produce multiple eggs Your treatment plan will be tailored to your specific needs. The principles of IVF treatment are the same in that the natural cycle is suppressed to stop ovulation from occurring at the wrong time allowing all the eggs that have been stimulated to grow to be lost. Then ovulation is precisely timed to so that the eggs are free within the follicles (egg sacs in the ovaries), to be removed by the harvesting needle. There are different ways to suppress ovulation and different doses of a variety of drugs to make the eggs develop. Mild stimulation It is worth pointing out that sometimes the body does not react in the way we expect so do not be disappointed if your treatment takes a few more days than originally predicted and your egg collection is a little later than you were originally told. This does not necessarily mean that something is ‘wrong’. We will always err on the side of caution and need to put a dose up rather than aim high at the start and have to cancel because we have overdone it. The next task in the nurse consultation is to plan your calendar. This very much depends on the treatment type we recommend for you Suppression of the natural cycle may begin with a period, or on day 21 of your cycle. It may only begin once you have started stimulation. It can take the form of a long acting injection or daily injections. Some women take the pill at the beginning too. Each cycle is individualised and your cycle plan will be clear in your treatment diary. Please be aware that our bodies don’t always “read the text book”, and sometimes we have to reschedule for minor delays eg period coming late… don’t worry, this is quite normal and the service will stretch to fit you in Explain long agonist, short antagonist Three Protocols Long cycle Short cycle Flare cycle