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FAQs

If you have a question related to Exeter Fertility, or your fertility treatment, please read the information on this page. If you still can’t find an answer to your enquiry, please get in touch with us using our online contact form.

 

Medication

I have run out of medication, how do I get more?

Contact the clinic and leave a message describing what medication you require and how much you need. A nurse or doctor will review your notes and ensure that more medication is available for you if necessary. If you are able to collect the medication in person you will need to arrange a time to do so with the reception staff, so that a nurse or doctor can supply your medication. If you are unable to attend the clinic and you are able to wait over 24 hours for your medication then a prescription can be faxed to Healthcare at Home on your behalf, and they will contact you to arrange your delivery.

The Gonal-f prefilled pens do have an ‘overfill’ in them. You will initially be prescribed enough medication for ten days of injections, up until your final scan (on a standard regime). The amount of pens you have been prescribed will correspond to the total amount of Gonal-F you require and the overfill has been taking into account in this calculation. Please remember to use the pen’s overfill, if you require more Gonal-F as you have been advised to keep injecting after your final scan we will supply it to you from the clinic stock at that appointment.

What do I do with any unused medications and filled sharps containers?

Please return any unwanted or out-of-date medications, including tablets and patches to the clinic where we can dispose of them safely for you. If the medications are in date then you may store them safely in your own home if you are considering future treatment. We can accept your used sharps containers providing they are returned, fully closed, and not overfilled beyond the line on the box. All needles must be returned within a closed, approved sharp’s container.

Can I take any other medications or supplements whilst taking my fertility medications?

We advise that all women trying to conceive take a folic acid supplement; the recommended daily dose is 400 micrograms. In pregnancy Vitamin A should be avoided. If you wish to take a multivitamin, please ensure that you are taking a supplement designed for those trying to conceive or in pregnancy so that these recommendations are taken into account. Don’t forget a healthy balanced diet should also help to ensure you are getting the right vitamins and nutrients so a multivitamin isn’t essential. If you are taking any medications, or are prescribed a medication during the course of your treatment then please discuss this with your GP and fertility doctor, it is important that we have a record of what you are taking in addition to your fertility medication in your notes. It is safe to take paracetamol or other mild analgesia for pain relief at its correct dose. When taking over-the-counter medications, homeopathic or herbal remedies it is important to check that they are safe to take whilst trying to conceive. Your pharmacist should be able to advise you whether this is the case but you should be aware that most of these preparations will not have been tested in proper drug trials and may interfere with your medication or be contra-indicated in pregnancy. Clinic staff will not be able to advise you on the safety of unlicensed medication.

What do I do if I have unpleasant side-effects caused by my fertility medication?

If you experience any of the side-effects that were explained to you during your consultation or planning appointment and find yourself feeling unwell or struggling to cope then you must contact the clinic to discuss the matter with a nurse. If you are having a serious reaction to a medication including a severe rash, breathing difficulties, swelling of the face or pain in your legs then you must seek emergency medical care immediately as you may be having an adverse reaction to a medication you are taking. There is an on-call service provided by the specialist fertility nurses over the weekend from 8am until 10pm which can be accessed via the Royal Devon and Exeter Hospital main telephone number (01392 411611), outside of these hours, you may call the same number and you will be directed to speak to a nurse on Wynard Ward (which specialises in gynaecology).

What are all the different size needles for?

You may be provided with syringes and needles from either the clinic or Healthcare at Home. From time to time the colour and packaging of these products can change but we will endeavour to keep you informed and we will provide injection training at your planning appointment before you are due to start self-injecting.

We recommend the following:

  • Buserelin: 1ml syringe with orange safety cap (needle already attached) or 1ml syringe with a yellow or grey needle attached (whichever you have been provided with). You may use the same needle to draw up and administer the medication.
  • Gonal-F and Ovitrelle: please use the needles supplied with the medication in its packaging.
  • Cetrotide: use the needles and syringes provided with the medication, mix with the larger needle and administer with the small needle.
  • Gestone: use a 2ml syringe with a blue or pink needle attached to draw up the solution, change to a green needle to administer the medication.
  • Pregnyl: Use a 2ml syringe and a blue needle to draw up and mix the medication, change the needle to a yellow or grey needle to administer.

Which medications need to be refrigerated?

Pregnyl, Ovitrelle and Gonal-F all need to be stored in a refrigerator. If you will be collecting any of these medications from the clinic then please bring a cool bag and frozen ice-pack with you to keep the medications cool on your journey home.

What do I do if my period is more than three days late following a course of Norethisterone tablets?

If you have waited for the three scheduled days on your drug regime for your period to arrive and it hasn’t yet come, then it is important that you do not start any injections. This isn't uncommon so try not to worry, when your period does arrive, please start your follicle stimulating hormone (FSH) injections (Gonal-F or Menopur) on day 2 of your bleed and inform the clinic of when you started these injections. The nurses will then adjust your regime if necessary as your final scan date may need to be postponed to allow for the delay in starting FSH. If your period has not arrived, seven days after the last tablet then contact the clinic where you will be advised further. Remember that day 1 of your cycle is always the first full day of bleeding, and ensure that your bleed has started properly before injecting.

Is it ok to drink alcohol whilst taking my fertility medication?

Current Department of Health advice is that alcohol should be avoided altogether whilst trying to conceive. The advice also states that if you do drink alcohol, to stick to no more than one to two units once or twice a week and not to get drunk. There is good evidence to show consuming alcohol can reduce male fertility so your partner may wish to consider their alcohol intake and cut back if necessary.

I think I am over-responding to the follicle-stimulating hormone I am injecting, what do I do?

If you think you have symptoms of ovarian hyper stimulation syndrome (OHSS), an over-response to fertility medications, then please contact the clinic immediately. Symptoms include feeling bloated, experiencing lower abdominal pain, feeling nauseous and sometimes being short of breath. The most efficient way of assessing if you have OHSS is to perform a trans vaginal ultrasound scan, therefore you will need to contact the clinic to discuss and arrange this with a specialist nurse. In mild cases, rest, increasing fluid intake, and taking paracetamol can help but in more severe cases an admission to Wynyard ward (gynaecology) may be necessary to assess and manage the situation appropriately.

 

Administration

I have left a telephone message for the nursing team, how long will it take for someone to get back to me?

All enquiries will be prioritised by the nursing staff as they are received, we will endeavour to contact patients with serious medical conditions as soon as we possibly can. Other urgent enquiries will be dealt with in order of priority, and you can expect a response within 24 hours. If you have called with your day 1 and need a regime then you will receive this in the post, but may also be contacted by a member of the administrative team to arrange scans and nursing appointments.

When will I be invoiced for my self-funded treatment?

Once you have been booked into a month for treatment then you will receive a bill shortly afterwards. The bill may be split into two components if you are booking in advance. One would be a deposit to reserve your treatment slot and the bill for the remaining amount outstanding would be sent nearer the time of commencing the drug regime.

How do I book a treatment cycle?

Once you have had a consultation appointment about your treatment choice the clinician seeing you can book the month you wish to have treatment in or the month for treatment will be confirmed at your first planning visit with the nursing team.

Can I attend my appointment alone?

If you are undertaking fertility treatment, as a couple, then you and your partner are welcome at all appointments including scans and clinical procedures, however we are aware that this is not always possible. It is essential that consent forms for treatment are completed in the clinic and witnessed by a healthcare professional, therefore both partners must be in attendance if undergoing treatment as a couple for these consenting appointments (IUI and 2nd IVF planning appointments). If you are undergoing treatment without a partner, or if you are in a couple and your partner is unable to attend, you are welcome to bring a friend or relative with you for support, although it is advisable to inform the person conducting the appointment if there are any confidentiality issues beforehand.

We understand that it is sometimes unavoidable to bring children with you to appointments however some appointments are very long and include in depth information and are for intimate examination therefore it may be advisable to bring suitable “entertainment ”for little ones. Most other patients view visiting children positively so please don’t feel anxious about bringing children if necessary.

How do I contact the clinic outside of working hours?

There is an on-call service provided by the specialist fertility nurses over the weekend from 8am until 10pm, and 4pm until 10pm on a Friday. This can be accessed via the Royal Devon and Exeter Hospital main telephone number 01392 411611. Outside of these hours, you may call the same number where you will be directed to speak to a nurse on Wynard Ward (which specialises in gynaecology). The on-call service is for emergency enquiries only and matters which are unable to wait until the next clinic working day.

I need to book a mid-cycle scan for my clomifene treatment, does it have to be on day 14?

Not necessarily, it depends how long your cycle length is, and availability of scan appointments. When you contact the clinic a member of the administration team will advise you on when you can book your scan.

I am having back to back IUI treatment, when do I book my scan between treatments?

If you have started bleeding following an unsuccessful IUI treatment then your scan can be booked on day 1 to day 4 of your cycle. You can use this appointment to collect further medication for your treatment and a copy of the drug regime, don’t forget to bring a frozen cool pack for transporting your medications home. Medications for future treatment will not be supplied until you have had your Day 1.

Nursing

When is my ‘Day 1’ exactly?

Your day 1 is the first full day of bleeding of your period. If this starts after mid-day then you can generally call the next day your ‘day 1’.

Is there any advice on what I should or shouldn’t eat during fertility treatment?

A healthy balanced diet is important during fertility treatment to help give you the best chance of conception, and also to prepare your body for a healthy pregnancy and beyond. We don’t advise that you avoid or eat any thing in particular, and the odd treat is certainly permitted!

What happens after I leave a telephone message to say my period has started?

The nurses will use your day 1 to schedule your fertility treatment. Once this has been calculated you will receive a copy of the dates and times of your medications on a regime for you to follow, along with appointment letters for any scans and other nursing appointments. You will be invited to the clinic for a second planning appointment to discuss your regime in person and provide injection training prior to you starting any medications if this is your first cycle of IVF.

Is it safe to have sex during treatment?

There are no contraindications to having sex during treatment although we do advise two to three days between ejaculates for treatment samples to ensure sperm quality is optimal, so it is best to avoid sex in the two to three days leading up to egg collection or intrauterine insemination. If you are having an endometrial scratch however, we do advise that you avoid trying to conceive in the cycle you are having the procedure.

I have done my pregnancy test and it is positive, what next?

If your home pregnancy test is positive, and you have tested on the correct day and not earlier, then contact the clinic to arrange a seven-week pregnancy scan and to collect or arrange a delivery of further medications if required. In the meantime, should you experience any one-sided or severe lower abdominal pain and/or bleeding you must contact the clinic immediately where a nurse will speak to you to give you urgent advice.

I have done my pregnancy test and it is negative, what next?

If you have tested on the correct date, and have experienced a full bleed then you may discontinue any medication you are taking (if applicable). If you have had a negative test but still not had a bleed then we would advise that you continue taking any medications necessary for a further two to three days and do anther home pregnancy test. If this is still negative then please contact the clinic to discuss before discontinuing any medication. You can arrange a debrief appointment following an unsuccessful treatment cycle via reception. If you wish to book further treatment then we would advise that you have a drug free period before commencing any further fertility medications.

Do I need to take time off work for treatment?

We advise that you should take a week off work for the week of your egg collection (in IVF cycles). This is to allow time to recover following your egg collection procedure and to allow time for your body to recover the effects of ovarian stimulation. This is especially important if you have responded well to fertility medications or have symptoms of OHSS as you will need to rest sufficiently. We cannot issue ‘sick notes’ for work purposes, but we can issue you with appointment letters for any appointments you have at the clinic.

What blood tests do I need to have for my treatment and why?

You will be sent a list of necessary screening tests prior to your initial appointment. You may be able to have these tests carried out at your GP surgery or the unit staff will arrange the tests you require at one of your visits to the hospital.

I have made a mistake with one of my drugs

You will need to contact the clinic to discuss the error, do not give more drug until you have spoken to one of the unit team. If you have given the drug at the wrong time inform the unit team as soon as possible. Don’t panic we can usually overcome most problems!

I have broken the glass vial during preparing for injection

You will need to speak to one of the unit team to discuss what to do. We have stocks in clinic if replacements are needed.

When do I take HCG, it’s not on my regime?

HCG will be provided at the scan appointment prior to egg collection or insemination by the nurse or doctor setting up your treatment. This will be in the form of Ovitrelle or Pregnyl and the dose and time of injection will be confirmed with you. Please bring a frozen cool pack and bag with you to transport the medication home with you as it will need to be kept chilled until you can store it in a refrigerator. It is important that you take the HCG at the time you have been advised, as the timing is crucial in relation to the maturation and release of eggs, and therefore the success of your treatment.

What do I do if my period is late and I am not pregnant?

Contact the clinic if your period has not arrived by day 35we will advise you if you need to take any medication to trigger a bleed and can supply this if necessary.

Where do I inject?

Buserelin, cetrotide, Gonal F and Menopur are all injected subcutaneously (just under the surface of the skin) and can be injected into either the tummy or front/side of the thigh areas. You will have injection training at your second planning visit where a nurse will demonstrate how and where to inject safely.

I’m spotting after having my embryo transfer, but it is too early to pregnancy test.

As it is too early to test it is difficult to determine the cause of the spotting, therefore we would advise that you continue taking any medications that you have been prescribed until you know the outcome of your treatment cycle. It is a really worrying time, and if you feel like you need some reassurance we are at the end of the telephone to discuss any anxieties you have.