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Invitro Fertility Unit in East Yorkshire.

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      05.07.2009 08:54
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      The Hull IVF unit will either make or break your dreams...

      Having been through infertility, & subsequently IVF myself, I have read many other accounts relating to the journey of achieving something that most couples take for granted, but what at times can seem like the impossible - a baby. I have gained so much insight from other people & have drawn strength from their stories, so I thought I would share mine & hopefully pass on some hope to other couples in similar situations.

      There are many IVF reviews on here, so I thought I would try & cover the hospital at which I myself received treatment (the Hull IVF unit). Since treatment can vary from hospital to hospital, I hope this will be of use to couples planning treatment here. Firstly, a bit of background information to set the scene...


      Background:

      We began TTC (trying to conceive) back in September 2005. Although current guidelines state that couple should TTC for a minimum of 1 year before being referred for tests, we were 'lucky' to be referred after 8 months due to the fact that I had undergone a lot of abdominal surgery as a child. Tests that we subsequently endured were several semen analyses & hormone tests for my husband and a HyCoSy (which involves dye being forced through the uterus & fallopian tubes to check for blockages), a laparoscopy (keyhole surgery to investigate the abdominal cavity), hysteroscopy (to stretch the cervix & investigate the uterus), & countless blood tests to check hormone levels for myself.

      The tests were carried out under the guidance of specialists who also run the Hull IVF unit. We were told very early on that our chances of conceiving naturally were a mere 1%, & we were fortunate to be placed on the IVF waiting list before even finishing prior tests & treatment. (IVF waiting lists vary from region to region, but are usually anything from 12 to 36 months). In the meantime, I requested to try a drug called Clomid, which can help to start ovulation. After only being on the drug for a few months, we received a call from the IVF unit to say funding was available & we could start treatment straightaway (this came after only a short wait of about 9 or 10 months). However, I wanted to complete the non-invasive treatment first (just in case it worked) & they agreed to hold our funding for a while longer. Unfortunately, 8 cycles on Clomid had gained me nothing but a fair few extra pounds, acne & a foul temper, leaving us with the realisation that IVF really was our final & only hope of achieving our dream...


      IVF process at Hull IVF unit:

      When a couple have reached their turn in the IVF queue, they are required to attend a lecture held at the IVF unit. This gives an opportunity to meet the staff at the unit, learn a bit more about the IVF process, ask any questions they may have, & also tour the unit to familiarise themselves with it. We attended the information evening in November 2007 and began treatment in January 2008. Couples are also required to undergo several further tests prior to treatment, including HIV & Hepatitis testing for both, a further semen analysis for the man, & a smear test for the woman.

      We were fortunate to live only a few miles away from the unit, which is located in the Hull Women & Children's hospital (HWCH), adjacent to the main Hull Royal Infirmary. We were already very familiar with the HWCH, since this is where the weekly infertility clinics are also held. I had seen the signs leading to the IVF unit every time I visited, always wondering if our journey would lead us there...

      The HWCH is a relatively new hospital, having opened in November 2003. The hospital also houses the maternity & labour wards - this is the downside of the IVF unit's location in that you are required to walk past heavily pregnant/in labour 'chavs' smoking outside the hospital...hardly what you need to see when you've struggled for so long for something they blatantly care nothing about...

      The IVF unit is located on the ground floor (follow the signs straight through & off to the right). Access is via a locked door - visitors to the unit must buzz & wait to be allowed in. IVF units throughout the country are privately run (patients who meet stringent criteria may be eligible for between 1 & 3 free treatments on the NHS, dependant on local health authorities...in our case, 2 free treatment cycles were available), & this is evident when entering the reception area. The reception incorporates a small waiting area, which is well equipped with comfy seating & tea & coffee making facilities. There are several large plants between the seating, enabling a small degree of privacy, which is important considering the fragile emotional state of the waiting patients. Relaxing music plays quietly in the background. The reception staff are friendly & helpful, but always keep a hushed tone, & remain behind a closed window when not dealing with patients, in order to maintain a sense of calm & privacy. There are plenty of informative leaflets & books available to read, as well as general magazines, & a notice board full of photos of babies'...evidence of the unit's successes....

      When called, patients are taken through a second locked door behind which is a consulting room (with plenty of boxes of tissues), a toilet, an ultrasound room, a treatment room, & a recovery area with beds for several patients. Which stage of treatment the patient is at will determine which room they are taken to.

      Hull IVF unit offer appointments on Mondays, Wednesdays, & Fridays. Once the woman has reached the required stage in her cycle, then treatment can begin. The first appointment involves completing paperwork relating to the storage of any embryos created etc, whilst also collecting the necessary equipment for the IVF cycle, & the drugs required for the initial stage of 'down-regulation'. You will receive a bag containing 3 types of sterile-wrapped needles, lots of syringes, alcohol swabs & information leaflets. You will also receive a 'sharps bin' for the used syringes. A plan will be drawn up for you to follow, stating drug doses (which are always subject to change at each appointment), & dates of when to commence injections. You will then wait back in the waiting room for your drugs to be brought to you. Once received, you will need to see the receptionist to book your next appointment & to pay for your drugs (should the treatment be privately funded).

      'Down-regulation' (putting the woman's body into a menopausal state by suppressing the release of hormones) then commences, by a daily injection (usually evening time) into the stomach. This stage lasts, on average, 2 weeks. Halfway through this stage I developed a terrible headache which continued NON-STOP for over a week, with painkillers having no effect whatsoever.

      You will then have a vaginal ultrasound scan at the unit to determine whether or not your natural cycle has been suppressed. If so, you will be given a second set of drugs (a fertility hormone called Follicle Stimulating Hormone - FSH). This is usually taken as a daily injection into the thigh for around 12 days. I found this injection to be quite a bit more painful, with some instances of my entire leg going dead. It's trial & error with the administration of the injections - you will find various techniques of your own which help. You will also need to keep up the daily injection into the stomach.

      The FSH will increase the number of eggs you produce - meaning that more eggs can be fertilised. With more fertilised eggs, the clinic has a greater choice of embryos to use in your treatment. Throughout this second stage you will be required to attend the clinic every other day (Mon, Wed, Fri) to monitor your progress. The number & size of follicles (hopefully containing eggs) on the ovaries will be measured by vaginal ultrasound, & your drug dosage may be adjusted accordingly.

      Once a certain percentage of eggs are above a minimum size you will be given a third drug, also administered into the thigh, which should be given 36 hours before egg collection. Egg collection will be scheduled in the morning of Mon, Wed, or Fri. On the day of egg collection, you will be taken to the recovery area & asked to change into a gown. A cannula will be inserted into the back of the hand for administration of painkillers & sedatives. Your partner will go to the 'little boys room' to provide his sample which is washed & spun to collect the healthiest sperm.
      Once taken to the treatment room, you will be asked to verify all your details to avoid any mix-ups & will be positioned in stirrups whilst the nurse checks your blood pressure & administers the sedatives. Eggs are collected by ultrasound guidance under sedation. This involves a needle being inserted into the scanning probe and into each follicle on each ovary. The eggs are, in turn, collected through the needle, & passed to the laboratory through an adjacent door.

      After the procedure, you are taken to recovery & allowed to rest before being discharged. You will be told at this point how many eggs were collected. You will be given progesterone pessaries to use nightly which will increase the thickness of the uterine lining, to hopefully allow the embryo's to implant.

      Your eggs are mixed with your partner's or the donor's sperm and cultured in the laboratory for 24 hours. They are then checked to see if any have fertilised. Those that have been fertilised (now called embryos) are grown in the laboratory incubator for another one - two days before being checked again. The best one or two embryos will then be chosen for transfer.

      The embryologists will telephone 2 or 3 days after egg collection to inform you how many embryo's have been fertilised (bearing in mind that in a small number of cases this may be zero), & when to come in for embryo transfer.
      The embryos are graded, according to 'quality' & the best ones chosen for transfer. Currently, you may choose to have 1 or 2 transferred (I chose to have 2 put back both cycles), but legislation is likely to change in the future, allowing only 1 to be transferred. Once again, you change into a gown & enter the treatment room, where you are made comfortable in stirrups. There is an LCD screen on the wall on which you can view your embryo(s) as they sit under a microscope in the lab, awaiting transfer. This is fantastic (when treatment works), as I can now say I saw my son when he was only 2 or 4 cells (depending on which embryo actually implanted). The embryo(s) are then transferred into the uterus by a long, thin catheter. This is a painless procedure, & after resting a while you are given a pregnancy test kit & test date, & are free to leave. Remaining embryos may be frozen for future IVF attempts, if they are suitable (we never had any which were of a high enough grade for freezing). Pessaries should be continued nightly.

      Approx. 16 days after transfer, you are required to take the pregnancy test. If the treatment hasn't worked, then chances are you will have started your period prior to this, but you must take the test anyway & contact the unit with the result. If treatment has worked, then you are given another appointment to collect further pessaries which should be continued for the first trimester of pregnancy. In all, from start of treatment to taking the pregnancy test, an IVF cycle takes approximately 6 weeks, but is dependant on the individual.

      Unfortunately our first IVF cycle failed. We didn't have any suitable embryo's for freezing, so had to endure a second cycle. Fortunately, funding for the second cycle was available immediately & we embarked on the second treatment May 2008. This cycle worked (even though I was positive it wouldn't as the embryo's were poorer quality than on the first attempt), & we went on to have our gorgeous little boy, born February 2009.

      IVF is emotionally & physically draining. It's not something to be taken lightly, & isn't always the right thing for everyone. Hull IVF unit do offer counselling at all stages - if you need to talk to someone, at any stage, just ask. I declined the counselling so can't comment too much on this side of treatment, although with hindsight probably should have taken up the offer, & almost certainly would have done had the second cycle failed.


      Success Rates:

      These are the latest success rates for Hull IVF unit (2007), taken from the HFEA (Human Fertilisation & Embryology Unit) website:
      Live birth rates per cycle started - 32%. This figure is based on women under 35, using their own eggs in fresh (rather than frozen) cycles. (For comparison, the national average for the same period was also 32%). In women aged 35-37, the Hull IVF unit success rate was 29%, versus the national average of 28%.

      Success rates at the clinic have risen steadily between 2003 & 2007, and have been consistently above the national average.


      Treatments available:

      A range of treatments are available at the Hull IVF unit, including:
      In-Vitro fertilisation (IVF), Intracytoplasmic sperm injection (ICSI), Artificial insemination, & Donor insemination. The unit do also offer an 'egg-share' scheme whereby patients can (if eligible) have free treatment providing they donate half their eggs to another patient. Waiting lists can be quite long for this treatment, depending on a match being available. Prices vary according to & drugs treatment required. Information can be requested from the clinic, see www.hullivf.org.uk. If anyone would like any further advice, please feel free to PM me.


      Summary:

      The staff at Hull IVF unit are all wonderful & compassionate, & I cannot thank them enough. They have made our dreams come true.
      To anyone embarking on this torturous journey, be it at Hull clinic or wherever, I wish you all the luck in the world. It's a journey no-one should have to endure, but there IS hope and dreams really DO come true....

      I am going to rate the IVF unit 4 stars. IVF itself can either be rated a big fat zero, or a 5, depending on the outcome, but since I'm reviewing the unit & the staff I shall award 4 stars (would have given 4.5 if I could), with minor points such as location & lack of parking facilities bringing the score down.

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