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Our commitment is to help our patients reach their ultimate goal. Patients who are having difficulty conceiving can either be referred to Spire Clare Park Hospital by their GP or arrange a self-referral to see Mr Elkington (consultant gynaecologist). At the appointment Mr Elkington will take a detailed history and may perform a physical examination. Common causes of subfertility include ovulation problems, tubal problems, endometriosis, male factor problems and ‘unexplained’ infertility. Some baseline tests will be organised (if they have not been performed already). These will include female blood tests to investigate hormonal status and to determine if ovulation is occurring. A male semen analysis is arranged. Assessment of the woman’s fallopian tubes can be investigated either by ultrasound (HyCoSy test), X-ray (HSG) or by Laparoscopy and dye test. Once investigations have been carried out, a couple will be seen for a follow-up appointment to discuss the most appropriate treatment. Often all that is necessary is simple fertility advice and reassurance that a natural conception will occur soon. If treatment is necessary, this may be with medication, surgery or the recommendation of IVF and/or ICSI treatment.

IVF (In vitro fertilisation)

IVF (In Vitro Fertilisation) is a technique involving the fertilisation of eggs by sperm outside the body.

Spire Clare Park Hospital offers IVF treatment in conjunction with Guys and St Thomas's Fertility Centre. This combined service is designed to offer patients convenient care locally and with two visits to London for the IVF procedure itself.

Patients will have their initial consultations and investigations with Mr Nick Elkington at Spire Clare Park Hospital and attend Guys and St Thomas's assisted conception unit for egg collection and embryo  transfer with Mr Khalaf. Ongoing follow-up and pregnancy scan will be provided by Mr Elkington at Spire Clare Park Hospital.

A treatment cycle is made up of six stages:

  1. The woman’s normal hormone production is temporarily switched off, using medicine, so we have control of egg production and release.
  2. The woman’s ovaries are then stimulated with hormone injections to produce eggs.
  3. The woman’s eggs are collected from her ovaries.
  4. The male produces a semen sample (on the day of egg collection).
  5. The eggs and sperm are placed together in a laboratory dish to allow fertilisation and early embryo development. 
  6. The embryo(s) are placed in the woman’s uterus usually on the third or fifth day after egg collection when the fertilised egg has divided and contains six to eight cells, or is a blastocyst.

A pregnancy test should be carried out 14 days after the embryo transfer, and if the result is positive an ultrasound test will take place two weeks later to check the number of embryos, that the embryo is alive and situated in the uterus.

What causes IVF to fail?

During the IVF treatment cycle, problems can arise which cause the treatment to be unsuccessful:

  • The ovaries may either fail to respond to the simulating drug or over respond. In the latter case, the treatment would be put on hold until it is safe to continue without the risk of ovarian hyper-stimulation.
  • Very rarely, despite ultrasounds indicating the presence of follicles, no eggs are found during the egg collection procedure.
  • The collected eggs fail to fertilise in the laboratory and therefore no embryos are available to transfer.
  • The eggs may fail to divide after fertilisation and cannot be placed into the uterus.
  • The most common reason for IVF failure is embryos failing to develop in the uterus.

ICSI (Intracytoplasmic sperm injection)

For couples where there may be a problem with the sperm, ICSI (Intracytoplasmic Sperm Injection) treatment can be used.

This is similar to IVF, however rather than combining the eggs and sperm and allowing the eggs to be fertilised naturally, a single sperm is injected directly into each egg. Fertilised eggs are then monitored and, at the appropriate time (Usually day five at ‘blastocyst’ stage), transferred back into the uterus.

ICSI can be used when there is a low sperm count, slow moving sperm and when an IVF fertilisation failed in-spite of good quality sperm. The development of ICSI means fertilisation is possible even with semen samples that have a very low sperm count. The average fertilisation rate per egg injected is about 60-70%.

IUI (Intrauterine insemination)

Intrauterine insemination (IUI) involves a relatively straight-forward laboratory procedure to separate fast-moving sperm from more sluggish or non-moving sperm. The woman will be given a course of drugs to stimulate the production of eggs.

The fast-moving sperm from the partner or donor sample are then placed into the woman's womb using a fine catheter close to the time of ovulation when the egg is released from the ovary.

As the timing of insemination is crucial, the woman's cycle is monitored using ultrasound scans to assess the development of follicles and occasionally urine tests to check for the time of ovulation. The sperm is inseminated when these tests indicate that ovulation is imminent.

Sperm donation

Donor Insemination (DI) uses sperm from a donor to help the woman become pregnant. Single and lesbian patients will need to use sperm from a donor, whether a known or unknown donor. Prospective parents can choose the appropriate physical characteristics from the panel of donors so that skin colour, height, eye and hair colour can be matched.

Donor sperm can be used as part of a treatment, such as IVF, or for IUI.

Only healthy donors are recruited and all donors are required to undergo a thorough medical examination and screening test. Counselling for donors and recipients is mandatory.

Surgical sperm retrieval

Surgical sperm retrieval can be used to extract sperm from the testes for use in IVF and/or ICSI.

It is only necessary when a man is unable to produce sperm in his ejaculate, has had a failed vasectomy reversal or has absent vas deferens - the duct that carries the sperm from the epididymis to the penis.

Sperm can be surgically recovered in two ways. Percutaneous Epididymal Sperm Aspiration (PESA) involves a needle being inserted into the epididymis and sperm is withdrawn. However, if sperm cannot be found in the epididymis, Testicular Sperm Aspiration (TESA) is used.

This involves extracting sperm from testicular tissue by inserting the needle directly into the testis. Following these procedures patients may experience discomfort or pain and may have some localised swelling. However, patients who undergo PESA typically may return to work the following day.

Preconceptual advice

When an individual or couple decide they want to become pregnant, it is important to consider their personal health and wellbeing. Lifestyle changes often need to be made to improve both a person's fertility and general health in preparation for conceiving and carrying a baby.

Stopping smoking, cutting out alcohol and improving diet and overall fitness are some things that can improve your chance of becoming pregnant and carrying a healthy baby.

Women trying for a baby are also advised to increase their daily intake of folic acid - a mineral vital to the growth and development of a baby's nervous system during its early stages. Folic acid tablets can be puchased in a chemist or be taken as part of a preconception tablet.

Preimplantation genetic diagnosis

Preimplantation Genetic Diagnosis (PGD) is an early prenatal diagnosis, designed for couples at risk of transmitting inherited disease to their children because of chromosomal abnormalities. The major advantage of PGD is that it allows couples to identify embryos that may be carrying genetic disorders and minimise the risk of a difficult choice of abortion, or possible miscarriage during the pregnancy.

Structural chromosomal abnormalities can include a number of different chromosomal defects and usually occur when there is an error in cell division.

Patients having PGD will undergo routine IVF to generate multiple embryos to increase the chance of obtaining chromosomally normal embryos. Both partners will have a cytogenetic karyotype test. The laboratory will then analyse your case over a period of two to three months, and both partners will meet with a genetic counsellor before commencing a typical IVF cycle.

Once the embryos are created, the laboratory will perform an embryo biopsy procedure using state-of-the-art laser drilling to create access for the removal of single cells from each embryo for testing. Laser drilling allows for higher accuracy cutting when accessing cells from within the delicate embryos.  Following a diagnosis period of 48 hours, approved embryos (up to two) are then transferred into the womb.

Causes of infertility

The causes of infertility vary between individuals, but ultimately result in a couple's inability to conceive a child. Infertility is not uncommon with one in six to one in seven couples in the UK affected.

Below describes some of the reasons conceiving can be made difficult, for both males and females. However, sometimes the reason for infertility cannot be explained for an individual or a couple.

Female factors

Infrequent ovulation or failure to ovulate

This factor represents 25% of infertility and is usually related to polycystic ovaries, which can affect how often eggs are released. It can be diagnosed through an ultrasound scan showing enlarged ovaries or small cysts and treated using medication or injections.

Blocked or damaged fallopian tubes

Fallopian tubes can be damaged leading to scarring or blockages following pelvic inflammatory disease, endometriosis or pelvic surgery. Blockages in the fallopian tubes can prevent sperm reaching the egg, and scarring can prevent mature eggs travelling down the fallopian tubes. Laparoscopy will confirm the extent of the damage and whether tubal surgery or IVF is the best treatment option.

Endometriosis

Endometriosis is the presence of endometrium cells outside their normal location such as the pelvic walls, on the ovaries or fallopian tubes. Endometriosis will bleed at the time of a period and small cysts filled with blood can be produced, usually resulting in a painful period. As a consequence, adhesions can occur which can affect fertility and can be treated using medication, laser treatment, surgery and/or IVF.

Fibroids

Fibroids are very common, and are made by fibrous benign growth within the uterine wall. When they are very large they can cause infertility because they distort the uterine cavity and in these cases they can be removed using laparoscopy, hysteroscopy or open surgery.

Male factors

Failure of sperm production

A problem with the quality of sperm is a common cause of subfertility. Men may have a low sperm count, slow moving sperm or abnormally shaped sperm. Genetics, lifestyle and certain medications can have an effect on the quality of sperm. A semen analysis can determine the quality of sperm and the necessary treatment.

Blocked vas deferens

The vas deferens are the ducts which carry sperm from the testes to the urethra. Blockages can prevent sperm appearing in ejaculation. An examination can determine if this is the case and can be treated by Microsurgical Epididymal Sperm Aspiration with IVF / ICSI treatment.

Fertility prices

When having fertility treatment at Spire Healthcare in partnership with the Assisted Conception Unit at Guy’s Hospital (Guy's ACU), your treatment will be delivered by leading consultants in the field of fertility and at one of the most successful units in the country. 

You will receive professional and personalised care throughout your treatment, delivered by Mr Elkington and Mr Khalaf. To make an appointment please contact our private patient team on 01252 895 490. 

Treatment prices

Treatment Price  
     
IVF Treatment package  £3,950  
IVF and ICSI treatment package £4,950  
Frozen embryo replacement cycle  £1,200 (Plus cost of drugs)
IUI £800  
HyCoSy £735

Price inculdes

Prices include:

  • Consultation with Mr Elkington
  • HFEA licence fee 
  • Trans-vaginal scans
  • Egg collection 
  • IV sedation 
  • IVF and/or ICSI
  • All embryology
  • Blastocyst culture (as appropriate) 
  • Embryo transfer
  • A follow up consultation 
  • First pregnancy scan    

Additional charges:

  • Medication ( approx £500-£1,200) 
  • Embryo freezing (£700)
  • Embryo annual storage (£300)
  • Frozen embryo replacement cycle (£1,300)  

Other treatments


Female screening tests
Price
     
Package 1 Follicle Stimulating Hormone (FSH) £140
Luteinising Hormone (LH)
Oestradiol (E2)
Prolactin
     
Package 2 HIV £150
HepB SAG
Hep C
Hep B Core
     
  Anti Mullerian Hormone (AMH) £50
     
  Chlamydia £40
     
  Full Blood count (FBC) £30
     
  Early Pregnancy Scan (Up to 20 weeks) Cons £100
     
  Early Pregnancy Scan (Up to 20 weeks) Rad £235
     
  Cystic Fibrosis Screen  £160

 

   
  Male screening tests
 
     
Package 3 HIV £150
HepB SAG
Hep C
Hep B Core
     
  Male sperm test £230

What is not included in the price?

  • Any travel expenses to London on the day of treatment
  • Additional early pregnancy scans
  • Any additional services
  • Initial blood tests and pathology - approximately £500-£700

Read about our first IVF baby at Spire Clare Park

On 27 June 2012, Spire Clare Park Hospital was thrilled to announce the birth of their first IVF baby Owen Davies, weighing 7lb 13oz.

In 2011, Spire Clare Park Hospital and consultant gynaecologist Mr Nick Elkington set up a satellite IVF service in partnership with the London Fertility Clinic to offer patients from Surrey and Hampshire initial investigations, consent forms, monitoring of cycles and pregnancy scans at Spire Clare Park Hospital for a more convenient and relaxed environment. This means patients only needed to travel up to London on two occassions for the egg collection  and embryo transfer.

Debbie and Gareth Davies had been trying to conceive for over five years. Following a treatment at Spire Clare Park Hospital and London Fertility Centre under the care of Nick Elkington and Hilary Andrews, they conceived after their first cycle. After Debbie’s very happy pregnancy, Owen was delivered by Mr Elkington at Frimley Park Hospital.

Debbie's experience:

"We had a wonderful experience going through our first and successful IVF treatment at Spire Clare Park Hospital and I was lucky to have a very happy, problem free pregnancy. 

"Mr Elkington and Mrs Hilary Andrews (fertility nurse) were there for us in a professional and personal capacity. We felt so well cared for and we spoke as friends throughout, we could say whatever we wanted, there was never any awkwardness and we always felt at ease, everything is explained in a way everyone understands. The treatment and appointments are clear and they are with you every step of the way. 

"I didn't mind the injections in the tummy which Gareth did for me (I think this really helps the husband to feel involved) they don't hurt at all as the needles are small. 

"We were so lucky to have gone into labor the night before the morning whereby it was Mr Elkingtons 'on duty' day at Frimley Park Hospital so he delivered the baby himself which made it a story from beginning to end - it was just all meant to be! 

"When we visited Spire Clare Park Hospital a couple of weeks later we honestly felt that we were visiting our family to let them see 'their boy' for the first time, it was just amazing. Of course handing Owen to Nick and Hilary for a cuddle felt so natural. We have kept in touch and always will. 

"We are so thankful to everyone at Spire Clare Park. All the hospital staff knew exactly who we were during the process and it was and still is a lovely friendly welcome whenever we visit. 

"Owen is now just about 19 months old now and we can't believe where the time has gone. Owen is now walking confidently and knows what he likes and wants. Owen likes the colour red, his wigwam, colouring in, cuddly toys and his pretend iPhone! Everyone who meets him loves him.

"Owen is a happy contented sweet boy - our little miracle!"

Our fertility consultant