Ishita Mishra - Fertility Specialist - Birmingham

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Dr Victoria Sephton - Chief Medical Director

Dr Anthony Rutherford - Medical Director Leeds

Prof Alison Campbell is Chief Scientific Officer

Alison Campbell 

Charlotte Swami

Char Short-General Enquiry Team Manager

Dr Nilkoletta Panagiotopoulou Consultant gynaecologist & subspecialist in Reproductive Medicine and Surgery

Dr Tom Bamford - Care Fertility Manchester- headshot

Audrey Dearing Genetics Counsellor

Hannah Wall - Central Donation Team Coordinator

Professor Charles Kingsland-Chief Medical Officer

Dr Amy Barrie - Group Chief Scientific Director - headshot

Kanna Jayaprakasan 

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Audrey Dearing

What is DNA?DNA stands for deoxyribonucleic acid and is the chemical that all forms of life on earth use as “instructions” about how to develop and function. It’s present in virtually every cell in your body and contains the genetic code which is unique to you.World DNA Day celebrates the date James Watson and Francis Crick published their research on the structure of the DNA molecule, on 25 April 1953. Their work paved the way for countless scientific discoveries which led to major advances in the diagnosis and treatment of diseases.The shape of DNA was shown to be a “double helix”, rather like a long, twisted ladder in which the rungs hold the genetic information. DNA molecules are very long and are coiled up very tightly into chromosomes.How&nbsp;does DNA relate to IVF treatment?Most cells in the body contain 46 chromosomes (23 pairs, one chromosome from each parent in each pair). Mature eggs and sperm each contain half that number – 23 single chromosomes – which come together during fertilisation to form an embryo with the 46 chromosomes necessary for normal development to a baby. If an embryo doesn’t have 46 chromosomes, or if the DNA within a chromosome is damaged, patients might find it more difficult to become pregnant or could be at higher risk of miscarriage. However, there are many things we can do to help identify any problems and create a treatment plan which will give you your best chance of having a healthy baby.When a sperm fertilises an egg, the resulting embryo should have 23 pairs of chromosomes, one of each pair from the egg and the sperm. If an embryo doesn’t have the right number of chromosomes, it results in a failure to implant, miscarriage or (rarely) a child with a serious genetic condition.How&nbsp;do&nbsp;I know if my embryo has the right number of chromosomes?Embryos with the wrong number of chromosomes are known as aneuploid. Any patient can be at risk of having aneuploid embryos. In fact, most have a mix of aneuploid and normal.The number of aneuploid embryos is known to increase as a woman gets older. Each month before ovulation, eggs go through a process of maturation, concluding with cell division (called meiosis). Older eggs are more prone to errors during this division process, which is why it’s more likely that older eggs will contain abnormal DNA. For women over 37, at least half of embryos are likely to be aneuploid, and the incidence increases to almost 80% by age 43.Embryos can be tested to see if they are aneuploid or not.&nbsp; This test is called PGT-A (<a href="https://www.carefertility.com/treatments-services/reproductive-genetic-testing/pgt-a">Pre-implantation Genetic Testing for Aneuploidy</a>). PGT-A works by analysing the amount of genetic material within embryos, checking how many chromosomes are present. In order to do this, a small number of cells are carefully removed (biopsied) from the outer layer of a blastocyst-stage embryo, and these cells are then sent to a specialist genetics laboratory for analysis. We would recommend that only chromosomally normal embryos are considered for replacement back into the womb, however all patients who choose PGT-A will have free appointments with our specialist fertility and genetics counsellors to help them decide on the treatment that is best for them.PGT-A could shorten the time from treatment to successful pregnancy as it prevents transfer of embryos that are aneuploid. Embryos with a normal number of chromosomes have lower miscarriage rates and higher live birth rates per embryo transfer.We can even do PGT-A testing on embryos that are already frozen. If you have frozen embryos and wish to know if they have the potential to lead to successful treatment, they can be thawed, biopsied for PGT-A, and then re-frozen. 98% of embryos survive thaw at Care, and if a patient has embryos elsewhere, we can transport them to one of our clinics for testing.Careunity testEmbryos that inherit a particular gene variant, known as the Annexin A5 gene M2 haplotype (also known at Care as C4M2), are at an increased risk of failing to implant or of miscarrying. As the priority at Care is to do everything possible to help our patients, the team have worked on a test that supports identifying one of the causes of miscarriage.The <a href="https://www.carefertility.com/treatments-services/reproductive-genetic-testing/careunity">Careunity screening test</a> can identify the presence of the Annexin A5 gene. If the gene is present in either the sperm or the egg provider, then there is at least a 50% chance that it will be present in the embryo. The test is simple, requiring a swab taken from the inside of the mouth of both partners and results take approximately 3 weeks. If the Annexin A5 Variant is found from either partner, the patient having the embryo transfer will be prescribed a blood thinning medication from the stage of embryo transfer until at least 12 weeks of the pregnancy.How can DNA damage affect fertility treatment?Many factors can cause DNA damage within all cells, including eggs and sperm, but using screening tests such as sperm DNA damage screening and the sperm oxidative stress test can provide an assessment. DNA damage can be caused by factors including your lifestyle factors or age.Sperm DNA damage screeningIf you are struggling with recurrent miscarriage or implantation failure, unexplained or persistent infertility, low fertilisation rates or poor embryo quality in IVF cycles, we would recommend sperm DNA damage screening.For this screening, you simply need to provide a semen sample. The sample is then frozen and transported to our laboratory, where it will be thawed and tested for DNA damage.Sperm oxidative stress testFor up to 50% of couples who require help starting a family, male factors will be the cause of infertility issues. A general semen analysis is often labelled the ‘gold standard’ of assessing the quality of sperm, after analysis 25 - 40% of male infertility cases could remain ‘unexplained’.Oxidative stress is a factor that can cause ‘unexplained infertility’, where high levels of oxidative stress have been linked to poor sperm function and cell DNA damage. Our bodies create antioxidants to minimise levels of oxidative stress, the ability to produce antioxidants is controlled by our genetic makeup but can also be influenced by lifestyle, such as a diet rich in fruit and vegetables. DNA damage is increased by factors such as smoking, alcohol, ageing and a poor-quality diet high in saturated fats and excess weight.As high levels of oxidative stress have been linked to poor sperm function, our <a href="https://www.carefertility.com/treatments-services/male-fertility-health/sperm-oxidative-stress-test">SOS (Sperm Oxidative Stress) test</a> can identify if a patient has high levels of oxidative stress by assessing the balance of DNA damaging particles (known as free radicals) and antioxidants in a semen sample. If the main cause of DNA damage is identified as being oxidative stress, lifestyle changes and antioxidants can be introduced. This test can be done at any time during fertility treatment at Care, or at the same time as a normal semen analysis. Our SOS test is a quick way of identifying whether further testing is necessary.If you are interested in PGT-A, Careunity, the SOS test or would like to learn more, <a href="https://www.carefertility.com/get-in-touch/">get in touch with your Care clinic</a>; our team will be happy to answer all of your questions.

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Audrey Dearing, Principal Genetic Counsellor across the Care Fertility group, explains how DNA affects fertility treatment and how we analyse embryos’ DNA to identify the embryos which are chromosomally normal.

Dr Ishita Mishra

What are Endometriosis and Adenomyosis?Endometriosis is a benign condition where cells similar to the cells of the womb's lining (endometrium) become implanted outside the lining of the womb. This can be in the ovary (forming chocolate cysts or endometrioma), around the womb, within the muscle layer of the womb, fallopian tubes, in the lining of the pelvis and abdomen (peritoneum), vagina, bowel or bladder. While the awareness about Endometriosis has increased in the last few years, little is known about its sister condition- adenomyosis. Adenomyosis is a condition where cells similar to the cells of the lining of the womb implant within the wall of the womb (muscle layer). It is also called Endometriosis of the womb.&nbsp;With every menstrual cycle, the lining of the womb and the endometriosis tissues change in response to the hormones. Whilst the cells of the lining of the womb are shed out in the form of menstrual blood, there is no outlet for the endometriosis tissue. As a result, the endometriosis lesions cause inflammation, pain and scarring. In adenomyosis, the muscle layer of the womb reacts to these uninvited guest cells of the lining of the womb and enlarges in size along with cyst formation.&nbsp;Although the exact cause is unknown, any female in the reproductive age group between menarche (the first menstruation during puberty) and menopause can develop Endometriosis.&nbsp;What are the symptoms of Endometriosis?Symptoms of Endometriosis and adenomyosis may vary and coincide with symptoms of other gynaecological conditions. Some women have no symptoms, whereas others might have severe symptoms affecting their quality of life. Some of the symptoms are:&nbsp;<ul><li>Menstrual pain that limits your routine activity without pain killers</li><li>Pelvic pain or pressure just prior to menstrual period</li><li>Long-term pain all the time in the lower part of the tummy, back, during bowel movements or the top of the legs</li><li>Cyclical pain on opening bowels or emptying the bladder or in the upper part of the abdomen under the ribs just prior to or during periods</li><li>Heavy menstrual bleeding&nbsp;</li><li>Painful rectal bleeding or the presence of blood in the urine just prior to or during periods</li><li>Cyclical cough, chest pain, or coughing of blood just before or during periods</li><li>Cyclical scar swelling and pain just prior or during periods</li><li>Pain during or after sexual intercourse</li><li>Difficulty getting pregnant</li><li>Fatigue</li><li>Depression</li></ul>&nbsp;You may find it useful to record your symptoms using a pain &amp; symptom diary (&nbsp;<a href="https://www.endometriosis-uk.org/sites/default/files/2022-08/pain-symptoms-diary_0.pdf">Event information/materials (endometriosis-uk.org</a>), which can support your discussion with your GP or gynaecologist.&nbsp;How can one diagnose Endometriosis?A pelvic ultrasound scan is a reliable first-line investigation to screen for Endometriosis and Adenomyosis. Usually, this is an internal vaginal scan performed to check the ovaries, the muscle layer of the womb, the junction between the lining of the womb and muscle layer of the womb, the area behind the womb. A scan may not always detect endometriosis lesions at every site involved.MRI is a second-line tool in cases where advanced Endometriosis affecting the bowel and bladder is suspected and where it is difficult to differentiate between adenomyosis and fibroids.&nbsp;Keyhole surgery (laparoscopy) is the gold standard investigation to diagnose Endometriosis and also has the advantage of treating Endometriosis. This is indicated if Endometriosis is suspected clinically and no endometriosis could be detected during ultrasound or MRI. This is carried out under general anaesthesia. Telescope is inserted through small cuts in your abdomen and allows you to have a detailed look at the structures affected by Endometriosis. You may have a biopsy of the endometriosis tissue removed to confirm the diagnosis. In case of severe Endometriosis, a second operation at an endometriosis specialist centre may be required.&nbsp;What are the treatment options?Treatment options are designed depending on individual needs, whether for symptom relief or fertility issues. Some of the treatment options are:<ul><li>Pain killers</li><li>Hormonal medications in the form of pills or injections</li><li>Keyhole surgery to remove or burn the lesions of Endometriosis (cysts on ovaries, lesions around the uterus or in the lining of the pelvis) and to release the scar tissue. This may be combined with hormonal treatment. Surgery for an endometriosis cyst in the ovaries can damage the ovary and may affect your ovarian reserve.&nbsp;</li><li>Removal of the womb if symptoms do not respond to the above treatment options and if you no longer wish to conceive.</li></ul>Measures like dietary changes (cutting out dairy or wheat products from the diet) and regular physical activity may be helpful as well.&nbsp;Endometriosis and fertilityNot all women with the diagnosis of Endometriosis have difficulty conceiving. It is estimated that 30 to 50% of women who have difficulty conceiving after one year of regular sexual intercourse have Endometriosis.&nbsp;At Care, we tailor the management plan in an individualized and patient-centric manner for your fertility journey if Endometriosis is diagnosed. The options include surgery or medically assisted reproduction.In mild to moderate Endometriosis cases, surgery for Endometriosis may improve your chance of getting pregnant spontaneously. Endometriosis Fertility Index (EFI) is a&nbsp;validated tool for predicting chances of conceiving spontaneously after endometriosis surgery and is based on surgical findings, age, years of fertility issues and any prior pregnancy.&nbsp;Fertility treatment, which can include intrauterine insemination (IUI) and in vitro fertilization (IVF), is recommended in the following cases:<ul><li>Moderate to severe Endometriosis</li><li>Endometriosis fertility index suggests low chances of natural conception</li><li>Advanced reproductive age</li><li>Patients with additional factors including blocked fallopian tube, low ovarian reserve, and abnormal semen analysis)</li></ul>Ovarian stimulation at the time of IVF does not worsen Endometriosis and is safe. Having surgery before starting IVF does not increase the chance of pregnancy. It is only recommended if one has significant pain or cannot reach the ovaries during IVF in case of a large endometriosis cyst of the ovary. We can reassure you that patients with Endometriosis have had babies successfully.If you think you may be suffering from Endometriosis, or if you are worried about your fertility, please don’t hesitate to contact your nearest Care clinic to discuss your fertility options. Or you can call our new patient enquiry team on 0800 564 2270. Our expert team will be happy to help you.

Endometriosis and Fertility

If you have Endometriosis, you are not alone - it affects 1 in 10 women and those assigned female at birth; however, this figure may be higher as the condition remains underdiagnosed. Care teams routinely provide fertility treatment to women affected by endometriosis and its sister condition, adenomyosis. Let’s explore some of the key issues about this condition to raise awareness.

Annexin 5 is partly responsible for normal clotting in our body, but if the person carries the M2 variant it may result in blood clotting disorders (sticky blood). We know this variant is carried by about 15% of Caucasians (it differs in incidence in various ethnic groups) but up to 44% of IVF couples[1]. It is also equally present in men and women, so it can be passed on to the embryo equally from the man or the woman if either (or both) are carriers.If this variant passes into the embryo and its placenta after conception, then it increases the risk of early miscarriage (the risk being up to 12 weeks of&nbsp;pregnancy) as well as other potential pregnancy complications.There is a helpful treatment for this condition - women can take low molecular weight heparin (LMWH) to keep the blood from forming tiny micro-clots in the placenta. For couples with this condition, if the woman takes LMWH then it increases her chance of carrying the pregnancy to term from 16% (without treatment) to 42%[2].In our early work, we had to take blood from the couples – it very important to test both the male (if he is providing the sperm) and female, so we were very keen to develop an easy test. However now, working with world-leading molecular geneticists in the US, Care now has a simple saliva test to help us screen our patients: Careunity.How does the Careunity test work?This screening test can identify the presence of the Annexin A5 gene. If the gene is present in either the sperm of the egg provider then there is at least a 50% chance it will be present in the embryo.Testing for it is simple, a swab is taken from the inside of the mouth of both partners and the results are available in about 3 weeks. If the Annexin A5 Variant is identified in either partner the woman having embryo transfer will be prescribed a blood thinning medication called Heparin, better known as Clexane. This is an under the skin injection that starts at the time of embryo transfer and continues until at least 12 weeks of pregnancy.SummaryUp to 44% of couples (22% of women, 24% of men) attending for IVF may be carriers of the M2 variant.Carriers have:<ul><li>4x risk of embryo loss up to 12 weeks of pregnancy</li><li>2x risk of preeclampsia</li><li>6x risk of the baby being small for its gestational age</li><li>2x risk of venous thromboembolism</li><li>2x risk of gestational hypertension</li></ul>1.&nbsp;Fishel, S. et al (2014). Multicentre study of the clinical relevance of screening IVF&nbsp;patients for carrier status of the annexin A5 M2 haplotype.Reprod. BioMed. Online&nbsp;29, 80–87.2.&nbsp;Fishel S, et al (2016). Precision Medicine in Assisted Conception: A Multicenter&nbsp;Observational Treatment Cohort Study of the Annexin A5 M2 Haplotype as abiomarker for Antithrombotic Treatment to Improve Pregnancy Outcome.&nbsp;EBioMedicine:10;298.

Reproductive and Genetic Testing

Over 10 years ago, Care became interested in the discovery of a new gene mutation that could cause miscarriage in early pregnancy. That gene mutation could also cause placenta-mediated pregnancy complications (also known as ‘PMPC’), such as ‘small for dates babies’, pregnancy-induced hypertension, venous thromboembolism or preeclampsia.

For most patients once eggs have been collected, they will be fertilised in the laboratory with your partners sperm, and in some cases with donor sperm.The collected eggs need to be mature to be able to be fertilized. So it is important to realize that only mature eggs will be able to accept a sperm and you may get some eggs which are mature and some which are not. Insemination may be with "standard insemination" by placing the sperm with the eggs or using ICSI. We often use the ICSI technique for patients who have sperm issues. Only mature eggs will be able to fertilize by either technique. So it is important to realize that not all the eggs collected at the egg collection will have the ability to fertilize.Once the eggs are inseminated they will be placed in our laboratory culture system. The following day we will know how many eggs have fertilised to form the initial numbers of embryos to take you to the next stage of your journey. At this stage the embryology team will call you to let you know how many eggs have fertilised to form early embryos.The next very important step is to find out which of the early embryos are the strongest. These early embryos will therefore be cultured in the laboratory following the egg collection. At this stage some of the embryos should have started to grow and increase the number of cells inside them. It is important to realize that not all the early embryos will grow. At this early stage if you have sufficient embryos of good quality the embryology team may recommend extending&nbsp; the culture beyond this early stage to&nbsp; 4, 5 or even 6 days after the egg collection. This extended, or Blastocyst culture, as it is known, allows the strongest embryos to self select and identify themselves as the most likely to result in a pregnancy. It is also important to realize that not all embryos will proceed to this stage - this is entirely normal and part of the process of identifying the best and strongest embryo or embryos for transfer or freezing for treatment in the future. At Care, we also provide our CareMaps-AI time-lapse incubation powered by Artificial Intelligence to select embryos.Rest assured our expert embryology scientific team will be available to update and advise you on the progress and the best plan for your embryos.Depending on the number and quality of your embryos the next step is the embryo transfer which will take place on days 4, 5 or 6 after the eggs are collected. This plan may be modified depending on your individual circumstances, the number of embryos available and if any of our cutting edge technologies - such as Pre-implantation Genetic Testing of embryos (PGT-A) have been recommended by your Consultant.&nbsp;

sperm fertilising egg

Following egg collection, what will happen in the embryology laboratory?

<h3>What is the menstrual cycle?</h3>The menstrual cycle is a series of natural changes in hormone production and the structures of the uterus and ovaries of the female reproductive system that makes pregnancy possible.The ovarian cycle controls the production and release of eggs and the release of oestrogen and progesterone. These cyclical changes are usually monthly and result in the growth and release of an egg.During the first or preovulatory phase of the cycle, the womb lining sheds, resulting in a period that usually lasts around 4 to 5 days. At this time, oestrogen levels are low, stimulating the brain to make FSH (Follicle Stimulating Hormone).FSH stimulates a number of small egg follicles to start growing in the ovary. By the end of the period, usually, one of these follicles has been selected naturally to carry on growing and become the dominant follicle that starts to produce oestrogen. The production of FSH hormone is reduced, as it is not required again until the next period. The dominant follicle will release an egg that month, and the other follicles die off. A new batch of follicles will begin growing at the start of the next menstrual cycle.The growing follicle releases an increasing amount of oestrogen hormone, which thickens the womb lining in preparation for possible embryo implantation.By around day 12 of a monthly (28 day) cycle, the dominant follicle has grown, and its oestrogen level has risen sufficiently to trigger a rise in another hormone called LH or Luteinising hormone. LH can be detected in urine in simple ovulation prediction kits.The LH surge in the middle of the cycle matures the egg inside the follicle so that it can be fertilised, followed by the release of the egg about 36 to 40 hours after the surge.LH also starts the production of progesterone hormone from the cells inside the egg follicle. Progesterone causes essential changes in the quality of the womb lining, making it receptive to an embryo. It also has a relaxing effect on the uterus muscles.If an egg is fertilised and starts to implant in the womb, signals from implantation encourage the follicle to continue to produce oestrogen and progesterone to help establish a pregnancy. If no such signal is detected, the hormones produced by the follicle reduce, and a period arrives.When the hormones are low, the next cycle of follicle growth, egg release and womb lining preparation begins.What can the menstrual cycle tell us about fertility?Cycle length and regularityThe average length of a menstrual cycle is 28 days, but anything between 26 and 32 is considered ‘normal’. If your cycle is shorter or longer than this or is irregular, the implications may depend on your age and personal circumstances.Additionally, if you have short cycles and but you still ovulate around day 14, you may have a “ short luteal phase” which means that you may need extra progesterone to prolong the post ovulation phase, giving extra time for an embryo to implant properly.Irregular cyclesIf you have very long or irregular cycles in your early teens or twenties, you may have Poly Cystic Ovarian Syndrome (PCOS). PCOS is very common but can make conceiving difficult if you aren’t releasing an egg regularly. PCOS can usually be treated very simply with tablets; you will need an ultrasound scan to see if you have polycystic ovaries.There are other less common reasons for having irregular cycles when you are young, including an underactive thyroid gland or a raised prolactin level. These both give changes in hormone levels which can be detected by blood tests and managed by your GP or gynaecologist.If you have an irregular, shorter or longer cycle in your late thirties or forties, it may be a thyroid problem or high prolactin. It also may indicate that your egg numbers (ovarian reserve) are changing; this can be checked by ultrasound scan and blood tests by your GP or gynaecologist.Long gaps in between periodsIf you do not have polycystic ovaries, long gaps could mean the onset of changes associated with menopause, and a hormone test will help to detect this.Extreme weight loss in younger women can sometimes stop periods, this tends to return once the ovaries have started cycling again.Light or heavy periodsIt can be challenging to describe what a regular menstrual flow is, but if you feel that you have very heavy periods, we recommend that you are checked for fibroids, thyroid gland problems, and hormone irregularities which can cause the lining to be very thick.If you have spotting or bleeding in between periods, you may have a polyp inside the womb; this can be diagnosed via a scan.If you have very light periods, this may be due to age and declining hormonal activity in older women.Painful periodsA little bit of cramping on the first day or two of your period is common, but you should be able to control the pain using simple over the counter medication. Anything more than this over a long time should be investigated, especially if your periods are very heavy.Fibroids and a hormonal imbalance are the most common reasons for painful periods, but some have endometriosis. Endometriosis can cause severe pelvic pain, even starting just before your period arrives.&nbsp; If your GP or gynaecologist thinks you may have endometriosis, you may be referred for a laparoscopy to treat it.What can your menstrual cycle tell you about your fertility?We can learn a lot from your menstrual cycle, including all of the things already mentioned above.As a general rule, a regular cycle, however long or short, usually means that you are ovulating (releasing an egg). You can use home testing kits to confirm that you have an LH surge which helps you to time intercourse efficiently. You can also get a blood test for progesterone level about a week after your presumed ovulation; this will confirm if you are ovulating.Some women notice a change in the consistency of normal vaginal discharge, which occurs around ovulation. Discharge can become more abundant and watery due to rising oestrogen hormone levels. The mucus discharge is thicker at other times of the month.If you are under 37, have signs of ovulation, have regular cycles, and have been trying for a baby for some time, the reason is likely something other than your ovulation cycles.Frequently asked questionsQ: When are people most fertile?A: An egg should be fertilised within 12 to 24 hours of release, so it is essential to time intercourse around ovulation. Sperm can last in the genital tract for up to 72 hours, so it makes sense to have intercourse from just before ovulation (just after your LH surge if you are testing for this).There are many apps available and urine testing kits that can help you time sex efficiently to maximise your chances.Q: How can contraception affect your menstrual cycle?A: Taking the combined pill will usually give you a false but regular withdrawal bleed in the seven days when you don’t take it. The oestrogen in the pill stops you from ovulating hence its contraceptive action.When you stop taking the pill, most people will start having a regular ovulatory cycle immediately. However, the return to normality can take a couple of months for some.The progesterone-only pill can give you very irregular bleeding or very light and infrequent periods. The contraceptive implant can also stop your periods and take some months for the cycle to return to normal once it is removed.The coil (IUCD) can give you heavy periods if it is a simple copper coil, and cycles should return to normal straight away after it is removed. The Mirena coil, which releases hormones, can make your cycles disappear or become irregular. Again, it may take a month or two for your periods to return to normal after its removal.Care are on hand to offer expert advice. From <a href="https://www.carefertility.com/treatments-services/assessments-tests">fertility tests</a> to advice on <a href="https://www.carefertility.com/where-to-start/causes-of-infertility/optimising-your-fertility">ways to increase your fertility</a>, we are here to support you.With love from Care x

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Many find the menstrual cycle a helpful way to understand your body. If you are beginning to consider your fertility, you might not know where to start; at Care, we are here to support and guide you at every stage of your fertility journey.

This might be useful if you have moved house, are considering treatment at an alternative IVF Clinic or are already receiving treatment at another Clinic. It is even possible to import frozen samples from a Centre outside the UK.It might seem like a risky business, transporting precious cargo such as human embryos or sperm, but it is actually an extremely safe and easy process, in fact hundreds of patients have successfully moved their samples to Care over the last 19 years since Care was established. And, you don't have to do it yourself!Using your frozen embryos and sperm at CareCare is particularly experienced in receiving frozen embryos and sperm from other clinics and advises a specialized courier service to do the physical transportation. Care will help to arrange the transport, which involves the use of a small tank designed to hold samples at temperatures of -190C for many days, the perfect conditions for frozen embryos and sperm. Care embryologists ensure the samples are safely stored on arrival.When it comes to using or thawing the frozen samples, the embryologists are able to thaw the embryos or sperm in just the same way as the original Clinic, so treatment is not compromised in any way.It may be that not all the samples are used in treatment and long-term storage is needed, again this is fine as there will be ample safe and secure storage facilities that will hold that precious cargo for many, many, years.For more information please contact the Embryology team at your Care clinic. Patient information documents are available to guide you through the process.

Egg/sperm/embryo freezing - vitrification with liquid nitrogen

Egg/sperm/embryo freezing

You may not know that if you freeze your embryos or freeze your sperm at another clinic, they can be safely transferred to any IVF Clinic in the UK for storage or fertility treatment; they don't have to be stored at the Clinic they were originally frozen at.

Take eggs for example. I remember the ‘Go to work on an egg’ campaign which portrayed eggs as the perfect breakfast food: high in protein and low in calories. Then eggs were found to be full of ‘dangerous cholesterol’ and people were told they could only eat the white but not the yolk (the tasty bit!). Now eggs are back in foodie fashion again! &nbsp;Some nutritionists take the view that all food is just basically fuel and whether the calories come from protein, fat or carbohydrate doesn’t really matter so long as the total number (2000kcal a day for an average active young woman) isn’t exceeded.But some interesting research in America suggests that for IVF patients at least, it really might matter where the calories come from!A clinic in California identified a group of IVF patients who weren’t doing as well as expected.&nbsp; They were young, normal BMI and normal ovarian reserve but this group didn’t respond so well to the drugs; got fewer eggs, lower numbers of top quality embryos and fewer positive pregnancy tests. Those that did get pregnant had a higher miscarriage rate.&nbsp; So what was going wrong? The team asked them to keep a ‘food diary’ and found that although they were having the right number of calories per day (about 2000kcals is perfect for active young women), almost all their calories were coming from carbohydrates. They would have cereal and toast for breakfast, a sandwich for lunch, pasta for supper and their favourite snacks were crisps and biscuits. Over 75% of their daily calories were Carbs!The ‘food diaries’ of the ‘normally’ successful group were very different: they had more protein and lots of leafy vegetables and fruit. Their live birth rates were almost double those of the ‘high carb’ patients.When PCOS patients (who may need help with weight loss) have followed a ‘low-carb’ plan they often found that the ‘low carb’ eating plan assisted their efforts to shed those stubborn pounds. This is not too surprising as part of the problem that PCOS women face (and the reason why they are five times more likely to develop Type 2 Diabetes) is that they don’t handle sugar properly. We then started recommending it for all patients (and encouraged their partners to join in as over-weight and obesity has been shown to reduce sperm quality too).The ‘sperm cycle’ is about 70 days so it takes over 2 months to see the benefit of lifestyle changes on the chaps’ sperm function. In just the same way, dietary and nutritional&nbsp; changes for women need to be started 2-3 months before a treatment cycle as the eggs we will be collecting for IVF or ICSI actually started developing 3 months before she even starts her treatment cycle drugs.This sort of Fertility Nutrition plan we have been advocating has now been given a huge boost by the publication of a paper in Human Reproduction, one of the world’s leading fertility journals, which claims that a ‘Mediterranean diet’ may help young women receiving IVF to boost their chances of achieving successful pregnancies.The researchers, from a University in Athens, Greece, asked women about their diet before they underwent an IVF treatment and found that those who ate more fresh vegetables, fruit, whole grains, legumes, fish and olive oil and less red meat and simple carbohydrates had an almost doubled live birth rate compared to young women who ate the ‘poorest’ diet. The effect was not so clear for women aged over 35 years where other factors can influence IVF outcome.Half of all women in the UK having IVF are 35 or under so wider knowledge about the role of good nutrition for fertility is absolutely vital.<a href="https://www.carefertility.com/where-to-start/top-tips-for-improving-fertility/">Here are more top tips for improving fertility.</a>

Nutrition (veg)

It is well known that some of the poorest parts of the world, where nutritional levels are low, also have very high birth rates. By contrast, the majority of IVF cycles take place in countries with a much higher per capita income and which could be assumed to have much better nutrition. There is a bewildering array of dietary theories around today and the pronouncements of ‘experts’ seem to change on an almost daily basis.

“From a fertility Doctor’s point of view, despite miscarriage being a very upsetting and unwanted complication of pregnancy, it’s an encouraging sign because if you have managed to get pregnant once, you'll get pregnant again” Often, women can feel utterly helpless, as do their partners and immediate family. This often leads to statements from your loved ones which are meant to be helpful and encouraging but in fact, are anything but. "Don't worry, you can always try again' or words to that affect can be hurtful and make you feel worse. Remember, your body has areas undergone many changes in anticipation for the pregnancy and simply cannot just reset itself instantly.It is essential therefore, that following an unexpected pregnancy loss, irrespective of how many weeks pregnant you were, you need to grieve, and grieve properly. Often you are grieving for the child you never saw which can be particularly difficult.Commonly, we have a misconception of what a miscarriage or pregnancy loss is, especially when it happens in the early stages. We have this perception that inside the uterus there is a tiny well-formed baby, hanging on by his fingertips, shouting "please mummy, don't let me fall out," and somehow when it happens, it is our fault.Well, this is simply not true; a good number of human embryos that are created either naturally or in the laboratory, as with IVF, are chromosomally abnormal. As we get older, the number increases. When a woman reaches the age of 35 this can be over 50 percent. By the time she reaches 40, over three quarters of the embryos she creates are, in fact, chromosomally abnormal.The female human body has a very sophisticated mechanism of recognising these fetal anomalies: the messages sent to the uterus from the growing baby result in one of two things happening: either, the uterus just lets the abnormal embryo pass through the body without allowing it to implant into the wall of the uterus, or if it is unsure, the uterus will allow it to implant. The body will then monitor the growth and development of the baby for a few days or weeks. If the baby is normal, the uterus will keep hold of the developing pregnancy. If it detects a significant abnormality, the uterus will let the pregnancy go or expel it.Ninety seven per cent of all early miscarriages, i.e. those before 12 weeks gestation, are chromosomally abnormal.If you think of it another way, the commonest chromosomal abnormality is Downs Syndrome.It is estimated that for every one hundred Downs babies conceived, only one is ever born, the remaining ninety nine per cent will be lost through miscarriage.As a general rule of thumb, up until twelve weeks of pregnancy, by far the commonest cause of miscarriage is through fetal abnormality. After twelve weeks of pregnancy, it becomes less likely that the baby is abnormal and more likely that there is a maternal component to the miscarriage.It is for these reasons that if a pregnancy threatens to miscarry, it is often best to let nature take its course. There is very little a doctor can do to stop an early pregnancy from miscarrying. Giving lots of hormones is not the answer. If a pregnancy is normal, it will stay put and simple advice such as rest will suffice. If the pregnancy is abnormal, the chances are, it will not survive.It is uncommon for a normal pregnancy to miscarry in the first twelve weeks.One final point; it is a complete myth that you should not try for another baby immediately following a miscarriage. There is no scientific basis for this unless you have suffered a medical or psychological complication. As a matter of fact, it’s quite the opposite. Women tend to be more fertile following a miscarriage.From a fertility doctor’s point of view, despite miscarriage being a very upsetting and unwanted complication of pregnancy, it’s an encouraging sign because if you've got pregnant once, you'll get pregnant again. Except this time - with a bit of luck - it will have a better, happier outcome.

Recurrent miscarriage 2 - no gradient

Miscarriages can be devastating, especially if you have undergone fertility treatment or have been trying for a long time to pregnant in the first place.

Dr Victoria Sephton

Your first call to Care will likely be to our new patient team, and they can make your consultation appointment for you. We will send you a questionnaire about your medical history and a registration form which you should preferably return before your appointment. You can provide these details electronically via our "Patient Portal". If you have details from previous treatment or investigations it is useful if we receive these before the appointment so your Consultant can read these before your consultation. Some patients may have already visited the clinic for an initial 1-2-1 visit and be familiar with the clinic and the process.On the day of your consultation please allow plenty of time and arrive promptly for your appointment to ensure we have enough time to provide you with the full assessment you need. You will be greeted by our friendly reception team where the details on your registration form will be confirmed. You will have a photograph taken to confirm your ID throughout your time with us. Following this you can relax in our comfortable lounge style waiting room with WIFI, television and coffee facilities.During the waiting time,&nbsp; female patients undergoing treatment will meet the nurse and have blood&nbsp; pressure, weight and BMI measured. Female patients will also have a pelvic ultrasound scan performed to assess your womb and ovaries. This is an internal scan which does not require a full bladder and takes about 20 minutes. If you find an internal scan difficult or if you have a latex allergy please tell the sonographer. Male patients undergoing treatment will be asked to provide a semen sample on the day in one of our very private rooms . If you feel this may be difficult for you then please let us know. The sample will be examined immediately by our embryology / andrology experts. The results of these tests will therefore be available for the consultation - so the doctor has all the information needed to assess your case accurately and quickly - in order to provide you with the very best treatment.The actual appointment with one of our expert and highly experienced Consultants will last about 1 hour. The doctor will go through your history and test results and advise on the basic treatment options applicable. The doctor might also offer some of our extra cutting edge technologies which may improve the chance of success if appropriate. The treatment process and pathway will be outlined in detail - along with the costs involved. Before starting treatment you will need to have some basic infection screening blood tests which can be performed on the same day if appropriate. Following completion of some basic consent forms and blood tests if necessary the appointment will be complete and your journey with us has begun. If everything is straightforward and no further tests or information is required your treatment can usually start in a short period of time.&nbsp;There will be a lot of information to take in during the consultation - and your doctor will aim to be as clear as possible. However should you have any further questions after the consultation&nbsp; - then our experienced Patient team will be happy to clarify anything, either themselves or in combination with the advice of your doctor.We are very aware that patients have very busy lives and this can be a stressful and anxious process but we aim to make the assessment and treatment process as quick, painless and seamless as possible. Therefore using our on-site facilities most of the work can be done at your initial consultation.Rest assured, all Care clinics have an outstanding history and a track record of excellent leading success rates - but above all we treat you as a person - helping you to achieve your very best chance of a pregnancy.

Termsofuse

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Touchpoint

Couple at consult


When you have selected the right clinic for you, it can help you feel prepared if you know what to expect at your first consultation



<h3>Who might need donor eggs for Surrogacy treatment?</h3>For patients using fresh donor eggs in their treatment, the cycles of you (or your surrogate) and your donor are synchronised using medication. This ensures that the womb lining of the woman receiving the eggs is prepared to receive an embryo at the same time as a donor’s mature eggs are collected and fertilised. After the donor’s eggs have been collected, our embryologists will fertilise the mature eggs using&nbsp;<a href="https://www.carefertility.com/treatments/ivf-in-vitro-fertilisation/">IVF</a>&nbsp;or&nbsp;<a href="https://www.carefertility.com/treatments/intracytoplasmic-sperm-injection-icsi/">ICSI treatment</a>&nbsp;with a specially-prepared sample of sperm that has either been provided on the day or which has been frozen in advance if your partner is unable to attend or if you are using&nbsp;<a href="https://www.carefertility.com/donation/ivf-treatment-using-donor-sperm/">donor sperm</a>.As frozen eggs have already been collected, we would simply need to gently warm the eggs at your convenience and fertilise them using ICSI, ready for embryo transfer. This embryo transfer can even be done with your natural cycle. For this reason, fertility treatment with frozen donor eggs can offer patients more flexibility, reassurance, and certainty in their treatment, as there is no risk of complications with your donor, such as their stimulation not going to plan.Once your embryos have been created, your treatment will follow the usual IVF pathway. You (or your surrogate) will prepare your womb lining for embryo transfer by taking medications, and we’ll check that everything is ready for transfer through ultrasound monitoring.Our embryologists will keep a close eye on your embryos as they are developing in our specialist laboratory, and then will select the best embryo for transfer using their extensive experience and, if you choose, our unique time-lapse imaging embryo selection model, CareMaps-AI.If the lining responds to medication as expected, your Care clinical team will carefully replace this embryo back into the womb through embryo transfer. We’ll then ask you or your surrogate to take the hormone progesterone during the ‘two week wait’ before your first pregnancy test, as this helps to support embryo implantation.Between 14 and 15 days after your embryo transfer, we will ask you to take a pregnancy test, and will later confirm the result of the pregnancy test with an ultrasound scan. If your pregnancy test is negative, we will encourage you to take as much time as you need and can support you with counselling. When you feel ready, we will organise a follow up appointment with your Care consultant to discuss the next steps. If we confirm a foetal heartbeat, we will discharge you into the care of your GP<div class="embedded-entry redactor-component block-entry" type="entry" data-sys-entry-uid="blt1c16049ff8cf5747" data-sys-entry-locale="en-gb" data-sys-content-type-uid="image_component" sys-style-type="block"></div>We understand that there is a lot to consider when thinking of fertility treatment with donor eggs, and we are here to support you with all the information, advice and empathy that you need to feel confident in your treatment. Your local Donation Team will always be there to answer your questions, but there are also many other people to talk to at Care. You can also read about or speak to other people going through Surrogacy treatment our forum.&nbsp;

White same sex male couple, one of them carrying child on their back

same sex male family - no gradient

We understand that deciding to have Surrogacy treatment is a big decision, and before starting treatment, there is a lot you will want to consider. This blog will explain each stage of the Surrogacy journey and hopefully answer any questions you have. At Care Fertility, we believe that family is for everyone, and we are committed to supporting you on your path to parenthood.

Mr Anthony Rutherford

Testosterone is the main hormone which regulates sperm production but it does not necessarily follow that high testosterone levels means high sperm production. Those gym bunnies who supplement their diets with testosterone either by injection or other means, are often&nbsp; hairy, sweaty and strong but the chances are, they wouldn't make it into the olympic sperm squad. In fact, very high levels of testosterone can stop sperm production. Sperm production is complex and relies on the normal function of the testicles, other glands and a delicate transport system. Conditions need to be optimal for men to produce plenty of high quality, healthy sperm.And it is not all about the numbers. Count is important but the way the sperm swim and the integrity of the DNA they are transporting, also matter.&nbsp;Here are some pointers to getting yourself&nbsp; good sperm:1. Keep cool; especially your testicles. They hang outside the body because sperm is best produced at a core temperature of about two degrees below body temperature. Anything that heats up your testicles – such as hot baths, tight underwear and working in a hot environment, can lower your sperm count. Therefore, try to keep your testicles cool..2. Don't smoke. Don't ever smoke, and if you do, give up because nicotine will harm you and your sperm.&nbsp; By quitting smoking, you can reduce the amount of “free radicals” (oxidative stress) your sperm is exposed to. This prevents potential DNA damage and can improve the quality of your sperm, in turn, making them more likely to be successful in fertilisation.3. Eat well. Avoid junk food. Give yourself a treat now and again but if you eat rubbish, don't naturally expect to have great sperm. It just doesn’t work like that.&nbsp;Research has shown that men’s diets are affecting their fertility. By ensuring you’re eating lots of fruit and vegetables, and a range of nutritious foods, you can help create and maintain healthy sperm. Many nutrients such as Vitamin B9 (folate), Zinc, Omega 3 and Vitamin D are key to keeping your sperm in tip top condition. These are all readily available in a balanced diet.4. Try not to be overweight. Overweight, and underweight people for that matter, can be less fertile than those of a normal weight. To calculate your Body Mass Index (BMI), divide your weight in kilograms by your height in meters squared and the result should ideally be between 18.5 and 24.9, according to the World Health Organisation..5. Be active. Besides being beneficial to your health overall, regular exercise can boost testosterone levels and improve fertility. Studies show that men who exercise regularly have higher testosterone levels and better semen quality than inactive men.&nbsp;6. Keep it natural. Health supplements are of little benefit, especially if you eat and live well. It’s sometimes hard to believe what some health foods claim to provide you with. A good healthy diet should be all you need and if you want to give your sperm an extra boost, you could take some&nbsp; zinc or vitamin E supplements. There is no need to go for the reassuringly expensive “Superman Supplements” – it’s all marketing and there is little evidence to support their use. In fact, some can have nasty side effects.. Long term steroid use can interrupt the hormones responsible for sperm production being released naturally and sperm production can cease; sometimes irreversibly.7. Have a healthy sex life; the tubes in and around your testicles need clearing out every few days. Sitting in the testicles for longer than this is not good for the sperm.8. Check your medication. If you have to take medication and you are trying for a baby, be sure to ask your doctor about its effect on sperm production and for an alternative treatment, if necessary.9. Think about your medical history. If you suffered from undescended testicles as a child, or any other below the belt operations, or if you have suffered from a serious illness, this may have harmed your testicular health.As it takes about 10 weeks to make sperm, a recent period of illness or high temperature can affect the manufacturing of your sperm. If this is detected by a semen analysis, you may be asked to repeat it in a few months to allow for recovery and to make new sperm. &nbsp;&nbsp;10.&nbsp; Alcohol. Alcohol can be detrimental to sperm production so be careful what you drink. Too much alcohol can&nbsp; impact your fertility and also the health of the baby. Occasional drinking will most likely not cause harm but a significant reduction in intake is well worthwhile if you drink regularly and excessively.11.&nbsp; Oxidative Stress.&nbsp; All of our cells (including sperm) use the oxygen we breath to produce energy, but this causes highly reactive molecules, known as free radicals or reactive oxygen species, to be produced which can cause damage to cells and tissues. High levels of oxidative stress can cause changes in the sperm cell membranes, affecting their shape (morphology) and motility, as well as causing damage to their DNA. Taking in enough antioxidants, such as vitamin C, in fresh fruit and veg, may help counteract some of these harmful effects.Remember that sperm counts can vary significantly over time which is why repeating the test can be a good idea if parameters are outside normal limits.Don’t forget, sperm are amazing cells. We estimate that to swim from the testicle to the egg is about the equivalent of a man swimming from Liverpool to New York at 600 miles per hour! They are remarkable, so look after them - they may just change your life.

Sperm and egg cell on microscope.  Scientific background. 3d illustration

sperm swimming

Unlike women who are born with all the eggs they will ever have throughout their life, men are like sperm factories, meaning, once they reach puberty, they continuously manufacture sperm.  The quality of the sperm produced can vary over time and studies have shown how sperm quality declines as men age, as their testosterone levels reduce.

<h3>What?</h3>It’s likely that most, if not all, of your scans will be Transvaginal (internal).The majority of women don’t find it uncomfortable. If you’ve survived a smear test this will be a breeze.In certain circumstances, if an internal scan isn’t suitable for you, an abdominal scan may be done instead, though this isn’t the preferred option as it’s usually less detailed.Ask as many questions during the scan as you like. We usually talk you through what we’re seeing (try and stop us!), but some findings need a second interpretation by a Consultant, so don’t worry if we don’t answer fully - all will be explained. Where and How?In a scan room within the clinic.We scan on adjustable beds with the foot part folded down. You’ll be asked to lie on your back, your bottom near the edge of the bed with your feet down below on a step.Your modesty is preserved by a covering sheet, a dimmed light and the fact that you won’t have your feet somewhere up near the Sonographer’s ears.How long?Timing depends on the type of scan. Some take as little as 5 minutes, more detailed scans including pregnancy scans might be up to 15 minutes.What to wear?Whatever you’re comfortable in that can be removed relatively easily (bottom half). All in one jumpsuits are probably not the best idea.Sonographer’s Tip: If you wear a dress or skirt you get to stay almost fully dressed which can help you feel less exposed.Who?A highly trained Sonographer or Nurse Sonographer. Training to full competency takes a minimum of a year to eighteen months and is ongoing afterwards.When?Any time in your own cycle for the very first Consultation scan. Once you start treatment you’ll be scanned whenever necessary to monitor your progress.We can (and often do) scan during your period but don’t be afraid to say if this bothers you.Lastly...We have lots of experience, we know that you can feel nervous about this. Please don’t worry, we’ll do everything we can to help you feel at ease.

Manchester external (blue sky)

Depending on what type of scan you’re having, we might be trying to identify a potential fertility problem, helping the doctor decide which treatment might be most suitable for you. Or, if you have started treatment, we will scan regularly to keep an eye on progress during your treatment. If all works out as planned, you’ll also be scanned to check the progress of a pregnancy.

Many doctors report that talking to their female patients about the need for weight loss is one of their most difficult consultations. Telling a patient that her weight is contributing to her fertility problem and that weight loss is the answer is equally painful for doctor and patient. When does this stop being a fertility consultation and start being ‘fat-shaming’? Obesity can be a consequence of physiological and demographic factors as well as lifestyle choices. Overweight patients are well aware that they weigh ‘too much’ but successful weight loss is complex, demanding and SLOW!Fertility patients often get referred for IVF with high BMIs and are desperately disappointed to be told that they will not be eligible for NHS funded treatment unless their BMI is 30 or under.&nbsp; Older patients can be devastated to realise that a sensible weight-loss plan (ideally 1-2 pounds a week) to get them to that target will use up precious months that they simply don’t have. Crash diets and ‘surgical solutions’ like gastric bands may achieve rapid weight loss, but the evidence is&nbsp; that the patients should be stable at their ‘new’ weight for a year before starting treatment or the response to treatment is poor.&nbsp; If ‘Mother Nature’ thinks you are starving, then she is unlikely to think a baby is a good idea just now!29% of the UK population are obese (that is have a BMI above 30) and the range of ‘healthy’ is in fact a BMI of between 19 and 25 (which only 40% of the population will have!). BMI is however a relatively poor way of looking at someone’s weight and assessing whether it poses a health risk or may be implicated in their fertility problem.BMI is calculated by comparing the ratio of height and weight – weight in kilograms divided by height in metres squared. Apart from the mathematics involved, this number may be misleading because muscle weighs more than fat and so athletes often have raised BMIs. The National Institute for Clinical Evidence (NICE) and the British Fertility Society (BFS) recommend a BMI of between 19-30 as being suitable for fertility treatment.Weight problems and fertility are frequently linked – in fact the majority of women with Polycystic Ovarian Syndrome (PCOS) are overweight and if they can lose just 10% of their body mass the irregular periods and absence of ovulation that is a symptom of the condition, and frequently the cause of their infertility, will improve the chance of a pregnancy occurring spontaneously.At the other end of the BMI spectrum, young women who have recovered from anorexia or bulimia will often still have very low BMIs (15-18) and in addition to irregular or absent periods, if they do achieve a pregnancy there is an increased risk of miscarriage or a low birthweight baby.Alternative measures of weight may be more helpful.Some women are ‘pear’ shaped (that is their hip measurement is greater than their waist) and some are ‘apple’ shaped where they have ‘no’ waist. For the ‘apples’ this means that they have deposits of fat around their middles which have been shown to significantly reduce fertility. An ‘apple’ shape is a waist : hip ratio &gt;0.85 and a ‘pear’ is a waist : hip ratio &lt;0.7. An Australian study of over 500 women having donor sperm insemination treatment showed that the ‘pears’ were twice as likely to achieve a pregnancy as the ‘apples’ – 63% versus 32% after 12 cycles of treatment.BMI studies also provide useful data about the impact on IVF outcome. A review of over 5000 IVF cycles for women of all ages showed that the chance of getting pregnant with a BMI over 30 was reduced by 25% and the risk of miscarriage was almost doubled.Waist measurement may provide an even more straightforward measure of not just fertility prospects but of general health too. A recent UK study which assessed &nbsp;the health of 300,000 people found that the ratio of waist measurement to height was a better predictor of high blood pressure, diabetes, heart attacks and strokes than BMI. Ideally we should all aim to keep our waist measurement less than half our height. So a 5ft 4in tall (64 inch) woman should keep her waist under 32 inches.Weight also has an impact on male fertility. Men with a high BMI produce fewer normal, motile sperm in the ejaculate as a result of the ‘heat’ effect of that tummy, so women who start a diet and exercise routine to boost their ‘fertility fitness’ should encourage their partners to join in!

Image of healthy nutritious smoothies and colourful fruit

Nutrition

Weight is such a difficult topic! Hard to define and even harder to talk about!

Alison Campbell

How do you assess what is a ‘good’ embryo? What technology is used to assess embryo quality?The way we assess embryo quality has significantly improved over the past few years, with great technological advancements allowing us to analyse embryos in our IVF laboratories in even more detail and with more certainty than ever before.Traditionally, embryologists would assess embryo quality by looking down a microscope and subjectively assessing an embryo based on their number of cells, how smooth and even those cells are, and whether or not there is any fragmentation (bits of cells that have broken off, which generally is not a good sign). This traditional method of assessing embryos is effective, but we can now use much more sophisticated tools to choose the best embryo for transfer and increase the chances of success.In standard&nbsp;IVF, we would usually carry out this traditional assessment of embryos once a day, opening up the incubator and very carefully taking out the embryos to look at them under the microscope. One of the more advanced methods we have for embryo assessment is&nbsp;time-lapse imaging using CareMaps-AI, where a photo is taken of the developing embryo every five to ten minutes throughout the whole period we have them in our care in the IVF laboratory, all without removing them from the optimum environment of their incubator. We use the vast amounts of data gathered from this time-lapse imaging to assess the embryos’ morphokinetics: how they look (their morphology) and they way they move and their behaviours (kinetics). With the ‘live feed’ of time-lapse imaging, we can continuously assess both these sets of information throughout the embryos’ whole developmental journey.How does time-lapse technology help to select the best embryo for transfer?The development of this advanced embryo analysis technology has been a very exciting journey. Eight or nine years ago, we started collecting all these images taken by our time-lapse incubators, and we looked at the data collected and compared the images of embryos which developed to a healthy, live birth to images of the embryos which sadly did not. A data analysist then investigated this huge amount of data and found that there were differences between these sets of embryo images, and that’s how we developed&nbsp;CareMaps-AI: our unique embryo selection model powered by AI. which helps us determine which embryos are actually good quality, whether they appear to be or not.Does time-lapse embryo assessment lead to higher success rates?There has been lots of work published about whether time-lapse embryo imaging assessment, like CareMaps-AI, improves the chances of success and the answer is yes, definitely. We have published work in peer-review journals, and even in a textbook! It is very difficult to give precise figures on how CareMaps-AI improves the pregnancy success rate as every patient, their medical history, and their treatment is different, but, in general, the average uplift is around 20% - that’s a relative increase, such as an improvement from 40% to 50% (not twenty percentage points). That is a significant improvement!How do IVF clinics grade embryos?There are many different systems that IVF clinics use to grade their embryos, and each IVF laboratory will pick the best embryo based on their embryo grading system. The important thing is that your embryologist keeps you updated on your embryos, and they will talk to you about the quality of each of your embryos, why we’re choosing the embryo we have, and the chances of success for all your embryos.Of course, not everyone chooses to use time-lapse imaging, but we can still use our experience from CareMaps-AI. What we’ve learned from our time-lapse imaging is that we don’t necessarily need to take an embryo out of its incubator every day and assess it, the most important grading is right at the end of it's culture, when the precious embryo is ready for transfer. This is one of the reasons why we felt confident implementing our&nbsp;@Do Not Disturb' approach, where we leave your embryos to develop in their specially-designed culture medium for five days without disturbing them. This ensures that the embryos are kept safe, continuously in the optimum environment of their culture medium, until they are ready for transfer, while minimising dish handling and footfall in the laboratory. Crucially, we still assess the embryos when they are ready for transfer, and that grading will help us to determine which embryo will give you your best chance of success.How does genetic testing help assess embryos?Looking at an embryo’s morphokinetics unfortunately does not tell us what is going on in its DNA – and this is where genetic testing comes in. With&nbsp;Pre-implantation Genetic Testing (PGT-A),we can find that an embryo that seems magnificent-looking can actually have an abnormal number of chromosomes.To explain, to give the best chance of success, we need to create an embryo with chromosomes from each the egg and the sperm, which form 23 pairs of chromosomes. In humans, aneuploidy (an irregular number of chromosomes) is, strangely, quite a common phenomenon, and aneuploidy is one of the greatest causes of miscarriage.Of course, we wouldn’t wish to transfer an embryo which could lead to a miscarriage, which is where PGT-A genetic testing comes in. In recent years, we’ve been able to take a few cells from an embryo, usually at blastocyst stage (on day 5 or 6 of development) when it has over 100 cells – it can easily space a few! So, we very carefully take just a couple of cells and send them to our specialist genetic testing laboratory, where they will count the number of chromosomes and report back to us on each embryo’s unique genetic makeup. Basically, telling us which embryos have the normal number of chromosomes and which are aneuploid.What is embryo mosaicism and how does it affect embryo quality?Sometimes, the genetics lab will tell us than an embryo is mosaic: where there is just a little bit extra of a chromosome, not a whole copy, meaning that some cells are euploid (have a normal number of chromosomes) and some are aneuploid. As scientists, we don’t really know what causes this mosaicism, but we do grade mosaic embryos as ‘high-level’ or ‘low-level’. The research and literature about this from around the world – which is always expanding – would suggest that embryos with low-level mosaicism have a reasonable chance of a health, live birth. High-level mosaic embryos will have a much lower chance. However, it is important to remember that every mosaicism is different, and if you have PGT-A testing which shows some embryos are mosaic, we will offer you an appointment with one of our specialist genetic counsellors to discuss your options.Who is PGT-A suitable for?PGT-A is not suitable for everyone. Generally, we would recommend PGT-A genetic testing for women over the age of 37, as we know that aneuploidy is more common in advanced maternal age. We might also recommend PGT-A to patients who have experienced recurrent implantation failure. Having said that, some women who have just the one embryo like to check its number of chromosomes to avoid the risk of miscarriage. Others might think that they only have the one embryo, and they want to give it a chance. It is a completely personal choice.How can women improve their egg quality?Of course, the main thing that will impact embryo quality is the quality of the egg and sperm.&nbsp;A woman is born with all the eggs she will ever have, and the number and quality of these eggs is genetically determined, and decreases over the years. However, the environment the eggs are growing in can be improved by lifestyle factors, just like any other cell in the body. Take a look at our <a href="https://www.carefertility.com/where-to-start/causes-of-infertility/improving-your-fertility">top tips for improving fertility</a> for how you can increase your chances of success at home. Overall, we can’t change the quality of the eggs collected, but, working with what we have and using the most advanced fertility technologies and techniques, we will do everything possible to give you your best chance of having a baby.<a href="https://www.carefertility.com/blog/a-relatively-easy-guide-to-becoming-a-sperm-machine/">How can men improve their sperm quality?</a>Unlike women, who are born with all the eggs they’ll ever have, men continuously make sperm from puberty, although (as you might expect) age does also have an impact on the quality of sperm. If our male diagnostic fertility tests identify an issue with your sperm, there are many tools in our toolbox which we can use to identify the best sperm for treatment and help successfully fertilise your eggs.One of these methods is&nbsp;ICSI. Also known as, intracytoplasmic sperm injection, this is a really phenomenal technique; as opposed to normal IVF, where the egg and sperm are put together in a petri dish, with ICSI we directly inject a single sperm into the centre of the egg, so overcoming that physical barrier between the egg and the sperm. We would generally recommend ICSI for those with low sperm count or poor sperm quality.Can freezing embryos affect their quality?Patients often worry that something will happen to their precious gametes and embryos, and we always reassure them of the robust protocols we have in place in our cryolabs to keep all your frozen eggs, sperm and embryos safe. We continuously monitor the temperature and the liquid nitrogen levels of our cryopreservation tanks, and the cryolab is regularly checked by embryologists.When it comes to success rates, IVF using previously-frozen eggs has a very comparable success rate to fresh eggs – almost exactly the same. In addition, the thaw survival rate of embryos at Care last year was 98.5%, so you can be reassured that almost all embryos at Care will survive the entire freeze-thaw process.Does the time of embryo transfer impact the chances of IVF success?The number of days an embryo has developed before transfer does impact its chances of success. For example, a day 5 embryo would have a better chance of success than a day 3 embryo. There are a few reasons for this, the first being that the longer we leave the embryos to development, the more data we have to analyse. Also, if an embryo were going to fail on day 3, 4 or 5 we wouldn’t know that on day 3, but by day 5 we’re choosing from a selection of potentially stronger embryos.In addition to this, the synchronicity of the window of implantation is better with a day 5 transfer. To explain, for women conceiving naturally, an embryo will be travelling down the tube on around day 3, and only arrive in the uterus to meet the endometrium when it is at around day 5 of development, by which stage the endometrium is prepared for the embryo to implant. So, if we transfer on day 3, the embryo has to sit around for a few days – which it wouldn’t naturally do – as the endometrium isn’t receptive. In many ways, it can therefore be better for an embryo to stay in the excellent incubators that we have in our IVF laboratories, and then transfer the embryo on day 5 when the environment of the endometrium is more optimised to receive the embryo.Overall, be assured that we gather information all the time to assess your embryos, and we are constantly fine-tuning our practices based on research, data and all our experience to give you your best chance of success. Your need for family is at the heart of everything we do – please&nbsp;reach out to us to find out how we can help you. You can call our new patient enquiry team on 0800 564 2270

Human (animal) cell under microscope. 3d illustration

embryo purple

Alison Campbell, Chief Scientific Officer at Care Fertility, answers patients’ most common questions about what makes a good embryo, including common factors that affect embryo quality and how they are assessed.

Prof Charles Kingsland

Taking long-term contraception can make you infertileIt is unlikely that contraception can affect your fertility. Some conceive immediately after they stop using contraception, and others may experience a temporary disruption to their menstrual cycle.Contraception is unlikely to affect your fertility, but it can hide a potential underlying problem, such as irregular periods.Most people conceive quickly Everybody has individual circumstances that can affect how long conception may take, so it would be wrong to say that most people conceive quickly.Approximately 1 in 6 may have difficulty conceiving; infertility is usually only diagnosed if you haven’t a year of trying. If you are concerned, we recommend that you speak to your doctor or <a href="https://www.carefertility.com/contact-us/?id=book">book a consultation</a>. Age only affects female fertility We are often made aware that egg quality naturally starts to decline when people are in their early 30s. A third of all eggs have chromosomal abnormalities by the time a person turns 40, making the eggs unable to form a viable pregnancy.Male fertility starts to decline from around 40 to 45 years of age; as testicular function and sperm parameters deteriorate.&nbsp;The only solution when struggling to conceive is IVF IVF is not the only solution when experiencing infertility. Although<a href="https://www.carefertility.com/treatments/ivf-in-vitro-fertilisation/">IVF</a> may be the right option for you, there is a vast range of treatments available. At Care Fertility, your treatment plan is bespoke and individualised to ensure your personal needs are met, these include:<ul><li><a href="https://www.carefertility.com/treatments/ivf-diagnostic-tests/">Diagnostic tests</a>: we would recommend this to achieve an accurate diagnosis before pursuing treatment</li><li>Fertility drugs</li><li><a href="https://www.carefertility.com/treatments/intrauterine-insemination-iui/">Intrauterine insemination</a> (IUI) </li></ul>Irregular periods signify infertility Irregular periods don’t always indicate a problem; factors such as weight loss or weight gain, stress or hormones can affect your menstrual cycle.The average menstrual cycle lasts 28 days, although it can be longer or shorter. An irregular cycle can make it challenging to know when your fertile window is, and you may not ovulate regularly.We recommend that you speak to someone if you have irregular periods, especially if your period lasts over 7 days or your periods have suddenly become irregular.Good health means good fertility <div class="embedded-entry redactor-component block-entry" type="entry" data-sys-entry-uid="blt0febbd2167ff557e" data-sys-entry-locale="en-gb" data-sys-content-type-uid="image_component" sys-style-type="block"></div>You can be in good health and still struggle with conceiving; good health doesn’t guarantee ‘good fertility’. From ovulation disorders to blocked tubes, there are many factors that could contribute to infertility; we are here to help.We recommend that when trying to conceive that you:<ul><li>Eat a balanced, nutrient-rich diet</li><li>Exercise regularly</li><li>Avoid excessive alcohol, and reduce caffeine intake</li><li>Avoid smoking</li><li>Manage your stress levels </li></ul>Our&nbsp;teams are here to help, support and guide you at every stage of your fertility journey. We believe that family is for everyone and we will do everything we can to help you. To find out more, and get answers to your questions, you can call our new patient enquiry team on 0800 564 2270. They have lots of knowledge and experience and they'll be happy to help you.

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As soon as you begin to research fertility online, you will find lots of information and some of it can be confusing. Our teams at Care are experts in fertility science and we can debunk some common fertility myths to help make things easier to understand.

Char Short

Our new enquiry team are very knowledgeable about all of our treatments and can provide information on anything ranging from IVF to genetics, the process, or potential costs, including our funding packages Carepay. After your call they can send you more&nbsp;information based on what was discussed, and if you are ready, they will book you an appointment for a consultation at your chosen Care clinic.Our new enquiry&nbsp;team always put our patients at the heart of everything they do. They really listen, do&nbsp;everything they can to understand and help you. They treat anyone who calls as part of our&nbsp;Care family.Here is Char, our new patient enquiry team manager talking through how to get started with Care.We know making that first call to a fertility clinic is daunting, so thought we would introduce you to some of the people who will be on the other end of the phone.We spoke with Elaine, Georgia, Julia, Ashlea and Lisa from our new patient enquiry team about why they joined our Care family, how they help patients, their advice for those starting their fertility journey and more…Why did you decide to join the Care family?Elaine: As soon as I saw the job advert for Care, I knew I needed to apply. My nephew was made at <a href="https://www.carefertility.com/our-clinics/ivf-clinic-northampton/">Care Northampton</a> and I had recently found out some sad news about my own fertility. The way I had been told about my own issues and the care I had received was quite awful, so my goal is to show the compassion and empathy that was severely lacking when I needed it and just be a sensitive ear and provide as much guidance as I can.Georgia: I went through 5 cycles of treatment myself – over that period I connected with many others going through treatment and realised the value and importance of speaking to people going through a similar experience. There is a real sense of relief to be able to speak freely about infertility with someone who has experienced it and therefore really understands its impact across every aspect of your life.Julia: I love trying to help people and always wanted to work where we can actually make a difference. I used to work on the front line in the ambulance service, and now as part of Care’s new patient enquiry team I always try to put myself in the patients’ position and help with whatever you need.Lisa: I have been part of the Care family for 20 years! I started as a part-time receptionist, moving on to reception manager and now&nbsp;part of our new patient enquiry team.When I saw the job advertised all those years ago, I thought it would be really interesting and applied. It is so much more than interesting! It really does feel like we are a family, all working together for the same aim: to help patients extend their family. We get upset for our patients when treatment hasn’t worked and we celebrate with them when it has. We do understand that treatment is not the easiest thing to go through, but we really want to help in making it better, in every way that we can.How can the Care new patient enquiry team help?Ashlea: Our main role is to provide patients with information about their clinic and treatments, register their details and book them in for their relevant appointments. However, it is much more than that; we are a listening ear for the majority of our patients who have had a tough fertility journey, reassuring them the best that we can. We are a walking Wikipedia with our knowledge as we never know what question we are going to be asked!Julia: You might not be trying for a baby just yet - you might just want to know prices or success rates, and we are here to help and send information for you to read. If you have any questions, we are all more than happy to talk through the stages. There is no obligation to go any further with your enquiry; we just want to help and reassure you that you can come to us in the future if needed.Is there anything our new patient enquiry team can’t help with?Julia: We can help with most things, but some areas of fertility treatment are very specialist, such as known donation, <a href="https://www.carefertility.com/where-to-start/ivf-for-lesbian-couples/">shared motherhood</a> and <a href="https://www.carefertility.com/donation/surrogacy/">surrogacy</a>, in which case we pass you on right away to our <a href="https://www.carefertility.com/donation/our-donation-teams/">Donation teams</a>, as they can give patients all the detailed information they need.Ashlea: If there is anything our new patient enquiry team can’t help with, such as treatment with <a href="https://www.carefertility.com/treatments/reproductive-and-genetic-health/pgt-m/">PGT-M</a> or <a href="https://www.carefertility.com/costs/nhs-ivf-funding/">NHS funding</a>, we will still take your details and pass them on to the relevant team, who will be in touch as soon as possible with more information – we are always want to help patients as much as we can!What’s your favourite part of being part of the Care family?Ashlea: My favourite part about working with Care’s new patient enquiry team is knowing that I have (hopefully) made a difference to somebody's fertility journey, just by being kind, listening to them, pointing them in the right direction and ensuring they get the most from all their appointments.Georgia: My favourite bit about being part of Care is helping to reassure patients about the processes. I also love spending time with the embryology teams and watching treatments like <a href="https://www.carefertility.com/treatments/intracytoplasmic-sperm-injection-icsi/">ICSI</a> being performed!Julia: I have only been with Care’s new patient enquiry team nearly one year, and I love how we work very well as a team! We help each other, learn from each other and have really grown, and I just love being part of this fab team.Lisa: So many things! My favourite memory being at Care is helping a patient who had her treatment cancelled last minute at a non-Care clinic due to staff shortages. We cannot always help due to timescales, but we were told if I could personally oversee the transfer of her care to us and liaise with all the departments then we could offer her treatment. I did take every aspect on and we got the patient her treatment, for which she was very grateful for and now has a little boy!What would you say to someone who is considering treatment but doesn’t know where to start?Lisa: I would say call us, the new patient enquiry team. We are really happy to talk through the initial steps with you and answer any questions you may have – no question is a silly question. We appreciate that sometimes it is very hard even just to make that first call, but we are here to help you in any way that we can. We won’t rush you, we will listen, promise!Georgia: Start a list of questions – no matter how silly the question may seem. It’s easy to forget to ask things when you’re making enquiries or have appointments. Also join free online support groups, such as the&nbsp;Care forum&nbsp;or charities like Fertility Network UK, where you can chat to others who have been through or are about to start treatment for lots of great suggestions and advice for starting out on your journey.Ashlea: For patients who are considering fertility treatment, I would say to call our new patient enquiry team where one of us will be happy to talk you through your first steps. We will provide you with some costs, treatment information and ensure you have all the correct investigations prior to speaking with our consultants to ensure there are no delays for you further down the line. We treat our patients on an individual basis and hope to ensure your journey is personal from the very beginning.&nbsp;Want to chat with our new patient enquiry team? Call us on <a href="tel:+448005642270">0800 564 2270</a>, or<a href="https://www.carefertility.com/contact-us/?id=info">request more information from the team through our website</a>.When you’re ready to talk about your next step, we’re here.With love from Care x

Care support

If you are struggling to become pregnant, it can be difficult to know where to turn or what questions to ask. Our friendly new patient enquiry team are here to chat with you, listen to your worries and reassure you with all the information you need and answers to your questions, with no obligation to book an appointment.

In many cases this is offered via a time lapse incubator, the EmbryoScope. This incubator takes a photograph of the embryos, every 10 minutes, allowing the time that the embryo reaches every key stage of development to be assessed and therefore producing a time-line of embryo development.However, there are many differences in the way that this equipment is used in IVF clinics, from just an incubator to improve culture conditions, to a revolutionary way of assessing which embryo from a group is most likely to implant. If used correctly, this technology has the potential to improve pregnancy rates, by improved embryo selection.At Care Fertility, we have had over one thousand births from our Embryoscopes and this has put us in the unique position of being able to compare the time-line of embryo development in embryos that have resulted in the birth of a baby, to those that have not. Interestingly, this has shown us that there are differences in the time-line of development of those embryos that are able to result in a birth, despite their appearance.Caremaps time-lapse imagingWith this information, we have created <a href="https://www.carefertility.com/treatments/embryology-treatments/caremaps/">Caremaps</a>, a unique algorithm, based on the ideal times that an embryo should reach certain key stages of development. With <a href="https://www.carefertility.com/treatments/embryology-treatments/caremaps/">Caremaps</a>, all of your embryos will be compared to this time-line and this information will be used to select the embryos for transfer that have the highest chance of becoming a baby.With Caremaps, we have demonstrated an uplift in pregnancy and birth rates, compared with standard methods in all age groups, using this technique.Many factors affect IVF outcome but female age has the greatest influence on success rates. Caremaps benefits all age groups and in women over 39 years, the relative increase in live birth rate is greatest. Compared with standard embryo culture and selection.

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Many fertility clinics are now offering time lapse technology in one form or another, to improve culture conditions and to provide additional information with which to select the best embryo.

What is the egg collection procedure?The egg collection procedure, also known as egg retrieval, involves using an ultrasound probe to detect follicles. A needle is then guided through the vagina into these follicles, before eggs are removed using a suction device connected to the other end.Is egg collection painful?The egg collection process is usually completely painless, but some women do experience minor cramps and a small amount of vaginal bleeding. Both of these symptoms should pass as soon as the retrieval is over.Monitoring egg developmentYou’ll be monitored throughout your IVF treatment using ultrasounds and hormone measurements. This allows your fertility specialist to adjust levels of IVF medication to improve follicle growth, giving us a clear picture as to when the egg collection will take place.You may need to visit your fertility clinic regularly throughout this time. Your consultant will discuss timings with you.Egg collectionThis is a straightforward procedure that takes around 30 minutes and is performed with pain relief. To collect your eggs, we pass a scan probe into the vagina and use ultrasound to guide a needle into one of the ovaries. We then extract eggs from the ovarian follicles.We recommend you have a short rest before going home.Possible side effects and complicationsThe risks of something going wrong with egg collection are minor, however the more common side effects include things like bloating, unusual discharges and minor infections.Other risks include:<ul><li>Constipation, which may last for a number of days after the procedure</li><li>Bloating, due to your ovaries becoming enlarged after the embryo transfer takes place</li><li>Vaginal discharge. You may find you pass a small amount of watery fluid after the retrieval</li><li>Breast tenderness caused by rapidly changing hormone levels</li><li>Infection or bleeding</li><li>Ovarian Hyperstimulation Syndrome, which can cause symptoms such as mild or moderate abdominal pain, adnominal bleeding, nausea or diarrhoea</li></ul>Severe symptoms should be discussed with your fertility specialist as soon as possible.

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Egg collection is a minor procedure that normally takes no more than 15 minutes to complete. It allows your fertility specialist to extract eggs to be used during IVF. During the procedure, your eggs will be collected with a small needle that’s passed through your vagina into your ovaries. 

Dr Nikoletta Panagiotopoulou

<ul><li>7310 babies born since the clinic opened</li><li>458 heartbeats seen on scan this year</li><li>Best success rates of all clinics in Manchester and North West region</li></ul>As recommended by the HFEA (UK Fertility Regulator) we present results per embryo transferred as the best measure of a clinic’s results. With our cutting edge technologies and treatments our talented and dedicated clinical and scientific team are proud to be the top clinic in the region for Clinical Pregnancy rates for Fresh IVF/ICSI &lt;38 ( 39.5% HFEA national average 30.8%) and for Frozen Transfer treatments for All Ages and our Donation treatments.Care Manchester also recently underwent a total, £5 million refurbishment, making it a world-class, state-of-the-art environment for our patients and was recently launched by the very first IVF baby Louise Brown. The clinic is close to Manchester city centre and all its surrounding areas in leafy Victoria Park.&nbsp; We also work alongside our Bolton and Lancaster satellite clinics for those from the North of the city and beyond. So getting the fertility treatment you need has a convenient location close to you. We have on - site parking and welcoming lounges with coffee and WIFI. I keep hearing again and again that people feel comfortable in our safe and welcoming surroundings. Helping patients to relax and encouraging them to let us take the strain goes a long way towards a positive outcome.<a href="https://www.carefertility.com/our-clinics/fertility-clinic-manchester/">Care Manchester</a> has a long tradition of successfully treating NHS funded patients, everyone is treated equally.&nbsp; If you are eligible for NHS funding please talk to us we may be able to help.For further details please contact the clinic on&nbsp;0161 249 3040 or&nbsp;book a consultation. You might also like to arrange a free 121 clinic visit. Our Patient Liaison team -&nbsp; Lauren Barker and Amanda Milligan will be happy to help with this.&nbsp; We also offer some weekend and early and late out of hours appointments for the convenience of our patients.Log on to our Care fertility Twitter, Facebook and Instagram accounts to keep in touch with trending news.Remember at Care - Family is for Everyone. The figures speak for themselves and it really is a "no brainer". It couldn't be easier to start your journey with us!

As the Medical Director of Care Manchester I am proud and delighted to announce that we have the very best success rate results of all clinics in the Manchester & North West region, with up to 39.5% clinical pregnancy rates compared to the national average of 30.8%. We are thrilled to say 458 heartbeats have been seen on scan this year, and 7310 babies born since the clinic opened!

<h3>Who might need donor eggs in IVF treatment?</h3>There are many reasons why a patient might need to use donor eggs in treatment, but the most common reason is related to a woman’s age. Egg quality deteriorates as a woman gets older, so even if the patient is having regular menstrual cycles, it might not be possible to conceive using her own eggs.Other reasons for needing donor eggs for treatment could be to avoid a known genetic condition being passed from the patient to her child, or because previous medical treatment, such as chemotherapy, has compromised their fertility. Of course,&nbsp;<a href="https://www.carefertility.com/where-to-start/ivf-and-surrogacy-for-gay-men/">same-sex male couples</a>&nbsp;or single men would need donor eggs to start their family too.Success rates using donated eggs are high, largely because we take great care to comprehensively screen potential donors to ensure their fertility is good. For example, all of our donors are younger than 36, have a healthy weight, and have no known genetic conditions. This thorough screening process contributes to our fantastic success rates for treatment using fresh and frozen donor eggs; our clinical pregnancy rate in 2019 was 48% for treatments with frozen eggs and 47% for treatments with fresh eggs.Find out more about how egg donors are screened and assessed in our&nbsp;<a href="https://www.carefertility.com/donation/egg-donation-ivf-with-care-fertility/ivf-with-donor-egg-faq/">Egg Donation FAQS</a>.

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We know that choosing to have IVF with donor eggs is a big step, and that there are lots of things you would wish to consider before starting treatment. In this blog, we have explained each stage of the Egg Donation IVF journey to help demystify the process and provide you with the information you need to take the next step towards family.

Dr Tom Bamford

Listen to two of our lovely LGBT <a href="https://www.carefertility.com/where-to-start/ivf-for-gay-couples/">same-sex</a> patients Chris and Les, and their wonderful surrogate Anna, as they offer their advice on some of the legal and practical aspects of <a href="https://www.carefertility.com/donation/surrogacy/">IVF treatment with Surrogacy</a>.Hannah and Mandy also talk about their IVF treatment&nbsp;at&nbsp;our <a href="https://www.carefertility.com/our-clinics/ivf-clinic-london/">London&nbsp;Fertility clinic</a>.<a href="https://youtu.be/bdA3_QUYVZc?list=PLv6nRdM5padLYDJw4VpWDvLlh5xEroCJh" target="_self">Click here</a> to watch the video.

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Listen to two of our lovely LGBT same-sex patients Chris and Les, and their wonderful surrogate Anna, as they offer their advice on some of the legal and practical aspects of IVF treatment with Surrogacy.

Hannah Wall

What are the criteria for donating eggs?· You must be between 18 and 35 years old· You need to be fit and healthy, with no family history of hereditary illnesses· For your safety, we can only accept donors with a BMI below 35· You should be a non-smoker (this includes vaping)If all these apply, we can send you some forms to fill in, and bring you in for some tests to assess you fully.What are the benefits to donating your eggs?Egg donation is an opportunity to give someone the chance of becoming a parent, and it can be a truly rewarding experience. Your generosity can make a real difference to someone’s life and there are some great benefits to donating:-Free fertility assessment: As part of the donor screening process, you’ll receive a free full fertility assessment. You’ll have a test to assess your levels of antimullerian hormone (AMH) and an ultrasound scan called an AFC, these will indicate your ovarian reserves, giving valuable insight into how you might manage your own fertility in the future.-Compensation for your time: all our egg donors receive a payment of £750 per donation cycle to cover any expenses incurred while taking the time to donate.-Giving someone the precious gift of parenthood: Having IVF treatment with donated eggs can increase chances of success from &lt;5% to potentially over 80%, removing the pain of unsuccessful treatment and miscarriage so you know you’re truly making a difference.How many times will you have to visit a Care clinic?This will vary slightly from person to person but you will usually visit the clinic between 5-7 times. You will need to visit the clinic for your scans and blood tests, in between these appointments at the clinic, you’ll also have a number of virtual (either telephone or video call) appointments with our lovely donation team. Depending on your availability, we could bring you through to donation in as little as 12 weeks from your application.1. Apply to donate – fill out our quick form here to register your interest in becoming an egg donor2. Complete a medical questionnaire - You will be asked to fill in some online medical questionnaires, including details of any genetic illness within your family. This will be reviewed by one of our doctors, who will decide if you are able to proceed.3. You will have a phone appointment with one of our Registered Practitioners in Fertility Care (Nurses/ Midwives) to go through your forms and discuss the donation process in more detail.4. Fertility assessment – you’ll come into the clinic for a vaginal scan and a hormone blood test to check how many eggs you have and to scan your womb and ovaries.5. Further blood tests – to screen for infectious diseases.6. Counselling session – After you’ve talked through the process with our donation team, we’ll also invite you to meet one of our experienced counsellors. This is a good chance to ask any questions you have and discuss the implications of donating your eggs.7. Online consultation – Once you’re happy to go ahead with your donation, you’ll meet again with one of our Registered Practitioners in Fertility Care (Nurses/ Midwives) - this is usually done online. They’ll describe the donation journey in detail, and look at when you may be able to start treatment. If all is well, things can move quickly; you might start the process as soon as two to four weeks later8. Starting treatment – you will begin your injections to stimulate your ovaries. You’ll need to give yourself daily injections for around twelve days, which we’ll teach you how to do.9. Monitoring – you may have one or two monitoring scans once you have started your stimulating drugs to monitor the progress of your eggs10. Egg collection – We’ll collect your eggs during a non-surgical procedure. It is typically done under mild sedation or local anaesthetic; you will not need a general anaesthetic. No incision is made, and no stitches are necessary!11. Compensation - You will receive your compensation payment within two weeks of your egg collection.Will I need to take time off work to donate?We'll do whatever we can to make sure your donation isn't too disruptive. During the short monitoring stage, we'll need you to attend the clinic on specific days, but the appointments won't take long and can be scheduled to suit wherever possibleIt will be necessary to be off work on the day of your egg collection. Sometimes, donors feel more comfortable if they also take a day off work immediately after their egg collection, but this is generally not necessary.In reality, you should only have to visit the clinic around six times, but we'll give you as much support as possible to make sure your visits are convenient and stress-free.Will donating my eggs affect my own fertility?No, not at all – and it can give you an insight into your own fertility potential!Women are born with all the egg cells they are ever going to have, between 1 and 2 million. By the time you’re in your 30s, you’ll have around 75,000 eggs left and each month you lose up to 1,000 eggs in a natural cycle, even though only one egg is naturally matured for fertilisation.This means that the eggs we collect during your donation would either have been ovulated or absorbed by your body, and if you donate eggs, you’ll still have thousands of eggs left. Many of our donors even donate more than once.Does egg donation hurt?It shouldn’t do, no. You may feel some discomfort, and of course different people respond differently to medical procedures, but our clinical teams work incredibly hard to keep you as comfortable as possible throughout your donation.In the UK there is a shortage of egg donors of all ethnicities, and many more eggs are needed to help women and couples to achieve their dream of having a baby. If you think you could give the gift of life or have any further questions or concerns regarding egg donation at Care, please don’t hesitate to get in touch with us.<a href="https://www.carefertility.com/donation/donating-your-eggs" target="_self">Donate your eggs</a>

Helping someone else to have a family of their own by donating your eggs is such an amazing and generous thing for any woman to do. We want to make the process as easy and straightforward as possible, and give you all the information you need to decide whether egg donation is right for you.

Dr Amy Barrie

When it comes to building a family, understanding what fertility options are available is key. Over the years, the LGBTQIA+ community has witnessed incredible progress when it comes to fertility options. Thanks to advancements in reproductive technology, individuals and couples from all sexual orientations and gender identities now have a range of empowering paths to parenthood. Whether it’s same sex male couples exploring the possibilities of IVF &amp; Surrogacy, same-sex female couples considering IVF using donor sperm or transgender and non-binary people considering fertility preservation prior to commencing hormone therapy or surgery, the journey to parenthood has become more accessible than ever before. Whether you're ready to start a family, future planning or just curious, understanding and being in control of your fertility is really important. We want to empower all patients in the LGBTQIA+ community to make more informed decisions about all aspects of fertility, not just when they’re ready to start a family. Let's take a look at what options are available for:Male couples &amp; single men<div type="entry" class="embedded-entry redactor-component block-entry" data-sys-entry-uid="bltfce25dc1430b9318" data-sys-entry-locale="en-gb" data-sys-content-type-uid="image_component" sys-style-type="block"></div>If you’re not quite ready to start a family just yet, fertility preservation is a crucial consideration for couples/single men planning to start a family in the future. Sperm freezing and storage is a hugely popular option that allows men to preserve their sperm and maintain the option of parenthood later on in life. This involves collecting and freezing sperm samples, which can be stored for up to 55 years, that can be used in treatments such as Intrauterine Insemination (IUI), In Vitro Fertilisation (IVF), or used in Surrogacy.&nbsp;Over the years, surrogacy has become a remarkable path to parenthood that has brought joy and hope to countless couples and individuals. Through the generosity of surrogates, this life changing journey has allowed gay men and male couples to fulfill their dreams of parenthood. Surrogacy involves a legal arrangement where a woman (known as the gestational carrier/surrogate mother), carries a pregnancy on behalf of the intended parents. For male couples, this treatment allows one partner's sperm to be used with a donor egg &amp; transferred into the surrogate's uterus through IVF. Surrogacy offers gay men the chance to experience the incredible journey of biological parenthood, whether your parenthood journey involves a partner or you’re embarking on this journey as a single parent.&nbsp;&nbsp;Surrogacy also requires the use of donor eggs, you can either use a ‘known donor’ or access the Care egg bank. The aim of our egg bank is to give our patients a wide choice of donors with little or no wait. You will be able to select your egg donor online and then have your treatment at one of our world leading clinics. As a leading provider of egg donation treatment in Europe, we truly understand our patient's needs and care about your future family. We have meticulously crafted our cutting-edge egg banking and donation programme with you in mind. We freeze eggs with a process called vitrification that allows eggs to be frozen and thawed successfully without being damaged. This method freezes eggs instantly at -196⁰C using liquid nitrogen and is so effective that an estimated 97% of eggs survive the freeze-thaw process.Thousands of babies have now been born worldwide from treatment using previously-frozen eggs. Thanks to state-of-the-art technology, using frozen donor eggs offers a more flexible approach to treatment. Embryo transfers can be done immediately, in line with natural cycles or at a time that best suits you. Using frozen eggs also gives patients more certainty, not only is there a shorter waiting time for treatment, but because we have already carefully collected and frozen the eggs the risk of treatment disruptions (as sometimes experienced with fresh eggs) is little to none.&nbsp;Female couples &amp; single women<div class="embedded-entry redactor-component block-entry" type="entry" data-sys-entry-uid="blt2ea9a7d91ca82309" data-sys-entry-locale="en-gb" data-sys-content-type-uid="image_component" sys-style-type="block"></div>If you’re not quite ready to start a family just yet, fertility preservation is a crucial consideration for couples/single women planning to start a family in the future. For LGBTQIA+ females, the most common method of fertility preservation is egg freezing. Whether you’re planning to conceive with a partner or as a single parent, egg freezing allows patients to proactively plan for their future family. This involves retrieving eggs from the ovaries, freezing them and storing them for later use. The standard storage period for eggs is 55 years, requiring a renewal of consent every 10 years, but there may be circumstances in which your eggs can be stored for longer (e.g. for those women at risk of becoming prematurely infertile due to medical reasons). When you feel ready to start your path to parenthood, your eggs will be thawed to be fertilized with sperm (from a donor or partner) and transferred into the uterus through IVF.&nbsp;Thanks to advancements in reproductive technology, Shared Motherhood (also known as reciprocal IVF), is an innovative treatment that allows both partners in a same-sex female couple to experience and share their journey to parenthood. This incredible treatment option enables one partner to provide the eggs, which are then fertilized with donor sperm, and transferred to the other partner's uterus and who then carries the baby as the ‘gestational or birth mother’.&nbsp;Transgender &amp; Non-binary peopleNavigating through the trans journey can be a difficult, challenging, and overwhelming experience when you're living in a body that doesn't reflect your authentic self. Although it's likely that fertility is the last thing on your mind, we're here to help answer any of your fertility questions.If you are planning to start your transitioning journey, it is important to consider what impact the treatments associated with transitioning will have on your fertility. These effects may be irreversible, so if in the future you wish to have children, preserving your fertility may be the answer.When you feel ready to start the next stage of your fertility journey, there are a number of future treatment options. These range from treatments such as IVF and intra-cytoplasmic sperm injection (ICSI), to surrogacy and using donor eggs/sperm. Our doctors will discuss all available options with you at your first consultation. One of the most important things you can do during your fertility journey is have a support system. Support comes in many forms: friends, family and even those who are not directly involved in your journey can help make you feel less alone and more supported.&nbsp;Whether you’re ready to start a family, trying to conceive or going through treatment, we believe that every person deserves access to the best fertility care available – and that includes accessible treatment options, a supportive community and helpful resources. Our goal is to help you feel confident about your choices and be empowered by the knowledge and support our dedicated team provides.&nbsp;

In today’s ever-evolving world, the paths to parenthood for the LGBTQIA+ community have become more diverse and empowering than ever before. We believe that family is for everyone, regardless of relationship status, sexual orientation or gender. From same-sex couples to transgender and non-binary individuals, we’re proud to offer personalised treatment plans to make dreams of family a reality. 

Tests &amp; questionnairesWe ask all of our donors to fill out a medical form and family history questionnaire. These forms are a legal requirement for all fertility clinics and help us to distinguish whether you are suitable for egg donation. They are relatively simple and easy to complete, and our donation teams are there to help with any questions you have.After your consultation with one of our Donation Coordinators, you will undergo blood tests and a quick ultrasound scan so the team can assess your fertility health.AppointmentsOnce you have decided to go ahead with your donation, you’ll need to visit the clinic between seven and ten times. We’ll do everything we can to ensure your appointments aren’t too disruptive to your day-to-day life.After your first consultation and initial blood tests, you will normally then have an appointment with a Care counsellor. Here, you will be able to talk through the ethics of egg donation and any queries you may have, or emotions you may be feeling towards the donation process. Following this, you will have a consultation with a doctor who will answer any of your medical questions. You will then be scheduled in for three to five monitoring appointments, and one final appointment for egg collection.<h5></h5>Self-administered injectionsWomen who choose to donate their eggs are required to administer injections in order to stimulate their ovaries in preparation for egg collection. These injections stimulate egg production, ensuring the optimum amount of eggs are matured and ready to be retrieved on collection day. The nurses will make sure you fully understand the process, and are comfortable to do this before leaving the clinic.The injections are easy to administer, and can be done in the comfort of your own home. If you do feel you are unable to administer the injections yourself, it may be comforting to ask a partner, friend or family member to help you carry this out.AnonymityIn 2005, the laws regarding egg/sperm donor anonymity changed to allow any child born from donated eggs/sperm access to identifiable data about their donor when they turn 18 years old.It must be noted that you will not be financially or legally liable for any children born from your donation. The recipients of your donated eggs are the legal parents of any child born as a result.If you decide&nbsp;that you would like counselling, our Care counsellors are available&nbsp;to chat with you virtually. They can&nbsp;advise you on things like the information&nbsp;that would be given to any children&nbsp;born from your donation and answer any questions you may have.We’re here to give you all the facts, figures advice, and support you need to give another woman the chance to have a family of her own. So, if you have any further questions or concerns regarding egg donation at Care, please don’t hesitate to get in touch with us.

Helping someone else to have a family of their own by donating your eggs is such an amazing thing for any woman to do. We want to make the process as easy and straightforward as possible, and give you all the information you need to decide whether egg donation is right for you.

For over 45 years, the remarkable scientific breakthroughs of IVF have helped thousands of patients across the globe to fulfil their dreams of having a family. While the spotlight is often on the pioneering technology, state of the art laboratories and doctors, today we would like to recognise the dedication, support and expertise of our nurses who work tirelessly behind the scenes. Our goal is to help patients feel confident about their choices and be empowered by the knowledge and support our dedicated team provides - with nurses playing a pivotal role in patient education. Sometimes the world of fertility can be quite complex and overwhelming, particularly if it’s your first time undergoing treatment.&nbsp;Like all medical experts, nurses dedicate a huge amount of time explaining the intricacies of fertility, the treatment processes, as well as the potential risks and benefits of procedures to patients. On hand to answer questions with patience and compassion and help clarify any doubts, nurses are a reliable source of knowledge, and play a key role in helping patients feel empowered and equipped to make decisions about their fertility.&nbsp;But it’s not just from a technical aspect, sometimes it’s the emotional support nurses provide that makes the world of difference. Fertility treatments can take their toll on patients and their loved ones both physically and emotionally, it can be a rollercoaster of emotions at times, particularly when patients are faced with uncertainties and challenges. This is where the power of a nurse shines through. A shoulder to lean on, a knowledge bank and a constant support to patients and their loved ones every step of the way, their guidance and comfort helps patients navigate their way through the highs and lows of the fertility journey.&nbsp;Recognising remarkable careTo mark this year’s International Nurses Day, we are proud to announce we are joining the Global DAISY Award scheme to recognise and celebrate the invaluable impact our nurses and midwives have on IVF and Fertility. Their tireless dedication, compassion and wealth of knowledge has helped change the lives of countless patients looking to start a family.The DAISY Award was established in 1999 by the family of J Patrick Barnes who sadly passed away at the age of 33 from complications of ITP. His family were completely awestruck by the care and compassion that they and Patrick were shown during his 8-week illness, which inspired them to create an award to recognise the exceptional care nurses provide. For 22 years, DAISY has been honouring extraordinary nurses around the world. There are now over 5,400 healthcare organisations and schools of nursing who are DAISY partners, and we’re proud to be the first independent IVF provider to join the global scheme.This award provides patients with a unique opportunity to express their gratitude and admiration for the care they received. Patient and family gratitude for a nurse’s extraordinary compassionate care is the most meaningful thank you a nurse can receive, and we're proud to recognise our nurses with this award.We encourage all patients to take a moment to nominate their nurse, <a href="https://forms.office.com/pages/responsepage.aspx?id=0S1OvdGsAUW9bje7TTrV9Gq9ncbRzJxNiu4KmiAXy6xUOFUzU0xHNDNaSVZXQzRMNlRPQk9SRldUVC4u">click here</a> to share your story of what your nurse has meant to you. We don’t want you to miss the opportunity to celebrate your nomination, so stay tuned on social media where we’ll share the proud recipients of the prestigious DAISY Award!

Sheffield Nursing team

Nurses play a pivotal role in comforting and guiding patients throughout treatment. They bring a unique blend of medical expertise and emotional support, providing patients with endless reassurance, guidance and care throughout their fertility journey.


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