Mother and Baby

Fertility Services

The Fertility Team offers a wide range of services from diagnostics and treatment to counselling and support for both NHS and privately-funded patients.

We provide impartial and expert guidance through the fertility treatment process and our patients have the assurance that, as we work within the NHS, we are committed to safety, quality and ethical conduct.

We also have strong links with education and a commitment to research and innovation.

Fertility Investigations (patient journey)

The patient journey normally starts with a visit to the GP, usually because you’ve been trying for a baby for more than a year. Alternatively there may be circumstances which you are already aware of that may prevent you from conceiving. Either way the GP can start any investigations and refer you to our department. If you are not in the Nottingham area but would still like to be seen here at NUH, you can either inform your GP or contact the department directly. For more information Tel: 0115 970 9238

Graph explaining patient journey

Who gets NHS funding?

Your GP can refer you directly to the NUH fertility services. This does not mean that you will always qualify for NHS funded treatment as this is guided by the criteria set by your local clinical commissioning group (CCG). However, quite often initial investigations will be included within the NHS funding. Currently, NHS funded treatment is restricted to couples who: live together, have no children either together or from previous partners, where the female partner is <43 years old for IVF and <40 years old for other treatments including ovulation induction (OI) and intra uterine insemination (IUI). In addition, patients who smoke or where the female has a BMI (Body Mass Index) of under 19 or over 30 or where the investigations indicate that the female has poor ovarian reserve may be excluded from some treatment options. Visitors from overseas may be asked to provide evidence of their current VISA status and are unlikely to be funded for treatment or investigations unless they have been given residency status. If you do not meet these criteria, you may still be seen but may have to fund investigations and/or treatment yourself. For more details on paying for fertility investigation and treatment please see the self-funding page.

 

The basics of Fertility Investigations

As fertility investigations must consider both male and female factors, the GP will usually start the process by organising a semen analysis for the male partner and blood tests and swabs for the female before they reach the Fertility unit. The first consultation will review these results and if necessary organise additional investigations to establish the cause for sub-fertility and also to guide the most effective fertility treatment. Medication to help with ovulation may be given as a first treatment and those couples found to have ‘unexplained infertility’ or a mild ovulation problem may move onto receive intrauterine insemination (IUI). This is a ‘first-line’ assisted conception treatment which combines the effect of good quality ovulation (egg release) with ensuring that sperm are of good quality and placed inside the Uterus at the right time. Approximately 35% couples will become pregnant through IUI but those who are unsuccessful may be recommended for IVF (in-vitro fertilisation). IVF is also a treatment for couples with poor quality sperm or with problems of the Fallopian tubes.

Specific information on all the investigations is available from the patient information page here. 

Fertility Treatments

Fertility treatment may vary enormously from basically taking medication to help stimulate or improve ovulation levels to more complex IVF where sperm and eggs are fertilised in the laboratory and therefore the resulting embryo/s develop outside of the body. The treatment decision depends entirely on what factors have been identified through diagnostic investigation, which appear to contribute to the fertility problem. The table below describes what treatments are provided and for what reasons

 

Fertility Treatments
Treatment Abbreviation Used for
Ovulation Induction OI

Used for recruitment and development of egg(s). 

Clomiphene (clomid) is a tablet that is often used to induce this. In some resistant cases, or with repeated failed cycles will be offered Gonadotrophins.

Gonadotrophins GT's A more powerful form of Ovulation Induction, usually given as daily subcutaneous injections.
Intrauterine Insemination IUI This is used alongside Gonadotrophins for couples with unexplained or 'mild male-factor' subfertility or following failed OI cycles. 
Donor Insemination DIUI

IUI but using donor sperm. Required when:

  • Male partner has no sperm or defective sperm
  • No male partner
  • Prevention of genetic disease transmission
In-vitro fertilisation IVF*

Used in the following situations:

  • Fallopian tube obstruction or absence 
  • After several unsuccessful IUI treatments
  • Moderate male factor infertility
  • Increasing female age
Intracytoplasmic sperm injection ICSI*

Used:

  • After unsuccessful IVF
  • Severe Male factor infertility
  • After surgical retrieval of sperm

*Not offered at NUH

Over the last few years, the fertility services in Nottingham have evolved such that IVF and related treatments are now provided by private providers in Nottingham. If your investigations suggest that IVF is the appropriate treatment for you, we will provide you with all the necessary information for you to make the right choice of local IVF clinic.

Self-Funded Services

If you know you don’t qualify for funded services within the Nottingham area or wish to be seen directly from outside of Nottingham you may do so as a ‘self-funded’ patient/couple. Even though we are an NHS fertility unit, not all treatments or even investigations can be funded. Both laboratory and fertility clinic services can be obtained privately through the appropriate team (investigations, treatments, sperm storage). If you do not live in the Nottingham area or cannot get a referral from your GP but would still like to access our services privately then please contact the admin or nursing team and they will either arrange a nurse consultation or visit to one of the consultant working regularly within the clinic. All patients are guided through investigations and treatment by an impartial expert and importantly as NUH is an NHS organisation, any fertility treatments are provided on a ‘not for profit’ basis. For private laboratory services such as:  diagnostic semen analysis, test wash, post vasectomy testing, sperm banking or purchase of donor sperm please contact the lab by writing to the address below or Tel: 0115 924 9924 Ext: 62749 or email nuhnt.andrology@nhs.net.

For access to ‘self-funded’ clinical investigations including scans, blood tests or fertility treatments, please contact our admin team on Tel: 0115 970 9238 or contact the nursing team on fertility.enquiries@nuh.nhs.uk.

 

Self-funded Investigations and Treatments

All the treatments mentioned in the accordian 'Fertility Treatments' are available both on the NHS or privately.

 

Investigations (Diagnostics)

Sperm testing – see andrology here.

 

Blood tests

(i) Infectious disease screening (HIV, Hepatitis B/C, syphilis, Gonorrhoea, Chlamidya screening, CMV)

(ii) Ovulation testing (FSH, LH, Oestradiol, Progesterone, AMH, TSH, prolactin, Testosterone)

(iii) Male testing (FSH, LH, testosterone)

(iv) Genetics (cystic fibrosis, karyotype, Y chromosome micro-deletion)

Fallopian tube assessment

Hysterosalpingogram (HSG)

 

Fertility Treatments

(i)  IUI - Intra uterine insemination (partner sperm)

(ii) DIUI - Intra uterine insemination (donor sperm)

(ii) OI – ovulation induction

 

Self-funded cost

For costs of both diagnostic tests and treatments, please download the latest private price list.

Postal  Address:

NHS Fertility Unit
B Floor, East Block
Nottingham University Hospitals NHS Trust
Queen's Campus
Derby Rd
Nottingham 
NG7 2UH

Tel: 0115 970 9238 (clinic) or 0115 924 9924 EXT: 62749 (Lab)
Fax: 0115 919 4497
Email:fertility.enquiries@nuh.nhs.uk

The unit is normally open Monday to Friday, 8am to 4pm for telephone enquiries.

Success Rates

It is important that your local clinic can provide successful treatment whether it is paid for by the NHS or you have to self-fund. As NHS funding is limited, private fertility treatments have become highly commercialised and competitive. It is very important that you therefore scrutinise and understand the success rates publicised by the clinic. Success rates are an important factor (but not the only factor) as well as cost when you start to choose a treatment clinic. Our success rates are as good as (if not better in many cases) than many clinics in the UK and abroad and indeed our Donor insemination service is more successful than the national UK average by some distance (see below).

Donor insemination live birth rates at NUH Fertility from 2016-2018 compared with latest National HFEA figures show a significantly higher success rate for unstimulated treatment. You can view these here.

 
Age Group NUH Fertility DIUI pregnancy rates (unstimulated) NUH Fertility DIUI birth rates (unstimulated) National DIUI  birth rates (unstimulated)**
All Ages 22% 19.5%

11%

>35 27.9% 23.5% 14%

**The majority of donor insemination treatments at NUH are performed either in the natural cycle or using mild stimulation with clomid.

 

National average live birth rates for IUI are difficult to obtain as these are not routinely collected like IVF. However we can compare our confirmed pregnancy data with that described by the HFEA. You can view these here. The table below shows the figures for 2016-2018. NUH figures are significantly higher than national averages (for the under 35s) according to the latest HFEA figures.

 
Age Group NUH IUI (stimulated) National (HFEA) IUI
All Ages 13.8% 11.4%
<35 19.3% 14.7%

Live birth rates are usually 10-20% lower than the pregnancy rate.