Welcome to The Fertility Centre
The Fertility Centre (formerly the Assisted Conception Unit) was established at Chelsea and Westminster Hospital in 1995 and is widely recognised as a centre of excellence for fertility care in London.
In 2020 we established a new satellite service at West Middlesex University Hospital, building upon the longstanding success and reputation of our services at Chelsea and Westminster Hospital. The new service extends patient choice and convenient access to fertility care across West London, and in early 2021 we formally established The Fertility Centre as our new name and identity.
Fertility problems can affect one in seven couples and assisted conception is a broad term for the treatments and interventions that can help result in pregnancy. These days there are a number of options available when considering assisted conception and our staff are experts in this highly specialised field. We oversee more than 600 fresh and 200 frozen cycles per year (hfea.org).
About Our Fertility Treatments and Services
We believe in treating all patients who have a reasonable chance of fertility success.
Forms and resources
Please make sure you read, print and sign your forms, then bring them to your appointments. Our specialists will be able to answer any questions when you meet with them.
We have prepared this library of resources to help you during your journey.
Please note: additional forms may need to be completed at the appointment for donor gametes, HIV positive patients and other specialist areas.
In order to be eligible for fertility treatment at The Fertility Centre, you must fulfil the following criteria:
- The female partner must be less than 46-years-old by the time that treatment is carried out
- The female partner should have a Body Mass Index (BMI) of less than 35kg/m2
- A ‘Welfare of the Child’ assessment must be carried out
When it comes to being referred for and paying for fertility treatment, there are two options:
- You may be eligible for referral and funding from the NHS
- You can choose to self-fund your treatment and self-refer
You may be eligible for NHS treatment at The Fertility Centre. Your local Clinical Commissioning Group (CCG) will have certain criteria that you and your partner will have to meet to receive NHS-funded treatment.
Please contact your local CCG directly as these criteria do vary. You will find your local CCG at www.nhs. uk, and more information can be found on http://www.fertilityfairness.co.uk or by email at firstname.lastname@example.org.
If you meet your local CCG eligibility requirements, your GP can refer you to the sub-fertility clinic at Chelsea and Westminster Hospital or at West Middlesex University Hospital through the NHS e-Referral Service (ERS).
After your GP has referred you to the clinic, you will complete a number of fertility investigations to review your eligibility for treatment as an NHS patient with The Fertility Centre.
If you are not eligible for NHS-funded treatment or prefer your treatment to begin before any NHS waiting list time allows, you can choose the self- funded treatment option.
In this case, you may choose to self-refer as a self-funded patient for an initial consultation with one of our experienced consultants–but please note that you will still need to meet the general eligibility requirements in all cases.
Non-UK based couples seeking fertility treatment at The Fertility Centre can arrange for treatment on a self-funded basis. Please arrange a private consultation with the consultant a week before the onset of the woman’s period. This will enable us to look towards starting a treatment cycle once the initial investigations and testing has been carried out.
Before Beginning Treatments
Fertility treatment has no guarantee of success, and the decision to embark on treatment is a personal one. You should carefully consider the risks and the chances of success that our expert staff will discuss with you at consultation.
Before you can begin any form of treatment at The Fertility Centre, you will require an initial consultation. At this visit, one of our fertility specialists will review your medical history, ensure that all the necessary investigations have been completed and advise you about the best treatment option for you. Some couples are referred by their GP and baseline investigations are arranged before their first visit to the Centre. If these have been undertaken elsewhere previously, please ensure that you bring any results with you.
Baseline investigations that must have been carried out before the treatment starts include:
Evidence and Success Rates
The success of a fertility clinic is determined not only by its pregnancy rate but also by the patient experience throughout treatment.
Pelvic Ultrasound Scan
This identifies any abnormalities in the uterus or ovaries. It should be carried out between the second and fifth day of a women’s monthly cycle as this is the best time to visualise the ovaries and check the lining of the womb.
Hormone Profile and Viral Screen
A blood test is carried out on the same day as the pelvic ultrasound scan to check blood count, hormone levels as well as a viral screen.
A semen analysis evaluates the health and viability of the man’s sperm; this measures the number of sperm, the shape of the sperm and the movement of the sperm.
Reproductive Ageing and Fertility Programme
Established in 2006 by our Consultant in Reproductive Medicine, Mr Dimitrios Nikolaou, this is one of the first programmes in the world and the first in the UK - specifically aiming to improve management and clinical practice in the following areas:
- Early ovarian ageing
- Fertility for women over 40
- Fertility for women with extremely poor ovarian reserve
- Fertility preservation for social or medical reasons
The term ‘early ovarian ageing’ was introduced in the medical literature by Mr Nikolaou and co in 2002-2003 to describe a process of accelerated decline of the ovarian reserve starting in the early 30s. This theory contributed to a shift towards rethinking and redefining ‘family planning’ and move towards ‘fertility planning’. The key points of the ‘early ovarian ageing’ original hypothesis of 2003 were the following:
- The average woman will go into menopause at the age of 51, having started an accelerated decline of the ovarian follicles at the age of 38, some 13 years earlier.
- On the basis of a fixed interval of around 13 years between onset of the accelerated decline of the ovarian reserve and the menopause, women who go into menopause before the age of 46 (early menopause) will have started an accelerated decline of their ovarian reserve before the age of 32.
- It was proposed that this process, which represents a shift to the left of the normal ageing process, should be called ‘early ovarian ageing’. Moreover, on the basis of epidemiological data that 10% of women go into ‘early menopause’ before the age of 46, it was estimated that 10% or women in the general population might be at risk of ‘early ovarian ageing’. While they are still young, these women are still fertile and completely asymptomatic.
Young, healthy women can have simple tests to have a basic assessment of their ovarian reserve and discuss their options in order to plan their fertility.
In some cases, if appropriate, there are various options for preserving fertility, such as egg-freezing or embryo-freezing.
The Fertility Centre has a long-established expertise in treating women in their late 30s and 40s and our clinical teams and fellows are involved in local and national projects.
Infertility is a complex condition that is biological, but often also psychological, mental and social. It is also a growing global issue.
Patients can often find themselves having to navigate, often with little advice, a complex ecosystem of healthcare services and clinics, professional organizations, support groups, online information and more. For women over
40, especially, there is little guidance from NICE and very limited NHS funding.
Using our experience and expertise, we strive to have a positive attitude towards engaging with women in this age group and welcome enquiries and referrals for initial discussions with our expert team.
We have an active programme for social fertility preservation which is based on individual assessment and counselling. In addition, the Unit has long established expertise in fertility preservation for medical reasons and have strong links with oncology centres such as The Royal Marsden.
How to Improve Your Chances of Success
Couples who come to our unit often ask…
The simple answer is…
Chemicals in cigarette smoke are harmful to both eggs and sperm. Smokers take up to 30% longer than non-smokers to conceive naturally and studies show that smoking reduces the chances of IVF working by 50–70% per attempt. It reduces the response to stimulation and the rate of fertilisation.
Minimise your alcohol consumption
Although the effects of alcohol on conception are less clearcut than with smoking, heavy drinking does affect sperm production and motility. In the case of the woman, heavy alcohol intake during early implantation and pregnancy will expose the foetus to toxins which could lead to foetal abnormalities—this is called foetal alcohol syndrome. During assisted conception we encourage both the man and woman to avoid alcohol as some studies suggest that even small amounts can reduce pregnancy rates.
Don’t take illicit drugs
There is very good evidence that both male and female fertility can be seriously impaired by illicit drugs. In addition, smoking can cause serious permanent damage to a foetus during pregnancy.
Take folic acid
Folic acid, which can be obtained over the counter from any chemist, reduces the risk of your baby having a neural tube defect such as anencephaly or spina bifida. You should take 400mcg of folic acid for 3 months before conception and for the first 3 months of your pregnancy.
Watch your weight
Being underweight or overweight may reduce your response to treatment to the point that you do not respond to stimulation at all. Your fertility specialist will measure your weight in kilograms divided by your height in metres squared—this is a ratio called the Body Mass Index (BMI). If your BMI is less than 19kgs/m2 or more than 30 kgs/m2, you will be advised to delay your treatment until your BMI is within this range.
Take gentle exercise
Although the woman should avoid strenuous exercise during the IVF programme, gentle exercise for 20–30 minutes 3–4 times per week is encouraged in both partners to improve health and help cope with the stress of investigations and treatment.
Ensure you are immunised against Rubella
Most women now trying to get pregnant were immunised against rubella when they were at school (this is now part of the MMR jab given to the children). If you are not immune and catch rubella when pregnant, the baby can develop problems with hearing and mental development.
Stress can affect your relationship with your partner and cause a loss of sex drive; in some cases, stress may affect ovulation and sperm production.
Concerns, Complaints and Compliments
If you have a concern about the treatment or care that you receive, it is best to address it straight away. Please ask to speak with the nurse in charge or clinic manager. Both are also contactable via the following details, Telephone: 020 3315 8585 or email@example.com. If your issues are not resolved locally, please contact our Patient Advice and Liaison Service. There details can be found on our Trust Website:- https://www.chelwest.nhs.uk/your-visit/advice-and-support/comments-and-complaints
If you feel you received great care or services, please let us know. It is important that we acknowledge staff with positive feedback and this also helps support their professional validation. Please feel free to contact The Fertility Centre directly via the following details, Telephone: 020 3315 8585 or firstname.lastname@example.org. The PALS team would also be happy to receive your feedback and will pass it on to the relevant staff or service. There details can be found on our Trust Website:- https://www.chelwest.nhs.uk/your-visit/advice-and-support/comments-and-complaints
The School Of Reproductive Medicine
We are one of the longest-established sub-specialty training centres in Europe. We train the leaders in the field.
In order to qualify as a fertility specialist, a gynaecologist needs to undergo structured “sub-speciality” training in Reproductive Medicine. There are now a few accredited sub-specialty training centres in the UK. The entry to these programmes is very competitive and upon graduation, the title “sub-specialist in Reproductive Medicine” is added to the doctor’s credentials in their GMC registration.
Our sub-specialist training program has been running without interruptions since 2002 and has produced several leaders in the field – now working as Consultant sub-specialists in some of the best Units in the country.
In addition to the sub-specialist training program, The Fertility Centre is a leading centre for learning, training and research in the field of Reproductive Medicine:
- Dr Nikolaou is the regional preceptor for the special skills modules for infertility and assisted conception for West London.
- We are an established training centre for reproductive ultrasound scanning and embryo transfer for the British Fertility Society.
- We are a nursing training centre for ultrasound and infertility.
- We have two active clinical research fellowships