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A GUIDE TO YOUR TREATMENT COSTS We hope this guide will help you assess the cost of your investigations and treatment fees. It provides information about what is included in the cost, when and how to pay, and how we make a refund if your treatment does not take place for any reason. Please note that this is a guide and prices can vary slightly. Full Terms and conditions are at the back of this guide. Please keep this information with you at all times during your appointments so that you can keep a record of your individual treatment costs. At any time, if you have any questions about the fees, payments or refunds, please contact us as soon as possible on 01245 201 544 This guide is valid from 25th April 2017 CONSULTATION AND INVESTIGATION PRICES TYPE OF INVESTIGATION COST Initial consultation Follow up consultation Pre-treatment trans-vaginal scan including antral follicle count and uterine assessment £200 £100 £160 Semen analysis AMH (Anti- Mullerian Hormone) HYCOSY (To check the fallopian tubes) Fertility Assessment package (AMH, Ultrasound scan with antral follicle count and full consultation) Comprehensive fertility Assessment package (as Fertility assessment package plus a semen analysis) assessment) Fertility Assessment package for same sex female couple- 2 x AMH, 2x AFC scan and full consultation £130 £85 £280 £300 £400 £400 SELECT BLOOD TEST PRICES (Prices for blood tests are a general guide – other tests requested will be charged individually) TYPE OF BLOOD TEST COST AMH FSH/LH/Oestradiol/Progesterone/ Prolactin/Testosterone Male partner screening Hep B, Hep C HIV blood test+ chlamydia urine test Female partner screening HebB, Heb C, HIV, Full blood count+ Chlamydia Couple screening package (Pre-treatment virology Screening for both partners) £ 85 £ 50 £ 150 each £ 200 £ 325 Screening for a known sperm or egg donor Cystic fibrosis Karyotype (Chromosomes) Chlamydia urine screening Natural Killer cells CMV status Miscarriage screen High vaginal swab Y Chromosome Microdeletion £1000 £ 200 £ 285 £ 50 £ 500 £ 50 £ 600 £ 50 £ 280 SF01-INF-FIN-0001 Version 4 SELECT Page 1 of 9 ASSISTED CONCEPTION TREATMENT PRICES (Please note drug costs are not included) TYPE OF TREATMENT PACKAGE COST SELECT IVF (excluding medication) £ 2900 £ 4050 FER (Frozen Embryo Replacement Cycle) £ 1500 IUI (Intra Uterine Insemination) £ 850 Donor Insemination package (Including IUI, Donor sperm and HFEA £ 1737.50 fee) Ovulation Induction £ 450 Egg freezing cycle (including freezing and first year storage fees) £ 3,600 Egg donation cycle using an anonymous donor (including donor £ 7025 medication) Egg donation using a known donor or partner-partner donation £ 4625 ICSI for an egg donor recipient or an egg share donor £ 1,150 IVF for an egg share donor No charge 3 cycles of natural IVF including freezing and ICSI- excluding meds £8250 Egg donor management and allocation £450 HFEA fee for all IVF/ICSI, egg donation cycles £80 Egg thaw cycle including ICSI and blastocyst £3050 ICSI (excluding medication) ADDITIONAL TREATMENTS not included in the above treatment prices ADDITIONAL TREATMENTS THAT MAY BE REQUIRED BUT ARE NOT INCLUDED IN TREATMENT COSTS TYPE OF TREATMENT General Counselling – (first session free) Counselling for known egg/sperm donor or surrogate Time-lapse incubation Blastocyst culture Embryo glue Laser assisted hatching Endometrial scratch (pipelle) Embryo transfer under sedation Embryo freezing (including first year of storage) Sperm freezing prior to IVF (including first year of storage) Donor sperm – 1 vial for one treatment cycle Annual storage fee for embryos, eggs or sperm Movement of frozen samples administration fee Courier fee for moving samples PGS –up to 5 embryos tested PGS additional embryos Freezing cost following PGS (no cost for first 3 months) Surgical sperm aspiration Fee for needles, sharps bin and disposal of clinical waste – for private prescriptions only- not delivery service SF01-INF-FIN-0001 Version 4 COST £ 100 £ 100 £ 400 £ 400 £ 100 £ 550 £ 175 £ 400 £ 900 £ 500 £ 850 £ 350 £ 150 £ 150 £2200 £200 each £350 £1450 £100 SELECT Page 2 of 9 TYPE OF TREATMENT Total price for IVF, Blastocyst culture, embryo glue and HFEA fee EXCLUDING MEDICATION Total price for ICSI, Blastocyst culture, embryo glue and HFEA fee EXCLUDING MEDICATION Total price for egg donation with IVF including egg donor medication but not recipient medication, Blastocycst culture, embryo glue and HFEA fee Total price for egg donation with ICSI including egg donor medication but not recipient medication, Blastocycst culture, embryo glue and HFEA fee Total price for partner to partner IVF cycle, blastocyst culture, embryo glue, and HFEA fee, EXCLUDING MEDICATION Total price for partner to partner ICSI cycle, blastocyst culture, embryo glue, and HFEA fee, EXCLUDING MEDICATION COST £3480 SELECT £4630 £7605 £8755 £5205 £6355 AVERAGE DRUG COSTS (dependant on dose) Treatment COST Stimulated IUI £500 approx. Frozen embryo cycle, egg recipient cycle or surrogate cycle £200 IVF/ICSI (150iu dose of Gonal F) £890 IVF/ICSI (225iu dose of Gonal F) £1300 approx. IVF/ICSI (300iu dose of Gonal F) £1900 approx IVF/ICSI (450iu dose of Gonal F) £2400 approx. approx. approx. Drugs can be issued through our homecare service. They will contact you directly for payment and to arrange delivery to an address of your choice. Alternatively you can request a private prescription which you can take to a chemist of your choice. The type and dose of drugs required during a cycle of treatment can vary depending on several factors so it is not possible to give an accurate estimate of cost. During treatment, drug doses can be varied according to individual response which may give rise to the need for additional purchase or wastage. Additional medication may be prescribed on an individual basis such as steroids, clexane, aspirin and high dose folic acid will incur further cost.Eg. Daily Clexane injections cost £61 for 10 days. For egg collection, you will require flight stockings which can be purchased from most pharmacies. OVERSEAS MANAGEMENT Patients being co-managed with an overseas clinic are charged per investigation. This includes patients undergoing treatment overseas and who attend the clinic for the treatment ultrasound scans and blood tests. SF01-INF-FIN-0001 Version 4 Page 3 of 9 WHAT IS INCLUDED IN TREATMENT PRICES IVF AND ICSI CYCLES Nurse pre-treatment Co-ordination appointment All blood tests and ultrasound scans during the treatment cycle Egg collection procedure Intravenous sedation administered by a Consultant Anaesthetist during egg Collection Embryo Transfer Medical and nursing care and advice before, during, and after treatment up to the pregnancy test and early pregnancy scan when treatment is successful Pregnancy urine test (home kit provided) Pregnancy ultrasound scan (to establish a viable pregnancy) and a Consultant review appointment within three months of the pregnancy test ICSI cycles include the Intra-cytoplasmic Sperm injection procedure FER CYCLES Nurse pre-treatment Co-ordination appointment All ultrasound scans during the treatment cycle Embryo Transfer Medical and nursing care and advice before, during, and after treatment up to the pregnancy test. Pregnancy urine test (home kit provided) Pregnancy ultrasound scan (to establish a viable pregnancy) and a Consultant review appointment within three months of the pregnancy test Embryo Glue IUI/ OI CYCLES Nurse pre-treatment Co-ordination appointment All ultrasound scans during the treatment cycle Insemination procedure Medical and nursing care and advice before, during, and after treatment up to the pregnancy test. Pregnancy ultrasound scan (to establish a viable pregnancy) and a Consultant review appointment within three months of the pregnancy test EGG FREEZING CYCLES Nurse pre-treatment Co-ordination appointment All blood tests and ultrasound scans during the treatment cycle Egg collection procedure Intravenous sedation administered by a Consultant Anaesthetist during egg Collection Medical and nursing care and advice before, during, and after treatment. Egg freezing and first year storage SF01-INF-FIN-0001 Version 4 Page 4 of 9 EGG DONATION CYCLE WITH ANONYMOUS DONOR Nurse pre-treatment Co-ordination appointment All blood tests and ultrasound scans during the treatment cycle Medication for the egg donor Egg collection procedure for the donor Medical and nursing care and advice before, during, and after treatment up to the pregnancy test. Pregnancy urine test (home kit provided) Pregnancy ultrasound scan and a Consultant review appointment within three months of the pregnancy test EGG DONATION CYCLE WITH KNOWN DONOR OR PARTNER-PARTNER DONATION Nurse pre-treatment Co-ordination appointment All blood tests and ultrasound scans during the treatment cycle Egg collection procedure Intravenous sedation administered by a Consultant Anaesthetist during egg Collection Embryo Transfer Medical and nursing care and advice before, during, and after treatment up to the pregnancy test. Pregnancy urine test (home kit provided) Pregnancy ultrasound scan and a Consultant review appointment within three months of the pregnancy test HOW TO PAY We prefer that you pay using debit or credit cards but we can accept cash if you do not have a card. We do charge 1.5% for credit card payments. You can also make a Bank transfer to: Simply Fertility Limited Natwest Bank A/c no: 21882916 , Sort code: 60 24 77 Card payments can be made over the telephone prior to treatment. Please see the Terms & Conditions of Treatment and Payments on page 9 SF01-INF-FIN-0001 Version 4 Page 5 of 9 WHEN AND WHERE TO PAY CONSULTATION AND INVESTIGATION TESTS You will be asked to pay for each consultation appointment on the day of attendance. All blood tests will be taken in the clinic and you will be asked to pay for this immediately before you have the blood test. If you have booked an assessment package, the package must be paid in full at the first visit (usually the AMH blood test appointment) TREATMENTS Before you start any treatment you will need to have a nurse pre-treatment appointment. You will be given an invoice at this appointment. This invoice should be paid prior to commencing the contraceptive pill. If it is not paid by the endometrial scratch appointment, then treatment will be abandoned. ADDITIONAL TREATMENTS If you are planning to have an additional procedure such as use of Time lapse, you should pay for these at the same time as your treatment payment. If the decision to have these procedures is not made until after your egg collection, then we ask you to pay as soon as you can prior to the embryo transfer procedure. If you have embryo freezing, you will be asked to pay for this on the day of the Embryo transfer. Payment for donated sperm must be paid at the time of ordering the sperm. ANNUAL STORAGE FOR EMBRYOS, EGGS OR SPERM Once you have consented to store your frozen embryos, eggs or sperm, every twelve months you will be asked to pay for continued storage. You will receive a letter asking for you to let us know if you want your samples to stay frozen and to agree to pay for a further year of storage. If you decide to dispose of your frozen storage you must complete and sign the form we send you so that it is received before the invoice is due. If we do not hear from you, or receive your payment we will send you a reminder invoice and if there is still no payment made we will try to contact you again before passing your details to our Debt Collection Company. It is very important therefore that you let us know if your contact details change. SF01-INF-FIN-0001 Version 4 Page 6 of 9 REFUND INFORMATION Occasionally, patients choose to delay the start of their treatment or decide not to go ahead with treatment at all. If this happens, then we will make a full refund of any treatment costs that you paid so long as you have the original payment receipt. If you would like to apply for a refund, please speak to one of the reception and administration staff or telephone the clinic on 01245 201 544 and speak to a member of staff. Unfortunately it is sometimes necessary to discontinue treatment for medical reasons, which can be due to poor or excessive response to the treatment drugs, or a co-incidental development of some other condition during the treatment. Depending on the stage of treatment at cancellation, a partial refund may be due. Refunds will be made by bank transfer or by cheque. Full details of the cancellation fees per treatment type are in the table below. IVF, ICSI, Egg Freezing or Egg Donation cycle If your cycle is discontinued for medical reasons before any drugs are taken, we will refund you the cost of the IVF Treatment Package. We cannot make any refunds for the cost of pre-treatment investigations or the cost of drugs for the treatment cycle. If an IVF, ICSI, Egg Freezing or Egg Donation cycle is discontinued for medical reasons after the drugs have started and before any eggs are collected, there will be a refund of the IVF Treatment Package cost less the cancellation fee. If no eggs are collected or eggs do not fertilise, then no refund can be made. If you are having an IVF, ICSI cycle and your embryo transfer is cancelled because you are at risk of hyperstimulation syndrome (OHSS), your embryos will be frozen and you will be offered a frozen cycle (FER) once you have recovered from the OHSS. You will not be asked to pay for freezing your eggs or embryos but will be expected to pay for a subsequent Frozen Embryo Replacement Cycle (FERC). IUI In the event that insemination does not take place but you have already started the stimulation drugs, a refund will be given less the cancellation fee. We do not refund any costs relating to the pre-treatment procedures or drugs. If you start an IUI cycle but the cycle is converted to IVF because of over response, you will be asked to pay the additional cost i.e. the difference between the cost of IUI and IVF. SF01-INF-FIN-0001 Version 4 Page 7 of 9 DONOR SPERM CYCLE If your treatment using donor sperm is cancelled for any reason, then a refund will be offered according to the criteria as set out above, depending on the type of cycle. Payment for the donor sperm cannot be refunded. FER If an FER cycle is cancelled for medical reasons before your embryos are thawed, we will refund the full cost of the Treatment Package cost less a cancellation fee. If when the embryos are thawed they fail to thaw successfully, there will be no refund. We are not able to refund the cost of drugs. FREEZING Once you have paid for freezing of embryos or eggs, if these procedures to not go ahead for any reason, then you will be eligible for a refund of the cost of the procedure. CANCELLATION FEES Cancelled IVF or ICSI before medication is started £ 250 Cancelled IVF or ICSI after one treatment scan £ 500 Cancelled IVF or ICSI cycle after more than one scan but before egg collection Cancelled IUI cycle prior to insemination £ 800 Cancelled FER after co-ordination £ 150 Cancelled FER after one treatment scan £ 500 SF01-INF-FIN-0001 Version 4 £ 350 Page 8 of 9 TERMS & CONDITIONS OF TREATMENT AND PAYMENTS 1. Private medical insurance companies do not generally cover assisted conception treatments but you may be covered for some consultation appointments, investigations and surgical procedures. Patients will be required to make payments directly at the time of the appointment or treatment and if appropriate, claim the cost retrospectively from the medical insurance company. 2. Patients having fertility treatments with be given an invoice at the Pretreatment appointment. Payment is due on day one of the cycle. 3. If you delay starting your treatment you may incur additional costs as some investigation tests may need to be repeated. 4. In the event that additional treatments are provided, we expect patients to pay for these prior to the treatment. This applies in particular for patients who have embryos frozen where a decision to freeze embryos may not be possible until it is known that there are embryos available to freeze. 5. If additional treatments have taken place and no payment is received, we will invoice patients for the outstanding amount and will expect payment to be made within 21 days of the date of the invoice. 6. In the event of payment not being received, following a reminder, and a courtesy call we will instruct a debt collection company to commence proceedings to recover the debt. Should this be necessary, debt collection, legal and administration fees and statutory interest will be added to the debt. In this case, your credit rating will also be affected. Simply Fertility Registered in England under no 08377409 at Institute of Reproductive Sciences, Alec Issigonis Way, Oxford Business Park North, Oxford, OX4 2HW SF01-INF-FIN-0001 Version 4 Page 9 of 9