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Patient Journey

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by

Merrion Fertility Clinic

on 19 February 2016

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Transcript of Patient Journey

Patient Journey
Referral
Investigations
Doctor
Consultation
Possible
Further
Investigation
Diagnosis &
Treatment Recommendations
Referral
We recommend that couples be referred for specialist review after regular unprotected intercourse for over 12 months without conceiving. Earlier referral should be considered if the female partner is over 35 or if there is a known fertility factor in the your history eg testicular issues, amenorrhoea, history of endometriosis, pelvic disease, recurrent miscarriage or ectopic pregnancy or a family history of early menopause. We accept referrals from a Doctor or you also have the option to self-refer, please contact our admin team to discuss how to organise this.
Referrals can be sent by:
Post to:
Merrion Fertility Clinic
60 Lower Mount St
Dublin 2
Fax to 01 6635070
Email to info@merrionfertilityclinic.ie
The journey through fertility investigation and treatment is difficult, to put it mildly. No two couples are the same and we realise this at Merrion fertility Clinic. We therefore try to develop a unique plan for every couple.
This starts with investigations. Certain tests and treatments are necessary for all couples but, depending on their unique situation, others may need more specialised tests.
Similarly with treatments, one approach may be suitable for one couple but not another. The list of possibilities is endless and we endeavour to guide you through this with the benefit of our training and experience.

Investigations
Initial baseline assessment includes a number of fertility hormone blood tests, ultrasound for the female and semen analysis for the male.
These are essential initial tests required for all couples hoping to conceive. Other essentials for pregnancy planning include an up to date normal Cervical Smear and confirmation of Rubella Immunity. Further additional tests & investigations are tailored to the individual.
Many of these tests can be arranged for you in advance of your first doctor visit, so that results are available for discussion with you at your visit. Further tests and investigations will be arranged as required.

Most frequent tests:
Semen Analysis
: This tests sperm count, sperm motility (number that are swimming) and sperm morphology (shape). We also check for antisperm antibodies and prepare your sperm to see which type of fertility treatment would be best if you are found to need treatment.
Ultrasound scan
: This gives us a lot of information about the woman’s pelvis including checking for cysts, fibroids, polycystic ovaries, endometriosis, polyps or swollen tubes (hydrosalpinx). We also do an antral follicle count which helps predict your ovarian reserve – an indicator of how many eggs are left in your ovaries.
AMH blood test
: This hormone test, in association with your scan, helps us to assess your ovarian reserve. It also helps in diagnosing polycystic ovaries.
Progesterone blood test
: This hormone test confirms that you are ovulating.
Doctor Consultation

Consultation with one of our fertility specialists
At this consultation, your individual situation will be discussed and also the results of your tests. We strongly recommend that both partners attend for this visit. Further tests may be required depending on your situation and these will be discussed at the consultation. If everything is normal, you may not need any treatment but all options will be discussed.

Possible further investigation
Hysterosalpingogram (HSG)
: This is an x-ray to evaluate the woman’s Fallopian tubes. This can be arranged with our radiology team in the National Maternity Hospital or St Vincent’s Hospital.
MRI scans
  and other advanced radiology: These can be arranged with our radiology team in the National Maternity Hospital or St Vincent’s Hospital.
Hysteroscopy
 ( to look inside the womb): This can be done by our doctors as an outpatient procedure or with anaesthetic, if required.
Laparoscopy
 ( to look inside the pelvic cavity): this requires general anaesthetic and can be done by our doctors at the National Maternity Hospital or St Vincent’s Hospital. Surgical treatment, if required, can be done at the same time.
Additional blood tests
possible further female or male hormone or genetic blood tests.
Diagnosis and Treatment Recommendations
Following consultation and discussion with your doctor, pertinent investigations and treatment are individualised to match each person’s needs. A personalised fertility treatment pathway is set in train for each couple/person and they can move from the simplest to the most technically advanced treatment as required and as appropriate for their individual case.
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