ChargesInformationTransparentchargeswithnohiddencostsBristolCentreforReproductiveMedicine(BCRM)

SouthmeadHospital,Bristol,BS105NB

t:01174146888|f:01174146899|w:www.info@bcrm.org.uk

Packages;ConsultationsandUltrasoundScans

ConsultationPackages,ConsultationsandUltrasoundScansatBCRM £

001 1stconsultationandultrasoundscanwithMrAkandeorMsJefferys 250080 1stconsultationandultrasoundscanwithFertilityconsultant 150002 Followupconsultation 150081 Short–followupconsultation 90003 ConsultationwithanEmbryologist 100004 Nurseconsultation 120008 Treatmentsupportsession/Implicationscounselling(ifnotincludedintreatment) 50009 DiagnosticFertilityUltrasoundscan(includingAFC/Ovarianreserveassessment) 150083 Pregnancyultrasoundscan 150084 UltrasoundFertilitymonitoringscan(ifnotincludedintreatment) 150352 FailuretonotifyBCRMofnon-attendance 75

ConsultationsandScansattheSPIREBristolHospital

085 1stconsultation&ultrasoundscanwithMrAkande 350087 Initialconsultation 250088 Followupconsultation 200089 Shortfollowupconsultation 150090 Ultrasoundscan 150

Fertilitytestsandprocedures

099 FertilityMOTpackage:ComprehensiveconsultationincludingFertilityultrasoundwithAFC;FertilitybloodtestsincludingAMH,FSH/LH/Estradiol/Prolactin/TSH/SHBG/ChlamydiaserologyandSemenanalysis

450045 Endometrialscratch 200048 Endometrialscratchundersedation 500049 Tubaltest:HyCoSy–HysteroConstrastSonographyandSalineSonogram(aquascan) 390058 Tubaltest:HSG–Hysterosalpingogram–(X-raytestoftubesandwombcavity) 390066 EndometrialbiopsyforNKcells,histologyandplasmacells 450067 Salinesonogram 350

Andrology(malefertilitytests)

010 Detailedsemenanalysis(spermtest)includessemenmicroscopy&MARantibodytest 90011 Advancedsemenanalysis-IVF/ICSIassessment–includesrecovery/survival&retrogradetest 150247 Pre-treatmentspermcheck 90093 SpermDNAfragmentation 395033 Ychromosomemicrodeletions 200094 AneuploidyFISH 700095 Spermreactiveoxidativetest 100096 SemenCulture 50097 Pre-treatmentspermstorage 345

Fertilitytreatments £

205 IVF-invitrofertilisation[Includespatientinformationmeeting;individualnurseplanningconsultation;monitoringultrasoundscans;eggcollectionwithanaestheticsedationinthecareofaconsultantanaesthetist;laboratorycosts;spermpreparation;assistedhatching;blastocyst/embryoculture;EmbryoGlueifappropriate;Embryo/Blastocysttransfer;pregnancyscanorfollowupconsultation;treatmentSupportsessionsincludingCounselling]

3299

ApproximatemedicationchargesperIVF/ICSI 500-1800

206 ICSI+IVF-Intra-CytoplasmicSpermInjectionprocedure[Includespatientinformationmeeting;individualnurseplanningconsultation;monitoringultrasoundscans;eggcollectionwithanaestheticsedationinthecareofaconsultantanaesthetist;laboratorycosts;spermpreparation;assistedhatching;blastocyst/embryoculture;EmbryoGlueifappropriate;Embryo/Blastocysttransfer;pregnancyscanorfollowupconsultation;treatmentSupportsessionsincludingCounselling]

4199

ApproximatemedicationchargesperIVF/ICSI 500-1800

338 Embryoscope+closedculturesystemandtimelapseassessment 450

340 Vitrifcation&freezestorageofembryos/blastocystsfor1year 495

370 PlanneddeferredfrozenembryotransferfollowingIVF/ICSItreatmentcycle(Includesfollowup,planningandmonitoringscans;excludesIVF,drugcostsandfreezing)

495

216 FET-Frozenembryotransfer(excludesmedication) 1295 ApproximatemedicationchargesforFET 200-400

207 IVF-multiplecyclespackage-upto3cyclesofIVF(Includesfreshorfrozentransfers,criteriaapplyandexcludesdrugsandcostofICSI)

6599

356 HFEAlicencefeepercycleofIVF/ICSIandFET 80

209 IVF-eggsharingcycle-donationtounknownrecipients(includesdrugsandHFEAfee) 500

210 ICSIprocedurepercycle(ifrequiredwithotherprocedures) 900

200 IUI-intrauterineinsemination-naturalcycle(nomedicationused) 600201 IUI-intrauterineinsemination-programmedcycle(excludesmedication/drugs) 750202 IUI-multiplecyclespackage-upto3programmedcycles(criteriaapply-excludesdrugs) 1500 ApproximatemedicationchargesperIUIcycle 200-600

UseofDonorSperm

231 UseofDonorspermpercycleoftreatment(anonymousdonor) 900232 UseofDonorsperm(knowndonor,donorscreening&storageforupto1year) 2035325 Importofdonorspermfromcommercialsupplier(includesstorageforupto1year) 190355 HFEAlicencefeeperinseminationcycleusingDonorsperm(DI) 40

Eggdonationtreatment

212 DonorEggTreatmentIVF–eggrecipientcycle(includesdonoreggsformunknowndonor,excludesdrugsandICSIifrequired)

5899

221 Eggrecipientwaitinglistfee(refundableifwaitexceeds1year) 350214 DonorEggTreatmentIVF–eggrecipientcycle-KNOWNDONORsupplement 975

Intra-coupleeggdonationtreatment £

227 IVF-intra-coupleeggdonor/recipientcycle(excludingdonor&recipientdrugs&donorsperm) 5565226 IVF–Eggsharingcyclewithintra-coupleeggdonationanddonationtounknownrecipient

(includingalldrugs&HFEAfee)1750

Othertreatments,proceduresandsupplements

222 OvulationInductionwithFSH/letrozole/clomifene(percycle–excludingmedication) 450 217 FertilityPreservation:Oocytes(eggfreezing)includesEggcollection,vitrificationandfreeze

storageforupto1year2800

326 FertilityPreservation:Sperm(spermfreezing)Includesshortconsultation;recoverytest,freezeandstorageforupto1year

495

340 Vitrificationandstorageofembryos/blastocystsfor1year 495324 Storageofembryos/blastocystsafterfreezingforoneyear. 295246 Vitrificationofembryos/blastocysts&1yearstorage(patientrequestoutsideoffreezecriteria) 595 219 SurgicalSpermRecovery:withsedation(includingupto1yearstorage) 1600240 SurgicalSpermRecovery:generalanaestheticsedation(includingupto1yearstorage) 2200 241 EmbryoTransfer:trialdummyRun 195225 SedationforEmbryoTransfer 300

AdditionalLaboratoryServices

338 EmbryoScope+(advancedclosedculturesystemandtimelapseassessment) 450336 EmbryoGlue 150324 Storageofembryos/blastocystsfor1year 295328 Storageofspermfor1year 295330 Administrationchargefortheimportofgametesorembryos/blastocystsfromanotherHFEA(UK)

licencedcentretoBCRMNone

325 AdministrationchargefortheimportofspermfromacommercialproviderIncludesupto1yearstorageortheimportofoocyte/embryoorblastocysts/partnerspermordonorspermfromanothercentreoutsideoftheUK

190

332 Admin/laboratorypreparationchargefortheexportofoocyte/embryoorblastocysts/partnerspermfromBCRMtoanotherfertilitycentre

250

340 Compleximport/exportofgametesorembryos POA333 Preparationandhireoffreezestorageshipper

RefundabledepositfortransportshipperFree300

TreatmentandtestsfornonBCRMpatients

242 Toarrangebloodtests&/orprescriptions(pertreatmentepisode) 250243 Toarrangeprescriptionsonly(pertreatmentepisode)includes15minconsultation 150244 Fertilitymonitoringscan 150245 Treatmentabroadpackage(Includesupto3monitoringscans;1pregnancyscan;arrangingblood

testsandprescription(pertreatmentepisode)and15minuteconsultation)650

069 Injection(perinjection-fornonBCRMregisteredclients) 75070 Administrationfeeforbloodtests(fornonBCRMregisteredclients) 50

Bloodandothertests £

060 Set1:HB;TSH;Prolactin:FSH;LH;Rubella;Testosterone;SHBG;Oestradial 150061 Set2:ThrombophiliaScreen 400062 Set3:HepatitisB&C;HIV;Syphilis 80063 Set4:FSH;LH;Oestradiol;Prolactin 100064 Set5:Testosterone;SHBG 90065 Set6:ThyroidProfile:T4/T3/TSH 60014 Rubella(IgG) 30015 Chlamydiaserology 40016 HepatitisBsurfaceantigen&Hepbcoreantibodyprofile 50017 HepatitisC 30101 HepatitisBPCR 100102 HepatitisCPCR 100018 Syphilis 30019 CMV 50020 HIV 30021 FSH/LH 40022 Prolactin 20023 TSH 60024 Testosterone 60025 Progesterone 50026 Oestradiol 40027 SexHormoneBindingGlobulin(SHBG) 40028 Anti-MullerianHormone(AMH) 75029 Haemoglobin 30030 Bloodgroup 30031 CysticFibrosisscreen 150032 ChromosomeAnalysis 250034 Thyroidantibodies 30036 DHEAS *037 Androstenendione *038 Electrolytes&Urea 50043 Liverfunction(LFT’s) 50046 HTLV1&2 50051 Antiphospholipidantibodies(APLA) 80052 BetaHCG-serum 50053 Cortisol 30054 Ferritin 30055 Anti-cardiolipinantibodies 50056 CA-125 50057 ZIKAVirusserology 120044 Vaginalmicroscopy(HVS-CT/GC/TVPCRSWAB) 80068 Chlamydia(swab) 50

Administrationfees £

350 MedicalReport 150370 Advicecorrespondence 80351 Photocopyofpatientrecord 50353 Photocopyofpatienttestresult(pertest) 10334 Privateprescription 75335 Miscellaneousadministration POA371 Miscellaneousclinical POA372 Miscellaneouslaboratory POA

Medication/Drugs £

374 Northisterone5mgtablets 10300 Cetrotidesubcutaneousinjection:0.25mgs-persyringe 30301 Cetrotidesubcutaneousinjection:0.25mgsx5syringes 135302 BuseralinNasalspray:1bottle 49303 Buseralinsubcutaneousinjection:1vial 32304 GonalFPen(£25per75iu)300iu 100305 GonalFPen450iu 150306 GonalFPen900iu 300310 Menopur:75iuperamp 25311 Menopur:150iux16amp 800309 Menopur:150iuperamp 50312 FETdrugpackage ~350313 Ovitrelle250mcgpen 20315 Cyclogest(progesterone)pessaries4mgeach@£1.40

Cyclogestpessariesx28percycleCyclogestpessariesx30percycle

4042

316 IMprogesterone50mgsperml 11317 Cabergoline0.25mgx8 50318 Progynova(estradiol)2mgtableteach@25pProgynova21perweek 5.25360 Oesrodialpatches100mcgeach 1.40361 Lubion(progesterone)25mgspervial 9362 Clexane20mgs 5363 Clexane40mgs 8375 Bemfolaper75ru 25376 Pregnyl5000ul 15377 Gonasi5000iu 20378 Ranitidine nocharge379 Testosteronegel tbc380 Zoladex3.6mg 120381 Gestone50mg/1ml 11382 Clomiphene50mg each@2383 Pregnisolone5mgstablets each@10p384 Ganirelix 30385 Fyremadel 40 NOTE DeliverychargeforMedicationtospecifiedaddress 50

Refunds

CancellednaturalcycleIUIduringmonitoring 230 CancelledprogrammedIUIduringmonitoring 150 IVFcancelledbefore1stmonitoringscan 2870 IVFcancelledbeforeeggcollection 1850 IVFcancelledaftereggcollection:noeggscollectedorfailedfertilisation Norefund ICSIcancelledbefore1stmonitoringscan 3770 ICSIcancelledbeforeeggcollection 2750 ICSIcancelledaftereggcollection 900 FET:failedthaw 535

Pleasenotechargesmaybesubjecttochangeatanytime.TheBCRMFinanceteamarepleasedtotakepaymentofthechargesoutlinedonthedayofattendanceatBCRM.IfintheexceptionalcircumstancethatpatientsareunabletomakepaymentatBCRM;aninvoicewillberaisedandsentbyemail.PaymentcanbemadebyBACSorbytelephonetotheFinanceteam.Foranyadditionalenquiries:pleasecontacttheBCRMFinanceteamon01174146888oremailfinance@BCRM.org.uk