Nurse Telephone Support Line - Frequently Asked Questions (FAQ)
Our Nurse support telephone line is very busy with patient calls and we know it can sometimes be difficult for people to speak to a nurse about a non urgent concern. We have compiled a list of the frequently asked questions we receive in the hope that your question, concern or query may be answered here.
What is the timeline from appointment to starting treatment?
There is never a clear answer as everybody has different care needs and circumstances, so a lot will depend on what treatment is considered best for you.
For a standard IVF NHS cycle:- From referral and funding approval, an appointment at our IVF clinic will usually take approx. 6 weeks. You will attend your IVF appointment at the Hewitt Fertility Centre and all of your previous investigations will allow our specialist team to discuss the best steps for you. If you are undertaking a routine IVF cycle, the specialist will create a care plan for you at your first appointment. Depending on where you are on your menstrual cycle - you will leave your IVF appointment that day with a drug appt (when we show you how to administer your own medication – usually injections) , or you will be asked to call our nurse team telephone line on the first day of your next period so that we can arrange the drug appointment for after your cycle . Your drug appointment may be 2-6 weeks after your IVF appointment as if we miss your next period, you will have to wait until your next cycle (bleed). We will do our best to book you a drug appointment predicting your next cycle.
In the time between IVF appointment and Drug appointment, your medication will be delivered so that you have everything ready to start. Please ensure you have paid for your medication in order for it to be delivered to you on time. Any delays may impact your start date.
From Day 1 of your next period
On the first day of your next period (sometimes referred to as Day1 of your cycle ) you will be asked to start your medication. This regime can continue for approx. 4- 6 weeks and throughout that time you will be asked to attend the Hewitt Centre for monitoring scans - this may be multiple visits. Once the specialist team are happy that your follicles indicate a supply of eggs, you will be booked in for your egg collection procedure. This is usually very short notice (sometimes within days) as once we know your eggs are ready – it is important that we collect them. The process from starting your medication to egg collection can be 4-6 weeks.
It is important to note that from your first appointment to egg collection the timeline could range from 8 weeks to 12 weeks depending on the factors outlined above.
What is my Cycle Day 1?
Cycle day 1 is when you have fresh red bleeding before 6pm. If the fresh red bleeding starts after 6pm, cycle day 1 is the following day. If your cycles are normally quite light or you never have fresh red bleeding, please contact the nurses when you notice your cycle starting.
What if my period starts on a weekend?
We are open 7 days a week, however, our phone-lines are only manned on a Saturday until 1230, anytime after this, please call and leave a message, we are still here until the early evening. The phonelines are not open on a Sunday, however, please left a voicemail and we will call you back in order of priority.
How will I get my medication?
The nurse will discuss this with you during your nurse consultation. Routinely we use an outside pharmacy for all our patient’s treatment medications. Our finance team will email you your invoice, once payment has been made, they will send your prescription directly to pharmacy, who will then arrange delivery to your home address. Unfortunately, we are not able to accept delivery of medications to the unit, due to limited storage.
Do I have to have my virology blood tests at the clinic?
It is not mandatory to have your virology blood tests at our clinic, however we would recommend you do. The HFEA (our regulatory body) require all virological screenings to be undertaken by a UKAS accredited laboratory, and the results need to be presented in a way that proves that. This can often be tricky for patients, and we find that usually patients end up having to have those tests with us anyway. This is something that can be discussed with you in more detail at your nurse consultation. Please note that if you do decide to have your virology bloods taken elsewhere, it is your responsibility to ensure the lab has the accreditation (as above) and that the results are with the clinic prior to your drug appointment.
How soon before my cycle will the nurses be in touch?
After your consultation with either our medical or senior nurse team, you will be seen by one of our nurses, who will take bloods (if required), issue any e-consents, answer any questions you may have, make a consent check appointment and make a drug appointment based off your period cycle and both your and our availability. If this is not possible when you call with day 1 of your cycle, we will triage the call and aim to return it within 1 week. Please note, that if you have not completed your consents on time or if there are any issues with your consents, this may delay the start of your treatment.
Can I still try to get pregnant naturally before starting IVF?
We recommend that if you are starting treatment, you must use barrier methods of contraception from day 1 of your period cycle and throughout your whole treatment. This may cause delays to starting treatment.
Medication FAQs
Can I source my medication elsewhere?
You can shop around for your medications if you wish, however, there are a few things to consider.Not all pharmacies will have your medication in stock, and you will need to allow time for them to order it.You must allow 5 working days for the nurses to arrange your paper prescription in the post. The pharmacy will require this before dispensing the medication.
Some pharmacies may not provide you with needles, syringes or sharps box to administer the medications; you will need to source these elsewhere. We predominantly work with CPL who dispense our patient’s medications at the correct temperature and with the right needles. They also keep us up to date with medication shortages.
How do I do the injections?
We have drug teach videos on our website, that show you step by step instructions on how to administer the medication. You will also have a drug appointment made after your clinic appointment, this is currently delivered face to face or via the telephone. We are moving towards virtual drug appointments using video calls but this will be later in 2025. Its is always useful to watch the website medication tutorials prior to your appointment and make a note of any questions.
What time should I take my medication?
The nurses will advise you when to take your medication. Some injections need to be taken in the morning and some in the evening, these times are for you to decide.Occasionally, medications need to be taken at a more specific time, such as a trigger injection. The nurses will give you the exact time to take the medication if required.
What do I do if I forget a dose?
You should take it as soon as you can as long as it is the same day and notify the nurses. If you remember the next day, please do not worry, just continue with your planned treatment and call the nurse’s line. Please do not take extra medication.
Do I need to take my medication with food?
You do not need to take your medication around food times, unless it is specified.
What side effects should I expect?
During your nurse consultation, side effects will be discussed depending on the medications planned for you. Headaches are most common with most fertility medications. Therefore, we recommend keeping well hydrated to prevent these. Other common side effects are bloating, heightened emotions and mild cramping.
Localised reactions to the injections are also common and normal. These can vary from slight redness, slight tenderness at the injection site and occasionally a stinging sensation too. If the injection site stays reddened, tender and is warm to touch for a prolonged period, please notify the nursing team to ensure that it’s not due to an infection.
Is bruising normal with the injections?
Yes, bruising is very common when doing frequent injections. Especially if you are taking anything that thins your blood, such as clexane, fragmin and aspirin. It is nothing to be worried about, we would recommend you avoid the area until the bruising has healed.
How should I store my medication?
The pharmacy will let you know if your medication needs to be stored in the fridge or not. For non-refrigerated items, we recommend you store them in a cool cupboard, away from direct sunlight and external heat sources, such as a radiator.
For refrigerated items, they should be stored in your fridge, not too close to the back or in the door. Once you have started using the medication, it can be left out of the fridge for up to 28 days if it is kept below 25 degrees. Please note that medication does not need to be stored in the fridge if you are using within a 3 month period.
Can I travel with my medication?
If you intend on flying, we recommend storing the medication in your carry-on luggage to avoid it going missing. Check with your airline if you need a letter covering your medications. If you do, the nurses can supply you with a letter. Please ask with a few days’ notice to allow time for it to be created and sent to you.
I am taking Cyclogest, how do I know when it is fully absorbed?
Cyclogest generally takes 20-30mins to be fully absorbed. White chalky discharge is very common, this is from the casing the medication sits in. If you are worried you are not absorbing the medication, you can speak to the nursing team.Please note that you must lie down for 20-30mins post insertion when using vaginally.
I am taking oestrogen tablets/patches, but I’ve been dispensed a different brand. Is this ok?
Oestrogen medication can go by many different brand names. To make things easier, we will prescribe you the generic name rather than the brand name. This allows the pharmacy to dispense what they have in stock allowing for a faster turnaround.It does not matter if you change brands throughout your cycle, you will still be receiving the correct dose of medication.
If you would prefer to only use one specific brand, this is absolutely fine. Please notify the nursing team when requesting a prescription so they are aware to prescribe the brand instead.
How do I dispose of my sharps bin?
You can drop these off to the clinic for us to dispose of safely or you can contact your GP or local pharmacy.
My GP has prescribed me antibiotics, are these safe to take?
It depends on what stage of treatment you are in. If you have not started treatment yet, this is perfectly safe for you to take. Same if you are in your stimulation phase, prior to egg collection or IUI. If you have had your embryo transfer or IUI procedure, you will need to ensure your GP is prescribing an antibiotic that is safe in pregnancy. Speak to your GP and they will be able to advise and prescribe and alternative if required. If you wish to clarify any medication please call the nurses line.
Does it matter if I am late taking my medication?
For in-cycle medication, take your dose as soon as you remember, as long as it is the same day. Then please contact the nursing team to check if any other doses or scans need to be adjusted to account for this.
What if I'm late taking my trigger injection?
If you’re triggering for an IUI, you can take your trigger as soon as you remember, as long as it’s the same day. If it’s not, contact the nurses for advice.If you are triggering for an egg collection, call the nurses emergency line and leave them a voicemail immediately. This may have a direct impact on the timing of your egg collection. Emergency numbers can be found in your treatment booklet.
I have medication left over from a previous cycle, what do I do with it?
Make a note of what medication you have left over and hold onto them for now. Continue to store these correctly and make a note of the expiry dates on the medications.This is useful information for the consultants when creating your next treatment plan and for the nurses when issuing a new prescription if you were to proceed with another cycle.
Any opened, partially used medication must be used within 28 days of opening.
How often do I need to be in the clinic?
IUI cycles – You will need to be available to attend the clinic for one to two scans over a three-week period. FET cycles – You will need to be available to attend the clinic for two to three scans over a three-week period.IVF/egg freezing cycles – You will need to be available to attend the clinic for three or four scans over a two-week period. The second week, the scans will be every other day.
The above timings are for the average patient, all treatment plans are bespoke so, it may be that your consultant wishes you to follow a different structure to your appointments. The nurses will inform you if this is the case.
When can I expect my egg collection to be?
Egg collections usually take place after 11-14 days of stimulation; however, it will depend on how your body responds to the medication.
In an FET cycle, when can I expect my embryo transfer to be?
Frozen embryo transfers usually take place around day 19-24 of your cycle, however this can depend on when whether you are having a medicated or natural treatment plan and your response.
Why does my medication dose keep changing?
We have standard treatment cycles, however, we are aware that this is not always suitable for everyone, therefore, your consultant will make a tailored treatment plan for you. As you proceed through treatment, this will be reviewed each time you come in for a scan, it is common that we would be adjusting your medications and dosages throughout your cycle in order to optimise the outcome.
Ovulation test FAQs
When should I do my LH / ovulation urine test?
We recommend doing your test with the first urine of the morning, using a clearblue ovulation kit.
Lifestyle FAQs
Can I drink alcohol, or smoke during my egg collection cycle?
We do not recommend and strongly advise against drinking alcohol or smoking during your egg collection cycle, and also recommend avoiding alcohol and smoking in the months leading up to your treatment also. We recommend you maintain a healthy diet both before and during your treatment cycle.
Please note that to obtain NHS funding, you should not smoke or if you do we can refer you to stop smoking support.
When can I exercise after egg collection and embryo transfer?
After your egg collection – we recommend you avoid any high intensity exercise or heavy weightlifting. After your embryo transfer – we recommend you avoid any high intensity exercise or heavy weightlifting.
What supplements should I be taking before I start my egg collection cycle?
We recommend our patients to take Vitamin D and Folic Acid, there are many other supplements patients consider when doing IVF treatment. Please discuss this with your consultant to decide if any extra supplements might be needed.
Early pregnancy FAQs
What do the blood tests indicate?
BHCG is the pregnancy hormone. We expect this to roughly double every 48hrs in the early stages. We will ask you to do your pregnancy test at home when due, using clearblue testing kits. There can be a huge variation in BHCG values, it is not necessarily the value that we look at but the trend in its rise. Please note that testing for BHCG is not routine unless medically indicated, then you would be referred to your local Early Pregnancy Assessment Unit (EPAU). Progesterone is what helps support the pregnancy in the early stages. However, this is not routine in our clinic, unless medically advised.
How do I calculate my gestation?
If you have had an embryo transfer, on the day of transfer, you’re 2 weeks and 5 days pregnant. You can then calculate further from there. If you had an IUI or timed intercourse, you calculate from day 1 of your last period.
When can I go back to exercising?
This will vary depending on your history. We advise to wait until after you have done your pregnancy test. From there, most people can go back to normal exercise, with modifications. If you work with a trainer, we recommend you inform them so they can modify your exercises accordingly.
Can I go swimming?
We would recommend avoiding swimming/being in a body of water until after your pregnancy test. From there, you can swim if the water isn’t too warm, such as a hot tub. Keep in mind the medication you may be taking, for example, if you are using oestrogen patches, these will likely fall off and lose their efficacy.
Can I travel?
Travelling at any time carries its risks. Take into consideration your destination and if there is a Zika risk in that country. We would recommend avoiding a country with a Zika risk due to the potential complications if you were to contract Zika.
If you are traveling to a country that does not speak your language and you experience complications, it can be much harder to find the right help. You will also need to ensure you carry all your medication with you, stored at the correct temperature. We would recommend storing it in your carry-on luggage to avoid it going missing. Check with your airline if you need a letter covering your medications. Please note if you travel to a country that carries a Zika risk, prior to your treatment starting, this may causes delays.
I'm pregnant and I'm bleeding, what do I do?
Rest assured that bleeding in early pregnancy is more common than you’d think; especially if it is light pink or brown in colour. Please contact the nurses with any blood-like loss for further advice.
When can I have my first ultrasound?
We schedule your first pregnancy scan in our unit, at around 7 weeks gestation. This will be carried out by one of our specialist nurses or sonographers. You can choose to have your scan more locally to you and forward the report to us for your consultant to review if you prefer. Please note, we are obligated to report all outcomes to the HFEA, therefore require the results of your scan, even when not carried out at our clinic.
How long do I need to continue my medications?
Most medications will continue through until 12 weeks of pregnancy. Once you have had your pregnancy scan you will be given a plan of how to come off your medications
How strict do I need to be with my medication timings?
Ideally you should take your medications at the same time every day within an hour’s window. If you are unable to, or forget your dose, you should take it as soon as you can as long as it is the same day. If you remember the next day, please take the medication and call the nursing team to inform them.
When coming off my medications, when do I change my dose?
You should adjust your dose/stop the medication at the start of the gestational week. For example, if you are to stop something at 12 weeks, you will take your final dose the day you hit 12 weeks.
