PRICE LIST LWC LONDON V32
September 1st 2015
THE LONDON WOMEN’S CLINIC PRICE LIST Effective from 1st September 2015
Our price list is reviewed quarterly [Please see the review date in the footer of the page]. Methods of payment accepted: Visa/MasterCard/Switch/Delta/Cash At your initial consultation you will be given a quote for your treatment which will be valid for three months. After this time, we suggest you contact the clinic to confirm your treatment costs. You will be expected to pay the full cost of your treatment prior to starting treatment at the clinic. Please note upon booking we require all of your contact and credit/debit card details to secure the booking of your appointment. We do not take payment from you until you attend the clinic for your consultation. However, should you need to cancel or reschedule, you will need to provide at least 24 hours notice or you will be charged for the consultation. We are unable to cancel or reschedule weekend appointments without incurring the full charge.
1. Consultation and Investigation Initial consultation Consultation with fertility specialist Pelvic ultrasound scan Counselling session (booked separately to the consultation)
£295
Gynaecology consultation Gynaecology pelvic ultrasound scan and report Consultation with a Gynaecologist Counselling session (booked separately to the consultation)
£295
Comprehensive initial consultation package (Female) Consultation with fertility specialist Pelvic ultrasound scan and antral follicle count Anti Mullerian Hormone (AMH) blood test Counselling (booked separately to the consultation)
£370
Comprehensive initial consultation package (Male & Female) Consultation with fertility specialist Pelvic ultrasound scan and antral follicle count for female partner Anti Mullerian Hormone (AMH) blood test for female partner Semen analysis for male partner Counselling session (booked separately to the consultation)
£450
Follow up consultation 15 minute follow up telephone consultation Semen analysis
£130
Analysis Copy of report
£120
£65
Semen analysis Analysis Copy of report “Swim-up” preparation
£200
Semen analysis with follow up consultation Analysis Copy of report Follow up consultation (30 minutes)
£250
Additional counselling sessions Genetic counselling consultation with a qualified genetic counsellor Pre-pregnancy consultation at the London Ultrasound Centre
£85
Document number:
2349
Review date:
st
1 Dec 2015
Author:
£180 £200
Christina Champion
Page 1 of 24
PRICE LIST LWC LONDON V32
September 1st 2015
2. IVF [Payment must be received in full on or before the first day of any treatment cycle] £3,450
Standard IVF
All ultrasound assessments during treatment cycle Ultrasound-guided egg collection Sperm preparation and laboratory fertilisation of eggs and embryo culture Embryo transfer Outcome follow up consultation and counselling session in the event of a negative outcome Pregnancy scan up to 8 weeks Additional (where applicable): HFEA license fee (refundable if no embryo transfer occurs) £75 IVF medication (section 3) Sedation for egg collection procedure £300 ICSI £1,250 Blastocyst culture/assisted hatching £500 Embryo freezing (see section 15 for storage costs) £325 Screening tests & any hormonal assessments during treatment (section 17&18) If the cycle is abandoned prior to egg collection, the cost of the cycle minus £500 for monitoring scans is refundable. Once egg collection has been performed no refund is applicable.
£6,900
IVF 3 cycle package
All ultrasound assessments during treatment cycles Up to 3 ultrasound-guided egg collections Up to 3 sperm preparations Up to 3 laboratory fertilisation of eggs and embryo cultures Up to 3 embryo transfers One outcome follow up consultation and counselling session in the event of a negative outcome Pregnancy scan up to 8 weeks Additional (where applicable) – per cycle: HFEA license fee (refundable if no embryo transfer occurs) £75 IVF medication (section 3) Sedation for egg collection procedure £300 ICSI £1250 Blastocyst culture/assisted hatching £500 Embryo freezing (see section 15 for storage costs) £325 Screening tests & any hormonal assessments during treatment (section 17&18) If a cycle is abandoned prior to egg collection, this will not be counted as one cycle. £500 for monitoring scans is chargeable in this instance. Once egg collection has been performed, this will be counted as one cycle. The package is considered to be fulfilled when a pregnancy is achieved beyond 20 weeks of pregnancy AND/OR all three cycles have been performed. All 3 cycles are to be completed within one year of purchase. Terms and conditions apply. No refund or credit will be given for any unused part of the treatment package. This package is not transferrable to another person/partner.
Document number:
2349
Review date:
st
1 Dec 2015
Author:
Christina Champion
Page 2 of 24
September 1st 2015
PRICE LIST LWC LONDON V32
3. IVF Medication Packages [Payment must be received in full on or before the first day of any treatment cycle] IVF medication package per cycle (Gonal F with Buserelin) - approx Buserelin 5.5ml x 2, OR Synarel 1x30 and 1x60 Gonal F 2700 IU/Menopur 3000IU HCG 400mg Cyclogest 3 boxes (15) OR 100mg Gestone 2 boxes ( 10) OR Lubion 25mg 4 boxes (7) OR 200mg Utrogestan 3 boxes ( 21) – do not use if allergic to peanuts OR Lutigest 100mg 3 boxes (21) Please note: Drug requirements may vary depending on age, weight, hormone levels and previous response to treatment – any additionally required medication is chargeable. Unused medication can not be returned or refunded.
£1,200
IVF medication package per cycle (Gonal F / with Orgalutran) - approx Orgalutran 0.25mg x 7 Gonal F 2700 IU/Menopur 3000IU HCG 400mg Cyclogest 3 boxes (15) OR 100mg Gestone 2 boxes ( 10) OR Lubion 25mg 4 boxes (7) OR 200mg Utrogestan 3 boxes ( 21) – do not use if allergic to peanuts OR Lutigest 100mg 3 boxes (21) Please note: Drug requirements may vary depending on age, weight, hormone levels and previous response to treatment – any additionally required medication is chargeable. Unused medication can not be returned or refunded.
£1,200
IVF medication package per cycle (ovum recipient) Progynova 2mgs x 4 strips 400mg Cyclogest 3 boxes (15) OR 100mg Gestone 2 boxes ( 10) OR Lubion 25mg 4 boxes (7) OR 200mg Utrogestan 3 boxes ( 21) – do not use if allergic to peanuts OR Lutigest 100mg 3 boxes (21) Gonapeptyl depot 3.75mg
£32 £120 £120
IVF medication package per cycle of egg freezing (Gonal F / with Orgalutran/Buserelin) Orgalutran 0.25mg x 7 Gonal F 2700 IU/Menopur 3000IU HCG Please note: Drug requirements may vary depending on age, weight, hormone levels and previous response to treatment – any additionally required medication is chargeable. Unused medication can not be returned or refunded.
Document number:
2349
Review date:
st
1 Dec 2015
Author:
£1,080
Christina Champion
Page 3 of 24
PRICE LIST LWC LONDON V32
September 1st 2015
4. Egg-sharing [Payment must be received in full on or before the first day of any treatment cycle] IVF for egg-sharers (to anonymous egg recipient)
Free
(saving in excess Hormonal assessments during treatment (if required) of £5,000) IVF medication (up to the pregnancy test) All ultrasound assessments during treatment cycle Sedation for egg collection procedure Ultrasound-guided egg collection Sperm preparation Laboratory fertilisation of eggs and embryo culture Embryo transfer Outcome follow up consultation and counselling session in the event of a negative outcome Pregnancy scan up to 8 weeks Additional – (where applicable): HFEA license fee (refundable if no embryo transfer occurs) £75 £325 Embryo freezing (see section 15 for storage costs) £1,250 ICSI £500 Blastocyst culture / Assisted Hatching (section 17&18) Screening tests If the donation cycle is abandoned prior to egg collection or not enough eggs are collected, the donor can either abandon the cycle at no extra charge to her or can continue and pay £2,300 (to cover administration costs, screening tests and monitoring scans) and medication (see section 3). If the egg-sharer withdraws from the programme, they will be liable for the costs of any investigations and medication.
Partner to partner shared donation / eggs shared between partner and matched recipient both being treated simultaneously
£1,350
IVF medication for the egg donor All ultrasound assessments during treatment cycle for both the donor and recipient partner Sedation for egg collection procedure Ultrasound-guided egg collection Sperm preparation and laboratory fertilisation of egg s and embryo culture Embryo transfer for the recipient partner Administration and co-ordination Outcome follow up consultation and counselling session in the event of a negative outcome Pregnancy scan up to 8 weeks Additional – (where applicable): HFEA license fee (refundable if no embryo transfer occurs) £75 Medication for the recipient (section 3) ICSI £1,250 Blastocyst culture/Assisted Hatching £500 Embryo freezing (see section 15 for storage costs) £325 Screening tests & any hormonal assessments during treatment (section 17&18) If the donation cycle is abandoned prior to egg collection or not enough eggs are collected, the donor can donate all her eggs to the recipient/partner and pay £4,700 (to cover administration costs, screening tests and monitoring scans) and medication or abandon the cycle and pay £500 to cover monitoring scans for the recipient.
Document number:
2349
Review date:
st
1 Dec 2015
Author:
Christina Champion
Page 4 of 24
PRICE LIST LWC LONDON V32
September 1st 2015
5. IVF treatment with donor eggs [Payment must be received in full on or before the first day of any treat ment cycle] Egg donation from a UK based, registered donor (5 fresh eggs) Treatment cycle All ultrasound assessments during treatment cycle for donor Sperm preparation and laboratory fertilisation of eggs (IVF) and embryo culture IVF medication package for the egg donor Iv sedation for the egg donor with ultrasound-guided egg collection Embryo transfer for the recipient Outcome follow up consultation and counselling session in the event of a negative outcome Pregnancy scan up to 8 weeks Administration and co-ordination fee Administration, co-ordination, counselling and support for donor All medical screening tests for the egg donor before and during treatment cycle Expenses payment to the egg donor (in compliance with HFEA guidelines)
£5,750
£3,050 £75
HFEA fee (refundable if no embryo transfer occurs) Additional – (where applicable): Additional 1-5 eggs from the same registered donor (Refundable if no more than 5 eggs are collected) ICSI Blastocyst culture/Assisted Hatching Embryo freezing (see section 15 for storage costs) Medication for the recipient Screening tests & any hormonal assessments during treatment (as recommended by specialist)
£2,500 £1,250 £500 £325 (section 3) (section 20)
The administration and co-ordination fee (£3,050) is non refundable. If the cycle is abandoned by the clinic or the donor, or the donor does not produce enough eggs, the treatment cycle fee (£5,750) is refundable. If the donor’s egg(s) fail to fertilise, there will be no refund available. If the recipient cancels treatment once the donor has started treatment the recipient will be liable for the full cost of treatment with no refund
Egg donation from a UK based, registered donor (6 frozen eggs) Treatment cycle Sperm preparation and laboratory fertilisation of eggs (IVF) and embryo culture ICSI Embryo transfer All ultrasound assessments during treatment cycle Outcome follow up consultation and counselling session in the event of a negative outcome Pregnancy scan up to 8 weeks Administration and co-ordination fee Administration, co-ordination, counselling and support for donor All screening tests for the egg donor before and during treatment cycle Expenses payment to the egg donor (in compliance with HFEA guidelines)
£3,350
£3,050 £75
HFEA fee (refundable if no embryo transfer occurs)
Additional – (where applicable): Blastocyst culture/Assisted Hatching £500 Embryo freezing (see section 15 for storage costs) £325 Medication for the recipient (section 3) Screening tests & any hormonal assessments during treatment (as recommended by specialist) (section 20) If the treatment cycle is abandoned the administration and co-ordination fee (£3,050) is non refundable. If the eggs fail to thaw, the treatment cycle fee is refundable (£3,350). If the egg(s) fail to fertilise no refund is available. If the recipient cancels treatment once treatment has started the recipient will be liable for the full cost of treatment with no refund.
Document number:
2349
Review date:
st
1 Dec 2015
Author:
Christina Champion
Page 5 of 24
PRICE LIST LWC LONDON V32
September 1st 2015
Three cycle egg donation package from UK based, registered donors (6 frozen eggs per cycle) Treatment cycle Sperm preparation and laboratory fertilisation of eggs (IVF) and embryo culture ICSI Embryo transfer All ultrasound assessments during treatment cycle Outcome follow up consultation and counselling session in the event of a negative outcome Pregnancy scan up to 8 weeks
£7,700
Administration and co-ordination fee Administration, co-ordination, counselling and support for donor All screening tests for the egg donor before and during treatment cycle Expenses payment to the egg donor (in compliance with HFEA guidelines) This is a one off fee for the three cycle egg donation package with frozen eggs. Patients may choose to pay £3,050 per cycle if preferable.
£6,100
£75
HFEA fee – per cycle (refundable if no embryo transfer occurs)
Additional – (where applicable) – per cycle Blastocyst culture/Assisted Hatching £500 Embryo freezing (see section 15 for storage costs) £325 Medication for the recipient (section 3) Screening tests & any hormonal assessments during treatment (as recommended by specialist) (section 20) If the treatment cycle is abandoned the administration and co-ordination fee (£3,050) is non refundable. If the eggs in one cycle fail to thaw, this will not count as one of the three cycles in the package. If the egg(s) fail to fertilise no refund is available. This is considered as 1 cycle. The package is considered to be fulfilled when a pregnancy is achieved beyond 20 weeks of pregnancy AND/OR if all three cycles have been performed. All 3 cycles are to be completed within one year of purchase. This package is not transferrable to another person/partner. Terms and conditions apply. No refund or credit will be given for any unused part of the treatment package. Please note we cannot guarantee the same egg donor for each cycle.
Ovum recipient from an anonymous egg-sharer (minimum 5 eggs) All aspects of IVF treatment for the donor including: IVF medication for egg donor All ultrasound assessments during treatment cycle for donor Sperm preparation and laboratory fertilisation of eggs (IVF) and embryo culture Administration, co-ordination, counselling and support for donor Iv sedation for the egg donor with ultrasound-guided egg collection for donor Embryo transfer for recipient Outcome follow up consultation and counselling session in the event of a negative outcome Pregnancy scan up to 8 weeks
£5,750
£75
HFEA fee (refundable if no embryo transfer occurs) Additional – (where applicable): ICSI Blastocyst culture/Assisted Hatching Embryo freezing (see section 15 for storage costs) Medication for the recipient Screening tests & any hormonal assessments during treatment (as recommended by specialist)
£1,250 £500 £325 (section 3) (section 20) If the donor’s cycle is abandoned by the clinic or the donor then the cost of the cycle minus £2300 to cover administration costs, screening tests and medication for the donor and monitoring scans for the donor and recipient is refundable. If the egg(s) fail to fertilise, there will be no refund available.
Document number:
2349
Review date:
st
1 Dec 2015
Author:
Christina Champion
Page 6 of 24
PRICE LIST LWC LONDON V32
September 1st 2015
Ovum recipient from a known donor or partner All aspects of IVF treatment for the donor including: All ultrasound assessments during treatment cycle for donor Sperm preparation and laboratory fertilisation of eggs (IVF) and embryo culture Administration, co-ordination, counselling and support for donor Embryo transfer for recipient Outcome follow up consultation and counselling session in the event of a negative outcome Pregnancy scan up to 8 weeks
£5,750
£75
HFEA fee (refundable if no embryo transfer occurs)
Additional – (where applicable): Medication for egg donor & recipient (section 3) Iv sedation for the egg donor with ultrasound-guided egg collection for donor £300 ICSI £1,250 Blastocyst culture/Assisted Hatching £500 Embryo freezing (see section 15 for storage costs) £325 Screening tests & any hormonal assessments during treatment for donor and recipient (as (section 19&20) recommended by specialist) If the donor’s cycle is abandoned then the cost of the cycle minus £2300 to cover administration costs, screening tests and medication for the donor and monitoring scans for the donor and recipient is refundable. If the egg(s) fail to fertilise, there will be no refund available.
Document number:
2349
Review date:
st
1 Dec 2015
Author:
Christina Champion
Page 7 of 24
PRICE LIST LWC LONDON V32
September 1st 2015
6. Frozen Embryo Transfer [Payment must be received in full on or before the first day of any treatment cycle] £1,250
Frozen Embryo Transfer (FET)
All ultrasound assessments during treatment cycle Thawing of embryos and embryo transfer Outcome follow up consultation and counselling session in the event of a negative outcome Pregnancy scan up to 8 weeks Additional – (where applicable): HFEA license fee (refundable if no embryo transfer occurs) £75 Blastocyst culture (if required) £500 Medication (section 3) Screening tests & any hormonal assessments during treatment (section 17&18) If the embryos do not survive after thawing, only the HFEA license fee will be refunded. If the cycle is abandoned prior to thawing, the cost of the cycle minus £500 to cover monitoring scans is refundable. If the original egg collection cycle in which the embryos were created was on or after August 2008, in which the initial transfer was an elective single embryo transfer, there will be a charge of one single fee of £75 regardless of a how many frozen embryo transfer follow.
£2,700
Frozen Embryo Transfer (FET) with donated embryos
Matching of recipient and donor characteristics Chromosome and sexual health screening for the embryo donors Donated embryos Storage of the matched embryos for one year from the time of consented match (annual storage fee applicable thereafter) All monitoring scans Thawing of embryos &embryo transfer Review consultation and counselling session in the event of a negative outcome Pregnancy scan up to 8 weeks Additional – (where applicable): HFEA license fee (refundable if no embryo transfer occurs) £75 Blastocyst culture (if required) £500 Medication for the recipient (section 3) Screening tests & any hormonal assessments during treatment (section 17&18) If the embryos do not survive after thawing, only the HFEA license fee will be refunded. If the cycle is abandoned prior to thawing, the cost of the cycle minus £500 to cover monitoring scans is refundable.
Document number:
2349
Review date:
st
1 Dec 2015
Author:
Christina Champion
Page 8 of 24
PRICE LIST LWC LONDON V32
September 1st 2015
7. Fertility Preservation [Payment must be received in full on or before the first day of any treatment cycle] Egg freezing
£3,300
Ultrasound assessments during stimulation cycle Ultrasound-guided egg collection Egg preparation and cryopreservation using vitrification and two years storage Outcome follow up consultation and counselling session in the event of an abandoned cycle Additional – (where applicable): Sedation for egg collection procedure £300 Subsequent storage (section 15) Medication package for egg freezing (section 3) Screening tests & any hormonal assessments during treatment (section 17&18) Conversion to or addition of embryo freezing (if required) will be charged as follows Donor sperm (from the London Sperm Bank) (section 11) Reservation of pregnancy slot per donor (section 11) Sperm preparation and laboratory fertilisation of eggs and embryo culture £800 Please note that If the cycle is abandoned prior to egg collection, the cost of the cycle is refundable minus £500 to cover monitoring scans. If there are no eggs available at egg collection there is no refund available.
Egg freezing for egg sharers
Free
Hormonal assessments during treatment (if required) (Saving approx. Ultrasound assessments during stimulation cycle £ 4.000) IVF medication Ultrasound-guided egg collection Sedation for the egg collection procedure Egg preparation Egg freezing and two years storage Outcome follow up consultation and counselling session in the event of an abandoned cycle Additional – (where applicable): Screening tests (section 17&18) Subsequent storage (section 15) Conversion to or addition of embryo freezing (if required) will be charged as follows Donor sperm (from the London Sperm Bank) (section 11) Reservation of pregnancy slot per donor (section 11) Sperm preparation and laboratory fertilisation of eggs and embryo culture £800 If the donation cycle is abandoned prior to egg collection, the donor can abandon the cycle with no extra charge or proceed and pay £2,300 (to cover administration costs, screening tests and monitoring scans) plus medication and the cost of any investigations.
Document number:
2349
Review date:
st
1 Dec 2015
Author:
Christina Champion
Page 9 of 24
PRICE LIST LWC LONDON V32
Egg freezing – 3 freeze package
September 1st 2015
£8,000
Ultrasound assessments during each stimulation cycle 3 ultrasound-guided egg collections Egg preparation and cryopreservation using vitrification and two years storage Outcome follow up consultation and counselling session in the event of an abandoned cycle Additional – (where applicable): Sedation for egg collection procedure (per cycle) £300 Medication package for egg freezing (per cycle) (section 3) Screening tests & any hormonal assessments during treatment (section 17&18) Subsequent storage (from date of first freeze) (section 15) Conversion to or addition of embryo freezing (if required) will be charged as embryo freezing (See embryo freezing – three cycle package) Donor sperm (from the London Sperm Bank) per cycle (section 11) Reservation of pregnancy slot per donor (section 11) Sperm preparation and laboratory fertilisation of eggs and embryo culture per cycle £800 Please note that If the cycle is abandoned prior to egg collection, the cost of the cycle is refundable minus £500 to cover monitoring scans. Once the egg collection is performed, no refund is applicable and this will be counted as one cycle. This package is not transferrable to another person/partner. If the cycle is abandoned for medical/personal reasons that is counted as one cycle. All cycles must be completed within one year.
Egg thawing, fertilisation and embryo transfer
£3,600
Ultrasound assessments during stimulation cycle Egg thawing Sperm preparation ICSI Embryo transfer Outcome follow up consultation and counselling session in the event of a negative outcome Pregnancy scan up to 8 weeks Additional – (where applicable): HFEA fee (refundable if no embryo transfer occurs) £75 Blastocyst culture/Assisted Hatching £500 Embryo freezing (see section 15 for storage costs) £325 Medication (section 3) Screening tests & any hormonal assessments during treatment (section 17&18) If the eggs do not survive after thawing or fail to fertilise no refund is available. If the cycle is abandoned prior to egg thawing the cost of the cycle is refundable minus £500 to cover monitoring scans.
Document number:
2349
Review date:
st
1 Dec 2015
Author:
Christina Champion
Page 10 of 24
PRICE LIST LWC LONDON V32
September 1st 2015
£4,100
Embryo freezing All ultrasound assessments during treatment cycle Ultrasound-guided egg collection Sperm preparation and laboratory fertilisation of eggs and embryo culture Embryo freezing and two years storage Outcome follow up consultation and counselling session in the event of an abandoned cycle Additional (where applicable): IVF medication package Sedation for egg collection procedure ICSI Blastocyst culture/assisted hatching Screening tests & any hormonal assessments during treatment Donor sperm (from the London Sperm Bank) Reservation of pregnancy slot per donor Subsequent storage
(section 3) £300 £1,250 £500
(section 17&18) £950 £1,500 (section 15)
If the cycle is abandoned prior to egg collection, the cost of the cycle is refundable minus £500 to cover monitoring scans. If no embryos are available to freeze then £650 is refundable.
£8,800
Embryo freezing – three cycle package All ultrasound assessments during each treatment cycle Up to 3 ultrasound-guided egg collection Sperm preparation and laboratory fertilisation of eggs and embryo culture Embryo freezing and two years storage Outcome follow up consultation and counselling session in the event of an abandoned cycle Additional (where applicable): - per cycle IVF medication package Sedation for egg collection procedure ICSI Blastocyst culture/assisted hatching Screening tests & any hormonal assessments during treatment Donor sperm (from the London Sperm Bank) Reservation of pregnancy slot per donor Subsequent storage (from date of first freeze) Pre-implantation genetic diagnosis
(section 3) £300 £1,250 £500 (section 17&18)
£950 £1,500 (section 15) (section 9)
If the cycle is abandoned prior to egg collection, the cost of the cycle is refundable minus £500 to cover monitoring scans. If no embryos are available to freeze then £650 is refundable (per cycle). If the cycle is abandoned for medical/personal reasons this will be counted as one cycle. This package is not transferrable to another person/partner. All cycles must be completed within one year.
Document number:
2349
Review date:
st
1 Dec 2015
Author:
Christina Champion
Page 11 of 24
PRICE LIST LWC LONDON V32
September 1st 2015
8. Surrogacy [Payment must be received in full on or before the first day of any treatment cycle] IVF Surrogacy using commissioning mother’s eggs/known donor/surrogate’s eggs
£7,850
Administration, co-ordination & counselling All ultrasound assessments during treatment cycle for the egg donor/surrogate Ultrasound-guided egg collection Sedation for egg collection procedure Sperm preparation and laboratory fertilisation of eggs and embryo culture Embryo transfer into the surrogate Outcome follow up consultation and counselling session in the event of a negative outcome Pregnancy scan up to 8 weeks Additional - (where applicable): HFEA license fee (refundable if no embryo transfer occurs) £75 Medication for commissioning mother and for surrogate (section 3) Screening tests and hormonal assessments during treatment for commissioning mother and surrogate (section 17&18) Screening tests and storage and quarantine of sperm for male partner (section 12&13) ICSI £1,250 Blastocyst culture/ Assisted hatching £500 Embryo freezing (see section 15 for storage costs) £325 If the commissioning mother’s cycle is abandoned prior to egg collection, the cost of the cycle is refundable minus £1000 to cover monitoring scans for the commissioning mother and surrogate. Once egg collection is performed no refund is available. If the eggs are available but the surrogate’s cycle is abandoned prior to embryo transfer because the eggs failed to fertilise, there will be no refund available. Embryo freezing and any subsequent frozen embryo transfer cycles will be an additional cost in this case.
IVF Surrogacy with donor eggs from a registered donor (5 fresh eggs) All ultrasound assessments during treatment cycle for the egg donor Ultrasound-guided egg collection for the egg donor Sedation for egg collection procedure Sperm preparation and laboratory fertilisation of eggs and embryo culture Embryo transfer into the surrogate Outcome follow up consultation and counselling session in the event of a negative outcome Pregnancy scan up to 8 weeks Administration and co-ordination fee (to be paid once matched) Administration, co-ordination, counselling and support for donor All medical screening tests for the egg donor before and during treatment cycle Compensation payment to the egg donor (in compliance with HFEA guidelines)
£7,850
£3,050 £75
HFEA fee (refundable if no embryo transfer occurs)
Additional – (where applicable): Additional 1-5 eggs from the same registered donor (Refundable if no more than 5 eggs are collected) £2.500 Medication for surrogate (section 3) Screening tests for surrogate & any hormonal assessments during treatment (section 17&18) Screening tests and storage and quarantine of sperm for male partner (section 12&13) ICSI £1,250 Blastocyst culture/Assisted hatching £500 Embryo freezing (see section 15 for storage costs) £325 If the treatment cycle is abandoned the administration and co-ordination fee (£3,050) is non refundable. If the egg(s) fail to fertilise no refund is available. If the recipient cancels treatment once treatment has started the recipient will be liable for the full cost of treatment with no refund. If the eggs are available but the surrogate’s cycle is abandoned prior to embryo transfer because the eggs failed to fertilise, there will be no refund available.
Document number:
2349
Review date:
st
1 Dec 2015
Author:
Christina Champion
Page 12 of 24
PRICE LIST LWC LONDON V32
IVF Surrogacy with donor eggs from a registered donor (6 frozen eggs) All ultrasound assessments during treatment cycle for the egg donor Ultrasound-guided egg collection for the egg donor Sedation for egg collection procedure Sperm preparation and laboratory fertilisation of eggs and embryo culture ICSI Embryo transfer into the surrogate Outcome follow up consultation and counselling session in the event of a negative outcome Pregnancy scan up to 8 weeks Administration and co-ordination fee (to be paid once matched) Administration, co-ordination, counselling and support for donor All medical screening tests for the egg donor before and during treatment cycle Compensation payment to the egg donor (in compliance with HFEA guidelines)
September 1st 2015
£5,450
£3,050 £75
HFEA fee (refundable if no embryo transfer occurs)
Additional – (where applicable): Medication for surrogate (section 3) Screening tests for surrogate & any hormonal assessments during treatment (section 17&18) Screening tests and storage and quarantine of sperm for male partner (section 12&13) Blastocyst culture/Assisted hatching £500 Embryo freezing (see section 15 for storage costs) £325 If the treatment cycle is abandoned the administration and co-ordination fee (£3,050) is non refundable. If the eggs fail to thaw, the treatment cycle fee is refundable (£3,350). If the egg(s) fail to fertilise no refund is available. If the recipient cancels treatment once treatment has started the recipient will be liable for the full cost of treatment with no refund.
£2,295
IUI Straight Surrogacy Administration, co-ordination & counselling All ultrasound assessments during treatment cycle Sperm preparation Insemination Pregnancy scan up to 8 weeks Additional – (where applicable): HFEA license fee (refundable if no embryo transfer occurs) Screening tests for surrogate & any hormonal assessments during treatment Medication for surrogate Screening tests and storage and quarantine of sperm for male partner
£75 (section 17&18) (section 3) (section 12&13)
If the cycle is abandoned prior to insemination the cost of the cycle is refundable minus £500 to cover monitoring scans.
£2,250
Surrogacy with a Frozen Embryo Transfer
All ultrasound assessments during treatment cycle Thawing of embryos and embryo transfer to surrogate Administration, coordination, counselling and support Outcome follow up consultation and counselling session in the event of a negative outcome Pregnancy scan up to 8 weeks Additional – (where applicable): HFEA license fee (refundable if no embryo transfer occurs) £75 Screening tests for surrogate & any hormonal assessments during treatment (section 17&18) Medication for surrogate (section 3) Blastocyst culture £500 If the embryos do not survive after thawing, only the HFEA license fee will be refunded. If the cycle is abandoned prior to thawing, the cost of the cycle is refundable minus £500 for monitoring scans. If the original egg collection cycle in which the embryos were created was on or after August 2008 in which the initial transfer was an elective single embryo transfer, there will be a charge of one single fee of £75 regardless of a how many frozen embryo transfer follow.
Document number:
2349
Review date:
st
1 Dec 2015
Author:
Christina Champion
Page 13 of 24
PRICE LIST LWC LONDON V32
September 1st 2015
9. Pre-Implantation Genetic Diagnosis [Payment must be received in full on or before the first day of any treatment cycle] Aneuploidy Screening (Preimplantation Genetic Screening) Standard IVF (section 2) Embryo biopsy and testing by Array CGH (24 chromosomes) analysis of up to 8 samples Additional samples Courier fee
£3,450 £3,100 £210 £3-500
Additional – (where applicable): HFEA licence fee (refundable if no embryo transfer occurs) IVF medication package Sedation for egg collection ICSI Blastocyst culture/ Assisted hatching Screening tests (including additional genetic tests if required) & any hormonal assessments during treatment Embryo freezing (see section 15 for storage costs)
£75 (section 3) £300 £1,250 £500 (section 17&18) £325
If embryo biopsy is not performed £2950 is refundable (£150 to cover administration costs). If genetic screening does not takes place following embryo biopsy £2600 is refundable (£500 to cover embryo biopsy and administration costs). Please note that any embryos used in a later frozen cycle are chargeable as per the frozen embryo transfer prices; that in-date screening tests are required when the embryos are replaced in a frozen cycle and these costs are additional.
Preimplantation Genetic Diagnosis for Translocations/Chromosome Imbalances Standard IVF (section 2) Embryo biopsy & testing by High Resolution Array CGH (24 chromosomes) analysis of up to 8 samples ICSI Additional samples Courier fee Additional – (where applicable): HFEA licence fee (refundable if no embryo transfer occurs) IVF medication package Sedation for egg collection Blastocyst culture/ Assisted hatching Screening tests (including additional genetic tests if required) and any hormonal assessments during treatment Embryo freezing (see section 15 for storage costs)
£3,450 £3,250 £1,250 £240 £3-500 £75 (section 3) £300 £500 (section 17&18) £325
If embryo biopsy is not performed £3100 is refundable (£150 to cover administration costs). If genetic screening does not takes place following embryo biopsy £2750 is refundable (£500 to cover embryo biopsy and administration costs). Please note that any embryos used in a later frozen cycle are chargeable as per the frozen embryo transfer prices; that in-date screening tests are required when the embryos are replaced in a frozen cycle and these costs are additional.
Document number:
2349
Review date:
st
1 Dec 2015
Author:
Christina Champion
Page 14 of 24
PRICE LIST LWC LONDON V32
September 1st 2015
Preimplantation Genetic Diagnosis for Single Gene Defects (with test development) Standard IVF (section 2) £3,450 Test preparation, embryo biopsy and testing 1-9 samples (per cycle) £5,000 Test preparation, embryo biopsy and testing 10-24 samples (per cycle) £7,000 Licensing application preparation fee (where applicable) £750 ICSI £1,250 Courier fee £3-500 Additional – (where applicable): HFEA license fee (refundable if no embryo transfer occurs) £75 IVF medication package (section 3) Sedation for egg collection £300 Blastocyst culture/ Assisted hatching £500 Screening tests (including additional genetic tests if required) and any hormonal assessments during (section 17&18) treatment Embryo freezing (see section 15 for storage costs) £325 If embryo biopsy is not performed and genetic analysis does not take place a refund of £3,000 is applicable. Please note that any embryos used in a later frozen cycle are chargeable as per the frozen embryo transfer prices; that in-date screening tests are required when the embryos are replaced in a frozen cycle and these costs are additional.
Preimplantation Genetic Diagnosis for Single Gene Defects plus HLA Matching (with test development) Standard IVF (section 2) £3,450 Test preparation, embryo biopsy and testing 1-9 samples (per cycle) £5,000 Test preparation, embryo biopsy and testing 10-24 samples (per cycle) £7,000 Licence application fee £600 ICSI £1,250 Courier fee POA Additional – (where applicable): HFEA license fee (refundable if no embryo transfer occurs) £75 IVF medication package (section 3) Sedation for egg collection £300 Blastocyst/Assisted hatching £500 Screening tests (including additional genetic tests if required) and any hormonal assessments during (section 17&18) treatment Embryo freezing (see section 15 for storage costs) £325 If embryo biopsy is not performed and genetic analysis does not take place a refund of £3,000 is applicable. Please note that any embryos used in a later frozen cycle are chargeable as per the FET prices; that in-date screening tests are required when the embryos are replaced in a frozen cycle and these costs are additional.
Document number:
2349
Review date:
st
1 Dec 2015
Author:
Christina Champion
Page 15 of 24
PRICE LIST LWC LONDON V32
September 1st 2015
10. Intrauterine Insemination [Payment must be received in full on or before the first day of any treatment cycle] £795
Intrauterine Insemination (IUI natural cycle)
Sperm preparation Insemination Pregnancy scan up to 8 weeks Additional – (where applicable): HFEA fee for using donor sperm (refundable if no insemination occurs) £37.50 Second insemination on the same cycle (not including donor sperm if required) £795 Screening tests prior to treatment & any hormonal assessments during treatment (section 17&18) LH kit test (digital) £25 Donor sperm (section 11) If the cycle is abandoned after sperm preparation has taken place no refund is due. If the cycle is abandoned prior to sperm preparation the cost of the cycle will be refunded minus £150 for the sperm preparation. If more than one sperm sample is prepped, each sperm sample will be charged for at a cost of £150 each.
£1,295
Intrauterine Insemination (IUI stimulated)
All ultrasound assessments during treatment cycle Sperm preparation Insemination Pregnancy scan up to 8 weeks Additional – (where applicable): HFEA fee for using donor sperm (refundable if no insemination occurs) £37.50 Second insemination on the same cycle (not including donor sperm if required) £795 Medication (section 3) Screening tests prior to treatment & any hormonal assessments during treatment (section 17&18) Donor sperm (section 11) If the cycle is abandoned after sperm preparation has taken place no refund is due. If the cycle is abandoned prior to sperm preparation the cost of the cycle will be refunded minus £150 for the sperm preparation and £500 to cover monitoring scans. If more than one sperm sample is prepped, each sperm sample will be charged for at a cost of £150 each.
Document number:
2349
Review date:
st
1 Dec 2015
Author:
Christina Champion
Page 16 of 24
September 1st 2015
PRICE LIST LWC LONDON V32
11. Donor Sperm [Payment must be received in full on or before the first day of any treatment cycle] Donor sperm from the London Sperm Bank catalogue (inc. VAT) £950
Donor sperm for one treatment cycle as per the LSB catalogue terms and conditions of sale Visit www.londonspermbankdonors.com
Three cycle donor sperm package from the London Sperm Bank catalogue (inc. VAT) Donor sperm for three treatment cycle as per the LSB catalogue terms and conditions of sale Visit www.londonspermbankdonors.com Conditions apply. Please note that we cannot guarantee that you can use the same sperm donor for each cycle. Donor sperm must be used at the London Women’s Clinic unless under exceptional circumstances. All treatments must be commenced within one year of commencement of the first treatment. A successful pregnancy (beyond 20 weeks) during the first/second treatment cycle does not lead to a part refund in fees. Should the pregnancy fail within the first 20 weeks of pregnancy and the 12 month period has not elapsed the patient is eligible to continue using the remainder of the package. If a pregnancy is achieved on the first or second cycle the sperm for any remaining cycles may be converted into sibling sperm from the same donor. A storage fee will be applicable (see section 15).
£1,900
Importing donor sperm from abroad Administration fee Please contact clinic prior to paying for imported sperm to ensure sample suitability and HFEA compliance. The courier fee is dependent on the destination and will be quoted individually. Storage of sperm
£200 (section 15)
Reservation of sibling sperm (inc. VAT) £950 £150 (section 15) (section 15)
Donor sperm for one cycle as per the LSB catalogue terms and conditions of sale Administration fee Storage of sperm Subsequent storage Please contact clinic immediately after viability scan to confirm sample availability
Administration fee to transport gametes/embryos to/from non-LWC clinics Within the UK mainland Outside the UK mainland This is non-refundable if the transfer does not go ahead. The courier fee is dependent on the destination and will be quoted individually.
£150 £1,800
Reservation of pregnancy slot (for embryo freezing)
£1,500
Document number:
2349
Review date:
st
1 Dec 2015
Author:
Christina Champion
Page 17 of 24
PRICE LIST LWC LONDON V32
September 1st 2015
12. Known Sperm Donor / Male partner providing sperm for Surrogacy [Payment must be received in full on or before the day tests are undertaken ] Stage 1 £200
Semen Analysis and Test Freeze Copy of report
Stage 2 Donor Physical Consultation Implications counselling Screening blood tests
£295 (section 13)
Stage 3
£325 (section 15)
Sperm freezing (per sample) Storage of sperm Quarantine process
Stage 4 (section 13) (section 15)
Post quarantine period screening Subsequent storage
13. Known Sperm Donor / Male partner providing sperm for Surrogacy Screening [Payment must be received in full on or before the day tests are undertaken] Known donor screening package (Stage 1) HIV I & II, Hepatitis B core antibody, Hepatitis B surface antigen, Hepatitis C, HTLV 1 and 2, Syphillis/TPHA, Urine Chlamydia, Gonorrhoea, Cytomegalovirus (CMV) IgM and IgG, Chromosomes, Cystic Fibrosis, Blood group and Rhesus status, Trichomonas and Semen culture
£1000
Donor screening [for specific racial groups] (Stage 1) - to be completed at the beginning of the storage process Sickle cell Tay Sachs Thalassemia
£50 £285 £55
Post quarantine screening tests (Stage 4) – minimum of 180 days post date of last freeze
£500
HIV I & II, Hepatitis B core antibody, Hepatitis B surface antigen, Hepatitis C, Syphilis/TPHA and Cytomegalovirus (CMV) IgM and IgG
Post quarantine tests [inc. NAT testing] (Stage 4) – minimum of 30 days post date of last freeze
£700
HIV I & II, Hepatitis B core antibody, Hepatitis B surface antigen, Hepatitis C, Syphilis/TPHA, and Cytomegalovirus (CMV) IgM and IgG
Document number:
2349
Review date:
st
1 Dec 2015
Author:
Christina Champion
Page 18 of 24
September 1st 2015
PRICE LIST LWC LONDON V32
14. Additional Charges [Payment must be received in full on or before the first day of any treatment cycle] DNA fragmentation test on sperm(TDL Lab only) Courier Semen Analysis and freeze DNA fragmentation Copy of report Follow up with a genetic counsellor by phone
£1000
PESA (Percutaneous Sperm Aspiration) Sperm collection Sedation For storage fees please see section 15 Please note that payment costs need to be paid in full whether sperm is retrieved or not
£1,500
TESE (Testicular Sperm Aspiration) Sperm collection Sedation For storage fees please see section 15 Please note that payment costs need to be paid in full whether sperm is retrieved or not
£1,500
Cyst aspiration/follicle reduction Theatre procedure Recovery care Please note that if sedation is required this will be chargeable (£300)
£200
Mock Cycle Scans Progynova OR Elleste OR Estraderm, and Cyclogest OR Lutigest OR Gestone OR Utrogestan medication Trial embryo transfer without sedation (if sedation is required, there will be an additional charge of £300)
Intracytoplasmic Sperm Injection (ICSI)
£1,000
£1,250
[Relevant IVF package will be payable in addition]
Blastocyst culture / Assisted hatching Intralipid infusion (medication and administration) - per infusion Natural killer cell blood tests (Monday – Thursday before 1pm) - per infusion Ultrasound monitoring cycle Intravenous (IV) sedation fee Copy of notes
£500 £500 £720
£500 £300 £50
Copying and checking of notes Postage and packaging or scanning and sending via email/fax
Prescription request for external patients Consultation and prescription Subsequent prescriptions will be chargeable at £65 each
£130
Primovision time lapse technology Egg donation waiting list fee (via London Egg Bank catalogue) Genetic Mutation Testing Endometrial scratch Sperm aneuploidy testing (5 chromosomes)
£750
Document number:
2349
Review date:
st
1 Dec 2015
£500 £350 £150 £750
Author:
Christina Champion
Page 19 of 24
September 1st 2015
PRICE LIST LWC LONDON V32
15. Embryo and Gamete Freezing [Please note that consent to storage must be in line with the fees paid] Unused whole years are refundable on application £325 Embryo and gamete freezing £500 2 years storage for gametes and embryos £700 3 years storage for gametes and embryos £1,100 5 years storage for gametes and embryos £1,550 7 years storage for gametes and embryos £2,200 10 years storage for gametes and embryos Review consultation to discuss extending storage £130 including counselling session if required
16. Gynaecology scanning services Gynaecology scan with colour Doppler Vaginal ultrasound scan and colour Doppler assessment of uterus, endometrium, ovaries, surrounding pelvis/adnexae
£270
HyCoSy Aquascan HyCoSy and Aquascan package Additional pelvic ultrasound scan
£450
2D vaginal ultrasound scan assessment of the uterus, endometrium, ovaries, surrounding pelvis/adnexae
£150
7-8 week 2D early pregnancy scan
£150
Document number:
2349
£270 £600
Review date:
st
1 Dec 2015
Author:
Christina Champion
Page 20 of 24
PRICE LIST LWC LONDON V32
September 1st 2015
17. Individual screening tests *to be done between days 1 – 4 of the female menstrual cycle
FSH*
£50
LH*
£50
Oestradiol*
£50
Anti Mullerian Hormone (AMH)
£95
βHCG
£40
Testosterone
£50
SHBG
£40
DHEAS04
£50
Prolactin
£50
Progesterone
£27
T4
£50
TSH
£50
HIV 1 & 2
£60
Hepatitis B Surface Antigen
£60
Hepatitis B core
£50
Hepatitis C
£75
Hepatitis B viral load
£250
Hepatitis C viral load
£270
HTLV 1 and 2
£110
Chlamydia
£95
TPHA (Syphilis)
£50
Rubella
£50
CMV IgM/IgG
£115
Cervical Smear
£60
Blood group and Rhesus factor
£40
Cystic Fibrosis
£110
Sickle Cell
£50
Tay Sachs
£50
Thalassaemia
£55
17 Hydroxy Progesterone
£115
Homocysteine
£170
Trichomonas
£29
Gonorrhoea
£49
Chromosome Analysis (Karyotype)
£280
Urine cotinine
£75
CA125
£140
Document number:
2349
Review date:
st
1 Dec 2015
Author:
Christina Champion
Page 21 of 24
PRICE LIST LWC LONDON V32
September 1st 2015
18. Investigation Packages [Payment must be received in full on or before the day the test is undertaken] Please note: HIV 1 & 2, Hepatitis B surface antigen, Hepatitis B core antibody, Hepatitis C and Chlamydia (female partner only) must be valid within 3 months of starting the 1st cycle of treatment
LWC 1 Pre-treatment blood test package (Female) HIV 1 & 2, Hepatitis B surface antigen, Hepatitis B core antibody, Hepatitis C, Chlamydia, Rubella If you test positive for Hepatitis B Core you will need to carry out a Hepatitis B viral load blood test
£295
LWC 2 Pre-treatment blood test package (Male) HIV 1 & 2, Hepatitis B surface antigen, Hepatitis B core antibody, Hepatitis C If you test positive for Hepatitis B Core you will need to carry out a Hepatitis B viral load blood test
£200
LWC 3 [Sexually transmitted infection screening] annually repeated HIV 1 & 2, Hepatitis B core antibody, Hepatitis B surface antigen, Hepatitis C If you test positive for Hepatitis B Core you will need to carry out a Hepatitis B viral load blood test
LWC 4 [Fertility screening]
£200
£120
FSH, LH, Oestradiol
LWC 5 [Tumour marker screening – type 1]
£235
HE4 (Ca125, HE4, ROMA), AFP, βHCG
LWC 6 [Tumour marker screening – type 2]
£200
Ca125, Ca19-9, AFP, βHCG
LWC 7
£90
LH, Oestradiol, Progesterone
LWC 8
£80
LH, Oestradiol
LWC 9
£200
FSH, LH, Oestradiol, AMH
LWC 10 OHSS2 [OHSS diagnostic test]
£125
Liver function tests, Urea and Electrolytes, Full blood count, Clotting screen
LWC 11 COL2
£65
Liver function tests, Full blood count
LWC 12 REC MISCARRIAGE [Recurrent miscarriage screen] Thyroid peroxidise antibodies, Coeliac antibodies, Vitamin D, Fasting Homocysteine, Lupus, Anti-cardiolipin antibodies
£360
LWC 13 PCOS [Polycystic ovarian syndrome blood screening] £200
Prolactin, Testosterone, SHBG, T4, TSH, AMH, Androstenedione, DHEAS, 17 Hydroxyprogesteron day 2-5 of cycle
LWC 14 Natural killer cells (Monday-Thursday before 1pm) 50:1, 25:1, 12.5:1, IgG conc 12.5 50:1, IgG conc 12.5 25:1, CD3%, CD19%, CD56%, CD19+, CD5+ Cells
LWC 15 Male Genetic Reproduction Profile
£720 £600
Chromosome analysis, Y Chromosome microdeletion, cystic fibrosis screen
Phlebotomy charge for outside patients (per visit)
£35
LH kit test (digital)
£25
Haemoglobin electrophoris
£70
Sickle Cell anaemia, Thalassemia
Document number:
2349
Review date:
st
1 Dec 2015
Author:
Christina Champion
Page 22 of 24
September 1st 2015
PRICE LIST LWC LONDON V32
19. Egg Donor Screening [Payment must be received in full on or before the day the test is undertaken] Please note: HIV 1 & 2, Hepatitis B surface antigen, Hepatitis B core antibody, Hepatitis C, Chlamydia, Gonorrhoea, HTLV and Syphilis must be valid within 3 months of starting the 1st cycle of treatment
LEB 1 HIV 1&2, Hepatitis B core antibody, Hepatitis B surface antigen, Hepatitis C, HTLV 1 and 2, Syphilis/TPHA, Urine Chlamydia, Gonorrhoea, Cytomegalovirus (CMV) IgM and IgG, Urine Cotinine and Trichomonas
LEB 2
£650
£350
Chromosomes, Cystic Fibrosis, Blood group and Rhesus status and Rubella
LEB 3 [during treatment] HIV 1 and 2, Hepatitis B core antibody, Hepatitis B surface antigen, Hepatitis C, HTLV 1 and 2 Cytomegalovirus (CMV) IgM and IgG, Chlamydia, Gonorrhoea and Syphilis
£350
Donor screening [for specific racial groups] £50 £285 £55
Sickle cell Tay Sachs Thalassemia
Document number:
2349
Review date:
st
1 Dec 2015
Author:
Christina Champion
Page 23 of 24
PRICE LIST LWC LONDON V32
September 1st 2015
20. Individual medication charges There are no refunds given for unused drugs that have been taken off of the premises. Drugs cannot be supplied, nor taken from the premises, without prior payment.
£30 £120 £180 £360
Buserelin
75IU 300IU 450IU 900IU 5.5ml (2)
Synarel 30
200mcg (1)
£90
Synarel 60
200mcg (1)
£150
Ovitrelle
250mcg (1)
£30
Cyclogest pessaries (for internal use)
400mg (3)
£120
Utrogestan (vaginal pessaries)
200mg (21)
£35 £42 £300
Gestone injections
0.25mg 0.25mg (7) 100mg (10)
Lubion injection
25mg (7)
£110
Gonapeptyl depot
3.75mg
£120
Menopur
75mg (10)
£300 £42 £300 £21 £168 £336
Luveris
0.25mg 0.25mg (7) 1 x 75IU 1 x 600IU multidose 1 x 1200IU multidose 75IU (20)
Elleste solo tablets
2mg (84)
£16 £130 £150
Progynova tablets
20mg (10) 40mg (10) 2mg (1 strip of 28)
Doxycycline
100mg (8)
£5
Prednisolene
5mg (56)
£5
Clomid
50mg
£2
Gonal F
Orgalutran
Cetrotide
Menopur
Clexane
£100
£300
£700
£8
100mg each Box of 8 x 100mg 21 pessaries
Estraderm patches Lutigest
£4 each £28 per box £40
All services and products provided at the London Women’s Clinic, and all applicable HFEA fees, must be paid in full, in advance. Please see separate Terms and Conditions.Private Health Insurance and Third Party Payment:As noted above, all fees payable to the London Women’s Clinic must be paid in advance including if a third party or insurance company are liable to reimburse or otherwise pay.
Document number:
2349
Review date:
st
1 Dec 2015
Author:
Christina Champion
Page 24 of 24