The Leeds Teaching Hospitals NHS Trust


Frequently Asked Questions (FAQ’s)


These pages have been written to further answer commonly asked questions that may arise during the course of your treatment. Please ask for clarification and let us have your comments and suggestions for future editions. This information is designed to supplement information that has been given already. We suggest that you refer to it periodically and when ever there is a query because you may find reassurance or answers readily and will not have to worry or become unduly concerned. You would also know of the correct action for any concerns that arise. Our intention is to keep the risk of an error in treatment at its minimum and to maintain safety with least stress to you.

Starting A Cycle

I was told to ring when I have started a period and started my medication to book for a scan appointment?

Please ring during the day Monday to Friday on The Centre direct line on the front page (8.30am - 5pm) and the reception staff will give you an appointment. Please note that appointments cannot be made out of normal working hours.

Long Protocol

I was told to take Microgynon at the same time every day from the first day of my period then ring the unit to be told when to take the suppression drugs. When should I ring?

It is important to contact the unit on the first working day that you start the Microgynon. Please ring during the day Monday to Friday on The Centre direct line (8.30am - 5pm) and ask to speak to a nurse who will arrange your next appointment and clarify the next instructions with you. This cannot be done out of normal working hours.

I was told to start my suppression drugs on the 1st day of my cycle. I have started my period but it is very light. Should I wait until tomorrow or start my medication now?

The day you start bleeding is the first day of the cycle so that is when you should start your suppression drugs, irrespective of the amount of bleeding or the time of the day when it starts. Even if the medication is given a day or two early, your treatment will not be affected. On the other hand delay in giving the injection can lead to a stimulatory response to start with which can delay your treatment.

I was told to start my drugs on the 21st day of the menstrual cycle?

The day you start bleeding is the first day of the cycle. Please count 21 days from this date and start your drugs as prescribed. A day before or after will not make a material difference so please do not worry. You can start drugs on 20-22nd day with the same effect.

I am taking drugs to suppress my cycle but have started to bleed again?

Your hormone levels fall once the suppression has occurred. It is very common at that time to have a 2nd period like bleeding. There will be no problems. Please keep your appointment as planned.

Short Treatment Cycle

I was told to take Microgynon at the same time every day from the first day of my period then ring the unit to be told when to take the stimulation drugs. When should I ring?

It is important to contact the unit on the first working day that you start the Microgynon. Please ring during the day Monday to Friday on The Centre’s direct line (8.30am - 5pm) and ask to speak to a nurse who will arrange your next appointment and clarify the next instructions with you. Please make sure you have your treatment schedule with you when you contact the unit.

NB These instructions and appointments cannot be given out of normal working hours.

I have started my stimulation injections and have either continued to bleed or have started to bleed. What should I do?

This is a frequent occurrence and is nothing to worry about. Continue with the medication as planned and inform the staff at your next appointment. If you are concerned or believe the bleeding to be excessive then call the unit and ask to speak to a nurse for advice.

Drug Related Concerns

I have had a scan and have been advised to take my late night injection at 10.00pm. I have 1-3 powders in my box and do not know if it is one powder and one fluid to mix or 3 powders and one fluid?

Most patients are prescribed 1-3 ampoules of HCG and each ampoule is 5000 IU in strength. You should take one ampule if prescribed 5000IU and 2 ampoule if prescribed 10,000 IU of HCG.

For 5000 IU you need to mix one powder with one solution for the injection. For 10,000 IU you can mix 2 powders with one solution for injection.

I have had a scan and have been advised to take my late night HCG injection at 10.00pm. How do I do it?

The instruction sheet says subcutaneously (just under the skin). You should do this injection in the same way as you do your injections for Menopur, Gonal F or Puregon.

I have broken an ampoule of powder and need another to replace. What shall I do?

If it is the HCG injection (Pregnyl or Ovitrelle), you have 3 doses and you can use one of the others. We will prescribe you another to replace the broken ampoule at your next visit to the unit.

If you have only one, you need to come into the hospital and be given a prescription for the duty pharmacist to dispense. You need to ring the The Centre on call phone OR contact the hospital and ask to speak to the on call person for The Centre. They will need to arrange for the drug to be dispensed to you when the unit is closed.

If it is a gonadotrophin (Menopur, Gonal F or Puregon) you should have sufficient for us to replace the broken ampoule on your next visit, except on the last day. Taking one less ampoule at this late stage will not make any difference and you should take what you have at the time advised.

You should come to the unit when next advised.

I have forgotten to take my drugs at the time advised. What shall I do?

On a weekend, if it is the HCG injection (Pregnyl or Ovitrelle) and you are one or two hours late then take it and inform the On call person for The Centre of the delay in your injection on the on call phone for further instructions.

If you have forgotten overnight then you should take this injection at the same time the next day (24 hours late) and ring the On call person for The Centre of the delay in your injection on the on call phone for further instructions.

If it is one of the following medications (Naferelin, Buserelin, Menopur, Gonal F or Puregon): Take the injection now and there after continue with the rest of the regime as prescribed.
You should advise the unit of the changes made at your next visit.

I have given my injection but it is aching now. Have I done it correctly?

You can expect some discomfort following the injection. This is not a problem and you should continue with your medication as prescribed. If uncertain regarding your technique, you should ring The Centre OR the person on call phone for The Centre OR the gynaecology ward (on a weekend) for a time when you can come in for the next injection under the nurse's supervision.

During the working week, please ring the unit for advice or another demonstration.

I have given my injection but have come up with a rash at the site of injection. What shall I do?

This could be a local reaction to the drug, an infection or inflammation. It sometimes occurs after Menopur and very rarely after Gonal F or Puregon.

If you just have a local rash or swelling where you have injected but feel well otherwise, there is no cause for immediate alarm. You should continue with your current medication and come to The Centre on the next working day so that any change in medication if required can be made. Please contact The Centre on its direct line number and speak to one of our nurses when the unit is next open.

If you are not well (flu like symptoms) you may need to come to The Centre OR speak to the person on call phone for The Centre OR the gynaecology ward for a doctor to examine you.
Out of hours and on weekends you need to contact as directed on the first page.

I gave my injection a little while ago and now have a rash all over my body. I am itching all over, cannot breathe and my mouth is swelling up. What shall I do?

This could become a serious allergic reaction. You need to go to casualty immediately or ring 999 for paramedic assistance.

My injection site has become red, painful and swollen. What shall I do?

This may be an infection. You need to go to The Centre, casualty, gynaecology ward or see your GP so that appropriate antibiotics can be given.

You should not use the same site for injection until approved by a doctor but you should continue with the medication as prescribed by the unit on alternative sites.

Be careful to follow the instructions carefully and wash your hands thoroughly before injection.

If necessary come in to The Centre (working days) or contact the On call person for The Centre as directed on the first page for your next injection under a nurse's supervision.

My nurse or GP is unable to give me my injection at the time given to me by The Centre. What shall I do?

You can bring your drugs and schedule to The Centre (during the week) or Contact the On call person for The Centre who would arrange for you to go to the gynaecology ward or the labour ward where the nurses will give the injection.

You should inform the ACU staff of such potential problems in advance so that they can organise weekend or late night injections for you. In this way your treatment will be smooth.
Please ensure that you bring your drugs and the drug schedule with you as the nurses CANNOT LEGALLY give you the injection without written evidence of it having been prescribed in the Assisted Conception Unit first.

Egg Collection & Embryo Transfer

I had my egg collection today / yesterday. I am now in pain, feeling faint and am bleeding. What shall I do?

It is very rare (risk < 1 in 10,000) for anybody to have a serious complication after an egg collection. The symptoms are most probably due to the effects of the sedatives you were given and some period like vaginal bleeding is common after an egg collection.

If you feel you need to be seen by a doctor you need to ring The Centre OR contact the On call person for The Centre who would arrange for you to be seen by a registrar on call for Gynaecology. You can also come to The Centre (working hours) or go to a local casualty for a doctor to see you.

Ovarian Hyperstimulation Syndrome

I had embryos put back 4-7 days ago. Now I am experiencing pain in the lower abdomen. What shall I do?

Ovaries after the embryo transfer commonly are several times larger than before. This happens to all patients and sometimes causes dull ache, bloatedness and tenderness in the lower abdomen.

When experiencing dull ache, you can take paracetamol or codeine based painkillers.
If you are still concerned, please ring The Centre as directed on the front page.

If you feel you need to be seen by a doctor urgently you can come to The Centre during the normal working hours. You need to contact the On call person for The Centre at other times so that we can arrange a doctor to see you.

I had a lot of eggs collected. The unit said that I had a risk of ovarian hyperstimulation syndrome and gave me forms to monitor my fluid balance. I am well but note that I have drunk more than I am passing as urine. Is there a cause for concern?

No, there is no concern if you are well and overall your urinary output is more than 500mls. You need to continue recording your fluid balance strictly.

Please keep your next appointment in The Centre (if within the next 24 hours) or ring The Centre to arrange an appointment.

If you have passed less than 500mls of urine (without forgetting to record all the urine that you have passed), you need to ring the On call person for The Centre at other times so that we can arrange a doctor to see you.

I had a lot of eggs collected. The unit said that I had a risk of ovarian hyperstimulation syndrome. I have had Gestone injections since my egg collection. They have put some embryos back in me. I have been monitoring my fluid intake and output at home. Now I am feeling nauseous, have been vomiting and my tummy is swollen. I am finding it difficult to breathe. What shall I do?

During normal opening hours you need to come to The Centre or the gynaecology ward for assessment and treatment. Outside normal working hours, please ring the On call person for The Centre at other times so that we can arrange a doctor to see you.

I had a lot of eggs collected. The unit said that I had a risk of ovarian hyperstimulation syndrome. I have had a Prostap injection after the egg collection. They have frozen all my embryos. I have been monitoring my fluid intake and output at home. Now I am feeling nauseous, have been vomiting and my tummy is swollen. I am finding it difficult to breathe. What shall I do?

During normal opening hours you need to come to The Centre or the gynaecology ward for assessment and treatment. Outside normal working hours, please ring the On call person for The Centre at other times so that we can arrange a doctor to see you.

I had embryos put back 10 days ago. Now I feel bloated and my tummy is swollen. What shall I do?

When symptoms present as late as this after the egg collection, it could be because you are pregnant. You should keep our appointments in the ACU as planned or ring the unit when it is open.

During normal opening hours you need to come to The Centre or the gynaecology ward for assessment and treatment. Outside normal working hours, please ring the On call person for The Centre at other times so that we can arrange a doctor to see you.

Pregnancy

I am due for a pregnancy test tomorrow or in a few days time. I have started bleeding. What shall I do?

It is likely that you are not pregnant. You must still attend for your appointment for a pregnancy test. This is to exclude an ectopic pregnancy.

I had a positive pregnancy test last week and have started bleeding. What shall I do?
If the bleeding is light you should rest and continue with any medication prescribed. It may be that you are having a very early miscarriage.

You need to contact the Assisted Conception Unit on the next working day for advice.
You should keep your pregnancy scan appointment for the necessary assessments. Scans or blood tests when performed earlier than this appointment are generally not helpful.

I had a positive pregnancy test 2-3 weeks ago. My scan in the ACU did not show a pregnancy sac and they took some blood. I have now started bleeding. What shall I do?

You may be having an early miscarriage. If you are also experiencing pain we need to make sure that you do not have an ectopic pregnancy (a pregnancy outside the womb). During working hours, you need to contact The Centre for advice OR the On call person for The Centre at other times so that we can arrange a doctor to see you. Alternatively you can attend any Casualty.

I had a positive pregnancy test 2-3 weeks ago. My scan in the ACU did not show a pregnancy sac and they took some blood. I have now started to have sharp pains and bleeding. What shall I do?

You may be having an early miscarriage. If you are also experiencing pain we need to make sure that you do not have an ectopic pregnancy (a pregnancy outside the womb). During working hours, you need to contact The Centre for advice OR the On call person for The Centre at other times so that we can arrange a doctor to see you. Alternatively you can attend any Casualty.

I had a positive pregnancy test 2-3 weeks ago. My scan in the ACU showed a pregnancy sac but not a baby. They took some blood and have given me a further appointment. I have now started to have pain and bleeding. What shall I do?

This is most probably a miscarriage. During working hours, you need to contact The Centre for advice OR the On call person for The Centre at other times so that we can arrange a doctor to see you. Alternatively you can attend any Casualty.

I had a positive pregnancy test 4 weeks ago. My scan in the ACU 1-2 weeks ago showed a pregnancy sac with a baby. I have now started to have severe pain in my side and have also had some bleeding. What shall I do?

This is most probably a miscarriage. During working hours, you need to contact The Centre for advice OR the On call person for The Centre at other times so that we can arrange a doctor to see you. Alternatively you can attend any Casualty.

Donor Insemination

I am a patient undergoing donor insemination (DI). My ovulation test is positive tonight and I was asked to ring when the test is positive to book my treatment. What shall I do?

You need to ring The Centre in the morning (between 8 - 8.30 am) during the working week and the Person on call for The Centre in the evenings or on a weekend as directed on the front page. The nurse will arrange a time for you to attend the ACU for insemination.