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Scotland's "fertility clinic landscape" differs significantly from that in other areas of the UK — with clinics spread further apart and better NHS access criteria, the competition simply isn't that significant. What do you need to know about private IVF?

Scotland counts six fertility centres that offer IVF. Three — the Edinburgh Assisted Conception Unit, the Assisted Conception Unit at Dundee’s Ninewells Hospital, and the Glasgow Royal Infirmary’s Assisted Conception Unit — are NHS-affiliated. Two, the Glasgow Nuffield and the Aberdeen Fertility Centre, are registered charities. The Glasgow Centre for Reproductive Medicine, part of the nationwide Fertility Partnership, stands out as Scotland’s lone truly private clinic.

With three clinics based in Glasgow and the other three — in Edinburgh, Dundee, and Aberdeen —  somewhere to the tune of 46 to 140 miles away, Scotland’s fertility centres are, honestly, few and far between.

Unless you do live in Glasgow, you won’t have more choice as a self-funding patient than you would as an NHS patient. If you do qualify for NHS-funded IVF, much more likely if you live in Scotland than if you live in England [1], there’s really not much of a reason to go private anyway. Rather than choosing the right fertility clinic for your needs, you are much more likely to simply be learning about the clinic you will, nearly inevitably, receive IVF at. If, that is, you are determined to have treatment close-ish to home.

This difference — this distinct lack of competition — is reflected in many of the Scottish clinics’ websites, some of which induce ‘90s nostalgia while others provide much less information than the clinics we’ve looked at in other regions of the UK. Notable exceptions are, unsurprisingly, the two non-NHS clinics in Glasgow.

Despite the fact that geographical distance means less competition, Scottish fertility clinics have historically achieved some of the highest success rates in the UK, along with the most highly rated doctors and most satisfied patients [2]. You may have less choice in Scotland than you would if you'd receive IVF treatment in the UK in another region, but you’ll undoubtedly be in good hands at any of the three fertility clinics in Glasgow, or those in Edinburgh, Dundee, and Aberdeen.

What IVF-Related Treatments Do Scottish Fertility Clinics Offer?

Part of the Royal Infirmary of Edinburgh, an NHS teaching hospital, the Edinburgh Fertility and Reproductive Endocrine Centre (also called the Edinburgh Assisted Conception Unit — confusing, we know!) provides IVF, ICSI, surgical sperm collection, fertility preservation, and pre-implantation genetic screening and diagnosis. HFEA-licenced since 1992 like many of the other Scottish clinics, this one has been around for a really long time. The vast majority of self-funding patients are able to start their treatment within three months of their referral, the unit says, though EFREC does have a six-month waiting list for pre-implantation genetic diagnosis. 

The Assisted Conception Unit in Dundee is located within the Ninewells Hospital, another NHS teaching hospital. They have been in practice since the 1980s, and offer IVF for patients with communicable diseases, surgical sperm collection, and an egg sharing programme. Privately-funding patients can expect to commence treatment within six to eight weeks, once they have been deemed suitable candidates for IVF.

Noting that male infertility is a common cause of a (heterosexual) couple’s fertility struggles, Ninewells notes that such couples may use donor sperm where other treatments haven’t been or won’t be successful. It then adds: "If appropriate, we may also consider single women and same sex (lesbian) couples for treatment." We’re not sure what that means, exactly, but we can tell you that we’ve seen clinics more openly friendly towards same-sex couples and single women. 

Having opened their doors to people seeking donor insemination in 1985, the Aberdeen Fertility Centre — affiliated with NHS Grampian and the University of Aberdeen and registered as a charity — has been licenced by the HFEA since 1992, helping thousands of people become parents. It provides IVF for patients with communicable viral diseases, fertility preservation, and surgical sperm collection. The Aberdeen Fertility Centre’s past successes inspire confidence and are a reflection of the fact that the clinic conducts ongoing scientific research — the first ICSI baby was created here, as well as the first baby to be born following a frozen embryo transfer. The clinic offers EmbryoScope embryo monitoring “free to all patients who have a sufficient number of embryos required to culture to at least day 3 embryo transfer.”

The Glasgow Royal Infirmary's Assisted Conception Service made it onto the national news when its success rates suddenly hit the rocks, apparently because building works on the floor above the clinic disturbed developing embryos [3]. Subsequently closed for renovation, the clinic made a comeback when it reopened in its new state-of-the-art incarnation in 2015. In addition to IVF and ICSI, you are at the right place for pre-implantation genetic screening and diagnosis at the clinic, and it also offers surgical sperm collection and fertility preservation. The EmbryoScope incubators, used for every cycle, ensure an optimal environment for your embryos, significantly increasing pregnancy rates and reducing the risk of miscarriage.

In the name of full transparency, we’ll confess that we’re not sure exactly what’s going on with this particular clinic. As you’ll see on the GRI’s website: “All treatments we provide are NHS services and are individually tailored to meet your needs. In addition, in partnership with the Glasgow Royal Fertility Clinic, we provide services for those who wish to consider self funding their treatment. ”

The “in partnership” bit makes it sound like the Glasgow Royal Fertility Clinic is a whole different clinic, but it’s actually based at the exact same location — and the HFEA success rates its own, separate, website links to are those of the GRI’s Assisted Conception Service. While the Glasgow Royal Fertility Clinic itself told us that the two are different administrative entities, in a brief phone call, the we found out that the Human Fertilisation and Embryology Authority didn’t exactly know what was going on either. We conclude that the Glasgow Royal Fertility Clinic is, in essence, the private wing of GRI’s ACS. We’re not exactly how it all works administratively, though.

Nuffield Health follows a different model — neither NHS-governed nor a private, for-profit business, it's a non-profit organisation, a charity. "All our income is invested back into operating and developing our health and wellbeing services and pioneering new models of care and delivery so that more people can benefit," Nuffield Health states, meaning you are, as the patient, truly its first priority.

At the Glasgow Nuffield Hospital, you can expect IVF, ICSI, and surgical sperm collection in a patient-centered environment. EmbryoScope, laser-assisted embryo hatching, and endometrial scratch are available at this clinic, along with an egg sharing programme. Nuffield makes it clear that it is supportive of same-sex couples.

Part of the extremely reputable Fertility Partnership group, which has fertility clinics across the UK, the Glasgow Centre for Reproductive Medicine opened its doors in 2006 and has already become an incredibly busy clinic that offers surgical sperm collection and pre-implantation genetic diagnosis. Patients who choose this clinic have the option to have the Harmony Prenatal Test, have an endometrial scratch to increase their success rates, undergo the Uterine Natural Killer (NK) Cell Test, and assisted hatching is available. For the right candidates, natural IVF is offered. Those patients who live in Edinburgh or the surrounding area can benefit from a satellite services offered through the Edinburgh Clinic . They’ll still need to attend the GCRM for theatre-based treatments, however.

What Are The Success Rates Like At Scottish Fertility Clinics?

Which of the Scottish fertility clinics had the best IVF and ICSI success rates? Let’s examine the HFEA data for the period of July 2014 to June 2015 for each of them [4].

Glasgow Nuffield started 341 fresh IVF/ICSI cycles with patient's own eggs, with 297 reaching the embryo transfer stage. This resulted in 117 pregnancies (which amounts to a pregnancies per cycle rate of 34 per cent) and 107 births (a live births per embryo transfer rate of 36 per cent). The clinic's hard work resulted in a live birth per embryo success rate of 36 per cent for women aged 35-37, 19 per cent for women aged 38-39, and 10 per cent for those aged 40-42. In the latter two categories, the lower number of total cycles means that the success rates are less reliable as they are more influenced by individual patient factors.

Ninety-three frozen embryo cycles were also started with patients' own eggs during this time, resulting in 90 embryo transfers and a live birth per embryo transfer success rate of 19 per cent. The success rates Glasgow Nuffield achieved are consistent with the UK national average.

The Glasgow Centre for Reproductive Medicine commenced 491 IVF/ICSI cycles in which patients' own, fresh eggs were used, and 410 made it to embryo transfer. This led to 131 pregnancies and 121 births, with a live birth per embryo transfer success rate of 30 per cent and a pregnancies per cycle success rate of 27 per cent.

The Glasgow Centre for Reproductive Medicine has the following live birth per embryo transfer success rates for fresh IVF/ICSI cycles with patients' own eggs:

  • Age 35-37: 37 per cent
  • Age 38-39: 30 per cent
  • Age 40-42: 22 per cent

These success rates are consistent with the national average, but in each case also a few percentage points higher.

The GCRM started 204 frozen IVF/ICSI cycles using patients' own eggs, of which 193 reached the embryo transfer stage. With a live birth per embryo transfer rate of 41 per cent, it scored significantly better than the national average of 29 per cent on this count.

During the time the Glasgow Royal Infirmary's Assisted Conception Unit's renovation, treatment was transferred to the Nuffield Hospital. Success rates are available for this time from the HFEA, but we thought it more prudent to report on the success rates available since the Glasgow Royal Infirmary's Assisted Conception Unit reopened its doors. In this case, the success rates are reported by the clinic itself, and are as follows:

  • 387 embryos were transferred during the first quarter of 2016 in 303 transfer procedures. This led to 136 live births, a success rate of 35.1 per cent.
  • During the calendar year of 2016, pertaining to fresh embryos, the clinic had a clinical pregnancy success rate of 43.5 per cent for women aged between 36 and 37, 29.5 per cent for those between the ages of 38 and 39, and 23.5 for those aged 40 to 42.
  • During the same time period, the clinic had the following clinical pregnancy success rates for frozen embryo transfers — 36.3 per cent for women aged 36 to 37, 41.5 per cent for women aged 38 and 39, and 27.5 for women between the ages of 40 and 42.

We can conclude that the Glasgow Royal Infirmary's Assisted Conception Unit immediately reacted when its success rates plummeted, resulting in a better-equipped, more modern clinic than ever before. The success rates it has attained since reopening demonstrate that you should have no qualms about being treated here today.

The Aberdeen Fertility Centre, meanwhile, commenced 451 fresh IVF/ICSI cycles with patients’ own eggs between July 2014 and June 2015. Four-hundred and four of these reached the embryo transfer stage, resulting in 118 pregnancies and 101 babies being born during this time; the Aberdeen Fertility Centre has a pregnancies per cycle rate of 26 per cent, and a live births per embryo transfer rate of 25 per cent.

Per age group, the live birth per embryo transfer rates for the Aberdeen Fertility Centre are as follows:

  • Age 35-37: 29 per cent
  • Age 38-39: 22 per cent
  • Age 40-42: 11 per cent

A total of 188 frozen embryo cycles were also started with patients’ own eggs during the same time period. Of these, 183 reached the embryo transfer stage, resulting in a live birth per embryo transfer rate of 21 per cent — consistent with the UK national average.

At Ninewells Hospital, 527 fresh IVF/ICSI cycles were started with patient’s own eggs, with 364 of these making it to embryo transfer. As a result, 147 women got pregnant (a pregnancies per cycle rate of 28 per cent) and 135 births occurred (a live birth per embryo transfer rate of 37 per cent).

Per embryo transfer, that means a live birth rate of:

  • Age 35-37: 26 per cent
  • Age 38-39: 24 per cent
  • Age 40-42: not applicable

The clinic started 188 frozen embryo cycles with patients’ own eggs over this period of time, resulting in 164 embryo transfers and a live birth per transfer rate of 39 per cent. All in all, this means that Ninewells Hospital has success rates in accordance with the national average.

The Edinburgh Fertility and Reproductive Endocrine Centre (EFREC) started 556 fresh IVF/ICSI cycles with patients’ own eggs, of which 492 reached the embryo transfer stage. During this time, it had a pregnancies per cycle rate of 34 per cent (amounting to 188 pregnancies) and a live births per embryo transfer rate of 33 per cent (a total of 162 births).

This translates to the following live birth per embryo transfer success rates broken down by age group:

  • Age 35-37: 37 per cent
  • Age 38-39: 27 per cent
  • Age 40-42: not applicable

The clinic likewise commenced a total of 294 frozen embryo cycles during the same time period. Of these, 285 reached the embryo transfer stage, resulting in 112 pregnancies and 91 births. The Edinburgh Assisted Conception Unit’s success rates consistent with the UK national average on all counts in a reflection of its clinical expertise.

What Do Former Patients Think About Scottish Fertility Clinics?

Privately-paying Glasgow Centre for Reproductive Medicine patients chose the clinic specifically because it is a specialist fertility clinic rather than a fertility department within a wider hospital. The patients we heard from were happy with the support they received, and experienced the clinic as intimate and patient-centered. One commented that she sometimes felt overwhelmed and a little bit uninformed, but quickly added that she was too results-focused to have asked many questions, and that she was sure she'd have received more information if she had asked for it.   

Patient experiences at Glasgow Nuffield are likewise positive — we've not spoken to any patients who had negative comments to make, nor come across negative reviews online. Those who have been treated at Glasgow Nuffield describe the staff as professional, supportive, and lovely.

Aberdeen Fertility Centre patients comment on the speed at which their treatment moved forward, and compliment the compassionate nursing staff. As you'll have a lot more contact with nurses than doctors, this matters a great deal.

Ninewells patients, both privately-funding and NHS, indicate that they are slightly dissatisfied with the waiting lists, and many women who have had IVF at Ninewells likewise note that communication with the clinic is difficult when arranging appointments. There are also those who have always received prompt replies from the clinic, however. Staff left a professional and caring impression on one patient who later had treatment at Glasgow Nuffield, but she still noted that Ninewells felt less personal to her.

Patient reviews indicate that patients are more than satisfied with the level of care they receive at EFREC, and with the staff's willingness to "keep them in the loop" by explaining their treatment in detail. Both privately-funding and NHS patients do, however, express the wish for shorter waiting lists.

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