Price List(Effective 8th February 2016)

www.fertilityclinic.ie

Galway Fertility Clinic, Galway West Business Park, Rahoon, Galway.Telephone: 00 353(0)91 515600 | Fax: 00 353(0)91 515280

Email: info@fertilityclinic.ie

Payment Terms and Conditions

• Accepted methods of payment are as follows:

Debit Visa Card up to €1500;

Cash; Cheques / Bank Drafts/ Postal Orders made payable to Galway Fertility Clinic.

Credit Cards are accepted but these incur a 2% supplementary charge, to cover chargeslevied by the processing bank (please notify your bank in advance of using this methodof payment).

• Fertility treatment costs are not normally covered under private medical insurance(e.g. VHI. etc) or by the HSE. Please check with your insurance provider for clarification.

• Costs may be claimed against Income Tax at the end of each financial year using MED.1 Formwith your receipts. You can download these forms from www.revenue.ie

• All treatment cycles for IVF / ICSI and FER must be paid for in full prior to each treatment.

• GFC Bank Transfer Details:Bank Name - AIB, University Branch, Newcastle Road, GalwayBIC/Swift code: AIBKIE2DIBAN Code:IE38AIBK93743610652045Payment Reference: Patient Name and IV Number (available from the clinic)

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No Hidden Costs for IVF Treatment - Embryoscope® and Blastocyst Culture included in all IVF Cyclesgiving you the best chance of success, saving you up to €1500.

www.fertilityclinic.ie

IVF Related Costs

Procedure Cost Cost after ReducedMed1form Rate*tax rebate

In-Vitro Fertilisation (IVF) €4,750 €3,800 €3,600*

Intracytoplasmic Sperm Injection (ICSI) €4,750 €3,800 €3,600*

Blastocyst Culture Included in cycle cost

Embryoscope® Included in cycle cost

Vitrolife Embryoglue® Included in cycle cost

Assisted Hatching Included in cycle cost

Review with consultant post cycle (within 6 months) Included in cycle cost

This fee includes all Ultrasound scans, blood tests, Egg Collection, Embryo Culture in the

Embryoscope®, Blastocyst Culture, Assisted Hatching, Embryo Transfer and Pregnancy Test.

(Additional fees are applied for Early Pregnancy Ultrasound Scans and Cryopreservation)

Cancellation of Cycle:

In the event of a cancellation of your cycle, the next cycle will be charged as follows:

Cancelled prior to Starting Injections €500

Cancelled prior to Egg Collection €1,500

Cancelled following Egg Collection (No Eggs Collected) €2,500

Cancelled prior to Embryo Transfer €3,300

Frozen Embryo Replacement

Frozen Embryo Replacement (FER) €1,500

Embryo Cryopreservation (if required) €800

Annual Cryopreservation Maintenance & Administration €300

Embryology/Laboratory Fees

Semen Analysis €100

Repeat Semen Analysis €100

Sperm DNA Fragmentation Test €350

Testicular Biopsy (excludes cryopreservation) €500

Semen Cryopreservation €300

Donor Sperm (per straw used) €400

Donor Sperm Allocation (fees vary depending on profile) from €300

Ovulation Induction/IUI Treatments

Procedure Cost Reduced Rate*

Ovulation Induction Cycles (TSI) €350 €200*

Artificial Insemination (AIH) €350 €200*

Intrauterine Insemination (IUI) (Partner) €750 €500*

Intrauterine Insemination (IUI) (Donor Sperm) €1,150 €800*

Cancelled Treatment Cycle €200 €100*

Tests/Procedures Cost

AMH Test €100

EU Bioscreen Blood Test (per person) €100

Progesterone (P4) Blood Test €50

Pregnancy (HCG) Blood Test €50

Hormone Profile / Thyroid Function Test €50

Rubella €50

Endometrial Scratch €150

Hydrotubation €200

Cyst Aspiration (includes laboratory analysis if needed) €300

Early Pregnancy Scan €150

Trial Embryo Transfer €150

Miscarriage / Implantation Failure Screening

Thrombophilia/Clotting Screens (female only) €100

Chromosome Testing per person €100

Cystic Fibrosis (CF) Testing per person €250

The above list is not exhaustive of all tests on offer at Galway Fertility Clinic,individualised testing may be arranged with your consultant.

Consultation Fees Cost

Initial First Fertility Appointment €200

Review Appointment €150

*Reduced Rate: Applies where both partners possess current medical cards(“GP Visit” Medical cards not accepted). Galway Fertility Clinic is a private clinic

and does not receive any payment from the HSE or Medical Card Scheme.