Fertility Treatment Referral Form

You can refer your patient to the Fertility and Research Centre here via this online form. To assist in timely access to our clinic, we ask that GPs organise the below tests for their patients prior to their FRC consultation. Please include summaries and investigations of all past pregnancies.

Female testing

Blood Tests

AMH (approximately $65), TSH, Prolactin, FBC, Iron Studies, HbEPG, Hep B, Hep C, HIV, Syphilis, Karyotype, Rubella IgG, Varicella IgG, CMV IgG, Blood Group

Ultrasound

Pelvic with Antral Follicle Count during first half of cycle

Male Testing

Blood Tests

HepB, HepC, HIV, Syphilis, FBC, IronStudies, HbEPG, Blood Group

Semen Analysis

With DNA Fragmentation (available through the RHW Andrology Laboratory via appointment – call 02 9382 6643). Charges do apply.