IVF

In Vitro Fertilisation (IVF)

In vitro fertilisation (IVF)

In vitro fertilisation (IVF) is an assisted reproductive technology that helps facilitate pregnancy through the process of fertilisation outside the body. In IVF, a woman undergoes hormonal medication to stimulate the ovaries to produce more eggs. These eggs are then collected and combined with sperm in a laboratory, resulting in the formation of embryos. Finally, the embryos are transferred into the woman's uterus, where they implant and lead to a successful pregnancy.

Who is suitable for IVF?

  1. Men with insufficient sperm count, poor sperm quality, or reduced sperm motility that affects conception.
  2. Women with diminished ovarian function, tubal factors, abnormal uterine lining, or other factors that affect conception.
  3. Unexplained infertility.
  4. Couples who carry genetic disease genes and require embryo genetic testing/screening.
  5. Women over the age of 35 with declining ovarian function, which affects their ability to conceive.
  6. Couples who have tried other methods such as intrauterine insemination (IUI) but have not been successful.

*According to the Hong Kong legislation, undergoing IVF treatment must be carried out by a legally married couple.

 

IVF-ET consists of the following steps:

  1. Ovarian stimulation: Injection of medications to stimulate follicles to grow in the ovaries, usually last 10-14 days. Ultrasound is performed every few days to monitor the follicles until they are mature in size.
  2. Egg collection: A minor operation to obtain the eggs from the ovaries. A needle is inserted through the vagina into the ovaries under ultrasound guidance. This is done under monitored anaesthesia, and usually lasts 15-30 minutes.
  3. In vitro fertilisation (IVF): The eggs are fertilised using the husband’s sperms in the IVF laboratory. Fertilised eggs (embryos) are further cultured for a few more days to select the best one(s) for transfer.
  4. Embryo transfer: The embryo(s) are transferred into the uterus using a small catheter. This can be done two days, three days, or five days after egg collection, depending on the number and quality of the embryos available. This is a simple procedure, no anesthesia is needed. Doctors usually recommend transferring one (or at most two) embryos to minimise the risks of multiple pregnancy (including miscarriage). Pregnancy test is performed about 10-14 days after embryo transfer.

If there are surplus embryos, they will be frozen for future use. Transfer of frozen-thawed embryos is simpler, without the need for another ovarian stimulation and egg collection.

Patient Journey of IVF treatment

Initial Consultation

Couples are invited to bring their infertility workup records, such as hysterosalpingogram (HSG) films, semen analysis reports, basal body temperature charts, and previous operative records. We will guide you through the programme and may order further investigations to establish the cause of your problems or to help with decision-making.

Counselling

We want to make sure that you have all the information you need to make an informed decision. Our attending doctors and nurses are here to offer you counselling services, so you can fully understand the procedures, potential complications and alternative options, like adoption. If necessary, we can also refer you to other professionals, such as legal experts or clinical psychologists.

Please know that we understand the importance of taking the time to consider your options and make the best decision for your unique situation. We want you to feel supported throughout this process, which is why we offer professional consultation from clinical psychologists if you need it. When you are ready, and only when you are ready, we will ask you to sign consent forms and present your marriage certificate before beginning IVF treatment.

Hormonal Stimulation

The IVF treatment journey typically begins with hormone injections to stimulate egg production. You have options available, and the most appropriate hormone therapy will be selected for you. In certain cases, natural cycle IVF or other types of in vitro fertilisation may be recommended—feel free to discuss this with our doctor.

Monitoring the Maturation of Follicles

Regular ultrasound scanning (USS) of the ovaries is an essential part of monitoring the size of your follicles, which helps us make informed decisions about the timing of egg collection. To complete the final maturation step and release the eggs on time, we will administer an additional injection, usually in the form of placental hormone (hCG). Egg collection will be scheduled for 34-36 hours after this injection, giving you time to prepare and rest.

Egg Collection

Through transvaginal ultrasound-guided oocyte aspiration, your doctor will carefully pass a needle through the vagina to obtain the eggs under the guidance of ultrasound imaging.

We prioritise the safe and efficient handling of the eggs, which will be immediately handed to the embryologist-in-charge for in vitro fertilisation and culture. We will make sure that you are comfortable throughout the procedure, and you can expect to leave the clinic in a few hours after the surgery.

Semen Collection

The husband will be kindly asked to provide a fresh semen sample on the day of egg collection. If you have any issues with semen collection or need to freeze a sample before the treatment cycle for backup, please let us know.

Fertilisation and Cleavage

Fertilisation, or insemination, is the process in which a sperm cell from a male merges with an egg cell from a female. Cleavage is the division of cells that occurs early in embryonic development after fertilisation.  

Fertilisation takes place in a laboratory using various techniques. The retrieved eggs will be placed together with sperm to attempt to create embryos. Our dedicated embryologists will carefully monitor the fertilised egg as they divide and develop into embryos.

Embryo Transfer

Typically, embryos are ready for transfer 2-5 days following egg collection. They are placed into your uterus through a thin tube (catheter) inserted through the cervix.

The procedure is similar to a routine gynaecological exam and usually does not require anaesthesia. After the transfer, you can expect to comfortably leave the clinic within half an hour.

Post-Embryo Transfer Blood Test

Blood tests will be performed to monitor your progesterone level after the embryo transfer and for evidence of pregnancy approximately 8-14 days later.

STEP

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