For most couples, having a baby is an exciting and joyful time. However, in reality, things don’t always go as planned; some couples will find that they struggle to conceive naturally.
Infertility problems in Hong Kong couples are more common than you think, with around one in six HK couples infertile. But it’s not just Hong Kong; one in eight women from the United Kingdom are infertile, and around 12% of women in the United States have trouble conceiving or carrying a pregnancy to term.
The struggle to get pregnant often leaves couples feeling frustrated, stressed and emotional. Fortunately, with modern advances in medicine, there are a wide range of fertility treatments now available. Some common options in Hong Kong include intrauterine insemination (IUI), intracytoplasmic sperm injection (ICSI), and the most widely chosen alternative — in vitro fertilisation (IVF).
So if you’ve been trying to conceive naturally for a while now with not much success and are looking for alternatives, let us help you understand everything you need to know about IVF.
What is In Vitro Fertilisation and how does it work?
In vitro fertilisation is a type of assisted reproductive technology that works using a combination of medicines and surgical procedures to help sperms fertilise an egg and implant into the uterine wall. This procedure is generally recommended for couples with:
- Damaged fallopian tubes
- Partners with low sperm count or sperm mobility
- Ovulation or genetic disorders
- Unexplained infertility
IVF procedures are typically successful, but a woman’s age is a key factor in the outcome of the treatment. Generally, the pregnancy success rate before the age of 35 is more than 50%, whereas, from the age of 35 to 37, it drops down to 42% per IVF cycle. At the age of 38 to 40, the success rate drops down to 26%, and beyond the age of 40, it drops below 15%.
What is the IVF process?
The IVF process varies slightly from clinic to clinic, but a typical treatment process will usually follow the main 6 stages below:
1. Ovarian stimulation
In this stage, a fertility specialist will prescribe several hormones that will help stimulate the ovaries to produce eggs. When the patient’s follicles and hormones are at the correct levels, a human chorionic gonadotropin (hCG) shot will be given to release the eggs.
2. Sperm collection
Sperm collection for fresh sperm is usually conducted when the eggs are collected. If you’ve decided to go with a donor, the sperm will be ready at the lab. The sperms are then washed in a special mixture to identify the best ones before they will be used for fertilisation.
3. Egg retrieval
The egg retrieval procedure is usually done between 34 to 38 hours after the HCG shot. Patients are mildly sedated during the process so they won’t feel much pain or discomfort during the process.
Once sedated, your doctor will use an ultrasound to identify your ovaries and will gently pass a needle attached to a catheter through the vaginal wall. The eggs are drawn out using a light suction and collected in test tubes, which will be handed over to the embryologist. Once done, your doctor will check your vaginal wall and ovaries again. Some women will feel a little discomfort and bleeding in the area, this is usually alleviated with medication.
4. Egg fertilisation
A few hours after the eggs have been retrieved, they will be inseminated with washed sperm. After around 24 hours, the embryologist will be able to determine the number of fertilised eggs. The embryos will then be cultured for 3 to 5 days, depending on the quality and numbers.
5. Embryo transfer
The fertility specialist will transfer viable embryos into the uterus using ultrasound as a guide. After a successful transfer, excess viable embryos may be frozen for future use and future cycles.
6. Testing for pregnancy
A blood sample is taken between 9 to 14 days after the transfer and will be used to determine whether the embryo successfully implanted and initiated a pregnancy. An ultrasound may also be conducted to double confirm. When your pregnancy appears normal at 9–10 weeks, you will be referred back to your obstetrician to start your pregnancy journey.
Is IVF safe?
Most IVF patients can resume their normal lives a day after the embryo transfer, but as with most medical procedures, there are some potential risks. Some of the more severe symptoms include:
- Decreased urinary frequency
- Severe bloating and stomach pains
- Abnormal weight gain within 3 to 5 days
- Shortness of breath
- Vomiting and nausea
You should speak to your doctor about any questions or concerns you have regarding IVF risks and side effects.
There are also some steps you can take after an IVF treatment to increase the possibility of success and mitigate potential risks, including:
- Getting plenty of rest
- Avoiding vigorous exercise
- Following a pregnancy diet
IVF treatments in Hong Kong – Public vs. Private
There is noticeably a big difference between fertility treatments in public and private hospitals in Hong Kong, especially when it comes to requirements, waiting times, costs and flexibility.
Only legally married couples can access IVF services in Hong Kong public hospitals. Additionally, the female partner must be a registered citizen and should be under 40. In the case of private hospitals and centres, couples also need to be married with a valid signed consent form, but citizenship and age disclosure are not mandatory (although this is different for each clinic requirement, please check with your clinics).
On average, it takes about 18 to 24 months for your first consultation and 6 months for your first treatment in a public hospital. In the case of a public hospital with private service, it takes about 1 to 2 months for your first consultation and 2 to 4 months for your first treatment. Private hospitals and centres offer the shortest waiting time compared to all public fertility services.
Flexibility and choice
With a public hospital, you will be given a few options when it comes to choosing appointment times, and you are not guaranteed to see the same doctor each time you visit. With a private hospital or centre, you can choose your appointment times and your preferred reproductive specialist doctor.
Like many other medical services, public hospital IVF is usually the cheaper option than going private. With public hospitals, IVF is not free but is subsidised. You’ll be paying approximately HK$10,000 to HK$24,500. For a fertility treatment through a private practice, the cost will be higher, ranging from HK$80,000 to HK$150,000 per cycle.
IVF support services
IVF doesn’t always work the first time. It can also be difficult emotionally for everyone involved. Many people having IVF treatments often struggle with anxiety, and even depression, throughout the process. In these cases, seeing a counsellor or therapist can be a good source of comfort to help you manage your emotions and expectations.
How OT&P can help
The decision to proceed with IVF treatment can be one of the biggest challenges a couple can face. But you should not give up. Sometimes, it can take up to 3 full cycles of IVF for a woman to get pregnant successfully. It’s important to be aware of your body and trust your doctor.
If you have any other concerns or questions about exploring IVF options or infertility in general, you can reach out to our OT&P fertility practitioners for an appointment.