Hong Kong Sanatorium & Hospital Assisted Reproduction Centre Founded in 1986 – History and Current Status of Assisted Reproduction

Opening: From the hospital process perspective

Starting Point of the Treatment Process — The treatment process at the Assisted Reproduction Centre of Hong Kong Sanatorium & Hospital follows a standardised medical pathway. From the initial consultation and registration to embryo transfer, each step has clear timelines and medical requirements. As an assisted reproduction facility established in 1986, its procedural system has accumulated nearly four decades of clinical experience, forming a unique diagnostic and treatment rhythm.

In which year was the Assisted Reproduction Centre of Hong Kong Sanatorium & Hospital established?

The Assisted Reproduction Centre of Hong Kong Sanatorium & Hospital was established in 1986. This centre is one of the earliest medical institutions in Hong Kong to provide assisted reproductive technology and one of the early clinical units in East Asia to introduce in vitro fertilisation (IVF) technology. Since its establishment, the centre has continuously updated its laboratory platform and clinical protocols. Currently, it offers a complete range of reproductive medicine services, including in vitro fertilisation, intracytoplasmic sperm injection (ICSI), preimplantation genetic testing (PGT), egg and sperm freezing, and fertility preservation.

Key Differences from Other Fertility Centres in Hong Kong

Hong Kong currently has over a dozen institutions offering assisted reproductive services, encompassing both public hospitals and private medical facilities. As a fertility centre within a private hospital system, the Assisted Reproduction Centre of Hong Kong Sanatorium & Hospital differs from public hospitals and other private centres in several aspects.

Furthermore, the Assisted Reproduction Centre is located within Hong Kong Sanatorium & Hospital, which has complete supporting departments such as obstetrics and gynaecology, paediatrics, and genetic counselling. For complex cases requiring multidisciplinary consultation (e.g., advanced age with uterine fibroids, recurrent implantation failure, genetic disease carriers), in-hospital referrals are possible—a condition some independent fertility clinics do not offer.

Most Easily Overlooked Details

During the actual treatment process, the following details are often overlooked by patients but may directly affect the treatment progress.

• Document Preparation and Validity: Hong Kong Sanatorium & Hospital requires patients to provide a valid passport or Mainland Travel Permit for Hong Kong and Macau Residents, marriage certificate (if applicable), past medical records, and test reports. Special attention is needed to ensure the validity of the passport or permit covers the entire treatment cycle (usually 3-6 months); expired documents may delay registration.
• Validity of Previous Test Reports: Some test results have time limits. For example: AMH (Anti-Müllerian Hormone) test results are valid for 6-12 months; chromosome karyotype analysis and genetic carrier screening are usually valid for life; while infectious disease screening (Hepatitis B, Hepatitis C, Syphilis, HIV, etc.) is generally valid for 6 months. Reports exceeding the validity period require retesting.
• Male Partner Investigations: Some couples focus only on female examinations, neglecting the male partner's semen analysis, sperm DNA fragmentation, and Y chromosome microdeletion tests. The hospital requires the male partner to complete a semen test within 1 month after the initial consultation, with an abstinence period of 2-7 days; the exact timing should be confirmed with the laboratory in advance.
• Correspondence between Ovarian Stimulation Protocol and Menstrual Cycle: Different stimulation protocols (antagonist protocol, long protocol, short protocol, etc.) have different start times. For example, the antagonist protocol usually starts on day 2-3 of the menstrual cycle, while the luteal phase protocol starts after ovulation. Failure to accurately record the menstrual cycle or premature medication use may lead to cycle cancellation.
• Timing Window for Embryo Culture and Transfer: The centre supports day 3 cleavage-stage embryo transfer and day 5-6 blastocyst transfer. The choice of transfer method depends on the number and quality of embryos and the patient's endometrial condition. Some patients may overlook the potential risk of blastocyst culture—approximately 15-25% of day 3 embryos fail to develop into transferable blastocysts.

Actual Treatment Process

A complete IVF cycle at the Assisted Reproduction Centre of Hong Kong Sanatorium & Hospital typically includes the following stages, each with clear operational milestones.

Stage 1: Initial Consultation and Assessment

• Schedule an appointment with a reproductive specialist, bringing identification, marriage certificate, past medical records, and test reports.
• The doctor takes a medical history, performs a gynaecological examination, and uses ultrasound to assess baseline antral follicle count and endometrial condition.
• Necessary tests are ordered: AMH, FSH, LH, Estradiol, Thyroid function, Infectious disease screening, Semen analysis, etc.
• Based on the results, the doctor preliminarily determines a suitable ovarian stimulation protocol and informs the estimated cycle duration.

Stage 2: Registration and Cycle Preparation

• Complete all required tests, ensuring reports are within their validity period.
• Sign informed consent forms to confirm the treatment plan.
• Verify identification documents and establish an electronic medical record.
• The nursing team provides medication guidance, including storage methods for stimulation drugs, injection techniques, and appointment schedules for follow-up visits.

Stage 3: Ovarian Stimulation and Monitoring

• Start injecting stimulation medications at the specified time (usually day 2-3 of the menstrual cycle or during the luteal phase) according to the protocol.
• Return to the centre every 1-3 days for ultrasound monitoring and blood tests (measuring estradiol, LH, progesterone, etc.) to assess follicle development.
• When the leading follicles reach 18-22 mm in diameter and the number is appropriate, the doctor decides on the trigger timing and administers hCG or a GnRH agonist (trigger shot).
• Egg retrieval surgery is scheduled 34-36 hours after the trigger shot.

Stage 4: Egg Retrieval and Embryo Culture

• Egg retrieval is performed under intravenous anaesthesia, lasting approximately 15-25 minutes. Patients are observed for 2 hours post-surgery.
• Laboratory staff assess the maturity of the retrieved oocytes and fertilise them via IVF or ICSI.
• Embryo development is continuously monitored from day 1 to day 6 post-fertilisation, recording cleavage, blastocyst formation, and grading.
• If PGT is planned, a biopsy of the blastocyst is performed on day 5-6 and sent for genetic testing.

Stage 5: Transfer and Luteal Support

• Based on embryo quality, endometrial condition, and patient preference, choose between fresh cycle transfer or freeze-all embryos for elective transfer later.
• Transfer is performed under ultrasound guidance, followed by bed rest for 30-60 minutes.
• Luteal support medication (oral, vaginal, or injectable) is started after transfer and continued until the pregnancy test day.
• Blood test for β-hCG is done 10-14 days after transfer to confirm pregnancy.

Time Schedule Reference

A complete IVF cycle from initial consultation to pregnancy test usually takes 2.5-4 months, depending on the speed of completing tests, the stimulation protocol, and whether PGT is performed.

If frozen embryo transfer is required, the interval from egg retrieval to transfer extends to 2-3 months, as it requires waiting for at least one menstrual cycle and performing endometrial preparation (natural cycle or hormone replacement cycle).

Suitable Candidates

The Assisted Reproduction Centre of Hong Kong Sanatorium & Hospital is suitable for the following types of patients:

• Individuals living in Hong Kong or nearby areas who wish to access private reproductive medical services close to home.
• Advanced maternal/paternal age (female ≥35 years, male ≥40 years) requiring comprehensive fertility assessment and personalised stimulation protocols.
• Couples who have experienced long waiting times in public hospitals and wish to start treatment more quickly.
• Those needing PGT (preimplantation genetic testing), such as genetic disease carriers, balanced translocation carriers, or patients with recurrent miscarriage.
• Individuals needing fertility preservation (egg freezing, sperm freezing, embryo freezing), whether unmarried or married.
• Complex cases: such as recurrent implantation failure, severe endometriosis, polycystic ovary syndrome with metabolic abnormalities, requiring multidisciplinary collaboration.

Frequently Asked Questions

What is the success rate at the Assisted Reproduction Centre of Hong Kong Sanatorium & Hospital?

The success rate of assisted reproduction is influenced by multiple factors including age, ovarian reserve, embryo quality, and uterine environment, with significant individual variation. Generally, the live birth rate per cycle for women under 35 is approximately 40-50%, for women aged 35-40 it is about 25-35%, and for women over 40 it is below 15%. The centre regularly submits data to the Hong Kong Council on Human Reproductive Technology; specific figures can be referenced in official annual reports. It is not recommended to use a single success rate as the sole criterion for choosing a centre.

What is the approximate cost at the Assisted Reproduction Centre of Hong Kong Sanatorium & Hospital?

The cost for a single IVF cycle (excluding PGT) is approximately HKD 120,000-160,000, covering initial consultation, tests, stimulation medications, egg retrieval surgery, embryo culture, and transfer. If PGT is required, an additional HKD 30,000-50,000 is added. A frozen embryo transfer cycle costs about HKD 30,000-50,000. The exact cost depends on the doctor's plan; it is advisable to request a detailed fee schedule from the finance department during the initial consultation.

Can Mainland Chinese residents undergo IVF at Hong Kong Sanatorium & Hospital? What procedures are required?

Yes. Mainland Chinese residents seeking assisted reproductive treatment at Hong Kong Sanatorium & Hospital must hold a valid Mainland Travel Permit for Hong Kong and Macau Residents or a passport, and apply for the appropriate tourist or medical endorsement. It is recommended to confirm document validity 2 months before the planned treatment and schedule the initial consultation in advance through the hospital's international department. Some tests can be completed in advance at a tertiary hospital in Mainland China (subject to report acceptance) to shorten the stay in Hong Kong.

Does the hospital provide assisted reproductive services to unmarried individuals?

According to current Hong Kong law and hospital policy, the Assisted Reproduction Centre of Hong Kong Sanatorium & Hospital requires patients receiving assisted reproductive treatment to be in a legal marital relationship (marriage certificate required). Unmarried individuals or same-sex couples are currently unable to undergo IVF treatment for reproductive purposes at this centre. However, fertility preservation (egg freezing, sperm freezing) exists in a legal grey area; it is recommended to consult the centre directly for the latest policy.

Can I still undergo IVF at Hong Kong Sanatorium & Hospital if my AMH is low?

Yes. Low AMH (<1.0 ng/mL) indicates diminished ovarian reserve but is not an absolute contraindication for IVF. The doctor will conduct a comprehensive assessment based on AMH, FSH, antral follicle count, etc., and may use mild stimulation, natural cycle, or antagonist protocols to obtain usable eggs. Individuals with low AMH usually require longer cycle planning and may need to accumulate embryos over multiple cycles. The centre has clinical experience in managing low ovarian reserve, but expectations should be managed.