IVF Process, Costs & Considerations at CUHK Medical Centre

Beginning: Hospital Process Style

The IVF treatment at the Reproductive Medicine Centre of the Chinese University of Hong Kong Hospital follows a standardised medical pathway from the initial consultation to embryo transfer. After booking the first appointment, patients must complete a comprehensive fertility assessment. Based on the results, the doctor formulates an individualised ovarian stimulation protocol. The entire cycle typically takes 8 to 12 weeks, with the exact duration varying depending on the stimulation protocol, ovarian response, and whether preimplantation genetic testing is performed.

Indications for IVF Services

The Reproductive Medicine Centre of the Chinese University of Hong Kong Hospital treats patients with the following main indications:

• Tubal factor infertility: Bilateral tubal blockage, severe adhesions, or post-salpingectomy.
• Male factor infertility: Oligospermia, asthenospermia, teratospermia, or obstructive azoospermia.
• Ovulation disorders: Polycystic ovary syndrome (PCOS) not pregnant after ovulation induction, diminished ovarian reserve, etc.
• Endometriosis: Moderate to severe endometriosis causing pelvic adhesions or reduced ovarian reserve.
• Unexplained infertility: No clear abnormality on routine investigations but no pregnancy after more than 1 year.
• Genetic disorders: Requiring preimplantation genetic testing (PGT) to avoid genetic risks.

For conditions that do not meet the medical indications for IVF, such as mild male factor or mild ovulation disorders that can be resolved with lower-cost treatments, doctors will优先 recommend other paths. Not all infertile individuals proceed directly to an IVF cycle; individualised assessment is the first step.

Detailed Treatment Process

The standardised IVF process within the hospital is divided into clear stages, each with corresponding monitoring checkpoints.

1. Initial Consultation and Fertility Assessment: Medical history is taken, and investigation forms are issued (female: AMH, FSH, LH, E2, thyroid function, infectious disease screening, karyotype; male: semen analysis + infectious disease screening + karyotype).
2. Developing the Stimulation Protocol: Based on age, AMH, antral follicle count, and previous cycle history, an antagonist protocol, agonist long protocol, or mild stimulation protocol is chosen.
3. Ovulation Monitoring: Transvaginal ultrasound monitors follicle development, combined with blood hormone tests. The cycle lasts approximately 10–14 days.
4. Egg Retrieval Surgery: Performed under intravenous sedation via transvaginal ultrasound guidance. The procedure takes about 15–20 minutes, followed by a 2-hour observation period.
5. Fertilisation and Embryo Culture: Conventional IVF or ICSI insemination. Embryos are cultured to day 3 (cleavage stage) or day 5–6 (blastocyst stage).
6. Embryo Transfer: The embryo is placed into the uterine cavity under abdominal ultrasound guidance. The patient rests in bed for 30 minutes post-procedure.
7. Luteal Phase Support: Progesterone gel or injections are used after transfer, continuing until the pregnancy test day.
8. Pregnancy Test: Blood test for β-hCG is performed 12–14 days after transfer to confirm pregnancy.

Key Examination Indicators Explained

Below are the most essential tests at the initial consultation and their clinical significance:

Abnormal test results do not directly mean IVF is impossible; rather, they help the doctor choose a more suitable insemination method and stimulation strategy. For example, when AMH is low, a mild or minimal stimulation protocol may be used to prioritise oocyte quality.

Impact of Age on IVF Treatment

Age is one of the most significant variables affecting IVF success. Different age groups show clear differences in oocyte yield, embryo euploidy rate, and cumulative live birth rate.

• Under 35 years: Ovarian reserve is generally good, with higher oocyte yield. Euploidy rate is approximately 50%–60%, and live birth rate per single transfer is about 40%–50%.
• 35–38 years: Ovarian reserve begins to decline, oocyte yield decreases. Euploidy rate drops to 35%–45%. Blastocyst culture + PGT-A may be considered to improve efficiency.
• 39–40 years: Oocyte yield is significantly reduced. Euploidy rate is about 20%–30%. Multiple egg retrieval cycles may be needed to accumulate embryos.
• Over 41 years: Ovarian reserve is markedly diminished. Euploidy rate is below 15%. Doctors will thoroughly discuss egg donation options and success rate expectations.

For individuals of advanced age or with AMH below 1.0, it is recommended to complete all investigations in advance to avoid delays due to test validity periods. Some tests (e.g., karyotype, infectious disease screening) are valid for 1 year, so retesting should be scheduled according to your planned timeline.

Cost Breakdown and Influencing Factors

The cost of IVF at the Reproductive Medicine Centre of the Chinese University of Hong Kong Hospital is not fixed; actual expenses depend on a combination of modules. Below is an overview of the cost structure:

The total cost for a complete fresh cycle typically ranges from HKD 100,000 to 200,000. Cost variations mainly arise from the choice of stimulation medications, whether PGT is performed, and the need for multiple egg retrievals. The hospital provides a detailed fee schedule, and patients can request a personalised quote from the finance department before treatment.

Comparison of Major Fertility Centres in Hong Kong

Institutions offering IVF services in Hong Kong include public hospitals, private hospitals, and specialist clinics. As a teaching hospital, the Chinese University of Hong Kong Hospital has the following characteristics:

• Medical Team: Composed of professors from the Department of Obstetrics and Gynaecology at CUHK and senior reproductive specialists, involved in clinical research and international collaboration.
• Laboratory Standards: The embryology lab is equipped with time-lapse imaging incubators and AI-assisted embryo grading systems, supporting blastocyst culture and PGT.
• Service Model: Patient-centred multidisciplinary collaboration covering reproductive endocrinology, embryology, genetic counselling, and psychological support.
• Appointment Cycle: As a private hospital, the waiting time for an initial consultation is usually 1–2 weeks, significantly shorter than public hospitals (6–12 months).

When choosing a fertility centre, it is advisable to focus on laboratory quality control data, the stability of the medical team, and your specific needs (e.g., PGT or special protocols), rather than merely comparing success rates. Success rates are influenced by patient age, diagnostic composition, and statistical methods, making direct comparisons of limited value.

Easily Overlooked Details

In preparation for your visit, the following aspects are often overlooked by patients:

• Referral Letter Requirement: Some insurance plans or hospital processes require a referral letter from a general practitioner or gynaecologist. Confirm this before booking your first appointment.
• Document Preparation: Hong Kong residents need to provide their ID card and proof of address; non-Hong Kong residents need a valid travel permit and visa. The hospital will require copies for records.
• Organising Past Medical Records: Including previous surgical records, hysteroscopy reports, hysterosalpingography, and semen analysis reports. Translating them into English or Chinese summaries in advance can speed up the initial consultation.
• Male Partner's Test Timing: Semen analysis requires 2–7 days of abstinence. Coordinate the timing with the cycle to avoid the situation where the female partner has started stimulation but the male partner's tests are incomplete.
• Waiting Period for Chromosome Results: Peripheral blood karyotype analysis usually takes 14–21 days for results. It is recommended to complete this well in advance, not overlapping with the stimulation cycle.

Frequently Asked Questions

Q: Can I still do IVF if my AMH is low?

Yes. Low AMH indicates reduced ovarian reserve, but it does not mean no eggs can be retrieved. The doctor will use a mild or minimal stimulation protocol to try to obtain a small number of good-quality eggs. For patients with AMH below 0.5, the doctor will objectively discuss the expected number of eggs retrieved and cumulative pregnancy rates, and may suggest a strategy of multiple egg retrieval cycles.

Q: What do overseas residents need to prepare for IVF at the Chinese University of Hong Kong Hospital?

A valid travel permit and visa, copies of complete past medical records, a referral letter (if required), and proof of sufficient funds. It is recommended to contact the hospital's international department in advance to confirm the appointment process and payment methods. Non-Hong Kong residents usually need to pay the full cost out-of-pocket. The hospital will provide a cost estimate before treatment.

Q: Do I need to prepare my body before IVF?

The doctor will assess nutritional status, thyroid function, vitamin D levels, and BMI. If significant abnormalities are present (e.g., hypothyroidism, vitamin D deficiency, BMI >30), it is recommended to correct these to an ideal range before starting the cycle. Folic acid supplementation (400–800 μg/day) is routinely recommended. Other supplements should be taken as advised by the doctor.

Q: How long do I need to rest in bed after embryo transfer?

You can leave the hospital after resting in bed for 30 minutes post-transfer. Prolonged bed rest is not recommended. Resume normal daily activities but avoid strenuous exercise and heavy lifting. Long-term bed rest may affect blood circulation and has no proven benefit for pregnancy outcomes.

Management of Special Situations

The following situations require additional medical arrangements:

• Previous OHSS History: The doctor will choose a low-dose stimulation protocol or a freeze-all strategy to avoid increasing the risk with a fresh transfer.
• Uterine Fibroids or Adenomyosis: Depending on the location and size of the fibroids, surgery may be performed first. Submucosal fibroids usually require hysteroscopic resection before transfer.
• Recurrent Implantation Failure: Investigations may include hysteroscopy to rule out endometrial pathology, ERA testing for the window of implantation, and immunological screening.
• Genetic Disease Risk: Requires genetic counselling followed by PGT-M or PGT-SR. After embryo biopsy, waiting for test results typically takes an additional 4–6 weeks.

This content is compiled based on industry consensus in assisted reproductive medicine and public information from the Chinese University of Hong Kong Hospital. It is for informational purposes only. Please consult a doctor in person for specific diagnosis and treatment plans.