Guide To IVF, IUI & Other Assisted Reproductive Technology In Hong Kong

Understanding Infertility

Generally speaking, infertility is a condition where you can't get pregnant after one year of trying to conceive - despite having regular sexual intercourse. Causes of infertility can include ovulatory disorders, endometriosis, low sperm count or low testosterone. Sometimes the cause of infertility is unexplained - however, what we do know is that the risk of infertility increases with age. For more information about risk factors and causes, please visit the Cleveland Clinic page here, which has compiled a very easy-to-understand guide.

The first thing your doctor or gynecologist may ask for is blood tests to determine your hormone levels, thyroid function, etc. The doctor might also test your AMH levels or Anti-Mullerian Hormone, to determine your ovarian levels. A pelvic or transvaginal ultrasound may be performed.

Other tests include a hysteroscopy, a doctor examines your uterus using a thin, lighted hysteroscope inserted through your vagina. In a saline sonohysterogram, saline is introduced to your uterus to enhance a transvaginal ultrasound image. A sono hysterosalpingogram involves filling the fallopian tubes with saline and air bubbles to detect blockages during an ultrasound. An X-ray hysterosalpingogram captures dye moving through the fallopian tubes via X-ray to identify blockages. Lastly, laparoscopy involves inserting a camera-equipped laparoscope through a small cut in the abdomen to diagnose conditions like endometriosis, fibroids, and scar tissue.

Lastly, sperm tests might also be requested as well at this stage.

Undergoing Fertility Treatments In Hong Kong

To undergo any assisted fertility treatments in Hong Kong you will need to be legally married and be able to produce a valid marriage certificate. Unmarried or same-sex couples will need to seek treatment abroad.

Your doctor will review all the next steps with you to decide together what treatment you may need and the risk factors involved. If you do go ahead with fertility treatments, you and your spouse will need to sign consent forms, showing that you understand the risks involved, as well as details surrounding egg, embryo and sperm storage. The form will also ask what you may want to do with any unwanted embryos- whether you would like to donate them or other.

Types Of Different Assisted Reproductive Technology

There are many assisted reproductive technologies available, and, depending on you and your spouse's test results and the doctor's recommendations, you may want to choose one of them. To boost your chances of pregnancy, you might take ovulation-stimulating drugs (such as Clomid) before considering these methods:

• In vitro fertilization (IVF) involves collecting eggs from your ovaries and fertilizing them with sperm in a laboratory. Afterward, a provider implants one to three embryos into your uterus.
• Intracytoplasmic sperm injection (ICSI) can be part of IVF, where an embryologist injects a single sperm into an egg. Then, up to three embryos are placed in your uterus.
• Intrauterine insemination (IUI), or artificial insemination, involves a provider inserting sperm into your uterus using a thin tube.
• Assisted hatching helps an embryo implant in the uterine lining by thinning the embryo's outer layer.

Infertility treatments can lead to complications, such as:

• A greater likelihood of having multiples (twins, triplets, or more), which can raise the risk of miscarriage, premature birth, low birth weight, neonatal death, and long-term health issues due to the common practice of producing and transferring multiple embryos.
• Ovarian hyperstimulation syndrome (OHSS), a painful condition with swollen ovaries caused by fertility drugs, sometimes requiring urgent care.
• An increased chance of ectopic pregnancy, particularly with IVF treatments.
• The possibility of unsuccessful treatment cycles that do not result in pregnancy - a failed cycle.

For more information visit the Cleveland Clinic and Hong Kong's Council on Human Reproductive Technology.

Deciding Whether To Go For IVF

Given all these risk factors, it can be overwhelming news to be told that you will need to undergo IVF in order to have a baby. The process is lengthy and costly, considering that we have one of the most expensive healthcare in the world. IVF packages vary widely. Also, not many insurance providers cover the costs of IVF in Hong Kong. Of those international providers who do, the waiting time may be costly, and you will need to have been an existing client before being diagnosed with infertility.

Insurance providers in Hong Kong that may cover (some) costs of IVF:

• AXA
• CCW Global

If you prefer going the public route, two Hong Kong hospitals provide IVF at subsidized rates:

• Prince of Wales Hospital
• The Queen Mary Hospital

You can also opt for private care within those hospitals - which will be significantly cheaper than going to a private clinic or hospital.

Private Clinics & Centers Offering IVF In Hong Kong

Several private clinics and facilities offer IVF treatment in Hong Kong - however it is expensive, and you can expect to pay upwards of HK$90,000 per cycle. Some clinics list their prices on their website making it a little simpler to make an informed decision.

• Heal Fertility, Central, Hong Kong - price list
• Hong Kong Assisted Reproduction Centre, Central, Hong Kong - price list
• Hong Kong IVF Centre, Tsim Sha Tsui, Hong Kong
• Hong Kong Reproductive Medicine Centre, Tsim Sha Tsui, Hong Kong
• Hong Kong Sanatorium, Happy Valley, Hong Kong - price list
• ProlIVFic A.R.T. Centre, Central, Hong Kong
• Reproductive Healthcare, Central, Hong Kong
• The IVF Clinic (The Women's Clinic), Central, Hong Kong
• Union Reproductive Medical Centre, Tsim Sha Tsui, Hong Kong
• Victory A.R.T Laboratory, Tsim Sha Tsui, Hong Kong

For a detailed overview of the services these clinics provide, click here.

Taking Care Of Your Mental Health

The IVF journey is a long and tumultuous one and does not always result in a positive outcome, unfortunately. That, combined with at times feelings of guilt and negative self-worth, fluctuating hormones due to the medication, physical and emotional discomfort and fatigue, amongst other factors can have a tremendous toll on your mental health and at times relationship. It is therefore important to take some time for self-care and to seek help and support when you need it. Many people combine IVF with counseling to make the journey slightly less arduous. There is also a wealth of online resources and support groups you can access.

Helpful apps to download:

• Embie - keeps track of all your treatments and appointments, sets up reminders, access the community features, offers real-time treatment monitoring assistance
• Tilly - connect with others on the same journey, provides self-care tools
• Mindful IVF - personalized meditations according to your IVF cycle

Supplementing With Traditional Chinese Medicine

Traditional Chinese Medicine (TCM) can not only help alleviate stress and anxiety but has also been proven to boost fertility. Most TCM doctors in Hong Kong are familiar with the IVF journey and can create personalized treatment plans to guide you through it. Here are some of the best in the city, specializing in fertility.

• Troy Sing, Health Wise, Central, Hong Kong - https://www.chinesemed.hk/troy-sing
• Oriental Health, Central, Hong Kong, https://www.orientalhealth.com.hk/ivf-support/
• Balance Health, Central, Hong Kong, https://balancehealth.com.hk/fertility-treatment/
• Master Ruth, Central, Hong Kong, https://www.masterruth.com/ivf-acupuncture
• Dr Michelle Law, Vitality Center, Central, Hong Kong, https://vitalitycenter.com.hk/practitioners/dr-michelle-law-pui-man/