Purpose: To review the experience of an assisted reproduction program.
Data sources: Department of Obstetrics and Gynaecology, University of Hong Kong.
Study selection: Assisted reproduction in a tertiary referral centre.
Data extraction: Results of assisted reproduction from 1986-1996.
Results: In the past ten years, 1561 treatment cycles of in vitro fertilization and embryo transfer (IVF), 257 of gamete intrafallopian transfer (GIFT) and 217 of pronuclear stage tubal transfer (PROST) were initiated. The clinical pregnancy rates per cycle started were 10.8% for IVF, 16.3% for GIFT and 15.7% for PROST. As a result of improvement in ovarian stimulation and embryo culture, the success rate of the program increased in recent years. The pregnancy rate of IVF per embryo transfer was 20.2% in 1995. Embryo cryopreservation program was started in 1992. Since then, 664 cycles of replacement of frozen-thawed embryos were completed with a pregnancy rate of 14.6% per cycle. One hundred and forty-three cycles of assisted fertilization using various techniques, namely partial zona dissection, subzonal sperm injection and intracytoplasmic sperm injection, were performed. The success rate was the highest for the latter technique with a pregnancy rate of 14% per transfer cycle. A prospective randomized control trial on the use of coculture in assisted reproduction had also been done. Results indicated that coculture of embryos with human oviductal cells improved the implantation rate of the embryos.
Conclusion: Various technique development have been made to improve the success rate of assisted reproduction as well as the quality of treatment of infertility.