booklet

香 港 中 文 大 學
威 爾 斯 親 王 醫 院
輔 助 生 育 技 術 中 心
Assisted Reproductive
Technology Unit
The Chinese University
of Hong Kong
The Prince of Wales Hospital
Annual Report
2016

01
Contents
3
Message from the Director
Team Members
4
6
Statistics of IVF-ICSI
(Fresh Embryo Transfer)
Statistics of FET (Frozen Embryo Transfer)
7
Outcomes of Embryo Transfer by Age
Distribution of Patients (Continued)
• Implantation Rate
• Miscarriage per Cllinical Pregnancy
(Preliminary)
Outcomes of Embryo Transfer by Embryo Stage
• Clinical Pregnancy of Cleaved
Embryo and Blastocyst Transfer
• Implantation Rate of Cleaved
Embryo and Blastocyst Transfer
Statistics of IUI
(Intrauterine Insemination)
9
11
13
8
10
12
Outcomes of Embryo Transfer by Age
Distribution of Patients
• Total Pregnancy per Embryo Transfer
• Clinical Pregnancy per Embryo Transfer
• Biochemical Pregnancy per Embryo Transfer
Outcomes of Embryo Transfer by Age
Distribution of Patients (Continued)
• Miscarriage per Clinical Pregnancy
(IVF-ICSI & FE) (Preliminary)
Outcomes of Embryo Transfer by Embryo
Stage (Continued)
• Miscarriage of Cleaved Embryo and Blastocyst
Transfer per Clinical Pregnancy (Preliminary)
14
Outcomes of IUI (Intrauterine Insemination)
by Age Distribution of Patients
Clinical Summary of IVF-ICSI
(Fresh Transfer) in 2016
15
16
Clinical Summary of
Frozen Embryo Transfer in 2016
Clinical Summary of
Intrauterine Insemination in 2016
17
18
Glossary
Appendix 1. Comparison of
Clinical Data (PWH) 2014-2016
19
20
Appendix 2. Comparison of
Implantation Rate and Clinical Pregnancy
Rate (PWH) 2014-2016

02

03
MESSAGE
FROM THE
DIRECTOR
Professor TC Li
Director & Person Responsible
I am so pleased to know that 2016 has been another fruitful year for us. We have
not only maintained the very encouraging improvement in results achieved in
the preceding year, with pregnancy rate per embryo transfer of >40%, but we
have also recorded a further improvement in the overall implantation rate, a
most sensitive key performance indicator of IVF treatment, from 29.6% in 2015
to 31.7% in 2016. Nevertheless, the most remarkable achievement may not be
instantly obvious from cursory reading of the statistics shown in the report.
The high pregnancy rate per embryo transfer has been achieved by keeping the
multiple pregnancy rate to a remarkably low level (9.1% in fresh embryo transfer
cycles and 13.3% in frozen embryo transfer cycles), a consequence of our
policy to replace a single blastocyst whenever possible. A high rate of multiple
pregnancy is undesirable as it is associated with increased obstetrical and
perinatal complications.
Another notable area of improvement this year is intra-uterine insemination,
with an almost doubling of pregnancy rate per insemination from 7.9% in 2015
to 14% in 2016.
The statistics presented in the annual report do not show the proud achievement
of our research team. There were a record high number of publications in
international journals in 2016 arising from the admirable efforts of the research
team, made possible by the full support of everyone in the clinical and laboratory
teams despite their busy workload.
I must take this opportunity to sincerely thank everyone in the unit for their
genuine dedication and tremendous hard work. I know that our significant
achievement and ongoing progress in 2106 would not have been possible
without the fantastic team work.

04
IVF Team Members
Medical Staff
Director
Clinical Director
Specialists
Professor TC Li
Dr. Cheung Lai Ping
Dr. Grace Kong
Dr. Cathy Chung
Dr. Jacqueline Chung
Dr. Jennifer Mak
Dr. Tracy Law
Nursing Staff
Advanced Practice
Nurses
Cheung Mei Chun
Janet Lau
Stella Tang
Annie Lai
Summer Ha
Amy Leung
Chan Wai Fun
Siu King Yan
Laboratory Staff
Laboratory Director
Laboratory Manager
Embryologists
Research Associate
Research Assistant
Dr. Chi Ling
Queenie Yeung
Professor David Chan
Leung Chiu Yi
Stephanie Lam
Carol Chan
Waters, Tarah Helen Buckley

05
ABCD
Research Staff
Research Co-ordinator Dr. Huang Jin
Visiting Scholar Dr. Saravelos Sotirios
PhD Students
Dr. Chen Xiaoyan
Dr. Shi Xiao
Dr. Joy Liu
Dr. Zhao Ming Peng
Research Nurses Tse Lai Yiu
Cosy Cheung
Administration Staff
Quality Manager Sandra Wong
Irene Chiu
Project Manager Lora Ng
Development Manager Dorothy Tse
Clerical Staff
Pauline Chan
Denise Lam
Yvonne Chiu
Sharisa Chuk
Stephanie Leung
Ancillary Staff
Health Care Assistant
Laboratory Attendants
Operation Assistant IIIB
Lee Wah Ying
Fanny Ho
Mony Lai
Tse Shun Kuen

06
Statistics of IVF-ICSI (Fresh Embryo Transfer)
No. of Stimulated IVF-ICSI Cycles (Fresh Embryo Transfer)
Autologous
MESA / TESA
Sperm
Donation
Oocyte
Donation
Total
Initiated 501 13 2 5* 521
Cancelled 58 0 0 0 58
With Oocyte Retrieval 445 13 2 3 463
With Embryo Transfer 241 3 1 2 247
*Three cycles for the oocyte donors and two cycles for the recipients.
Age Distribution of Patients with Oocyte Retrieval
26%
34%
18%
22%
40

07
Statistics of FET (Frozen Embryo Transfer)
No. of FET (Frozen Embryo Transfer) Cycles
Natural
Hormone
Replacement
Total
Thawed 186 226 412
With Embryo Transfer 185 221 406
Age Distribution of Patients with FET (Frozen Embryo Transfer)
29%
32%
20%
19%
40

08
Outcomes of Embryo Transfer by Age Distribution of Patients
Total Pregnancy per Embryo Transfer
Fresh
60%
Frozen
50%
40%
30%
20%
41%
53%
55%
46%
33%
52%
32%
10%
20%
0%
40
Age Group (year)
Clinical Pregnancy per Embryo Transfer
Biochemical Pregnancy per Embryo Transfer
60%
12%
50%
10%
40%
30%
20%
10%
0%
36%
46%
45%
43%
28%
48%
13%
22%
8%
6%
4%
2%
0%
40 40
Age Group (year)
Age Group (year)
5%
7%
10%
3%
5%
4%
8%
10%
Fresh
Frozen
Fresh
Frozen

09
Outcomes of Embryo Transfer by Age Distribution of Patients
(Continued)
50%
Implantation Rate
Fresh
Frozen
40%
30%
20%
31%
44%
36%
38%
45%
10%
0%
21%
8%
18%
40
Age Group (year)
Miscarriage per Clinical Pregnancy ( Preliminary)
Fresh
50%
Frozen
40%
30%
38%
40%
39%
20%
10%
0%
13%
18%
26%
11%
19%
40
Age Group (year)

10
Outcomes of Embryo Transfer by Age Distribution of Patients
(Continued)
Miscarriage per Clinical Pregnancy (IVF-ICSI & FE) (Preliminary)
50%
40%
30%
20%
25%
10%
16%
17%
39%
0%
40

11
Outcomes of Embryo Transfer by Embryo Stage
Clinical Pregnancy of Cleaved Embryo and Blastocyst Transfer
50%
Cleaved Embryo
Blastocyst
40%
30%
44%
47%
20%
28%
27%
10%
0%
Fresh
Frozen
Implantation Rate of Cleaved Embryo and Blastocyst Transfer
50%
Cleaved Embryo
Blastocyst
40%
30%
39%
45%
20%
10%
21%
22%
0%
Fresh
Frozen

12
Outcomes of Embryo Transfer by Embryo Stage (Continued)
Miscarriage of Cleaved Embryo and Blastocyst Transfer per
Clinical Pregnancy (Preliminary)
Cleaved Embryo
Blastocyst
30%
25%
20%
26%
24%
15%
20%
10%
12%
5%
0%
Fresh
Frozen

13
Statistics of IUI (Intrauterine Insemination)
No. of IUI (Intrauterine Insemination) Cycles
Natural Stimulated Total
Initiated 35 226 261
Cancelled 0 19 19
With Insemination 35 207 242
Age Distribution of Patients with IUI (Intrauterine Insemination)
35%
14%
29%
22%
40

14
Outcomes of IUI (Intrauterine Insemination)
by Age Distribution of Patients
Clinical Pregnancy per IUI
20%
15%
13%
15%
19%
10%
11%
5%
0%
40

15
Clinical Summary of IVF-ICSI (Fresh Transfer) in 2016
Total Number of Cycles Initiated 521*
Number of Cycles Cancelled 58
Number of Cycles with Oocyte Retrieval 460
Number of Oocytes per Retrieval (mean ± SD) 9.2±5.8
Fertilization per mature Oocytes 73.9%
Number of Cycles with Embryo Transfer 247
Number of Embryos Transferred per Cycle (mean ± SD) 1.5±0.5
Implantation Rate 25.6%
Pregnancy per Embryo Transfer 40.5%
Clinical Pregnancy per Transfer 33.6%
Biochemical Pregnancy per Transfer 6.9%
Miscarriage per Clinical Pregnancy 25.3%
Multiple Pregnancy per Clinical Pregnancy 10.8%
Number of Embryos Frozen per Cycle with Freezing (mean ± SD) 3.0±2.0
*Three oocyte donors and two recipients were included.
**26 cycles were converted to IUI.

16
Clinical Summary of Frozen Embryo Transfer in 2016
Total Number of Frozen-thawed Cycles Initiated 453
Total Number of Cycles with Embryo Transfer
> Natural Cycles
> Hormone Replacement Cycles
406
185
221
Number of Embryos Transferred per Cycle (mean ± SD) 1.2±0.4
Implantation Rate
> Cleaved Embryo
> Blastocyst
36.3%
21.6%
44.7%
Pregnancy per Embryo Transfer 46.3%
Clinical Pregnancy per Transfer 40.6%
Biochemical Pregnancy per Transfer 5.7%
Miscarriage per Clinical Pregnancy 18.2%
Multiple Pregnancy per Clinical Pregnancy 7.9%

17
Clinical Summary of Intrauterine Insemination in 2016
Total Number of Intrauterine Insemination Cycles Initiated 261*
Number of Cycles Cancelled 19
Number of Pregnancies 34
Clinical Pregnancies per Insemination 14.0%
* 26 cycles of IVF-ICSI converting to IUI were included.

18
Glossary
Embryo transfer (ET)
The process of transferring a fertilized egg in the course of IVF procedures, where following
development in vitro for 2 or 3 days, or after flushing from a woman's uterus by lavage (at 5
days), an early embryo is placed in the uterus of an infertile woman in order to try to achieve
implantation and pregnancy.
Fertilization
The fusing together of the maternal and paternal genetic material from the sperm and the
egg.
Implantation
The process whereby the embryo becomes embedded in the lining of the uterus.
Intra cytoplasmic sperm injection (ICSI)
A process by which a single sperm is injected into the inner cellular structure of the egg.
Intrauterine insemination (IUI)
A procedure whereby a fine catheter with processed sperm is inserted gently through
the cervical opening up into the uterine cavity during the period of ovulation to facilitate
fertilization.
In-vitro Fertilization (IVF)
A method by which processed sperm is placed together with collected oocytes to allow
fertilization.
Clinical pregnancy
A pregnancy documented by 1 or more gestational sacs on ultrasound or the histological
confirmation of gestational products in miscarriages or ectopic pregnancies.
Clinical pregnancy rate
The percentage of treatment cycles that result in a clinical pregnancy, including ectopic
pregnancies, miscarriage and viable pregnancies of at least 6 weeks' gestation but excluding
biochemical pregnancies. Pregnancy rates should be expressed per 100 embryo transfer.
Miscarriage
Loss of an intrauterine pregnancy detected clinically or by ultrasound, and less than 20
weeks' gestation (as estimated by the day of embryo transfer or day of ovulation).
Multiple pregnancy
More than 1 gestational sac on ultrasound of at least 6 weeks' gestation.

19
Appendix 1. Comparison of Clinical Data (PWH) 2014-2016
2014 2015 2016
Fresh Embryo Transfer
> Total Number of Cycles
202
307
247
> Mean Age (years)
36.8
36.4
37.0
> Number of Embryo Transferred
1.7±0.5
1.5±0.5
1.5±0.5
per Transfer Cycle (mean ± SD)
> Implantation Rate
19.6%
25.7%
25.6%
> Pregnancy per Transfer
32.2%
40.7%
40.5%
> Miscarriage per Clinical Pregnancy
20.0%
19.2%
25.3%
> Multiple Pregnancy per Clinical Pregnancy
13.3%
10.6%
13.3%
> Live Birth per Transfer
23.3%
25.4%
24.7% #
Frozen Embryo Transfer
> Total Number of Cycles
228
386
406
> Mean Age (years)
36.5
37.0
37.1
> Number of Embryo Transferred
1.4±0.5
1.2±0.4
1.2±0.4
per Transfer Cycle (mean ± SD)
> Implantation Rate
28.9%
34.1%
36.3%
> Pregnancy per Transfer
40.8%
47.6%
46.3%
> Miscarriage per Clinical Pregnancy
22.1%
23.9%
18.2%
> Multiple Pregnancy per Clinical Pregnancy
5.8%
3.2%
9.1%
> Live Birth per Transfer
28.9%
29.0%
33.0% #
Intrauterine Insemination
> Total Number of Cycles
357
304
252*
> Mean Age (years)
37.0
36.6
36.6
> Clinical Pregnancy per Insemination
8.3%
7.9%
14.0%
> Live Birth per Insemination
6.2%
6.6%
10.7% #
* 26 cycles of IVF-ICSI converting to IUI were included.
#
On-going pregnancies beyond 13 weeks were included.

20
Appendix 2. Comparison of Implantation Rate and
Clinical Pregnancy Rate (PWH) 2014-2016
Implantation Rate (Fresh and Frozen Embryo Transfer Combined)
40%
30%
20%
10%
24.1%
29.6%
31.7%
0%
2014
2015
2016
Age Group (year)
Clinical Pregnancy Rate (Fresh and Frozen Embryo Transfer Combined)
40%
30%
20%
34.0%
37.4%
38.0%
10%
0%
2014
2015
2016
Age Group (year)

輔 助 生 育 技 術 中 心
Assisted Reproductive Technology Unit
www.ivfhk.com