Assisted reproduction in Hong Kong: Status in the 1990s

Information on assisted reproduction in Hong Kong for the period from January 1992 to December 1993 was collected from the three centres that offer assisted reproduction. Altogether, 912 treatment cycles of in vitro fertilisation and embryo transfer, 158 treatment cycles of gamete intrafallopian transfer, and 87 cycles of zygote intrafallopian transfer were initiated during this period. The delivery rates per cycle started were 8.4% for in vitro fertilisation, 29.1% for gamete intrafallopian transfer, and 13.8% for zygote intrafallopian transfer. During the same period, 233 cycles of replacement of frozen thawed embryos were completed with a delivery rate of 11.2% per cycle. Pregnancies were also achieved using oocyte donation and micromanipulation techniques.published_or_final_versio

Alternative donor site for alveolar bone grafting in adults with cleft lip atid palate

Grafting of the alveolar ridge with autogenous bone is an integral stage of contemporary management of complete cleft lip and palate cases. Alveolar bone grafting restores continuity of the dental arch, closes oronasal fistulae, supports the alar base, and facilitates spontaneous eruption of permanent teeth adjacent to the cleft. However, timing of the graft and the selection of materials have been topics of much debate in the literature. This article discusses an alternative donor site in cases where rehabilitation has passed the recommended time. Harvesting bone from the third molar regions allows not only the removal of impacted third molars during the same surgical procedure, but also eliminates the morbidity associated with additional surgical sites such as the ilium or mandibular symphysis. This report should not be interpreted as a recommendation for the use of this alternative site in cases where grafting is carried out within the optimal time period, which is usually in the mixed dentition stage. However, when grafting is necessary in young adults suffering from complete cleft lip and palate, the third molar region may provide another acceptable donor site.link_to_OA_fulltex

The value of transabdominal pelvic ultrasonography in monitoring of ovulation induction with gonadotropins

Seventy-five patients with a total of 306 human menopausal gonadotropin treatment cycles over the period 1984-1989 were analysed retrospectively to evaluate the value of transabdominal pelvic ultrasonography in prevention of complications arising from ovulation induction with human menopausal gonadotropins. There were 60 pregnancies giving a pregnancy rate of 19.6% per cycle. There was positive correlation between the number of follicles ≥14 mm in mean diameter and the incidence and degree of hyperstimulation (p<0.005) as well as the incidence of multiple pregnancies (p<0.01). Ultrasonography is a useful adjunct for monitoring in such a program.link_to_subscribed_fulltex

An analysis of ectopic pregnancies following in vitro fertilisation treatment in a 10-year period

Of clinical pregnancies in our in vitro fertilisation (IVF) programme, 5.4% were ectopic and 0.85% of clinical pregnancies (15% of ectopic pregnancies) were heterotopic. Ectopic pregnancies were more common after IVF/embryotransfer (ET) than frozen embryotransfer (FET). Although there was a suggestion that tubal factors were more common in those with ectopic pregnancies, the difference did not reach statistical significance. No relationship existed with regard to the ovarian stimulation regimen, the dosage/duration of human menopausal gonadotrophin used, the details of embryo transfer and number of embryos transferred. Patients who develop ectopic pregnancies after IVF can be counselled that they have a good chance of achieving a normal pregnancy with subsequent attempts.link_to_subscribed_fulltex

A randomized trial comparing the efficacy of ovarian stimulation and intrauterine insemination versus ovarian stimulation alone in the treatment of male infertility and unexplained infertility

Poceedings of a British CongressSession FC19 - Infertiltty 1link_to_OA_fulltex

Basal serum pituitary hormone levels and outcome of in vitro fertilization utilizing a flare nasal gonadotropin releasing hormone agonist and fixed low- dose follicle-stimulating hormone/human menopausal gonadotropin regimen

Day 2 serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are prognostic indicators in treatment with in vitro fertilization (IVF) and FSH is especially useful in predicting the ovarian response to superovulation.link_to_subscribed_fulltex

Ultrasound-guided embryo transfer: A prospective randomized controlled trial

Background: Recent reports suggested that ultrasound guidance during embryo transfer might improve the pregnancy rate. Methods: A prospective randomized controlled trial was performed to compare embryo transfer under ultrasound guidance versus the clinical touch method. A total of 800 embryo transfers was studied; 400 were randomized to ultrasound-guided transfers and 400 were randomized to the clinical touch group. Of these, 441 were fresh cycles and 359 were frozen-thawed cycles. Results: The clinical pregnancy rate was 26.0% in the ultrasound-guided group and 22.5% in the clinical touch group; the difference was not statistically significant. The ongoing pregnancy rate was 23.5% in the ultrasound-guided group compared with 19.0% in the clinical touch group and the difference was again not statistically significant. The implantation rate was slightly higher in the ultrasound-guided group (15.3%) than the clinical touch group (12.0%) (P = 0.048). There were no differences in the incidences of ectopic pregnancy, miscarriage and multiple pregnancy between the two groups. Conclusions: A significant improvement in implantation rate was observed following the use of ultrasound guidance during embryo transfer. The extent of improvement in the pregnancy rate may depend on the specific techniques and methods of embryo transfer used in individual centres.link_to_subscribed_fulltex

Efficacy of the urinary hemagglutination test (Higonavis) and enzyme immunoassay (Ovustick) in detection of the spontaneous luteinizing hormone surge in an in vitro fertilization/gamete intrafallopian transfer (IVF/GIFT) program

Fifty-eight treatment cycles in an in vitro fertilization/gamete intrafallopian transfer (IVF/GIFT) program were studied to compare the efficacy of two urinary methods, hemagglutination test (Higonavis) and enzyme immunoassay (Ovustick), in detection of spontaneous luteinizing hormone (LH) surge. If an isolated rise in urinary LH level was taken as indicative of LH surge, the false-positive rate was 36.7% for Higonavis and 10.2% for Ovustick. The difference was statistically significant (P < 0.001). If only a sustained rise in urinary LH was taken to indicate LH surgery, the false-positive rate was 6.1% for Higonavis and 0% for Ovustick. In the seven cycles with a spontaneous plasma LH surge, there was a positive correlation between the plasma LH levels and the two urinary assay methods in six cycles (85.7%). Compared to plasm LH, there was a mean delay of 17.4 hr by the Higonavis test and 15.6 hr by the Ovustick test. If a sustained rise in urinary LH levels was taken as indicative of LH surge, both methods are quite accurate but the Ovustick appeared to be more specific.link_to_subscribed_fulltex