1. Initial Consultation
Couples should bring along their records of infertility workup they possess, such as hysterosalpingogram (HSG) films, semen analysis reports, basal body temperature charts, previous operative records and laboratory test results.

The gynaecologists/ reproductive specialists will advise them on the programme, and some further investigations may be ordered to establish the cause of their problems, if not clearly known, or to help decision-making on choosing the most appropriate technique.

6. Semen Collection
The husband will be asked to submit a sample of fresh semen on the day of egg collection. If you have problem with semen collection or need to freeze a sample before treatment cycle for backup, please contact our staff for arrangement.

	Sperm of low motility	Sperm after washing

2. Counselling
After preliminary examination and investigation, the patients, as a couple, need to receive counselling service offered by the attending doctor and nurses, in order to have an in-depth understanding of the meaning and procedures of reproductive technology. They will also learn about the complications that might be induced by the treatment and other options for the situation, such as adoption. Patients will be referred to other doctors, clinical psychologists or lawyers for counselling when they have the need or when it is required for certain reproductive technology. The patient couple must have sufficient time before making the decision.

Consent forms must be signed when the patient couple decides to take up treatment. Marriage certificate must be presented before the treatment begins.

If needed, professional consultation from clinical psychologists can be arranged.

7. Fertilisation and Cleavage
The fertilised egg cells begin to divide and become embryos. Embryologists will monitor the embryonic development and choose the best embryo and the best day for embryo transfer.

3. Hormonal Stimulation
IVF treatment usually begins with the use of hormones to induce egg production. There are different hormone injections available and our doctor will choose the most appropriate one for the patients.

Natural cycle IVF or the in vitro maturation technology may sometimes be conducted for certain clinical situation. Please talk to our doctor for details.

8. Embryo Transfer
Embryos are usually ready for transfer about 2-5 days following egg collection. They are placed into the uterus by means of a thin tube (catheter) through the neck of the womb (cervix). The procedure is similar to a routine gynaecological examination; it usually does not require anaesthesia. The patient may leave the hospital half an hour after embryo transfer.

4. Monitoring the Maturation of Eggs
Ultrasound scanning (USS) of the ovaries is done regularly to monitor the size of the follicles. Once the time of egg collection is decided, an additional injection (usually in the form of placental hormone (hCG)) is given to complete the final maturation step and to release the eggs timely. Egg collection will be scheduled 34-36 hours later after this injection.

9. Post-Embryo Transfer Blood Test
Blood tests are performed to monitor the progesterone level following embryo transfer and for evidence of pregnancy approximately 8-14 days later.

5. Egg Collection
Transvaginal Ultrasound-Guided Oocyte Retrieval (TUGOR) – The doctor will pass a needle though the vagina to obtain the eggs under the guidance of ultrasound imaging. The eggs, thus obtained, will be handed to the embryologist-in-charge immediately for in vitro fertilisation and culture. The patient can leave the hospital in a few hours after the surgery.

	Egg with inclusions	Normal looking egg