Publications by authors named "Vivian C Lee"
Article Synopsis
- Low- and middle-income countries face significant health challenges, particularly due to a lack of drug research and access to essential medications, especially for neglected diseases associated with poverty.
- The Health Impact Fund aims to improve drug accessibility and promote research for neglected diseases, currently focusing on partnerships with big pharmaceutical companies in high-income countries.
- Exploring collaborations with pharmaceutical industries in BRIC nations could enhance local innovation, create equitable drug development pathways, and benefit stakeholders across all involved regions, despite some limitations in drug development expertise.
Background: Miscarriage is a common complication of pregnancy occurring in 15-20 % of all clinically recognized pregnancies. Currently, there is still no good scientific evidence to support the routine use of progestogens for the treatment of threatened miscarriage because the existing studies were not large enough to show a significant difference and some of them were not randomized or double-blind.
Methods: This is a double-blind, randomized controlled trial.
Article Synopsis
- This study aimed to assess how serum adiponectin levels relate to metabolic syndrome in Chinese women diagnosed with polycystic ovary syndrome (PCOS).
- Researchers conducted a cross-sectional analysis of 116 women at a hospital in Hong Kong between 2010 and 2011, using various clinical and biochemical parameters.
- The results indicated that serum adiponectin, along with age and BMI, is independently linked to metabolic syndrome, suggesting further research is needed to explore its long-term health implications.
Objective: To report the outcomes of more than 100 cycles of preimplantation genetic diagnosis for monogenetic diseases.
Design: Case series.
Setting: Tertiary assisted reproductive centre in Hong Kong, where patients needed to pay for the cost of preimplantation genetic diagnosis on top of standard in-vitro fertilisation charges.
Objective: To determine the live birth and cumulative live birth rates of expected poor ovarian responders according to the Bologna criteria and to compare their outcomes with those of expected normal responders.
Design: Retrospective analysis.
Setting: University infertility clinic.
Article Synopsis
- IVF embryos exhibit a significant level of aneuploidy, impacting the success of assisted reproduction treatments, with this study focusing on mosaicism in high-quality embryos from young donors.
- A total of 36 day-2 embryos were analyzed, revealing that a substantial percentage of embryos showed varying degrees of aneuploidy and mosaicism after detailed genomic analysis.
- Errors during meiosis and mitosis were identified in these embryos, contributing to chromosomal abnormalities, with specific error types being linked to the observed mosaicism.
Objectives: To compare the pregnancy outcome of the fluorescent in-situ hybridisation and array comparative genomic hybridisation in preimplantation genetic diagnosis of translocation carriers.
Design: Historical cohort.
Setting: A teaching hospital in Hong Kong.
Objective: To evaluate ovarian response and cumulative live birth rate of women undergoing in-vitro fertilization (IVF) treatment who had discordant baseline serum anti-Mullerian hormone (AMH) level and antral follicle count (AFC).
Methods: This is a retrospective cohort study on 1,046 women undergoing the first IVF cycle in Queen Mary Hospital, Hong Kong. Subjects receiving standard IVF treatment with the GnRH agonist long protocol were classified according to their quartiles of baseline AMH and AFC measurements after GnRH agonist down-regulation and before commencing ovarian stimulation.
Purpose: To perform Preimplantation Genetic Diagnosis (PGD) on a paternal Brca2 unknown mutation carrier with early-onset breast cancer, whose paternal grandmother and mother had breast cancer at 60s.
Method: Elucidating the linkage via single sperm haplotyping on patient's carrier brother, and identifying the genomic deletion via BLAST followed by PCR screening. PGD was subsequently conducted.
Study Question: Does endometrial injury in the cycle preceding ovarian stimulation for in vitro fertilization (IVF) improve the ongoing pregnancy rate in unselected subfertile women?
Summary Answer: Endometrial injury induced by endometrial aspiration in the preceding cycle does not improve the ongoing pregnancy rate in unselected subfertile women undergoing IVF.
What Is Known Already: Implantation failure remains one of the major limiting factors for IVF success. Mechanical endometrial injury in the cycle preceding ovarian stimulation of IVF treatment has been shown to improve implantation and pregnancy rates in women with repeated implantation failures.
We report a live birth from a couple with two genetic diseases, namely: reciprocal translocation carrier and alpha-thalassaemia trait, following pre-implantation genetic diagnostic tests. This is the first case in Hong Kong in which the technique of using one blastomere biopsy for two diseases was established, using array comparative genomic hybridisation and polymerase chain reaction.
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- The study aimed to assess whether DHEA supplementation before IVF could enhance ovarian response and IVF outcomes in women expected to have a poor ovarian response.
- The research involved 32 women divided into two groups: one receiving DHEA and the other receiving a placebo, with a focus on measuring various ovarian response markers.
- Results showed that while DHEA supplementation increased certain hormone levels, it did not significantly improve ovarian response indicators or IVF success rates compared to the placebo group.
This retrospective cohort study aims at determining whether baseline antral follicle count (AFC) and serum anti-Mullerian hormone (AMH) level in the index stimulation cycle predict live-birth outcome in subsequent frozen-thawed embryo transfer (FET) cycles. We studied 500 women undergoing the first IVF cycle who had embryo(s) cryopreserved. The main outcome measures were live-birth in the first FET cycle and cumulative live-birth in all the FETs combined after the same stimulation cycle.
View Article and Find Full Text PDFObjective: To assess the incidence of P elevation (PE) in natural cycles and evaluate its effect on frozen-thawed embryo transfer cycles performed in natural cycles (FET-NC).
Study Design: Retrospective analysis.
Setting: A tertiary assisted reproductive unit.
Objective: To compare the live birth rate, multiple pregnancy rate, and obstetric outcomes of elective single and double embryo transfers.
Design: Case series with internal comparisons.
Setting: University affiliated hospital, Hong Kong.
Purpose: This retrospective cohort study evaluated the cumulative live birth rate in women with polycystic ovary syndrome (PCOS) and isolated polycystic ovaries (PCO) undergoing in-vitro fertilisation (IVF) treatment.
Methods: We studied 104 women with PCOS, 184 with PCO and 576 age-matched controls undergoing the first IVF treatment cycle between 2002 and 2009. The main outcome measure was cumulative live birth in the fresh plus all the frozen embryo transfers combined after the same stimulation cycle.
Purpose: To validate the use of the ovarian sensitivity index (OSI) as a measure of ovarian response during in-vitro fertilization (IVF) treatment.
Methods: This is a retrospective study carried out in an assisted reproduction unit in a teaching hospital. We analysed data from 2,556 women undergoing the first IVF cycle between 2002 and 2009.
Study Question: What is the effect of letrozole on the expression of steroid receptors in the placentae in cases of termination of pregnancies?
Summary Answer: The expression of estrogen receptor-α (ERα) and progesterone receptor (PR) transcripts, as well as ERα protein, in placentae was suppressed by letrozole pretreatment in second trimester termination of pregnancy.
What Is Known Already: There have been no data in the literature on the effect of letrozole in termination of human pregnancies.
Study Design, Size, Duration: This study is part of a clinical randomized trial in which 50 subjects were recruited and 44 placentae were collected.
Objective: This retrospective study determined for the first time the role of baseline antral follicle count (AFC) and serum anti-Mullerian hormone (AMH) level in the first in-vitro fertilisation (IVF) cycle in predicting cumulative live birth from one stimulation cycle.
Methods: We studied 1,156 women (median age 35 years) undergoing the first IVF cycle. Baseline AFC and AMH level on the day before ovarian stimulation were analysed.
Article Synopsis
- The study aimed to compare pregnancy outcomes in natural cycle frozen-thawed embryo transfers (FET) with and without luteal phase support (LPS).
- A total of 408 FET cycles were analyzed, revealing no significant differences in clinical pregnancy or miscarriage rates between the two groups.
- The only significant predictor of clinical pregnancy rate identified was the woman's age, suggesting that further randomized trials are needed for confirmation.
Article Synopsis
- Preliminary reports indicate that DHEA may be beneficial for women with poor ovarian reserve and primary ovarian insufficiency (POI), but more rigorous studies are needed.
- The study aimed to evaluate the impact of 16 weeks of DHEA treatment on ovarian response markers in 22 women with unexplained POI, compared to a placebo.
- Results showed improved antral follicle counts and ovarian volume in the DHEA group, although serum AMH and FSH levels did not change significantly; higher testosterone and estradiol levels were also noted.
Article Synopsis
- Previous research indicated that combining letrozole with misoprostol improved abortion rates compared to misoprostol alone and linked higher estradiol levels to increased failure rates.
- This pilot study involved 20 participants who received letrozole for 7 days before taking misoprostol, aiming to boost estradiol suppression and complete abortion rates for pregnancies up to 63 days.
- Results showed a 95% complete abortion rate, with most participants (88%) favoring the option of medical termination in the future, indicating that this new method is as effective as the standard regimen.
Background: The aim of this randomized trial was to evaluate the abortion rate of combined regimen of letrozole and misoprostol in second-trimester abortion.
Study Design: This was a randomized, double-blinded, placebo-controlled trial of 130 women requesting legal termination of pregnancy at gestational age between 12 and 20 weeks. Letrozole 7.
Article Synopsis
- The study evaluated the pharmacokinetics of vaginal misoprostol using three different methods: dry tablets, tablets moistened with saline, and those with acetic acid, involving 42 women seeking a pregnancy termination.
- Results indicated that the moistened tablets had significantly higher peak drug concentrations and faster absorption times compared to the dry tablets, with saline or acetic acid enhancing the drug's effectiveness.
- The findings suggest that using moistened misoprostol may improve clinical outcomes, particularly in terms of absorption and efficacy.