Expert in Assisted Reproduction Aims to Ease Patient Stress

For his patients, their goal is to give birth to a healthy baby. For Professor Ernest Ng, an expert in assisted reproduction, his aim is to simplify every aspect of this potentially arduous journey.

Professor Ng is edging closer to this target after he was awarded the Tsao Yin-Kai Professorship in Obstetrics and Gynaecology at the end of 2024.

His Endowed Professorship recognises his 30-year career as a clinician-scientist at HKUMed.

Professor Ng graduated from the Faculty in 1986 and completed his training in obstetrics and gynecology in Hong Kong and the United Kingdom. He joined the Department of Obstetrics and Gynaecology to work with Professor Ho Pak Chung, an expert in reproductive medicine in 1996.

The newly appointed Endowed Professor thanked Dr Walton Li Wai-Tat, who established the professorship in honour of his uncle, Dr Tsao Yin-Kai, for his generosity.

“We’ll carry on our research, especially with this financial support to increase our understanding of the biology and also to provide the best quality evidenced-based care to our patients,” he said, describing how he plans to use the additional funding from the professorship.

Endowed Professorships are among the most significant awards given to leading academics at the University of Hong Kong. They are named in honour of a donor, corporation, or other honoree recommended by the donor. Since their establishment 20 years ago, 120 Endowed Professorships have been awarded to scholars.

In celebration of the Medical Faculty’s newly appointed Endowed Professors, we sat down with them to discover more about their research goals.

Professor Ng first experienced the field of obstetrics and gynaecology during medical school. At the time, students were required to follow mothers through their labour, potentially waiting through the night to conduct the delivery.

These “joyful” experiences coupled with the ability to combine medicine and surgery in one discipline encouraged him to pursue this path.

He later narrowed this focus to assisted reproduction as it allows him to work with a wide range of colleagues.

“The reason I chose assisted reproduction is there’s close collaboration with scientists, and advances in the technologies, [such as the] ways we culture the embryo, that mean it’s very interesting to work in this area,” he said.

Describing himself as primarily a clinician, Professor Ng said his research is driven by the desire to give his patients evidence-based advice, something that was often absent early in his career.

“That made us feel pressured and that we should give the patients the best evidence so we can stand up our practice,” he said. “Very often, research questions have been posed by patients, and when we don’t have good confidence in a practice we’re doing.”

Through every aspect of his clinical practice and research, Professor Ng seeks to minimise the psychological and physical burden on his patients.

From launching social media pages to share waiting list times, to hosting monthly webinars on in vitro fertilisation, and providing access to counselling services, he has focused on making his patients’ lives easier.

Professor Ng and his colleagues have also introduced several new technologies for patients in Hong Kong. Their firsts include intracytoplasmic sperm injection and pre-implantation genetic diagnosis for conditions, including the blood disorders α-thalassaemia and β-thalassaemia.

Funding from his Endowed Professorship will help further this work. The expert in assisted reproduction methods said the professorship will support two current research projects.

The first project addresses one of the major challenges for Professor Ng’s field — the age of the mother. The average age of his patients has risen to 36 from 34 a decade ago.

As women age, their ovarian reserve drops, meaning their ovaries hold fewer healthy immature egg cells. This poses an additional challenge for fertility treatment as fewer eggs mean fewer potential embryos for implantation.

To improve these patients’ chance of pregnancy, Professor Ng and his colleagues are working on techniques to select the best quality embryos for implantation. These include examining the embryo’s chromosome makeup and the microRNA present to identify the healthiest embryo.

“You won’t be able to change the background of the patient, but if the patient has a number of embryos, and if you choose the best one so that they get pregnant the first time… that helps the patient to reduce the burden and pain during the journey,” he said.

The second project, which is in collaboration with Professor Kui Liu from the Department of Obstetrics and Gynaecology is working to identify more effective drugs to stimulate follicle growth.

Women seeking fertility treatment are given drugs to stimulate the development of follicles in the ovaries to produce mature egg cells.

New drug options will provide more avenues for patients who have a poor response to existing medications, Professor Ng explained.

Drawing from a library of around 1,000 drugs that already have US Food and Drug Administration approval, Professor Ng said the team are now ready to progress to clinical trials.

“We used a laboratory model to test whether it improves the activation of follicles,” he said. “We are now able to identify some drugs that have been shown in animal models using the mouse [showing] the follicle grows faster and better.”

As for his goals for once he completes these research projects, Professor Ng said he will remain committed to achieving meaningful incremental improvements for his patients.

“It’s not the end of the study, it’s the beginning of other studies,” he said.