Success Rate for IVF Decreases With More Cycles

18 Jan 2006, The Straits Times

Question

Name of the Person: Janet Lee Siew Ling (Mdm)

Success Rate for IVF Decreases With More Cycles

Give more help to couples attempting IVF (Jan 4, 2006) 

I HAVE been married for more than five years and have been trying for a baby since I had an ectopic pregnancy in 2000. 

But my efforts have been to no avail, even after some operations as advised by my doctors. 

My husband and I decided to give in-vitro fertilisation (IVF) a try after the Medisave withdrawal limit for the procedure was raised in 2004. 

Of course, we were aware that the Medisave subsidy would not be able to cover the cost of IVF, so we set aside about $15,000. 

We were also aware that there is no 100 per cent guarantee of success in IVF treatment.Up to now, I have gone for three rounds of embryo transfer over a period of one year, but I am yet to get pregnant. 

For the three failed IVF attempts, we spent about $30,000, not inclusive of Medisave. 

With our ageing population and falling birth rate, the Government has implemented measures to encourage citizens to give birth. 

It should also consider: Allowing the husband to use his Medisave for his wife's IVF treatment. 

I would like to try IVF again even after the failed attempts, but the cost of treatment can easily go up to $50,000, without Medisave. So this measure would help women like me. Giving more benefits or tax rebates to couples trying to have babies through IVF. 

Now, the Government gives baby bonus and tax rebates to couples who have babies. 

More can be done for couples like my husband and myself, who spend so much on IVF because they want to have babies.

Name of the Person: Seah Liang Chiang

IVF treatment: More ways to help couples (Jan 6, 2006) 

HAVING recently gone through two unsuccessful in-vitro fertilisation (IVF) cycles, I can empathise with Madam Janet Lee Siew Ling ('Give more help to couples attempting IVF'; ST, Jan 4). 

My wife and I agree that more can be done to assist couples in the area of assisted reproduction. 

The cost of an IVF cycle can range from $7,000 to $20,000, depending on where one seeks treatment. The bulk of the cost goes towards paying for the drugs. 

To make IVF or, for that matter, any assisted conception procedures (ACP) more affordable, couples who undergo such treatments are able to use Medisave for up to three treatment cycles - $6,000 for the first, $5,000 for the second, and $4,000 for the third. 

The withdrawal from Medisave for the purpose of ACP can be from either spouse's account. So I am puzzled as to why Madam Lee was not allowed to use her husband's Medisave. 

In addition to Madam Lee's request, I hope the Health Ministry can consider the following suggestions: Allow Medisave withdrawals for up to five treatment cycles instead of the current three, at a minimum withdrawal of $3,000 for the fourth and fifth treatment cycles. Subsidise the cost of drugs required for assisted reproduction. Increase the age limit for women for acceptance into assisted reproduction programmes from the current 45 to 50, but only if they are deemed medically fit. Increase the number of treatment cycles for women who enter the assisted reproduction programme at above 40 years of age from a maximum of five treatment cycles to 10 cycles. 

Singapore is ever changing to adapt with the times. Perhaps we should also be bold in our approach to assist childless couples like Madam Lee and her husband achieve their dream of having a baby. 

People are not only living longer, they are marrying later in life and having children at an older age. This is not an abnormal phenomenon in a progressive society and is a trend that is unlikely to be reversed. 

Instead of taking a pragmatic approach, both the Health Ministry and Central Provident Fund Board should take a more compassionate view in helping childless couples. 

If it is not in lessening the burden of assisted reproduction, then perhaps, in giving them a greater sense of hope. 

Before going for our third treatment cycle, we were told that our chances of conceiving were less then 5 per cent. 

To us, that 5 per cent chance meant there was hope. That sense of hope eventually resulted in a healthy baby girl.

Reply

Reply from MOH 

Medisave designed primarily for inpatient hospital bills 

I refer to the recent letters in the ST Forum Page urging for the greater use of Medisave for in-vitro fertilisation (IVF). Suggestions include extending the current Medisave withdrawals from three to five treatment cycles; subsidising the cost of drugs required for assisted reproduction; and increasing the women's age limit from current 45 to 50 for acceptance into Assisted Conception Procedure. 

The Ministry fully understands the disappointment of couples who have tried IVF several times but without much success. We empathise with their predicament and the emotional and financial strain that they have to go through in trying for a baby. 

In support of the overall Government's initiative to encourage childbirth, Medisave usage for ACP has been revised in 2004 , up to $6,000 , $5000 and $4000 for the 1st, 2nd and 3rd cycle respectively , up to a maximum of 3 treatment cycles. The limit of 3 treatment cycles was put in place as scientific data, both local and international, have shown that success rates decrease with increasing attempts for various reasons, such as diminishing egg reserves and quality of eggs as a woman ages, and beyond the third IVF treatment cycle, the success rate is very low (less than 5% based on our local data). As the main purpose of Medisave is to help Singaporeans pay for their lifetime hospitalisation needs, especially in old age, where medical bills may be high, it would not be prudent to further liberalise more Medisave usage for IVF's treatment, especially when chances of success after the first few cycles are slim. 

We would also like to clarify that one can use their own, their spouse's Medisave or both combined to pay for the procedure.