SINGAPORE – Singapore is ramping up the capacity of in-vitro fertilisation (IVF) facilities at public hospitals as the number of couples seeking medical help to have a baby is expected to keep growing.

About 10,500 cycles of assisted reproductive technology (ART) treatments were carried out in Singapore in 2022, the latest data available.

This is a 14 per cent increase from about 9,200 cycles in 2020, and an 81 per cent jump from about 5,800 cycles in 2013, a spokeswoman for the Ministry of Health (MOH) told The Straits Times.

ART treatments refer to IVF and its variations, such as intra-cytoplasmic sperm injection and gamete intrafallopian transfer.

In response to a parliamentary question in April, Health Minister Ong Ye Kung said KK Women’s and Children’s Hospital (KKH) and Singapore General Hospital (SGH) plan to increase their capacity for ART treatments progressively over the next few years. National University Hospital (NUH) renovated its IVF laboratory in 2022 to increase its capacity.

When the expansion plans are completed, the ART capacity across the three hospitals will increase by about 20 per cent, he said in the reply to Nee Soon GRC MP Louis Ng, who asked if public hospitals are planning to increase their capacity to carry out ART treatments.

Doctors say the demand for medical help to have a baby has increased due to various reasons, such as a greater awareness and acceptance of IVF here.

Associate Professor Yong Tze Tein, head of SGH’s Department of Obstretrics and Gynaecology, said: “With greater awareness, there is also less taboo about (the) difficulty of conceiving, and more couples are open to come for help.”

Professor P.C. Wong, head of NUH’s Division of Reproductive Endocrinology and Infertility, said that couples are marrying at a later age, and as fertility declines with age, more couples require help conceiving.

The median age at the first marriage was 29.3 years for women and 30.7 for men in 2022. This was up from 28 years for women and 30.1 years for men in 2012, according to the latest data from Statistics on Marriages and Divorces 2022 published by the Department of Statistics.

Doctors say many of their patients are aged 35 and older.

Prof Yong said the lifting of the age limit of 45 for women undergoing ART treatments in January 2020 means that older women have access to IVF here. Although their numbers are “not large”, they add to the overall numbers here.

Couples also get financial help from the Government if they seek ART treatments at public assisted reproduction centres, which are located at KKH, NUH and SGH.

For example, the Government will co-fund up to 75 per cent of the cost for eligible couples undergoing IVF and other ART treatments at the public assisted reproduction centres. The government co-funding covers up to $7,700 for a fresh cycle of ART treatment, up to a maximum of three fresh cycles and three frozen cycles of ART treatments.

The estimated cost for a single fresh IVF cycle at KKH’s KKIVF Centre for a Singapore citizen ranges from $12,000 to $16,000, said Dr Liu Shuling, director of the centre.

However, most Singaporean couples have minimal out-of-pocket expenses as the bulk of their IVF cost can be claimed from MediSave and the government co-funding scheme, she said.

Expansion plans

KKH recorded a more than 40 per cent increase in IVF cases between 2014 and 2023.

Dr Liu said that a new IVF speciality laboratory, which will expand the hospital’s capacity for the more specialised cases, such as performing biopsy procedures for pre-implantation genetic testing and elective egg freezing, is expected to be ready by 2024. 

SGH is shifting its Centre for Assisted Reproduction to a new location within the hospital compound in 2027 so that it can accommodate more consultation rooms, a larger operating theatre and a laboratory that can fit more incubators.

Prof Yong said: “Meanwhile, we are training more doctors, hiring more staff, including embryologists and a clinic co-ordinator.”

NUH’s Prof Wong said its IVF capacity has increased by about one-third after the renovation in 2022. Among other things, the renovation increased the hospital’s capacity to store frozen eggs and embryos. 

The MOH spokeswoman told ST that the three hospitals’ expansion plans are to prepare for future increases in demand for such treatments.

The current utilisation rate at the public assisted reproduction centres is only about 61 per cent, she said.

At NUH, the waiting time for IVF services is very short, said Prof Wong. The average wait for subsidised patients is about nine days, and less than seven days for private patients.

At SGH, most patients have an average waiting time of two weeks for their first consultation with the doctor, Prof Yong said.

KKH’s Dr Liu said: “There is currently no wait time for couples starting IVF treatment, and the patient can commence IVF as soon as she feels well and at her next menses.”

Surge in demand at private centres

In Singapore, about 60 per cent of women who sought ART treatments between 2020 and 2022 did so at a public assisted reproduction centre or at both public and private centres, said the MOH spokeswoman. The remaining women sought treatment at only private centres. 

There are currently 13 licensed assisted reproduction centres, and 10 of them are private.

These include private centres such as Thomson Fertility Centre and Virtus Fertility Centre Singapore, which have seen a significant rise in their patient load in the past decade.

Thomson Fertility Centre saw a more than 70 per cent increase in the number of IVF cycles done in 2023, compared with 2015, said Mr Jack Ng, chief operating officer of Thomson Medical.

In 2019, Thomson Fertility Centre increased its capacity by over 50 per cent by moving from Novena Specialist Centre to Paragon Medical Centre, where it has a larger IVF laboratory and more operating theatres, among other things.

In April, Virtus Fertility Centre Singapore announced the launch of its Ready Baby grant to “lower the cost barrier for couples embarking on their journey to parenthood”, said its managing director Tim Kwan.

The grant gives between $2,000 and $5,000 to eligible couples to help them cover the treatment fees at Virtus, and the centre expects at least 10 to 15 patients to benefit from the grant in its first year.

A cycle of IVF at Virtus costs from about $15,000 to $17,700.

One couple who sought help at NUH to have a baby is bank officer Sophia Phua and sales executive Alvin Teo, both 32.

From left) Dr Huang Zhongwei, consultant at NUH’s Division of Reproductive Endocrinology and Infertility, Ms Sophia Phua and Mr Alvin Teo with their daughter Sonya, and senior staff nurse Janice Tay. ST PHOTO: HESTER TAN

The couple dated for 10 years before tying the knot five years ago, and they faced questions from anxious relatives about their baby plans.

Ms Phua said: “Everyone is waiting for a grandchild, and family and friends keep asking us why we don’t have kids yet and why are we waiting? They told us not to wait. So, this can be quite awkward.”

Ms Phua tried four cycles of intrauterine insemination – an artificial insemination procedure – without success, but she finally had good news from her second cycle of IVF.

Her daughter, Sonya, is now eight months old.

The couple are thankful for the government co-funding, which they say helped them a lot. With the co-funding and MediSave deductions, they had no out-of-pocket expenses for their entire ART treatment, which amounted to less than $18,000.

Mr Teo said: “We get joy just from looking at her (Sonya). The happiness is really there.”