In Vitro-Fertilisation (IVF) in Singapore: Process and Cost
In August 2019, it was announced by the Ministry of Health that Singapore would be removing the age limit for women undergoing Assisted Reproduction Technology (ART) procedures, such as In-Vitro Fertilisation (IVF) treatments, as part of the government’s ongoing efforts to encourage and support marriage and parenthood.
Other measures that were announced included enhanced government co-funding for ART procedures.
This article explains more about IVF, including the requirements to qualify for IVF treatments, the procedure and costs involved. It will also explain alternative treatments to IVF that are currently available in Singapore.
What is In-Vitro Fertilisation (IVF)?
IVF is an ART treatment to help couples who experience difficulties conceiving.
In IVF, a couple’s egg and sperm are fused together in a laboratory. The highest-quality developed embryos are then selected and transferred into the mother’s uterus for conception.
IVF is usually recommended for couples who have been diagnosed with fertility disorders. These include:
- Women with blocked or damaged fallopian tubes, or who have had their fallopian tubes removed;
- Men with decreased sperm count or sperm motility;
- Women with ovulation disorders or conditions such as endometriosis (where the lining of the uterus is found outside the womb, and the scarring/inflammation of it may block the fallopian tubes and keep an egg and sperm from uniting); and
- Individuals with a genetic disorder.
Couples with unexplained infertility issues may also seek IVF treatments to increase their chances of conceiving.
What is the difference between IVF and surrogacy?
In IVF, the female partner carries the child throughout the duration of the pregnancy.
However, in surrogacy, a woman (also known as the surrogate) is artificially impregnated to carry the child for the couple, where the female partner is unable to carry the child. For example, due to her inability to conceive through ART treatments, or where pregnancy is risky.
In Singapore, however, the provision of surrogacy services is currently illegal.
Assisted Reproduction (AR) centres in Singapore are prohibited from carrying out surrogacy services and risk having their licences suspended or revoked if they do so.
You may refer to our other article for further information on the legal issues to consider about surrogacy in Singapore.
What is the IVF Process?
A typical IVF cycle can be explained through the following steps:
Currently, there is a cap on the number of IVF cycles that a woman can undergo. This is set at 10 cycles for women aged 40 and below, and 5 for women above 40. However, this cap will be removed from 1 January 2020.
Typically, the first 3 steps of the IVF cycle (from the first injection of the hormone medication to egg retrieval) last for 10 to 12 days. However, this may vary across couples depending on whether they may need to undergo any additional tests or treatments prior to commencing the IVF process.
Generally, the success rate of 1 IVF cycle ranges between 50% to 60%. On average, not more than 3 to 4 IVF cycles are required as most couples successfully conceive in less than 3 cycles.
Do I Qualify for IVF?
With effect from 1 January 2020, there will be no age limit for women who wish to undergo ART procedures, including IVF treatments. However, women will have to be assessed by their doctor and certified fit to carry a pregnancy to its full term of 9 months before proceeding with the treatment.
A couple who wishes to undergo IVF treatment will first need to be assessed by a fertility specialist to understand their overall reproductive health. Tests will also be conducted to help identify any underlying causes that are affecting the couple’s ability to conceive naturally.
For women, these tests may include blood tests and ultrasound scans, while additional tests may be required to check the fallopian tubes and condition of the uterus. For men, a semen analysis will be conducted which measures the volume, shape and movement of his sperm.
Can foreigners undergo IVF in Singapore?
Yes, foreigners can undergo IVF treatments in Singapore. However, do note that co-funding of IVF treatments is only available for Singapore citizens, or where one person in the couple is a Singapore citizen (explained below).
What is the Cost of IVF in Singapore?
IVF treatments are offered in both public hospitals and private hospitals or medical institutions in Singapore.
The costs of IVF treatment are typically between S$10,000 and S$15,000 per cycle at the 3 public hospitals that currently offer IVF treatments:
- KK Women’s and Children’s Hospital;
- National University Hospital; and
- Singapore General Hospital.
Private medical centres may offer IVF treatment packages at a rate of between S$7,999 and S$20,000 per cycle. Their treatment packages may include the following services:
- Doctor’s consultation fees during follicle scans
- Ultrasound follicle scans
- Doctor’s professional fees for egg collection and transfer
- Laboratory charges
- Nursing fees, use of operating theatre, standard consumables and recovery room charges.
However, do note that some IVF packages may not cover initial consultation fees with a doctor, medication and other optional procedures which will incur additional costs.
You should review the costs of IVF treatment at both public and private centres to determine which would be the most affordable option for you.
Co-funding options for IVF treatments and eligibility requirements
Co-funding options are also available to increase the accessibility and affordability of IVF treatments. Do note that co-funding is only available for treatment at public centres.
In addition, to be eligible for co-funding:
- You must not have already received 3 co-funded fresh and 3 co-funded frozen cycles in the past; and
- Either you or your spouse must be a Singapore citizen.
The current co-funding options are set out in the table below:
|Couple’s citizenship||Per fresh cycle||Per frozen cycle||Coverage|
|Both Singapore citizens||Up to S$7,700||Up to S$2,200||Maximum 3 fresh cycles and 3 frozen cycles|
|1 Singapore citizen, 1 Permanent Resident||Up to S$5,700||Up to S$1,600|
|1 Singapore citizen, 1 foreigner||Up to S$3,600||Up to S$1,000|
From 1 January 2020, up to 2 of the 6 co-funded cycles can be carried out at age 40 or later. This is in contrast to the current position where co-funding for up to 6 cycles is only available for women aged below 40 at the start of the cycle.
However, the couple must have previously attempted ART treatments or procedures before age 40.
A Singapore Citizen or Permanent Resident couple can also use their Medisave to help fund the costs of IVF treatments. The withdrawal sums are set out in the table below:
|Treatment cycle||Amount||Withdrawal limit|
|First treatment cycle||S$6,000||Lifetime withdrawal limit of S$15,000 per patient applies|
|Second treatment cycle||S$5,000|
|Third treatment cycle||S$4,000|
What Other Fertility Treatment Options are There in Singapore?
Besides IVF, there are other fertility options that are available to couples. These include:
Intra-Uterine Insemination (IUI)
This involves inserting the prepared sperm sample (from the male partner or a donor) through the neck of the womb and into the uterus, close to the time of ovulation. IUI can be performed during a natural menstrual cycle or with artificial hormone stimulation.
It aims to increase the number of sperm that reach the fallopian tubes and subsequently increase the chances of fertilisation. If a couple performs the IUI procedure each month, the pregnancy success rates may be as high as 20% per cycle.
One may opt for IUI due to conditions such as unexplained infertility or ejaculation dysfunction in the male partner. It is however not recommended to women whose fallopian tubes are diseased, or who are suffering from endometriosis, where their fallopian tubes may be blocked (as mentioned above), decreasing their chances of fertilisation.
Intra-Cytoplasmic Sperm Injection (ICSI)
If the male partner has been diagnosed with male fertility problems such as low sperm count or low sperm motility, the ICSI procedure may help a couple conceive.
During ICSI treatment, an embryologist will use a micromanipulation equipment to inject a single sperm into each egg. The ICSI technique assists in the penetration of the egg by the sperm. This is different from IVF where thousands of sperm are added to each egg for fertilisation.
Both IVF and ICSI procedures can be carried out together to increase the chances of a successful fertilisation.
Intracytoplasmic Morphologically-Selected Sperm Injection (IMSI)
IMSI is offered where the male partner is diagnosed with severely reduced levels of sperm morphology or with mid to high-range DNA damaged sperm. It may be appropriate where the couple has a history of recurrent implantation failures or unsuccessful ICSI treatments.
A sperm sample is first obtained from the male partner. Through IMSI, the laboratory can enlarge the images of sperm to over 1,200 times its actual magnification.
The male partner’s sample is then compared against pre-defined sperm that are determined to have the best sperm quality in terms of size and shape to select the most appropriate sperm to be injected into the egg of the female partner.
IMSI offers couples a significant increase in fertilisation and pregnancy rates, as well as a reduction in miscarriage rates. However, this treatment option is not widely available and is only offered in selected fertility treatment centres.
If you are considering IVF treatments, you should consult specialist gynaecologists who are accredited IVF clinicians. They will be able to assist you with any concerns or queries that you may have about undergoing IVF.