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In support of marriage and parenthood, Singapore is removing its age limit for women undergoing in-vitro fertilisation (IVF) treatments, it is also removing the cap on the number of IVF cycles, and enhanced subsidies for Assisted Reproductive Technology (ART) treatments will be implemented.

This newest set of government measures is a step in the right direction as it leaves the choice of childbearing to women.

By removing the IVF age limit, women who are beyond 45 but are still fertile and remain healthy are allowed to continue trying for a baby. This will also be beneficial to women who marry late and want to have children.

The removal of the limit to the number of cycles is also a welcome development as older women are likely have to gone through more cycles to obtain healthy eggs.

These measures will reduce the need for women to seek fertility treatments elsewhere.

Gynecological problems/fertility issues

The risks for older women are mainly associated with medical disorders, like hypertension and diabetes, as well as a much higher chance of miscarriage due to the inherent risks of having chromatically abnormal fetuses. When a miscarriage takes place, there may be a need for invasive procedures to remove the pregnancy tissue.

This can potentially damage the uterine environment, and as a result of the emotional stress, also further decrease the woman’s fertility. And as a woman ages, there is also an increased risk of other gynaecological problems like fibroid or endometriosis, which can also reduce the chance of conception.

What can be done 

Currently in Singapore, egg-freezing is only allowed on medical grounds. However, many women across the world have the option to preserve their fertility, so that when they are ready to have a baby, they are able to.

Egg-freezing has been accepted as a useful tool – it is not a proposition for everyone, but perhaps it is time to consider adding this option to improve women’s chances of conception in the city state.

Preimplantation Genetic Testing for Aneuploidy (PGT-A) is another tool to help reduce the risk of having an abnormal embryo implanted, and therefore wasting an ART cycle.

To improve the take-home baby rate, checking the embryos to determine which is normal prior to transfer has the potential to reduce cost as well as physical and emotional trauma for a couple.

Most of all, there is a need to educate and stimulate more conversations around fertility even as the provision of financial and emotional support for those having difficulties have improved. This will go a long way in improving pregnancy and take-home baby rates in Singapore. -/TISG