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Assisted reproduction to boost Singapore's fertility rate?

08 June 2012

Prof Eric Blyth (centre, in white) discussing fertility issues with seminar participants

Can assisted reproductive technology (ART) help Singapore's languishing fertility record?

NUS Visiting Professor Eric Blyth from the University of Huddersfield, England, addressed this question at a recent seminar organised by the Department of Social Work. The attendees comprised Department staff and research students; professionals from local hospitals; and representatives from the Ministry of Health (MOH, Ministry of Community, Youth and Sports (MCYS) as well as the National Population and Talent Division.

The discussion covered the extent, causes and consequences of nearly 40 years of below replacement fertility in Singapore, and the potential benefits of publicly funded fertility treatments and accessibility to elective oocyte cryopreservation. The latter, frequently described as "social egg freezing", has been suggested as a means of protecting the fertility of young women against ageing and thus increasing their chances of successful conception if they later decide to expand their family.

Participants agreed that while clinical expertise in Singapore enjoys a high international reputation and success in ART, essential support and intermediary provision such as counselling are less well-developed compared to some other countries.

Government financial support for eligible couples undergoing ART appears to be meeting current demand although MOH is reviewing whether extending the upper age limit and the number or types of funded treatment cycles might enhance the aspirations of couples with fertility problems and the government's desire to boost fertility rates.

Prof Blyth illustrated the experience of Israel's generously funded ART programme, generally perceived as a successful model of state funding that other countries might emulate. Recent research has highlighted the significant psychosocial pressures on women whose treatment is not successful, and identified the unintended negative consequences of unlimited state-funded provision.

Regarding elective oocyte cryopreservation, its outcomes have been insufficiently evaluated to warrant making this available as a routine clinical service, despite the aggressive marketing by American fertility clinics. However, it was suggested that Singapore might provide an optimum location to initiate a properly evaluated clinical trial.

Participants agreed that the overall impact of ART on population growth was likely to be modest but it could form part of a wider programme to promote family-building.

By NUS Department of Social Work