NAME AND CONSTITUENCY OF MEMBER OF PARLIAMENT
Mr Louis Ng Kok Kwang
MP for Nee Soon GRC
QUESTION NO. 372
To ask the Minister for Health (a) for each year in the past five years, what is the total amount of subsidies provided for In-Vitro Fertilisation (IVF) treatments; and (b) based on current amount of subsidies and data, what is the expected increase in subsidies expenditure where subsidies are provided beyond the current three fresh and three frozen subsidised cycles for (i) an additional fresh cycle (ii) an additional frozen cycle (iii) two additional fresh cycles and (iv) two additional frozen cycles respectively.
To support couples in fulfilling their marriage and parenthood aspirations, the Government provides co-funding for patients seeking Assisted Reproduction Technology (ART) procedures, including In-Vitro Fertilisation (IVF), to defray their out-of-pocket costs for such procedures at public hospitals. Eligible couples  can receive up to 75% in co-funding from the Government for ART treatment cycles, for a maximum of three fresh and three frozen ART cycles. From 2015 to 2019, annual co-funding provided has increased  more than 40% from approximately $14 million in 2015 to $20 million in 2019.
Government support for ART is based on clinical evidence that the success rate of ART decreases for successive cycles as a woman progresses in age. In 2019, among the 48 couples who utilised their sixth co-funded cycle, close to 75% of the women were aged 35 and above at the time of their sixth co-funded cycle. Clinical data shows that while success rates exceed 24.6% for women aged 34 and below, this falls to 17.1% for women from ages 35 to 39, and falls further to 6.7% for those aged 40 and above. Given the significantly lower success rate for couples undergoing additional co-funded cycles beyond the sixth cycle, it is important that we remain grounded by the clinical evidence when extending co-funding to more cycles at this point, while bearing in mind that the couple will still be subject to the emotional strain faced in each attempt. Hence, we must continue to encourage couples to seek treatment early, in order to maximise the chances of conception.
Co-funding of six cycles hence strikes a balance between providing financial support to couples with parenthood aspirations and ensuring that public funds are used in a targeted way.
 ART co-funding eligibility criteria include: a. The patient has not already received three co-funded fresh and three co-funded frozen cycles in the past; b. The patient or her spouse must be a Singapore Citizen at the start of the ART cycle; c. The patient must be below 40 years of age at the start of the cycle; d. The treatment is a fresh or a frozen cycle; and e. The patient has been assessed by a doctor to have met the clinical requirements for ART.
 2020 data has been excluded as it is not yet complete and likely distorted by the local COVID-19 situation.