It is difficult not to sympathise with patients with infertility problems ("Relook neonatal insurance requirement in IVF process" by Mr Sim Eng Cheong; Feb 20).

The costs incurred in normal pregnancies pale in comparison with those for in-vitro fertilisation (IVF) pregnancies.

Without compulsory assisted reproduction programme insurance, many will find it financially crippling to complete the whole 40 weeks of pregnancy.

IVF babies also have about 1.25 times more chances of having congenital abnormalities, compared to others conceived naturally.

It is unethical not to treat complicated IVF pregnancies or babies with health problems, no matter the cost.

But where patients cannot pay and insurance is not purchased, the state (and so the taxpayer) is burdened unjustifiably.

Of course, the less likely the event, the less the insurance premium, and every covered episode is discrete.

We pay car insurance before any accident happens and the insurance has to be renewed every year, even if we have a clean record.

And so it is with every attempt at IVF. By paying before any conception and paying per IVF treatment, the cost per attempt is controlled to a manageable level.

One is uninsurable or else has to pay heftily loaded premiums when the event is diagnosed.

Asking for the return of neonatal insurance premiums should no live delivery result is akin to demanding the refund of one's car insurance premium when no accident occurs during the period of coverage.

It defies the mutually beneficial established covenant between insured and insurance company, and is not the way actuarial science works.

Yik Keng Yeong (Dr)