S'pore couples get help to pay for tests to cut risk of passing on genetic diseases in IVF

Mr Edmund Lye, 37, Ms Tan Chia Hui, 36, and their child, Eliza, two. The couple had undergone pre-implantation genetic testing at NUH. ST PHOTO: NG SOR LUAN

SINGAPORE - From July 1, Singaporean couples who wish to conceive but are worried about passing on serious inheritable diseases to their child will receive government funding support of up to 75 per cent to test for known genetic disorders in embryos in the in-vitro fertilisation (IVF) process.

The Ministry of Health (MOH) said on Thursday (June 30) that the funding is for two types of pre-implantation genetic testing (PGT), which are done on embryos created via IVF and would reduce the risk of genetic diseases being passed on.

The first type of test, known as PGT-M, screens for common and rare disorders, such as the blood disorder beta thalassemia and spinal muscular atrophy.

The second type of test, PGT-SR, checks for chromosomal structural abnormalities, which may manifest themselves in developmental delays or learning disabilities in conditions such as Down syndrome.

The tests cost about $11,000 to $31,000 each, with that for rare disorders costing the most as it involves more preparatory work. The funding covers the tests and the embryo biopsy done by an assisted reproduction centre.

For instance, a Singaporean couple can get funding of up to $17,100 for the PGT process for common disorders and up to $31,420 for the process to test for rare disorders.

On average, 40 to 50 couples a year are expected to benefit from the scheme, said Ms Indranee Rajah, Minister in the Prime Minister's Office, at a doorstop interview in National University Hospital (NUH), where she was visiting to find out more about fertility treatment processes and to announce the details of the funding scheme.

“We have been looking at a whole raft of measures to support families... this is a specific part... Think of the couple who give birth to a child who has inherited diseases or defects. They go through a lot, and there’s the costs, it’s emotional, and the difficulty. So, the question is whether you can help to circumvent this,” she said. 

“The key indicator for PGT is if you or your family member has some kind of genetic defect or mutation, or you could be a carrier... Then you would want to test and make sure.. that you will have a healthy child,” she added.

Ms Rahayu Mahzam, Senior Parliamentary Secretary for Health, who was also at the same event, said the funding support is part of the Government's larger effort  to support couples who wish to conceive.

“These are the things that would perhaps encourage parents as well as those who want to try for a second child,” she said. 

Associate Professor Samuel Chong Siong Chuan giving Ms Indranee Rajah (right) and Ms Rahayu Mahzam a tour of the centre. ST PHOTO: NG SOR LUAN

This funding scheme is for couples with at least one Singaporean spouse who is clinically eligible for PGT and the funding is subject to co-funding caps.

It is for couples where the wife is below 40 years old and covers up to six cycles of PGT.

Those who have gone for an assisted reproduction technology or intrauterine insemination cycle before 40 and wish to try again after 40 can receive the funding for up to two cycles of PGT.

Some 5½ in 1,000 people have changes in the structure of their chromosomes, but they are usually not aware of it, said Associate Professor Samuel Chong, the director of NUH’s Pre-Implantation Genetic Diagnosis Centre.

“It’s only when they are married and want to have children that they find that they can’t get pregnant or, sometimes, they have offspring with a genetic condition,” he said. 

PGT will reduce the risk of miscarriages that result from genetic abnormalities and, so far, most cases have been referred, said Prof Wong Peng Cheang, emeritus consultant and the head of the division of reproductive endocrinology and infertility at NUH’s department of obstetrics and gynaecology.

“What happens is most people who have repeated miscarriages (will) see a doctor (who will) then investigate this. Then they usually do their… chromosome analysis called karyotyping,” he said.

This will tell whether the husband or the wife has genetic abnormalities, and a genetic counsellor may then refer the couple for a PGT test, he added. 

“There are a lot of miscarriages that happen and there are no explanations. This is different (as) the wife or the husband has an identified abnormality. Then we’ll know what to look for (in the PGT test),” said Prof Wong.

MOH introduced PGT as regulated clinical services in May last year. Prior to that, the tests had been available only under a pilot programme since 2005.

MOH said the level of co-funding and the co-funding caps depend on the citizenship status of the couples. This is similar to existing co-funding schemes for assisted reproduction technology and intrauterine insemination procedures, the ministry said.

A couple made up of a Singaporean and a permanent resident will receive up to 55 per cent co-funding support while a couple with one foreign spouse will get up to 35 per cent co-funding support.

Eligible couples can also tap their own or their spouse's MediSave to pay for PGT, regardless of whether they are seeking care at a public or private centre.

There are nine assisted reproduction centres here, but only one lab - at NUH - that can process the tests. If the embryo biopsy is done at the private centres, the specimens will be sent to the NUH lab.

However, the co-funding for embryo biopsy is available only for couples whose biopsies are done at public assisted reproduction centres, MOH said. Apart from NUH, these public centres include those at KK Women’s and Children’s Hospital and the Singapore General Hospital.

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