So, what choices do you have when you can’t conceive naturally? We list them out for you.
1. Fertility treatment
For most couples who aren’t able to conceive, fertility treatment is an obvious option.
According to Dr Roland Chieng, medical director at Virtus Fertility Centre, couples who experience a delay in pregnancy should seek a fertility specialist’s advice. They will undergo a fertility assessment to determine the problem and learn what treatments are available to improve their conception chances.
Dr Chieng says that in-vitro fertilisation (IVF) is the most effective method for treating infertility. “The procedure addresses complex issues related to fertility and offers a good success rate of having a baby.”
In IVF, embryos are created when sperm fertilise the eggs in a laboratory dish. The embryos are incubated in the dish for three to five days before being transferred to the woman’s uterus for implantation. One IVF cycle will set the couple back around $15,000.
Another option is a Gamete Intra-fallopian transfer, or GIFT, where fertilisation takes place inside the woman’s fallopian tubes instead of a laboratory dish, Dr Chieng notes. “This pin-hole surgery is performed after two or three eggs are mixed with the sperm in a catheter, and the mixture is then inserted into the fallopian tube for fertilisation. After fertilisation, the embryos move into the uterus for implantation,” he explains.
Artificial insemination, a simpler and less invasive procedure, is when prepared sperm are inserted through the neck of the womb and into the uterus, close to the time of ovulation.
In-vitro fertilisation (IVF) is the most effective method for treating infertility.
In Singapore, couples can adopt a child from their relatives, friends or other parties. A signed consent from the child’s birth parents is required.
They can also adopt a child under State via the Ministry for Social and Family Development (MSF), although a home study has to be completed first. A home study is also needed when a couple adopts foreign children.
Both married couples and singles who are Singaporean citizens or permanent residents can adopt a child, under Singapore’s Adoption of Child Act.
The adoptive parents have to be at least 25 years old, and at least 21 years but less than 50 years older than the child. Single males are not allowed to adopt a girl, unless special permission is granted. Exceptions may be made if the child is related to the adopter by blood.
The adoptive child has to be under 21 years old. It generally takes about five to seven months for the adoption process to be completed, longer if the child is adopted from a foreign country.
Couples who want to adopt will first need to attend a compulsory pre-adoption briefing conducted by an MSF-accredited adoption agency. After this, a home study will be carried out, if needed. When a suitable child has been identified, the birth parents will be required to give their signed consent, while the adoptive parents will have to obtain the child’s identification documents. If the child is born elsewhere, they will need to apply for a Dependent’s pass.
Once these are completed, the application will be submitted to the Family Justice Courts. A hearing will determine if the adoption is successful.
While it’s illegal to pay the birth parents for giving the child up for adoption, the adoptive parents can pay for the prenatal and postnatal expenses, as well as the hospital delivery cost. Those who find a suitable child via an adoption agency can expect to pay fees of around $30,000.
Couples use surrogates to carry the foetus if the woman is unable to conceive, or complete a pregnancy. There are no explicit laws that prohibit surrogacy in Singapore, but the Ministry of Health states that clinics providing fertility treatment are not allowed to carry out surrogacy arrangements.
However, couples are known to have sought out this option ― if not within Singapore, then in other countries, such as Thailand or India. Parents who have gone abroad for it and returned home to apply for adoption of their surrogate children will have their applications assessed on a case-by-case basis. To date, the courts have granted the adoption of 10 children to married couples who used surrogacy because of infertility issues.
The main concerns arising from surrogacy are ethical in nature. Among the issues are the exploitation of the surrogate mothers, some of whom come from poor backgrounds, and who decides the citizenship of the child. In one instance in December 2013, a young surrogate mother from Thailand gave birth to an Australian couple’s twins ― a boy and a girl. The surrogate mum said that the couple took only the girl and left the boy with her after discovering that he had Down syndrome. The Australian couple claimed that the Thai woman had demanded to keep the boy.
Unlike adoption cases, a child who is fostered will keep his identity as the legal child of his birth parents.
In January 2019, it was reported that the government is looking into this issue. Noting that this is a complex subject, Minister for Social and Family Development Desmond Lee acknowledged in Parliament that it has “ethical, social, health and legal implications for all parties involved”.
He added, however, that the authorities will also “(keep) in mind the wishes, aspirations and concerns of mothers who would otherwise not be able to conceive their own flesh and blood”.
4. Fostering a child
Couples who aren’t able to conceive, but are able and willing to provide a loving home for a child may wish to consider fostering.
MSF has a fostering scheme that provides care arrangements for children who have been abandoned, neglected or ill-treated by their parents, or guardians. Kids whose parents or guardians are ill and are unable to look after them may also fall under this scheme.
To be eligible for foster parenting, you’ll have to be a Singapore resident, at least 25 years old, medically fit to care for a child, and have a household income of at least $2,000.
Potential foster parents will be assessed as they’ll need to provide a child-safe environment for the child. The process takes six to eight weeks, and will involve home visits, as well as an interview with the applicants, and other members of the household. Unlike adoption cases, a child who is fostered will keep his identity as the legal child of his birth parents.
The foster period usually lasts from a few months to a year ― there is no limit to the number of foster children you can take on.
Financial support will be provided, including a monthly fostering allowance, childcare subsidies and exemption from medical fees. The foster parents will also have to attend ongoing training and support group sessions.
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