Couples to get co-funding to help pay for pre-implantation genetic testing during IVF

Angelica Cheng

Active Member


SINGAPORE: A new co-funding scheme will be introduced for couples undergoing two types of pre-implantation genetic testing (PGT), the Ministry of Health (MOH) announced on Thursday (Jun 30).
PGT is the process where embryonic cells are tested for previously identified genetic abnormalities. This allows doctors to select healthy embryos for implantation to the womb during in-vitro fertilisation (IVF).
It ensures that the genetic abnormality is not passed on and reduces the possibility of miscarriages arising from such abnormalities.
About 40-50 couples currently undergo PGT annually and are expected to benefit from the scheme.
From July, couples with at least one Singaporean spouse who are clinically eligible for pre-implantation genetic testing for monogenic/single gene defects (PGT-M) and for chromosomal structural rearrangements (PGT-SR) can receive up to 75 per cent in co-funding by the Government, subject to caps.
Similar to existing co-funding schemes for assisted reproductive technology and intra-uterine insemination procedures, the level of co-funding and caps will depend on the citizenship status of couples.
Co-funding will be provided to eligible couples for individual stages of the PGT cycles. Each couple will be eligible for up to six co-funded cycles of PGT-M or PGT-SR.
Couples who are clinically eligible for PGT-M or PGT-SR will also be able to tap on their own or their spouse’s MediSave to pay for treatment cycles.
“We have been looking at a whole raft of measures to support families and that's really been our thrust - Singapore that's made for families - and it's got different parts to it. So this is a specific part targeted at an area which is growing I think in concern, which is fertility health,” said Minister in the Prime Minister’s Office Indranee Rajah, who was speaking on the sidelines of a visit to NUH.
The ministry introduced PGT-M and PGT-SR as regulated clinical services last year. Before that, the tests were available as part of a pilot programme.
PGT-M is used for screening single gene mutation in embryos that may result in severe forms of genetic disorders such as spinal muscular atrophy type 1 and 2.
On the other hand, PGT-SR is for detecting structural abnormalities in chromosomes which may manifest as conditions resulting in developmental delays or learning disabilities.
“These changes aim to provide financial support for eligible couples who would like to conceive but are at risk of transmitting serious inheritable diseases to their offspring, and are part of the Government’s larger efforts to support couples in their parenthood plans,” said MOH.
A typical PGT-M test first involves a pre-test work-up where a couple’s genetic materials - obtained via blood samples - are used to develop a specific laboratory test. This test is optimised and validated for use during the actual PGT.
There is no work-up for PGT-SR.
PGT is conducted with the help of IVF - which involves recovering the eggs from an ovary and fertilising them with sperm outside the body in a laboratory.
Next, the embryos are then sent for a biopsy at an assisted reproduction centre - there are nine of such centres in Singapore - before the embryonic cells are tested at the National University Hospital (NUH) Pre-Implantation Genetic Diagnosis Centre.
The centre is currently the only laboratory in Singapore approved to provide such testing.
Following testing, healthy embryos are then selected and transferred artificially into the uterus or fallopian tube.
On average, it takes about six months to one year to complete an IVF cycle and PGT.
 
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符条件人工受孕夫妇 胚胎植入前基因检测可获部分津贴

明天起,接受人工受孕的夫妇如果符合条件进行胚胎植入前基因检测,将获得政府部分津贴。
卫生部发表文告说,措施主要是为那些想生育、但又担心把严重遗传病传给孩子的夫妇,提供经济支持。
在计划下,使用辅助生殖技术的夫妇在进行胚胎植入前的单基因病检测或染色体结构重排检测时,只要其中一人是新加坡公民,就可享有高达75%的津贴。政府的津贴额和顶限将视夫妇的公民身份而定。
植入前基因检测周期的各个阶段都可获得政府部分津贴,但仅限六个周期。
文告指出,要获得相关津贴,除了至少一人必须是新加坡公民外,夫妻俩也必须获得医生临床诊断两人符合相关检测。另外,妻子在检测开始前,年龄必须在40岁以下。如果妻子年满40或以上,只能获得最多两个周期的津贴。
另外,进行人工受孕的夫妇在接受植入前基因检测时,也可以动用保健储蓄支付相关费用。
公众可以到卫生部网站查询更多详情。
 
S'pore couples get help to pay for tests to cut risk of passing on genetic diseases in IVF

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.

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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