Why has Singapore's total fertility rate been declining even though marriage rates have remained constant?

According to a recent report released by I Love Children (ILC) (after surveying 1,000 respondents about fertility health), most couples have indicated that they want a child within 3 years of marriage.

But many are facing roadblocks in trying to conceive. And many are unaware of the importance of fertility health checks.

Do you know how you can get a fertility health check in Singapore?

Report says 58 per cent of couples are unaware of fertility health check in Singapore.

HERE ARE THE KEY FINDINGS FROM THE SURVEY CONDUCTED BY ILC:

• Of the 1,000 surveyed, 58 per cent of the respondents say they have come across people with difficulties when trying to have their first or second child.
• Almost 40 per cent of respondents trying for a child are not happy with the progress of their current child-bearing efforts and appear to have difficulties conceiving.
• A high 77 per cent of newly-wed couples want to have a child within three years of getting married.
• More than half (58 per cent) of Singaporean couples have not heard of fertility health checks.
• 69 per cent of the 1,000 respondents were mistakenly confident that infertility is treatable with the help of modern technology - for example with assisted reproduction technologies (ART).
• However, only 27 per cent are aware that the success rate of live births from ART is less than 50 per cent and this rate decreases with age.

It is worth noting that 77 per cent of couples want to have children within three years of getting married.

Yet, despite Singaporean couples marrying between the age of 28 and 30 years old, doctors have shared with ILC that most couples who consult a doctor for fertility health issues are aged 35 years and above.

Which means that the number of 'patients' who are largely 35 are "creeping up", and that, Singaporeans are seeking fertility help too late.

This has a direct impact on the success of natural conception and fertility treatments. It is important to note that there is a big drop in success rates of assisted reproduction technologies (ART) like IVF, with age.

While many Singaporean couples remain ignorant about the need for fertility health checks, many would consider going for them if they were affordably priced.

RECOMMENDATIONS TO THE NATION FROM ILC: 

Meanwhile, within the report, ILC has made these recommendations to the nation:

1. STEP UP CONVERSATIONS ABOUT FERTILITY AND INFERTILITY

Fertility health is not commonly discussed at home, workplaces, in the community or among friends.

This lack of conversation results in a lack of awareness and oftentimes, couples seek medical attention a tad too late.

ILC encourages everyone in Singapore to openly talk about fertility health. By creating a new positive mindset, there can be direct positive impact on Singapore's TFR.

2. INCREASE FERTILITY HEALTH EDUCATION AND INFORMATION

Similar to the way diseases and other health issues are addressed, education is key to prevention, early detection and intervention.

To normalise fertility discussions, ILC has the following recommendations:

• Universities to consider including fertility health as part of their supplementary talks and seminars, driving awareness amongst youths
• In the workplace, companies can support soon-to-weds and newly-weds by providing them with fertility health information
• Within the community, families and friends can help by sharing their own fertility health experiences and encouraging one another to share theirs

3. IMPROVE ACCESS TO FERTILITY HEALTH CHECKS

To enable soon-to-wed and newly-wed couples in making informed decisions when planning for a family and seeking medical attention earlier than later,

In the past five years, more private hospitals and clinics have started providing fertility health checks as a package to couples.

There are currently no similar fertility health check packages by public healthcare providers.

If these are made available, couples can easily visit any polyclinic and have themselves checked. ILC proposes that, public healthcare providers consider making these packages available in Singapore.

4. IMPROVE ACCESS TO FERTILITY HEALTH TREATMENTS

Many couples in Singapore with fertility health issues turn to ART with hopes to conceive.

However, more couples are seeking treatment in the public hospitals due to the co-funding options available.

To ensure couples can get timely help, ILC suggests extending the co-funding option for fertility health check and ART to qualified private clinics and centres who can match the public hospitals' fees.

Dr Tan Kai Lit, Obstetrician and Gynaecologist from Thomson Women's Clinic shared from his own experience, "I am not surprised that close to 70 per cent of the respondents were confident that infertility is treatable with the help of modern technology. This corresponds with my experience in the clinic with patients - that if they want a child, surely they will be able to conceive with medical assistance."

"It could be because of media stories about celebrities or well-known personalities who successfully conceive when they were older. Unfortunately, this is not the case. The success rates of live births from assisted reproduction technologies remain less than 50 per cent and this rate decreases with age."

RECEIVE YOUR FERTILITY HEALTH CHECK IN SINGAPORE:

A fertility health check is an assessment of a couple's fertility. It helps identify contributing factors and eliminate any conditions that could prevent or delay a healthy pregnancy.

Each fertility health check comprises of two to three trips to the clinic.

Couples would need to go for hormone blood tests for the wife, and semen analysis for the husband.

Once the tests are completed, the results will be reviewed, together with an ultrasound scan, during a consultation session with the doctor.

This July 2019, for just $30 admin fee (non-refundable), I Love Children, in partnership with Thomson Fertility Centre is offering 200 couples sponsored fertility health checks worth $400 each, as part of 'Know Your Fertility Wellness 2019'.

Do note that the couples need to be Singaporean, and legally married to sign up.

To sign up, visit https://ilovechildren.sg/fertility-health-check-2019.

This article was first published in theAsianparent.