According to United Nations data, Singapore has one of the lowest fertility rates in the world. It’s a struggle faced by 15% of couples in the country today, but it doesn’t stop there. Couples who wish to start a family must likewise contend with the cost of infertility treatment.
One such treatment is intrauterine insemination (IUI), a lesser known assisted reproductive technique compared to IVF. For those who are interested in taking this route, here are important facts about the cost of IUI treatment and other information that could be very helpful in the decision-making process.
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What is IUI?
IUI is a type of artificial insemination in which a processed sperm sample is placed inside a woman’s uterus around the time the ovary releases one or more eggs. It is done to increase the number of motile sperm that will reach the egg in the fallopian tubes, to facilitate fertilization.
IUI is often the first step in fertility treatment for many patients who choose to undergo assisted reproductive treatment. It’s also a great option for those dealing with PCOS (polycystic ovarian syndrome), poor ovulation, mild sperm abnormality, and patients with unexplained infertility.
Two types of IUI:
1. Natural cycle IUI (Unmedicated)
Natural cycle IUI is one of the simpler forms of assisted reproduction methods. It doesn’t require any hormonal stimulation through medications. Instead, it is done around the time of ovulation and as such it is more suited for women with regular menstrual cycles, where ovulation is predictable.
2. Stimulated IUI (Medicated)
Depending on your diagnosis, your doctor may recommend an IUI cycle that uses medication to stimulate ovulation. The fertility drugs can either be orally administered tablets or through injections. Medication is usually given on Day 2 of your cycle, for 5 days. Ultrasound tracking of the follicles (eggs) is performed and often another injection medication is given once the follicles are mature at a certain size to trigger ovulation. This method is better suited for women who have difficulty ovulating on their own, perhaps due to Polycystic Ovarian Syndrome (PCOS), which causes irregular cycles. It’s also advised for those who want to increase their chances of getting pregnant with a single cycle, by generating more than one follicle/ egg.
Success rates for IUI
Many studies have shown that IUI plus ovarian stimulation gives a higher success rate than insemination in natural menstrual cycles.
The success rates of IUI depend on several factors:
- Female factors. Age, ovarian function, fallopian tube blockage, endometriosis, uterine abnormalities and other related factors.
- Male factors. A higher number of progressively motile normal sperm favours the chances of fertilisation.
- The timing of insemination. Once the doctor determines when ovulation will occur, they will schedule the IUI.
Being aware of IUI success rates should help you to prepare for the different factors that will affect your expenses. It also gives you a more practical view of the process. For instance, you could expect that an unmedicated IUI will cost less than a stimulated process with medication. Oral medication for stimulation would also be less expensive than injected hormonal medication. You should also know that it may take three to six IUI attempts before you conceive. IUI is often advised for a few cycles before proceeding to more costly and intensive IVF (In-Vitro Fertilization).
The associated costs of IUI
One round of artificial insemination can cost anywhere from SGD$600 to $1000. This excludes GST, doctor consultation fee, medication and other investigation costs which can add up to another $2000.
If you dissect the IUI process further, the cost is affected by three important components that may or may not be used in your cycle.
- Monitoring and Bloodwork. This is done to ensure that ovarian stimulation is safe to avoid hyperstimulation and multiples. Monitoring also allows proper timing of insemination.
- Medication. As mentioned earlier, medications are part of the process to stimulate ovulation. The costs for these medications are highly variable and dependent upon protocol. An hCG injection, which is given to trigger ovulation, costs an average of $80-100.
- Sperm wash and insemination. These are part of the IUI procedure itself when the sperm are prepared then injected directly into the woman’s uterus. This will also have its separate cost, which will vary depending on where you had your IUI procedure done. If you’re using donor sperm, expect to incur additional costs through a donor agency.
Any additional costs in your final bill is dependent on a couple’s individual needs. It may also vary depending on additional investigations, medications and doctor consultations.
How Can You Afford An Infertility Treatment in Singapore?
IUI is not cheap, but there are ways to help couples afford the treatment. Through Medisave you can pay for cycles that are co-funded by the government and cycles that are not.
Take note that you can withdraw the following amounts for an IUI procedure from your own/your spouse’s Medisave accounts.
- 1st Cycle: $6,000
- 2nd Cycle: $5,000
- 3rd & Subsequent Cycle: $4,000
Medisave has a lifetime withdrawal limit of $15,000 per patient for assisted reproductive treatments ( including IVF) done locally.
Government co-funding for IUI
From 1 Jan 2020, the government introduced co-funding for IUI at public hospitals. Couples will need to meet the following criteria to be eligible for co-funding for IUI:
- The female spouse should be below 40 years of age at the start of the cycle;
- The couple has been assessed by a doctor at a public assisted reproduction centre to be suitable to try IUI prior to ART treatment; and
- One spouse must be a Singapore Citizen.
The co-funding will cover IUI for a maximum of 3 cycles. The amount of co-funding varies, depending on the citizenship of the couple:
- SG Citizen Couple: 75%; up to $1,000
- SG Citizen & SG PR Couple: 55%; up to $700
- SG Citizen & Foreigner Couple: 35%; up to $500
Most insurance plans in Singapore don’t cover maternity-related costs, much less the costs of fertility treatments. For those that do, assisted conception procedures like IUI comes with an additional premium. Usually, these supplementary benefits can be claimed 12 months after treatments commence. Do note that these claims are also subject to certain caps.
We hope that the information shared here will help you in your journey to start a family. The cost of these procedures and the waiting game can all be taxing on a couple, but it could be well worth it when you’re well-informed before diving in. If you have any questions on IUI or other fertility concerns, you can schedule a non-obligatory consultation with Dr Pamela Tan today. You may call our clinic at +65 6254 2878 to book your appointment.
Disclaimer: While efforts have been made to publish accurate and up-to-date information, we are not liable for any inaccuracy or changing rates that differ from what was quoted or published.
Dr Pamela Tan is a board certified obstetrician and gynecologist in Singapore. She finished her undergraduate studies at the National University of Singapore and earned her post-graduate degree at the Royal College of Obstetricians and Gynaecologists in the UK. She is an accredited specialist by the Specialist Accreditation Board (Ministry of Health), and a fellow of the Academy of Medicine, Singapore. She subspecialises in colposcopy and is certified to perform Level 3 minimally invasive keyhole surgeries such as laparoscopic hysterectomy, myomectomy and cystectomy. Dr Pam also supports the natural birthing method and she strives to provide a personalised care and treatment for each patient.