SINGAPORE - Some couples have all the five Cs - cash, car, credit card, condominium and country club membership.
Now they want another C - children.
But not everyone can conceive them naturally.
In-vitro fertilisation (IVF) is an option for couples who have difficulty in conceiving.
In August 2008, Singapore started subsidising Assisted Reproduction Technology treatments such as IVF at public hospitals to help more older women conceive.
Since then, it has spent $13 million funding the scheme that has led to 1,430 births.
This breaks down to about $9,000 a child. What's interesting is that even single women who get the maternal urge are considering artificial insemination to conceive.
Three local celebrities - actress Michelle Tay, singer- host Liu Ling Ling and 100.3 DJ Limei - have spoken about resorting to this to fulfil their dream of having a child. (See report on Page 19.)
But single women, who can adopt children, are not allowed to undergo IVF in Singapore.
Gynaecologist Christopher Ng of GynaeMD Women's & Rejuvenation Clinic said those interested in IVF have to present a valid marriage certificate to qualify. So, single women like the three celebrities mentioned must go to neighbouring countries like Malaysia if they want to conceive in this manner. Couples who turn to IVF usually have stable careers and incomes as the procedure is not cheap.
A cycle of IVF treatment costs between $8,000 and $11,000 at public hospitals and up to $15,000 at private centres.
Dr Ng said most couples are in their late 30s or early 40s. "They have been trying for children since their late 20s and are in their early 30s by the time they turn to IVF," he said.
There's no guarantee that the treatments will be successful. "For women over 40, the chance of success is 8 per cent. For those in their 30s, it is higher, at 25 per cent to 35 per cent," Dr Ng said.
As the risks are higher for older women, there is a regulated age cap of 45. (See report at right.) Those who are older can appeal to the Ministry Of Health. Like those who conceive normally, IVF parents cannot screen the foetuses by gender. International Urology, Fertility and Gynaecology Centre gynaecologist Julianah Abu, explained that gender selection is not legal here.
"That is unless one has a confirmed medical diagnosis of a sex-linked genetic disease such as haemophilia and cystic fibrosis," she added. Dr Ng said IVF should never be the first choice. It is for couples who have run out of options, such as when the woman has a blocked fallopian tube.
"We look into their reasons for IVF. Whether it is a problem with the woman or the man or both. We also look at what other treatments they have undergone."
There are several treatments for infertility. If the woman has problems ovulating, medication can be given.
If that doesn't work after six months, she can undergo superovulation intra-uterine insemination (SO-IUI).
In SO-IUI, several eggs are stimulated and brought to maturation and ovulation.
Prepared sperm are placed directly into the uterus to increase the chances of conception.
The potential mother would have to deal with a lot of stress from trying to conceive via IVF.
"(There are) physical side effects from medications, emotional stress from the anticipation of a pregnancy, risk from the medications and egg retrieval. It's basically an emotional roller coaster," said Dr Julianah.
Adoption is another option. Again, most couples who take this route are those who have worked hard for financial stability and a comfortable standard of living.
Mr John Nguyen, 30, the owner of Singapore Adoption Agency, said his clients are usually in their 40s.
Most own a car and live in an HDB flat. Some of them turn to adoption because they have been disappointed by IVF attempts. Potential adopters should be financially stable because raising a child is a financial commitment, said MrNguyen, who claims to have the only agency here handling the adoption of Vietnamese babies.
He charges about $25,000, including a trip to Vietnam for the adopters to see and bond with their baby in its native country.
"That is where the home study report comes in as a check and balance. You can't just abandon adopted children (because you cannot afford to raise them).
"The (report) checks the adopter's financial situation, criminal records and family background. Then they interview the adopter and do a house check to see the environment the child will be growing up in.
"It is not an easy process. The (report) is very rigorous because each child is a life. We definitely want the child to be adopted into a happy family."
The home study report became a requirement on Feb 1, 2005, for those who wish to adopt a foreign child.
It can be done only by agencies accredited by the Ministry of Community Development, Youth and Sports (MCYS). The MCYS website states that the adopter cannot be more than 50 years older than the child to ensure that the adopter can effectively perform his parental duty.
The adopter must be at least 21 years older than the child, but exceptions may be allowed under special circumstances.
MCYS statistics show that there were 325 adoptions in 2010, compared with 419 in 2009 and 445 in 2008.
An MCYS spokesman told The Straits Times last year that adopters are usually aged between 35 and 45, and prefer infants and toddlers. Mr Nguyen declined to reveal how many clients he has had, but said that business has been picking up.
One trend he has noticed in his agency is that the number of girls adopted is twice that of the number of boys.
"Girls tend to be more emotionally attached to their parents." He jokingly added: "Boys, on the other hand, like to go out to look for girls."
This article was first published in.