Update on Pilot for Pre-implantation Genetic Screening and its Inclusion as Mainstream Clinical Service
Ministry of HealthSpeakers
Summary
This question concerns the progress of the Pre-implantation Genetic Screening (PGS) pilot and its potential transition into a mainstream clinical service. Mr Louis Ng Kok Kwang inquired about the timeline for the study’s conclusion and the possibility of expanding the pilot to include private clinics. Senior Parliamentary Secretary Ms Rahayu Mahzam stated that while 590 patients have enrolled as of January 2024, more data is needed to reach the 300-patient target required for a robust evaluation. She noted that expanding the pilot to the private sector is currently being reviewed, though private centers can already refer eligible patients to participating public centers. Ultimately, the ministry must consider clinical efficacy, costs, and potential risks such as blastocyst damage before determining if PGS will be mainstreamed or subsidized.
Transcript
4 Mr Louis Ng Kok Kwang asked the Minister for Health whether he can provide an update on (i) the pilot for Pre-Implantation Genetic Screening (PGS) and (ii) when PGS can be included as a mainstream healthcare service.
The Senior Parliamentary Secretary to the Minister for Health (Ms Rahayu Mahzam) (for the Minister for Health): Mr Speaker, under the Ministry of Health's (MOH’s) pilot on Pre-implantation Genetic Screening (PGS), any woman enrolled in an accredited in-vitro fertilisation (IVF) programme, who is 35 years and above, who has suffered two or more recurrent implantation failures, or experienced two or more pregnancy losses, is eligible for PGS. This is to improve IVF success rates.
As of January 2024, 590 patients were enrolled to the study but only 195 patients had undergone PGS. Of which, 131 completed their embryo transfers. This has led to 70 pregnancies with 56 live births and five ongoing pregnancies. More patients need to be recruited into the pilot for a robust evaluation of the clinical efficacy of PGS, before it can be determined if PGS can be a mainstream clinical service. In the meantime, PGS will remain accessible to eligible patients.
Mr Speaker: Mr Ng.
Mr Louis Ng Kok Kwang (Nee Soon): I thank the Senior Parliamentary Secretary for the reply. I think this pilot has been going on for about seven years now. So, I am just wondering when the study will finally come to an end. Is there a specific number of patients which we need to go to this study before we can consider ending the study and nationalising PGS?
Second, could I also asked whether the MOH is looking into expanding this to the private sector as well, where the private assisted reproduction (AR) clinics can also be part of this study, so that we can finally reach that number of patients that we are hoping to?
Ms Rahayu Mahzam: I thank Member for his questions and his interest in this matter. Firstly, I think as a matter of point on the numbers, I think the Member has asked some questions on this previously and we have indicated that a number of 300 will be a good reference. However, as you can see, over time, we have worked on trying to increase the numbers and there are enrolments. The problem is not all then follow through with the process, for many different reasons. And because of that, we have not yet achieved that number for a good statistical reference.
Secondly, this is also something that the Member has raised earlier about the extension to the private AR centres. And this is something that we are reviewing and we are looking into. The fact remains that right now the PGS remains accessible to people and experts in the private centres can make referrals to the three AR centres and in the public setting.
As a matter of principle, I also want to highlight that there exists an infinite number of tests and screens that are available for many different conditions, including this one. Just because early detection may be valuable for certain circumstances, this does not mean we should deploy all of them and we should subsidise all of them. So, this is something we do need to take into consideration. It is not just an issue of cost. It is also an issue of the side effects and some negative detrimental effects that may come. In this particular case, as we understand, there are some side effects that may happen to the blastocyst. So, we do need to consider this and we need to take into account all these factors before we can decide to mainstream this.