SINGAPORE – When Madam Lim Wen Ling, 43, became pregnant, a sense of fear that she would suffer yet another miscarriage crept in amid the joy of expecting a baby.

After all, she miscarried five times within a span of two years and the cause of the miscarriages remains unknown, even after a battery of tests.

She and her husband, Mr Eddy Goh, were “scared and scarred” by the miscarriages, as Mr Goh, a 41-year-old business development manager, described it.

Madam Lim, a homemaker, said: “By the fifth time, we felt pretty lost as we didn’t know what was happening. It has been a very heart-breaking journey.”

The couple finally welcomed their first son, Evan, who is now two years old, after they tried pre-implantation genetic screening (PGS). PGS is a procedure to boost the in-vitro fertilisation (IVF) success rates.

Madam Lim said: “When our baby was born, I was very happy and relieved. Every day, we were just hoping and praying that everything would be okay.”

They are now expecting their second child, a boy as well, through PGS. The baby’s due date is at the end of May.

The couple learnt about PGS only when they were referred to Dr Liu Shuling, lead physician at the Recurrent Pregnancy Loss Clinic at KK Women’s and Children’s Hospital (KKH).

PGS is an additional step in IVF that screens for chromosomal abnormalities before the embryo is transferred back into the womb.

If abnormalities are detected, the embryo may not be suitable for implantation in the womb, hence reducing the risk of a miscarriage or failed implantation, said Dr Liu, who is also director of the KKIVF Centre at KKH.

In their first cycle of PGS, the couple had four embryos screened, but only one was deemed healthy and implanted in Madam Lim’s womb – and Evan was later born.

In Singapore, couples can undergo PGS under a pilot programme that started in 2017, and only if they meet any of the following criteria:

• The woman must be 35 years old or older.
• The woman must have suffered at least two pregnancy losses.
• The woman must have suffered two or more implantation failures. Such a recurrent implantation failure is when a woman is unable to become pregnant after repeated embryo transfers through IVF.

In February 2024, Nee Soon GRC MP Louis Ng asked in a parliamentary question for an update on the PGS pilot programme and if it can be included as a mainstream healthcare service.

Senior Parliamentary Secretary for Health Rahayu Mahzam said that 195 patients had undergone PGS as of January, and of the 131 patients who had completed the embryo transfer, 56 babies were born, and five women were currently pregnant.

Ms Rahayu said that more patients have to be part of 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.

Madam Lim said she wanted to share her story as PGS is relatively unknown here and Singaporeans tend to keep mum about miscarriages.

Although talking about her multiple miscarriages still brings tears to her eyes, she wants to let other women know they are not alone in their fertility struggles and that help is available.

The miscarriages were also tough for Mr Goh to bear. The couple has been married for six years.

He said: “As a guy, I felt quite helpless as I couldn’t do anything to help my wife. I can only be there (for her).

“We have to be open and supportive of whatever our wives need, as they are going through all the pain, and all the stresses are mostly on them. It is very stressful trying for a baby.”

But what kept them going was Madam Lim’s perseverance in having children.

“I keep asking myself: If I stop trying, will I regret it in the later part of my life?”, she said. “I never expected to have to go through so much just to have one baby.”