The Cost of Fertility Treatments (in Malaysia)

If you and your partner have been trying to get pregnant without any success, know that you are not alone. The World Health Organisation estimates that 48 million couples and 186 million individuals worldwide suffer from infertility.  

Infertility is defined as the inability to get pregnant even after having regular unprotected sex for one year and affects both men and women. 

Although Malaysia does not have official statistics on its infertility rates, our country saw the lowest fertility rate (measured by the number of children born each year) in four decades in 2020 —  1.7 children, compared to in 1970 when the fertility rate was at 4.9 children per woman.  

A study on ‘Public Awareness and Knowledge Regarding Infertility’, published on the National Population and Family Development Board’s (Lembaga Penduduk dan Pembangunan Keluarga Negara) website estimates that infertility in Malaysia stands at 10% to 15%. 

Typically, couples who suffer from infertility need to undergo numerous tests to identify the problem. If a couple is found to have hormonal imbalance, they may be prescribed medication. Sometimes, surgery is required if their infertility is caused by issues such as polyps or fibroids.  

Couples can also opt for assisted conception. Here’s a look at two of the most common assisted conception treatments, how it works and how much it costs.  

1. Intrauterine Insemination (IUI) 

What it is: 

During treatment, sperm is inserted into a woman’s uterus when she is ovulating, in hopes that it would fertilise the egg. This is a relatively painless, non-invasive, and less costly procedure compared to IVF.  

Who it is for:  

Men who have low sperm count or weak sperm. For women, at least one fallopian tube must be working and not blocked to qualify for this procedure.  

How it works:  

In natural conception, healthy sperm must travel through the cervix into the uterus and up the fallopian tubes to reach the ovaries. With IUI, sperm is taken, washed and selected (most motile sperm is chosen), then inseminated into a woman’s uterus using a catheter when she is ovulating. This reduces the distance for the sperm to reach the egg, increasing the likelihood of pregnancy.  

The procedure can be done with or without medication – you can wait for a woman’s natural cycle, or a woman can opt to take hormone medications (tablets or injections) to produce more eggs, which increases the chance of pregnancy.  

This is usually the first line of treatment, especially when no fertility problems have been identified. This treatment is uncomplicated but as IUI closely mimics natural conception, couples may need more than one insemination attempt to achieve pregnancy.  

Average cost: RM1,000 to RM3,000 per cycle 

2. In Vitro Fertilisation (IVF) 

What it is:  

IVF is a complex series of procedures that help with fertility and conception. Here, mature eggs are collected from a woman’s ovaries. The eggs are then fertilised by sperm (from her partner) in a lab. IVF can also be used to prevent genetic problems from being passed on to your offspring. 

Who it is for: 

Women who have both fallopian tubes blocked; their partner’s sperm is healthy. If the man’s sperm is not healthy, they have to perform an additional procedure called ICSI (see below).  

How it works: 

Sperm and eggs are collected from both partners, then mixed together. The most motile sperm is allowed to make penetration into the egg on its own. Once an embryo is created, it is incubated in a lab and transferred into a woman’s uterus around two to six days later.  

The treatment often involves these main steps: 

1. Ovulation induction: Stimulation of a woman’s ovaries with hormone injections to produce more eggs.  

1. Egg retrieval: Collecting eggs from a woman’s body. 

1. Sperm retrieval: Collecting the partner’s sperm.  

1. Fertilisation: Eggs are fertilised in a laboratory and monitored.  

1. Embryo transfer: The healthiest embryo will be selected and placed into the uterus. 

If there is a surplus of viable embryos, a couple can choose to freeze it. This can be used at a later stage, should the couple want to attempt pregnancy again.  

Sometimes, if a partner’s sperm is found to be too weak, a couple can opt for Intracytoplasmic Sperm Injection (ICSI), where sperm is selected and injected directly into an egg during the fertilisation process.  

According to science, the natural fertilisation of an egg by a sperm is highly dependent on the motility of sperm to travel to the site of an egg, then bind to, penetrate, and fertilise that egg. By injecting sperm directly into an egg, it bypasses a lot of steps, increasing the chance of fertilisation.  

Average cost: RM4,000 to RM30,000 per cycle 

Success rate of IUI and IVF 

The success rate of these treatments is largely due to personal factors such as lifestyle, general health, and age. Age is the single biggest determinant in identifying a couples’ chances of a successful pregnancy.  

For example, a woman in her 20s has a 25% to 30% chance of getting pregnant. By age 40, the chance for that same woman drops to about 5%.  

Then, there is unexplained infertility or idiopathic infertility where the cause for why a couple can’t conceive cannot be found, even after multiple tests. This affects 15% to 30% of couples facing infertility. 

Regardless of the cause, couples often have to undergo multiple tests and fertility cycles before they get a successful pregnancy. This can be emotionally and financially draining. 

Financial assistance for couples seeking IUI and IVF treatment

As an increasing number of Malaysians are plagued by infertility issues and the cost of treatments (which are not cheap), the government has come up with ways to help ease their financial burden.  

Use your Employees Provident Fund (EPF)

Married couples with infertility issues can use their EPF savings to pay for these treatments. The treatments allowed under this scheme are IUI, IVF and ICSI.  

EPF members can withdraw their savings individually, or as a joint withdrawal from both accounts of a legally married couple. Applicants can claim for the amount of a treatment, or the entire savings in their Account 2; whichever is lower. 

Those who are interested must provide supporting documents of the procedures and medications they are planning to undergo. These documents must be signed off by doctors before the application is submitted to EPF.  

The withdrawal can be done either before or after the applicant has undergone the treatments. If they have outstanding medical bills, the withdrawal will be paid directly to the medical institution, however, if the bills have been paid by the couple, the withdrawal will go directly to the applicant. 

Tax relief 

Fertility treatments can be claimed as tax relief under medical expenses. Individuals can claim up to RM6,000 for medical treatments such as IUI, IVF, ICSI and other treatments. They can also claim for consultation fees and medicine that fall under this category.   

The long journey ahead 

Infertility can be a long, stressful and emotionally draining journey that can easily impact your finances. And while you cannot completely plan for the outcome (as we do not know whether a treatment would be a success, or not), it is always good to set aside savings for family planning and medical emergencies.