By Dr. Jessie Wai Leng Phoon, MRCOG
Medical Director, GenPrime Fertility Singapore
Last reviewed: January 2026
When COVID-19 first emerged, uncertainty dominated every aspect of healthcare. For people undergoing fertility treatment, the questions were especially difficult:
Should treatment stop entirely? Is IVF “elective”? What happens if time is not on your side?
This article explains how assisted reproductive treatment (ART) was safely and thoughtfully provided during the COVID-19 pandemic in Singapore—balancing infection risk, fertility urgency, and patient wellbeing. It is based on clinical experience from Singapore’s largest public fertility centre, published in the Singapore Medical Journal.
Providing ART during covid comm…
Why fertility care posed a unique challenge during COVID-19
Unlike many medical treatments, fertility care is time-sensitive.
- A woman’s ovarian reserve is finite
- Delaying treatment can affect long-term success
- Many patients are already in their late 30s or have poor ovarian reserve
At the same time, COVID-19 raised real concerns about:
- Infection risk during clinic visits
- Unknown effects of the virus on early pregnancy
- The need to preserve hospital resources
This created a difficult balance between public health safety and individual reproductive timelines.
How Singapore’s healthcare response evolved
Singapore’s response to COVID-19 progressed through several phases, each requiring adjustments in fertility care.
Early phase: heightened screening
When COVID-19 risk was initially identified:
- Patients were screened for symptoms, travel, and contact history
- High-risk patients delayed treatment
- Extra precautions were taken for those already mid-cycle
Fertility services continued, but with strict infection-control measures.
DORSCON Orange: pausing and reassessing
When the national alert level was raised:
- New fertility cycles were temporarily halted
- Patients mid-treatment were counselled on:
- Cycle cancellation
- Freeze-all strategies (freezing embryos for transfer later)
- Clinics rapidly restructured workflows to reduce crowding
Once in-house COVID testing became available with fast turnaround times, treatment could resume more safely for selected patients.
Circuit breaker: prioritising time-sensitive care
During Singapore’s partial lockdown:
- Fertility treatment was classified as an essential service
- However, only time-sensitive cases were offered treatment
These included:
- Older patients
- Women with low ovarian reserve
- Poor-prognosis patients
- Patients requiring fertility preservation for medical reasons (e.g. cancer)
Others were advised to delay treatment, as a short postponement was unlikely to significantly affect outcomes.
Circuit breaker: prioritising time-sensitive care
During Singapore’s partial lockdown:
- Fertility treatment was classified as an essential service
- However, only time-sensitive cases were offered treatment
These included:
- Older patients
- Women with low ovarian reserve
- Poor-prognosis patients
- Patients requiring fertility preservation for medical reasons (e.g. cancer)
Others were advised to delay treatment, as a short postponement was unlikely to significantly affect outcomes.
What safety measures made treatment possible
To protect patients and staff, extensive measures were implemented:
- Pre-visit screening and temperature checks
- Staggered appointment times to reduce waiting-room crowding
- Limiting accompanying persons
- Mandatory masks and PPE for staff
- Deep cleaning between procedures
- Separation of procedure rooms
- Use of negative-pressure rooms for high-risk cases
- Split laboratory teams to ensure service continuity
These measures allowed treatment to continue without any COVID-positive patients undergoing ART at the centre during the study period.
What about pregnancy risks?
Early in the pandemic, there were concerns about:
- Increased severity of COVID-19 in pregnancy
- Risk of transmission to the baby
At the time of publication:
- Evidence did not show increased severity in early pregnancy
- No clear evidence of vertical transmission was identified
Even so, patients were counselled carefully, and decisions were made collaboratively, based on evolving evidence.
Is fertility treatment “elective”?
This question was debated globally.
Some international bodies initially recommended stopping all fertility treatments. Others emphasised that:
- Infertility is a disease
- Delaying treatment may permanently reduce success for some patients
Singapore’s approach recognised this nuance:
- Fertility treatment is not purely elective
- But not all cases carry the same urgency
This allowed clinics to continue offering care to those who needed it most, while protecting public health.
What this experience teaches us
This period highlighted several key lessons:
- Fertility care must be individualised, especially during crises
- With proper safeguards, treatment can be delivered safely
- Clear communication reduces anxiety and builds trust
- Time matters in reproductive medicine
For many patients, continuing treatment during the pandemic provided not just medical care, but hope and emotional relief during an uncertain time.
Questions to ask if care is disrupted
If fertility treatment is ever affected by external events (pandemics, system strain, travel restrictions), consider asking:
- Is my situation time-sensitive?
- What are the risks of delaying treatment in my case?
- Are there alternatives, such as freezing eggs or embryos?
- What safety measures are in place?
- How will decisions change as the situation evolves?
A simple next step
If fertility care is disrupted or delayed, ask for a clear, personalised discussion about timing and priorities.
Understanding why certain recommendations are made can help you navigate uncertainty with confidence—especially when the stakes are personal.
About the Author
Dr. Jessie Wai Leng Phoon, MRCOG is a leader in fertility innovation and integrated women’s health, blending advanced clinical training with a deeply patient-centred approach. An MOH-accredited IVF specialist, she previously served as Director of KKIVF Centre and the National Sperm Bank, and co-founded Singapore’s pioneering OncoFertility Clinic. She has been actively involved in shaping safe fertility care delivery during periods of healthcare disruption.