A Singaporean woman chose IVF to ensure her baby would not inherit a hereditary condition that had already shaped her own life. Diagnosed with familial adenomatous polyposis (FAP) at age 12, Felicia Lee, now 42 and living as a homemaker, underwent part of her colon removal when she was 15. FAP is a rare genetic disorder, affecting about 1 in 8,000 people, and it drives the growth of hundreds or even thousands of non-cancerous polyps in the colon and rectum. Although these polyps themselves are not cancerous, they substantially raise the risk of colorectal cancer, often at a relatively young age. The culprit is a mutation in the APC gene, a tumor-suppressor gene that normally helps regulate cell growth.
Because a child has a 50% chance of inheriting the FAP-causing mutation from an affected parent, Ms. Lee opted for IVF with pre-implantation genetic testing (PGT). This allowed the couple to screen embryos for the defect before implantation, reducing the likelihood that their child would inherit FAP. In Singapore, hereditary cancers account for roughly 5% to 10% of all cancer cases, a figure that underscores why some families pursue genetic screening in assisted reproduction.
Ms. Lee’s journey toward diagnosis began with her father, who later received the same condition. She recalls persistent bowel changes during her teens that prompted medical review. Cascade testing—a process that screens relatives once a hereditary disease is identified in a family—revealed that she, her younger sister Alicia, and two cousins also carried the FAP mutation, all before they reached adolescence.
Experts explain that the APC gene governs cell growth and division, especially in the colon. Carrying the mutated gene correlates with a high likelihood of multiple colon polyps and a markedly increased risk of colon cancer. When Ms. Lee was around 14 or 15, doctors performed a colonoscopy that found thousands of polyps and several large ones that blocked a substantial portion of the colon passage. At 15, she underwent a prophylactic colectomy to remove part of the large intestine and reduce cancer risk. A temporary ostomy bag collected waste during recovery, a detail she describes as challenging but manageable, with her mother learning to change the bag and even attending school with it concealed under her uniform.
Dietary adjustments became part of daily life after surgery, with Ms. Lee avoiding spicy foods and dairy to prevent uncomfortable symptoms. Her healing progressed quickly, and a second operation reconnected her remaining intestine to restore normal bowel function.
Colorectal cancer often develops from polyps and is sometimes called a silent killer because early stages can present few or no symptoms. In Singapore, colorectal cancer ranks as the leading cancer among men and the second most common among women, highlighting the importance of regular screening beginning at age 50 for those with no elevated risk. For individuals with a family history or early-onset disease, genetic testing and cascade testing of relatives may be recommended to detect problems sooner and guide prevention.
Ms. Lee married Cedric Ng, an information technology engineer, in 2022 when she was 39. They decided to pursue IVF to increase their chances of a healthy child and to minimize the possibility of passing FAP to their offspring. After two IVF cycles, the couple welcomed Phoebe, now one year old.
Ms. Lee’s pregnancy posed additional challenges due to her condition. Phoebe was delivered by cesarean section at SGH, with colorectal specialists on standby, and Ms. Lee experienced a postoperative intestinal obstruction that required a week-long hospital stay after a brief readmission three days following delivery.
Her perspective on the experience is deeply positive: despite the medical hurdles, the daughter’s arrival is viewed as a precious reward for the family’s perseverance.
