Rarely highlighted in the Singaporean media, the egg freezing process is slowly gaining prominence in many countries around the world. Two of the main reasons why egg freezing is entering the public consciousness are:
- Advancements in the medical industry that have made the process safer and with higher rates of success
- The giant strides that women have made in the corporate world
While the first reason is self-explanatory, the second reason, when taken at face value, might seem unrelated to the increasing popularity of egg freezing. However, dig a little deeper and the implications are quite clear – as women invest more and more of their time and energies at work, naturally, other life choices often take a backseat, like marriage and starting a family.
The first successful case of a human pregnancy using frozen eggs was reported in 1986 by Dr Christopher Chen of Australia. More than two decades later, it is estimated that there have been between 300,000 and 500,000 successful human births using frozen eggs, with numbers expected to rise exponentially in the next few decades due to lifestyle choices and longer life expectancies.
In Singapore, egg freezing or oocyte cryopreservation is only allowed under two circumstances:
- During the in-vitro fertilisation (IVF) process, under certain circumstances (e.g. if the wife is waiting for a sperm donor)
- Clinically-indicated reasons to preserve their fertility before undergoing therapy which impairs or may impair their reproductive health (e.g. chemotherapy)
A woman who opts to freeze her eggs and meets either one of the two circumstances is also required to be below the age of 45 (a woman above 45 would not be allowed to freeze her eggs since she is unable to go through the IVF procedure). Unfortunately, at the moment, egg freezing cannot be carried out in Singapore for elective or social reasons.
One of the major stumbling blocks to the egg freezing procedure is its cost. Since frozen eggs can only be re-inserted into a woman’s body through IVF, the costs incurred can range between S$10,000 and S$12,000, based on current IVF charges.
There is also a minor risk present when using high doses of hormones for producing eggs. “Some women may experience potential complications from hormonal stimulation and procedure of egg retrieval, such as ovarian hyperstimulation syndrome which may require hospitalisation, and other risks related to the procedure. However, thus far, literature on babies born from frozen-thawed eggs has not shown any health complications different from those born from natural conception,” Dr Bala says.
There have also been newer reports emerging in the scientific community that pregnancy rates using frozen eggs are comparable to fresh embryos, affirming how far cryopreservation technology has advanced.
As for the maximum safe period of egg storage, doctors have divided opinions. Most medical professionals agree that eggs can be safely frozen up to ten years while a few believe that the eggs can be stored indefinitely without suffering any deterioration in quality. It is important to note, however, that normally, eggs from younger women survive better than those from older women.
Now, the most important question Singapore faces is whether or not egg freezing should be allowed for social reasons such as overcoming age-related fertility loss. Supporters in the “for egg freezing” camp categorically state that egg freezing is one effective way for Singapore to overcome its declining, aging citizen population while those who oppose egg freezing are concerned about the medical, religious and possible social implications.
According to a report published by BELRIS, a think-tank based in Singapore that funds research addressing the controversial ethics brought about by the advances in reproductive technology, “concerns on the legalisation of elective egg freezing include the commodification of women’s bodies, a consumerist approach to medicine, and the changing image of an ‘ideal’ family”.
Already, countries such as the USA, Belgium and Netherlands permit social egg freezing while Israel has classified age-related fertility decline has a medical condition. So, it is only a matter of time before Singapore must also decide on her stance for egg freezing.
Five Easy Steps to Egg Freezing
Step One: Select your preferred hospital or egg bank. At the moment, most hospitals in Singapore offer facilities for egg freezing.
Step Two: Your gynaecologist evaluate your ovarian reserve or egg quality to determine what medications will work best for you and whether egg freezing is an
appropriate, safe choice.
Step Three: You will receive hormone injections that will aid your body in producing multiple eggs. Then, within the next 12 days, you will undergo blood tests and ultrasound scanning to monitor the growth of your eggs. After the eggs almost reach maturity, you will receive another hormone injection to ripen the eggs.
Step Four: Your gynaecologist will retrieve the eggs transvaginally from your ovary using an ultrasound-guided needle. No abdominal incision is needed.
Step Five: Once the eggs have been successfully retrieved, the embryologist will remove any adhering cells before freezing them, either using the conventional slow freezing technique or the vitrification technique. According to Dr Ethiraj Bala, Chief Embryologist of the Thomson Fertility Centre, “vitrification yields better survival of eggs after freezing and thawing than slow freezing”.
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