SINGAPORE: After six years of trying to get pregnant – including multiple rounds of IVF – Chloe (not her real name) was not about to concede defeat.
“I’m taking a break, but I know biologically I’m still ageing,” said the 40-year-old manager in an email to Channel NewsAsia.
Like many women who go through the arduous journey of attempting to conceive, Chloe was anxious about her ticking biological clock.
“I wanted a backup plan, in case one day I do decide to try again,” she said.
Chloe first heard about egg freezing after reading an article that Google was paying for its employees to undertake the procedure. While her company or health insurance did not cover such treatment, Chloe was determined to secure “Plan B”.
Last year, Chloe, a Singapore permanent resident, flew to a fertility clinic in Sydney to freeze her eggs. It wasn’t a snap decision – it took her nearly four years to consider her options.
“I ended up going for my gut instinct,” said Chloe.
“I knew that if I didn’t try everything I could to have children, I would have regretted not having my eggs frozen.”
EGG QUALITY DROPS WITH AGE
Chloe faced an issue that all women go through – the quality of her eggs would diminish over time.
A woman is born with a finite number of eggs which continuously depletes throughout her lifetime, said Dr Lim Lei Jun from Sunfert International Fertility Centre in Kuala Lumpur.
“Women are most fertile in their twenties and early thirties. After the age of 30, egg quantity and quality starts to decline,” said Dr Lim.
The rate of decline is steepest after 37 or 38 years old.
“Even the healthiest diets or the best workout plans cannot reverse this fact."
Older eggs also have a higher chance of being genetically abnormal, such as having an extra chromosome which causes Down’s syndrome, said Dr Lim.
Egg freezing, or oocyte cryopreservation, therefore provides women the possibility of preserving younger and possibly healthier eggs until they are ready to start a family.
The process first involves stimulating the ovaries with hormones to produce multiple eggs, which is similar to the initial stage of IVF.
The eggs are then retrieved using a needle, and subsequently frozen in subzero temperature for later use.
WHY ARE WOMEN FREEZING THEIR EGGS?
Some women choose to freeze their eggs for medical reasons.
For example, a woman who has to undergo cancer treatment would freeze her eggs since chemotherapy could adversely affect her fertility.
In Singapore, only women with justifiable medical conditions are allowed to freeze their eggs.
Because of this, healthy women in Singapore are going overseas to countries like Thailand, Malaysia, Australia and the US to undergo social egg freezing.
While career demands play a part, most women freeze their eggs because they have not found a suitable partner with whom to start a family, said Dr Suresh Nair from Seed of Life, a fertility centre at Mount Elizabeth Novena.
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Speaking to Channel NewsAsia, Dr Nair said women – usually in their late 30s – find themselves with the looming question: “Will I be childless forever - even if I meet Mr Right?”
In 2017, the proportion of singles among Singaporeans across most age groups increased, with the biggest rise among women aged 25 to 29.
Women in Singapore are expected to juggle so much and meet society’s expectations, said Dr Nair.
“They must do well in university, but (also) do well at her workplace. She must be a good daughter, must be a good wife … and produce children, (and) look after them,” he listed.
Egg freezing can give time to plan out a future, along with a suitable partner and stable finances, Dr Nair said, adding that he has seen an increase over recent years in queries about egg freezing.
Sunfert, located in Kuala Lumpur's affluent suburb Bangsar, said it receives an average of one Singaporean woman each month wanting to freeze her eggs.
The clinic charges around RM20,000 to RM25,000 (S$6,600 to S$8,300) for the procedure, which includes fertility medications, clinic visits, and the egg retrieval itself.
However, this doesn’t cover the storage fee, future thawing or fertilization when the woman is ready to use her egg.
Though the hefty price tag itself might be a deterrent for many, Chloe said the cost was “not an issue for my peace of mind”.
NOT 100 PER CENT FOOLPROOF
Even if a woman had good eggs that can be frozen, other factors also play a part in the success of a pregnancy, cautioned Dr Nair.
“Your womb ages, you age, your heart ages, your lungs age, everything ages.
"Pregnancy is a massive onslaught to the female body. All sorts of other problems can arise,” he said.
According to a report published in the Canadian Medical Association Journal, an older pregnant woman faces an increased risk of certain conditions, such as gestational diabetes and preterm delivery of a baby with low birth weight.
The 2015 report also cited a study showing that the success rate of a clinical pregnancy using a frozen egg was only 4.5 to 12 per cent.
This data was derived generally from eggs obtained from women younger than 30 years old.
In response to Channel NewsAsia’s queries, the Ministry of Social and Family Development (MSF) said that egg freezing, like other assisted reproductive techniques, was “not a guaranteed solution to delaying parenthood”.
“The risks of developing age-related complications during pregnancy are not mitigated by egg freezing,” said a ministry spokesperson.
The ministry also had to be “mindful” of the potential ethical and social implications associated with legalising egg freezing for non-medical reasons, added the spokesperson.
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“Fulfilling one’s marriage and parenthood aspirations sooner increases the chances of conceiving children naturally,” said MSF, adding that age-related fertility problems can affect both men and women.
“There is no better substitute to having healthy children than when couples are relatively young and healthy,” said the spokesperson.
MSF added that the Government was carefully reviewing the possibility of allowing egg freezing for non-medical reasons, while also bearing in mind the various ethical and social implications.
NO NEED TO BE EMBARRASSED ABOUT FERTILITY TREATMENTS
Even though fertility might be considered a taboo topic in some Asian societies, women in Singapore are becoming more open in discussing this issue, said Dr Nair.
Despite the common misconception that egg freezing implied being a spinster, this is a non-issue for women, he added.
“Most women are beyond that, they don’t care about that anymore,” said Dr Nair.
“They say: ‘I will choose who I want to marry … I don’t need men to support me. I am fully independent’.”
He added that women – single or married - should not be embarrassed to talk about their plans to have children.
Although some parents may sometimes be antagonistic towards fertility treatment methods, a woman should be able to make her own choices, said Dr Nair.
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The most common reactions women receive from family or friends about their decision to freeze their eggs are reactions like: “Don’t be so choosy, you just get someone lah”, relayed Dr Nair.
But for Chloe, people’s opinions did not matter.
“It’s a personal choice … Don’t worry (about) what others say about it. Do it for yourself,” she said.
“Support from others is important, but you need your own internal strength and courage to do this.”