The egg freezing dilemma of women in Singapore

SINGAPORE: Time is not on wedding planner Rubina Tiyu’s side. Her biological clock is ticking, and she has been deliberating over freezing her eggs since her mid-30s.

“I’m not getting any younger. I can’t wait another two, three years,” said the 36-year-old. “Also, I don’t know when I’m going to meet a partner … and work is crazy busy; the stress doesn’t help — so a lot of factors.”

Egg freezing has become a sought-after procedure — with countries like Thailand, Malaysia, Australia and the United Kingdom having well-established programmes, highlighted Dr Yeong Cheng Toh from Virtus Fertility Centre Singapore.

And some women are banking on science buying time for their fertility as they look to progress in their career while planning for a family later in life.

READ: ‘Doing it for myself’: The women freezing their eggs to raise their chances of conceiving

But in Singapore, egg freezing is allowed only on medical grounds. That leaves women like Ms Tiyu in a dilemma, as the programme Talking Point finds out in a look at some social and moral aspects of this reproductive technology. (Watch the episode here.)

RESEARCH NEEDED

One of her first questions, when she recently decided to explore her options with a fertility doctor — and learnt that she would have to freeze her eggs overseas — was about how secure the places are where the eggs are put.

Another question mark over egg freezing lies in the length of time the eggs are kept. In the UK, it is 10 years, with exceptions made only for women with certain conditions, like premature ovarian failure, Dr Yeong told her.

“That means you can’t produce any more eggs,” explained the consultant gynaecologist and reproductive endocrinologist. He pointed out, however, that a legal fight has begun in the UK to extend the 10-year limit for all.

After the consultation, Ms Tiyu said: “I need to do a lot more research to think about what I can do as a woman who lives in Singapore and what my next step is.”

She believes egg freezing is a reproductive right, as do a number of women. Dr Yeong also thinks one reason younger women want to freeze their eggs is that “the medical technology has reached a pinnacle where it’s actually safe”.

“It’s robust enough to say, ‘I promise you that if I were to freeze your eggs, it’s going to be good as having fresh eggs from you,’” he said.

WASTE OF MONEY OR TIME FOR CHANGE?

Does egg freezing, however, offer women a false sense of security about their fertility? One of the things women should consider, suggested medical ethics researcher Voo Teck Chuan, is the odds of using those eggs for reproduction in future.

“There’s a credible study done last year that shows that fewer than 10 per cent of women use their eggs after freezing them,” cited the assistant professor at the National University of Singapore’s Centre for Biomedical Ethics.

At the same time, he acknowledged that “women have a strong desire to have their own biological child”. Should a woman use her frozen eggs to try for a baby, however, “there are multiple failure points” to consider.

“There’s the risk of losing the eggs through the process of thawing. You may not get a suitable, viable embryo for implantation. You have to undergo the procedure of IVF, which isn’t an efficient system per se,” said Dr Voo.

“You might fail to get pregnant. And after you get pregnant, it might not result in a live birth. So, very much like natural pregnancy … in the first trimester, there’s a risk of miscarriage. And this increases for older women.”

As to whether egg freezing is thus a waste of money, he said that perspective must be “answered from each person’s life circumstances, their age, the resources, their understanding of the whole process, the downsides and so forth”.

He believes an ethical question is at the heart of the matter: To what extent are women informed about the procedure?

Besides social egg freezing, IVF treatment for women aged 45 or older is also not allowed in Singapore, where the fertility rate fell last year to 1.14, the lowest figure recorded in the country’s history.

Considering how “dismal” it is, said Talking Point host Diana Ser, “some might suggest that it’s time” to relax the laws. “But even then, the road to assisted reproduction is paved with challenges,” she added.

Watch this episode of Talking Point here. New episodes on Channel 5 every Thursday at 9.30pm.