IN FOCUS: Is the time right to allow women to choose to freeze their eggs?
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IN FOCUS: Is the time right to allow women to cull to freeze their eggs?
With egg freezing for not-medical reasons among the recommendations made in a joint paper on women'due south evolution by the PAP Women's Fly and Young PAP, CNA looks into why some people retrieve it'south time to lift the ban on the procedure.
Allowing egg freezing is one of the recommendations made by the PAP Women'due south Wing and Young PAP in a joint paper. (Illustration: Rafa Estrada)
- Egg freezing for non-medical reasons is currently banned in Singapore
- There is an "urgent demand" to review the electric current position, according to the PAP Women's Fly and Young PAP, as the reproduction rate of Singaporean women has continued to decline over the by ii decades despite measures put in place to encourage procreation
- Those confronting it have raised ethical and social concerns
SINGAPORE: When she was in her early 30s, Ms Tan was in a serious relationship with a man she thought she would marry. When that didn't work out, she yet wanted to have children eventually – and this led her to explore the option of egg freezing.
At the age of 35, she went to freeze her eggs in Valencia, Espana. She didn't desire a biological "ticking clock" to influence her determination on getting married, she told CNA. She was referring to the natural turn down over time in the quantity and quality of her eggs.
"I knew I wanted a family, but I didn't want to brand any rushed, impulsive kind of decision. So, by freezing my eggs, it gave me similar a form of insurance," she said.
Now 39, Ms Tan (she didn't want her full name to be published) has frozen her eggs twice. The second time was in Kuala Lumpur and while that was closer to abode, she wishes she had been able to have the procedure done in Singapore.
"That would have made things then much easier, more user-friendly. I think information technology might have been more than price-effective as well," said Ms Tan, who spent most S$xx,000 in total on the ii procedures.
Women like Ms Tan have to go overseas for the constituent process known equally "social egg freezing" because information technology is currently banned in Singapore.
Nevertheless, freezing of eggs is allowed for medical reasons, such as for cancer patients undergoing chemotherapy that may bear on their fertility.
Some groups here are lobbying to change the situation. In July, the People'southward Action Party's (PAP) Women'south Wing and Immature PAP released a joint paper on women's development that recommended allowing the procedure for non-medical reasons.
The groups also suggested putting in identify a regulatory framework to impose weather or limit the use of eggs to certain circumstances, such as "simply within the confines of marriage".
What is egg freezing?
Egg freezing involves retrieving a adult female's eggs, freezing and storing them. The eggs and then stop ageing and can be warmed and fertilised with sperm when needed.
Upon successful fecundation, the eggs are transferred to the uterus as embryos.
The procedure involves the woman undergoing hormone injections for an average of x to fourteen days. She will have to go for regular blood tests and ultrasound scans to monitor her response to the injections, said Dr Lim Min Yu of Astra Women'southward Specialists.
When at that place are sufficient mature follicles in her ovaries, the woman will accept a "trigger" injection to prepare the eggs for egg collection, he said.
Egg collection is done in an operating theatre, with the woman under sedation or a general anaesthetic. The nerveless eggs are then frozen past a method known every bit vitrification, or ultra-rapid freezing, and stored in special liquid nitrogen containers until information technology is time for them to be warmed up and fertilised.
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Ethical AND SOCIAL CONCERNS
The risks of egg freezing are the same every bit for women undergoing an in-vitro fertilisation cycle, including "some pain and bruising" at the injection sites, said Dr Lim.
"There may exist mood or emotional changes in response to the hormone injections, and in that location is a risk of a condition chosen ovarian hyperstimulation syndrome, where the ovaries become swollen, and fluid tin can accumulate in the abdomen," the fertility specialist said.
The Government reiterated its position on social egg freezing last yr. The Ministry building of Social and Family Development (MSF) said in response to a question in Parliament that it was "carefully reviewing" the thing of extending egg freezing to be allowed across medical grounds.
MSF acknowledged that social egg freezing "may benefit some women because of their personal circumstances", such as not being able to find a partner and wanting to preserve their chances of conceiving if they ally after.
"However, we too take to take into account the ethical and social concerns over legalising social egg freezing, including inadvertently causing more to delay marriage or parenthood based on a misperception that they tin have a child whenever they wish to," MSF said.
The ministry noted that the risks of developing complications during pregnancy likewise increment with age, "even if the kid is conceived through a frozen egg".
REVIEW THE POLICY?
Singapore'southward social issues and biological realities are among the reasons why some are advocating a review of the current policy.
The position paper past the PAP Women's Fly and Young PAP, which said there is an "urgent need" to look into the event, noted that the reproduction rate of Singaporean women has continued to decline over the past two decades. This is despite the availability of monetary and other social incentives put in place by the Government to encourage procreation.
Singapore's fertility rate reached a celebrated low of 1.1 babies per adult female terminal year, compared to 1.6 in 2000, co-ordinate to the latest data from the Singapore Section of Statistics.
Singapore's Full Fertility Charge per unit
| 2000 | 2010 | 2019 | 2020 |
| one.60 | one.15 | 1.14 | one.10 |
Source: Singapore Department of Statistics
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Singaporean women who choose to pursue their career aspirations and delay marriage and childbirth reflect the "irresolute realities", the newspaper said.
"We should continue our efforts to make it conducive for people to marry and have children early, but we need to exist cognisant of these current realities and consider pragmatic, multi-pronged approaches to accost our declining nascence rates and back up women in their journey to maternity," it added.
MP Cheng Li Hui (PAP-Tampines), who is role of the PAP Women's Wing, has been championing the cause since 2016. She found out near egg freezing after the topic came upwards in her conversations with young families in her ward.
The women who want to freeze their eggs should be able to benefit from Singapore'south "world-class healthcare system", Ms Cheng said.
"We should give peace of listen to our ladies undergoing the procedure – nowhere better than hither really," she said, adding that the procedure could promote medical tourism.
"Now more than ever, the ladies who have been wanting to freeze eggs in the last 2 years … They can't. In the last ii years, their quality of eggs would have dropped, the quantity of eggs would also have dropped," she said, referring to the limits the COVID-19 pandemic has placed on international travel.
THE ARGUMENT AGAINST EGG FREEZING
Ms Cheng acknowledged that some are against the idea of egg freezing.
A survey she did in 2022 with more than 700 respondents establish that 63 per cent supported egg freezing. Among those who did not, a common business organisation was that allowing the procedure would encourage people who are not in a traditional family unit nucleus, such as same-sex couples and unmarried women, to have children, she said.
The National Council of Churches released a statement in 2022 on its stand against egg freezing for non-medical reasons.
In the statement, which explored ethical and social problems, the NCCS said information technology is "unable to support the legalisation of social egg freezing because of the serious upstanding and social issues information technology raises".
"The primal problem with social egg freezing is that this technology is used for non-medical reasons. The technology is not used to treat a particular pathology or to prevent an illness but rather to facilitate and consequently promote a lifestyle option or preference," the statement read.
NCCS besides called the elective process a "profoundly selfish human activity because information technology sees career as more important than the interests and welfare of the child". Assuasive social egg freezing would encourage women to postpone childbearing in order to "take information technology all", the council said.
"The legalisation of social egg freezing reinforces a perspective on priorities that would have profound social implications."
On the point raised in the survey on non-traditional family structures, the recommendation past the two branches of the PAP is for the use of eggs to be allowed when a woman is married, Ms Cheng pointed out.
She stressed that the procedure would be elective.
"I would think that if it is allowed and you're against it, don't do it. But don't make the rest of lodge follow your rules," she said.
Associate Professor Tan Ern Ser from the department of sociology at the National University of Singapore noted that the "central factor" for delayed marriage and childbirth thus far has been the priorities women placed on career aspirations, together with work practices that are non entirely friendly to having children, even with the ban on social egg freezing in identify.
He suggested that women should have the "freedom to choose".
"Women should have the right to pursue what they consider to be their priorities, including when to have children," he said.
If the country wants to enhance the fertility rate, it should use incentives and make work-life practices friendly, and "not apply direct or indirect pressure", he said.
"Every bit a sociologist, I'd argue that social egg freezing would empower women further," he said.
REASONS FOR WANTING TO FREEZE EGGS
Autonomously from career aspirations and not being able to observe a partner, there may be other reasons why some women delay starting a family, according to Ms Emma Zhang, who set upward a page called "myeggsmytime" on Instagram.
The women she encountered through the folio have reasons that range from having to care for elderly parents to non being financially stable enough, said the 31-year-old freelance content strategist.
"The Government needs to realise that should whatsoever woman choose to requite birth later on in life and take on the adventure, she does and then for the sake of her unborn child," she told CNA.
"What's the bespeak of having children immature if one is unable to provide for them emotionally and financially, especially in a society that places then much emphasis on success. Sometimes y'all can't have it all now – but y'all tin can have it later. What'due south incorrect with that?" she asked.
She added that "about importantly", if a woman chooses to give birth later, that is "her correct".
Ms Cheng said that egg freezing is non a determination that will exist taken lightly.
"It's not a elementary procedure. This procedure requires yous to jab yourself every twenty-four hour period. And at that place is a process to extract the eggs, so it'southward not risk-complimentary. It's not fun. Why would a person want to go through information technology? Information technology's merely because they want to preserve that correct to be a mother."
She said that women may not have been able to find a partner earlier in their lives.
THE REALITY OF EGG DECLINE
Egg quality is the "most important factor" in the chances of successful pregnancy, said Dr Lim. However, he noted that a woman is born with all the eggs she will ever have.
As she becomes older, both the quantity and quality of her eggs volition diminish, he said.
"The younger the egg, the higher the chance of pregnancy. The chances reduce afterward the age of 35, and even more steeply after the historic period of 40," he said.
Elective egg freezing allows women to take action about the drop in their fertility, he said, adding that the chances of success are "much higher" if eggs are frozen before the adult female reaches 35 years quondam.
Dr Suresh Nair from fertility centre Seed of Life in Mount Elizabeth Novena Hospital similarly said the quality of eggs has a "sharp drop" from age 34.
With the option of freezing eggs, at the age of 34 with 20 extracted mature eggs, the chances of one successful birth is 90 per cent, Dr Nair said, quoting published enquiry on the subject. This chance of success drops to 75 per cent for a 37-twelvemonth-old woman, he said.
"Women don't actually tend to start affectionate this (the decline in fertility) until they are 36, 37, 38 (years old)," he said.
Dr Nair said that while getting pregnant at an older historic period comes with its own medical risks, these tin be managed.
"There's a college run a risk of Caesarean sections, higher run a risk of diabetes, higher chance of hypertension no dubiety, simply we don't remember is terribly problematic, so the only thing that suffers is eggs," he said.
Both doctors said that at that place is a demand to educate the public about the refuse in female fertility with age.
For 32-year-old Stephanie Zheng, who has been married for two years, existence allowed to freeze her eggs would give her fourth dimension to be fix to be a mother.
"Basically, I'chiliad trying to get my life on track to practice all the things that I want to do showtime, earlier I think about having enough money and enough time and effort to nurture another human existence," said Ms Zheng, who holds a total-time job and manages two side businesses.
She said that if she wants a kid at a later age, it would be her "torch to bear" fifty-fifty if it means her body may non be as strong.
"If I can't go a child, then it's as well sort of on me. But at least I accept that selection ... if we have the resources to do so, to freeze our eggs, then we should have that choice."
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Source: https://cnalifestyle.channelnewsasia.com/singapore/focus-egg-freezing-social-women-allow-singapore-277311
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