You heard it right – In 2023, Singapore is getting ready to legalise social egg freezing.
This would allow women, including singles, to freeze their eggs for non-medical reasons.
The drawback is the eggs can only be used within the context of a legal marriage.
Previously, only women with justifiable medication conditions were allowed to freeze their eggs. For example, conditions like cancer where treatment is known to adversely affect fertility or conditions where treatment requires the removal of the ovaries and fallopian tubes.
Social trends
Singapore’s population birth statistics demonstrate a consistent increase in the proportion of females choosing to delay childbearing until later in their reproductive years.
In 1980, birth rates were highest among females aged 25-29 years. In 2021, this has become highest among females aged 30-34 years instead.
The 5-year BTO wait weighs heavily on every practical Singaporean couple, often cited as a common cause of delaying marriage or parenthood. But the truth is we have our careers and we take pride in them, Mr. Right doesn’t always come along as how we would like – so why not prioritise our career aspirations and financial stability first?
The hard truths about female fertility
This question often leaves us conflicted as we all know the female biological clock starts ticking louder from the age of 30.
A woman is born with a finite number of eggs which continuously depletes throughout her lifetime.
After 30, the quality of the eggs starts to decline. The rate of decline is the steepest after 37 years old, and by age 45 years, as many as 99% of women are infertile – the average age of natural menopause among Singaporean women stands at 49 years.
Unfortunately for us, 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.
Egg freezing: a hopeful change we embrace
Let’s face it – rising costs of living and the current economic situation are likely to support the continued delay in marriage and parenthood.
Egg freezing provides women the possibility of preserving younger and possibly healthier eggs until they are ready to start a family.
In 2014, many companies overseas have already followed the lead of Apple and Facebook offering financial support to female employees to access egg freezing.
Such a policy offers female employees the freedom to pursue family planning according to their own timeline, although the ethics of such a policy is a point for debate.
But… why is the Singapore government jumping in on the bandwagon only now?
Technological advances
Well, the Singapore government still takes the stand of supporting and encouraging Singaporeans to pursue their marriage and parenthood aspirations as early as possible.
Biologically, our fertility rates and chances of a successful pregnancy remain the highest in our 20s.
What has been increasingly recognised is that egg freezing is no longer considered an “experimental” procedure.
Advances in egg freezing techniques, notably the development of vitrification – a flash-freezing method reduces the chance that damaging ice crystals will form inside a frozen egg.
This advancement increased egg survival rates to 85% or more. In comparison, only about 60% of eggs survived being frozen and thawed using the old technique of slow freezing.
This advancement has paved the way for medical bodies around the world to support egg freezing as an established option for fertility preservation. This allows the establishment of medical guidelines to be set in place to safeguard the health and safety of women who are interested in their options for fertility preservation – just like any other medical procedure.
Singaporean women who have yet to find a suitable partner now have an option to preserve their fertility –preserving their chance to conceive and start a family when they marry later.
However, the maximum legal age for egg freezing will be set at 35 years. It has been determined by international scientific evidence and “professional consensus” that egg quality declines significantly after age 35.
Studies have also shown that the ideal age to pursue fertility preservation procedures is typically between 30 and 35 because patients in this age group are the most likely to have good quality eggs to freeze while also having a relatively high probability of utilising their frozen eggs.
Egg freezing: the harsh reality of “fertility insurance”
Egg freezing gives us time to plan out a future, once a suitable partner and stable finances come along.
It only buys us “fertility insurance” and it must be known that it is not a guaranteed solution to delaying parenthood.
A difficult process
The egg freezing process is similar to the initial stages of an in-vitro fertilisation (IVF) cycle.
It involves a series of hormone injections over a period of time to stimulate your ovaries to grow as many eggs as possible. Regular blood tests and ultrasound will follow to determine treatment response. When the eggs are mature, they will require to be extracted under sedation. Once extracted, they will be frozen and stored.
The process is not without its risks and you might need to undergo multiple egg collection and freezing cycles to obtain a sufficient number of eggs for a reasonable chance of pregnancy success in the future.
Even if a lady had good eggs that can be frozen, other factors also play a part in the success of a pregnancy. Pregnancy at a later age is associated with a higher risk of miscarriage, gestational diabetes and preterm delivery of a baby with low birth weight.
The risks of age-related pregnancy complications are not addressed with egg freezing.
The statistics
Interestingly, in a study of 1468 women who underwent egg freezing for planned fertility preservation (mainly due to advancing age), only 9% of these women returned to use their eggs.
This is consistent with other studies – fewer than 10% of women use their eggs after freezing them.
The same studies also reveal that successful live birth rates per patient ranged from 50% (in patients ≤35 years old) to 23% (in patients >35 years old).
Costs of egg freezing
Egg freezing is a huge commitment – the regular clinic visits, scans and injections. This also comes with a huge financial cost.
The cost of social egg freezing in Singapore is not readily available yet, however we can look at the cost of egg freezing for medical reasons as a reference.
The estimated cost of one cycle of egg freezing in Singapore is SGD 10,000. This does not involve the ongoing costs of egg storage and the cost of IVF treatments using the frozen eggs once you are ready for pregnancy. The cost of one IVF cycle ranges from SGD 10,000 to SGD 30,000.
The good news is if you are a Singapore Citizen or Permanent Resident, the government provides up to 75% in co-funding as well as the use of Medisave withdrawal (a limit of SGD15,000) as part of the Marriage and Parenthood Scheme.
As with many things, the cost of living is a lot friendlier when we look across the Causeway.
In 2019, when social egg freezing was not allowed in Singapore, Channel News Asia reported that Sunfert, a clinic located in Kuala Lumpur’s affluent suburb Bangsar, receives an average of one Singaporean woman each month wanting to freeze her eggs.
The clinic charges around RM 20,000 to RM25,000 (SGD 6,600 to SGD 8,300) for the procedure, which includes fertility medications, clinic visits and the egg retrieval itself. However, this does not cover the storage fee, future thawing or fertilization when the woman is ready to use her egg.
Egg freezing has become a sought-after procedure with countries like Australia, Malaysia, South Korea, Taiwan, Thailand, the United Kingdom and the United States having well-established programmes.
Freedom Edge, a Singapore-based egg freezing concierge, helps women travel overseas to freeze their eggs, supporting them through the difficult process from fertility testing to arranging hospital appointments.
Besides social egg freezing, IVF treatment for women aged 45 or older is also not allowed in Singapore. With many restrictions still in place, many Singaporean women still continue to search for their options overseas.
Birth control and egg freezing – embracing the road ahead
You may currently be on a form of birth control and are wondering how it may affect your fertility and chances of egg freezing.
The good news is that long-term use of birth control pills should not affect your fertility or impact your ability to get pregnant. They prevent ovulation and it is commonly recommended to stop using it before starting the egg freezing process. You can resume using the pill after your egg retrieval.
If you have an IUD, you do not have to remove it during the egg freezing process. It is best to raise your concerns to your doctor.
Fertility is a personal choice; there are just so many considerations and options that are now available. Here at Dame, we are here to empower you and to support your fertility goals together.
We answer all your questions about birth control here.
Disclaimer: Articles on Dame are for informational purposes only and do not constitute medical advice, diagnosis, or treatment. If you have concerns about your health, please consult a licensed doctor for personalised medical advice.
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Speak with a Licensed Doctor Online
Our doctors are experienced in women’s health and provide confidential consultations through our secure telemedicine platform. If you have questions about symptoms, treatment options or your overall health, our team can help guide you with evidence-based medical advice.
