Egg donation by export of Husband's frozen sperm sample overseas to a foreign fertility clinic and subsequent import of frozen embryos into Singapore

[Angelica Cheng]

To circumvent COVID-19 travel restrictions, Singapore now allows IVF patients to freeze and transport the husband's sperm to foreign fertility clinics or egg banks, where these can be used to fertilize fresh donor eggs to produce frozen embryos, which can then be imported into Singapore.

This has 3 major advantages over the import of frozen unfertilized donor eggs:

(i) Fresh donor eggs typically produce better quality embryos and higher IVF success rates than frozen donor eggs.

(ii) It is well-known that sperm and embryos, particularly Day 5 Blastocysts are much more hardy and survive the freezing process much better than unfertilized eggs. Therefore, it is always better to transport frozen embryos rather than frozen unfertilized eggs into Singapore.

(iii) Best results are obtained by using the IVF lab affiliated with the egg bank, which recruited the egg donor and froze her eggs. IVF patients should avoid using frozen donor eggs that are transferred to their clinic from an external egg bank. This is because the thawing protocol must be matching and compatible with the freezing (vitrification) protocol (somewhat analogous to a lock and key). Only the same IVF lab that performs both the freezing and thawing processes can ensure this, to attain best IVF success rates.

Please refer to the following video podcast by Dr. John Jain, an American fertility specialist:

Sunfert International Fertility Centre (KL, Malaysia), now accepts frozen sperm samples from Singapore for fertilization of donor eggs to produce embryos, which are then frozen down and transported back to Singapore. Please note that import of IVF embryos into Singapore is only permitted if these have not been genetically tested by PGS / PGT-A.

Sunfert @ Bangsar South
Sunfert International Fertility Centre Sdn. Bhd.
Unit 2-2, Level 2, Nexus, Bangsar South
7, Jalan Kerinchi, 59200 Kuala Lumpur, Malaysia.

T +60 (3) 7622 8688
F +60 (3) 2242 3168
E [email protected]
W www.sunfert.com
S www.facebook.com/sunfert


Details of egg donor program at the Singapore side:

Sunfert International Fertility Centre is currently working with the following fertility specialists in Singapore, for the freezing and export of the Husband's sperm sample into Malaysia, and subsequent import of the produced frozen embryos into Singapore for transfer to patients.

• Dr. Suresh Nair - Seed of Life:

Meet Dr. Suresh Nair | Seed Of Life

Meet Dr. Suresh Nair "We utilize the minimally invasive robotic approach to surgeries that help women conceive. Robotic surgery is optimal in reproductive surgeries as it is less painful, offers smaller incisions; thus very minimal scaring, and provides for faster recovery time, which means an...

seedoflifesingapore.com

• Dr. Christine Yap - Mt. Elizabeth Fertility Centre:

Dr. Yap Hui Ann Christine - Mount Elizabeth Medical Centre - Private Healthcare In Singapore

1991 MBBS National University of Singapore1995 MRCOG Royal College of Obstetricians and Gynaecologists (UK)1996 MMed National University of Singapore1996 MRACOG Royal Australian College of Obstetricians and Gynaecologists 1999 FRANZCOG Royal Australian & New Zealand College...

www.memc.com.sg

For the exact costs of freezing Husband's sperm sample and subsequent frozen embryo transfer, please contact the above doctors and their affiliated fertility centres.

Details and costs of egg donor program at the Malaysia side -Sunfert International Fertility Centre:

The IVF-Egg Donation Programme Package costs MYR 32,000 + MYR 16,000 (donor's reimbursement via CASH / BANKTRANSFER ONLY).

The egg donation program has many Chinese donors. These donors are selected based on good ovarian reserve (good AMH levels) therefore between 8 - 12 eggs are expected to be harvested. However, there is no guarantee that eggs will be recovered or that fertilization will occur, embryo development / transfer / pregnancy from any fertility treatment.

The egg donation package includes the following:

• Donor's clinical & blood investigations related to infectious disease screening.
• Medication for the donor & recipient (up to pregnancy test).
• Doctor's professional fee & Laboratory charges (IVF/ICSI)
• Blastocyst culture, Laser Assisted Hatching (if necessary) & Time-Lapse Imaging up to 12 eggs by using one of the best platforms called the EmbryoScope®)
• Cryofreezing of excess embryos & cryopreservation maintenance charges for the first 6 months
• Psychological Assessment & Counselling (PAC) session (compulsory 1.5 hour session for all recipient)
• 1st Frozen Embryo Transfer (FET)

However, the egg donation package price does not include the following:

• Initial consultation and scan with our specialist, initial blood screening & semen analysis
• Embryo cryopreservation maintenance charges (MYR 1200 / year)
• Other adjunct treatment/services such as sperm separation, Pre-implantation Genetic Diagnosis/Screening (PGD/PGS), IMSI & Colorado Protocol
• Further medications once pregnancy is confirmed by blood test

Costs of export and import of frozen sperm and embryos respectively, by Ulink Sdn Bhd:

The Malaysian company Ulink (Sdn Bhd) can now handle export of Husband's frozen sperm sample to any fertility clinic in Malaysia, together with subsequent import of frozen embryos into a local IVF clinic in Singapore.

Their charges are RM4,500 for one-way, or RM9,000 for to-and-fro transportation, including all administrative fees for custom paperwork, as well as custom duties.

Ulink (Sdn Bhd) company website: ulinkassist.com
Contact person: Ms. Charmaine Khoo
Email address: [email protected]
Tel: +6016 625 2923 +603 7866 0640
Address: 8 Jalan 55 1/9A, Petaling Jaya 47301, Selangor, Malaysia

 

[Angelica Cheng]

Such an Egg Donation Scheme is also available at Thomson Fertility Centre in Singapore, in collaboration with Santa Monica Fertility Center in the USA.

Information on procedures and costs at the Thomson Fertility Centre Side:

Collection and freezing of Husband's sperm sample: SGD$175 (before GST)

Frozen Embryo Transfer procedure: SGD$3,500 to SGD$4,500 (before GST).
Variability is due to medications and consumables used by individual patients,
as well as whether there is need for Assisted Hatching procedure.

Information on procedures and costs at the Santa Monica Fertilility Centre Side:

Our fresh shared egg donor cycle packages start at USD$29,800 and includes a batch of 8 fresh eggs, all embryology, ICSI, assisted hatching, all surgical fees, IVF, donor compensation, donor medications, donor legal representation, embryo freezing if needed, one year of storage for frozen material, the initial embryo transfer and transfer of remaining embryos at no cost if the first does not result in a live birth. Depending on your individual cycle plan you may need to purchase medication which can cost approximately USD$500 to USD$1,000 and legal representation, which is approximately USD$750. If you secure a fresh batch of eggs and for some reason, there is a shortage of mature eggs to fertilize the day of retrieval you will receive a refund for eggs not received. If you fertilize fresh eggs you have the option of shipping frozen embryos to another clinic if you wish. In this case, we would subtract the embryo transfer portion of the package (USD$1,830) and you would be responsible for the costs of shipping the embryos to your lab but we will help with all coordination needed on our end. Embryos created from fresh eggs have a live birth rate of approximately 70 percent and with 8 eggs we typically see 2-3 or more embryos. The batch size can be increased based on your fertility goals and there would be an additional fee of USD$3,725 per egg added to the package. PGS (PGT-A) testing is an additional fee to add to the package but my understanding is that is not allowed to be added if the embryos are being shipped back to Singapore. The other items not included in the package would be out of town monitoring visits if needed, routine preconception and prenatal tests which may be covered by insurance, and any early pregnancy OB ultrasounds should you choose to have them here.

Shipping costs of sperm and embryos (depending on individual courier company):

A quote would be needed regarding the international shipping as it depends on the company chosen, type of insurance, and where in Singapore they are traveling to. I believe the last few quotes in that area with Cryoport were about $4,000 for one way shipment, from Singapore to the USA. Cryoport website is https://www.cryoport.com/ and their phone number is +1-949-232-1900.


Availability of Asian and Chinese egg donors at Santa Monica Fertility Centre:

There is however limited availability of ethnic Chinese egg donors at Santa Monica Fertility Centre. But they also have other East Asian donors such as Japanese, Korean, Vietnamese and Kyrgyz. Please see attached PDF file.

You can also view their egg donor database at the following website link https://www.santamonicafertility.com/find-an-egg-donor/

 

[Angelica Cheng]

The Malaysian company Ulink (Sdn Bhd) can now handle export of Husband's frozen sperm sample to any fertility clinic in Malaysia, together with subsequent import of frozen embryos into a local IVF clinic in Singapore.

Their charges are RM4,500 for one-way, or RM9,000 for to-and-fro transportation, including all administrative fees for custom paperwork, as well as custom duties.

Ulink (Sdn Bhd) company website: ulinkassist.com
Contact person: Ms. Charmaine Khoo
Email address: [email protected]
Tel: +6016 625 2923 +603 7866 0640
Address: 8 Jalan 55 1/9A, Petaling Jaya 47301, Selangor, Malaysia

 

[Angelica Cheng]

The advent of international 'mail-order' egg donation

OBGYN

obgyn.onlinelibrary.wiley.com

Abstract

The rising demand and increasing scarcity of donor oocytes in developed countries have led to some fertility clinics sourcing oocyte donors from abroad, particularly from poorer countries, in what is referred to as 'transnational' or 'international' oocyte donation. In a further new 'twist' to this scheme, frozen sperm of the recipient's male partner is exported abroad through courier mail and is used to fertilise donor oocytes in a foreign clinic to produce embryos, which are then cryopreserved and imported back by mail for transfer to the woman. There are numerous ethical concerns with regards to such means of procuring donor oocytes. First, there is an issue of exploiting economically underprivileged women in poorer countries and disproportionate gains on the part of medical doctors and fertility clinics. Second, there is a question of abdication of responsibility for the donor's welfare on the part of the fertility doctor who takes charge of the recipient's treatment abroad if oocyte donors were to develop severe ovarian hyperstimulation syndrome. Third, the issue of responsibility and accountability becomes even more contentious if congenital defects were to appear in offsprings born from transnational oocyte donation or in the case of transmission of communicable diseases such as hepatitis B, syphilis and AIDS to the recipient. Last, cost savings from the lower prescription price of fertility drugs in economically less-developed countries may not be passed down to the oocyte recipient but instead be exploited to boost the already substantial profit margin of fertility clinics and doctors.

 

[Angelica Cheng]

The advent of international ‘mail‐order’ oocyte donation
N Mukhopadhaya I Manyonda

OBGYN

obgyn.onlinelibrary.wiley.com

Sir,

We read with great interest the commentary1 on the disturbing developments in the commercialisation of procreation. Boon Heng has rightly highlighted the very pertinent ethical and legal issues related to ‘mail‐order’ oocyte donation. However, there are at least two other issues of significance that merit attention.

First, patients often express concerns about the possibility of ‘gamete mix‐up’ and measures in place to reduce the risk of such human errors. In the UK, the Human Fertilisation and Embryology Authority (HFEA)’s expanded sixth edition of the Code of Practice published in 2003 contains sections dedicated to giving guidance on witnessing clinical laboratory procedures,** 1991–1993, the Committee on Social and Ethical Issues; from 1991 to 1999, social and ethical issues were considered by the Authority as a whole and ad hoc working groups which reported on individual areas of work; in 1999, a standing Ethics Committee was established, which became the Ethics and Law Committee in 2003, and these measures can reduce the occurrence of such events. Unfortunately, most European countries do not have a regulatory body. ‘Mail‐order’ oocyte donation poses the real danger of ‘gamete mix‐up’, a topical issue in the UK, which has attracted extensive media attention in recent months. Such a mix‐up has occurred in the UK, despite the stringent regulations put in place by the HFEA.

Second, the option or possibility for children born following gamete donation to access information about their genetic parents, and therefore be able to trace them, has been recognised as a ‘human right’. This has led to the abolition of statutory guarantees of anonymity of donors as of April 2005 in the UK. In the absence of a dedicated register of donors and recipients in most other European countries, it would be near impossible for the offsprings to trace their genetic parents in years to come. There is therefore an urgent need for the creation and maintenance of enforceable centralised registers, such as that maintained by HFEA, to record licensed treatment services and details of the gamete donors.

Whatever one’s views on the matter, international ‘mail‐order’ oocyte donation is now a reality and is probably to expand. Where this is possible, such as in the European Union, the challenge is for governments to step in and develop enforceable regulations that may minimise the unacceptable exploitation of egg donors in developing countries and provide safety and legal redress where required to the recipients in the developed world.

Without these measures and the others proposed by Boon Heng, it will not be long before we witness the ‘amazonisation’ of gamete sale on amazon.co.uk or on Ebay.

 

[Angelica Cheng]

J Assist Reprod Genet. 2007 Apr;24(4):107-9.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3455062/

Legal and ethical issues in the international transaction of donor sperm and eggs

Abstract

Pertinent ethical and legal issues in the international transaction of donor sperm and eggs are discussed. Firstly, there may be legislative and ethical "contradiction" by the local health authority in permitting import of donor gametes, due to varying policies on donor reimbursement in different countries. This is particularly significant in countries where the underlying principle of gamete donation is altruistic motivation, and where reimbursement is given only for direct "out-of-pocket" expenses i.e. traveling costs. Secondly, there is a lack of clear and coherent internationally-binding legislation and regulatory guidelines overseeing the exchange of donor gametes across international borders. In particular, provisions should be made for donor traceability if gametes are sourced from abroad. Thirdly, in the case of "frozen-egg donation" from abroad, patients must rightfully be informed that current cryopreservation technology is still sub-optimal, and all studies have consistently shown that the chances of conception are always lower with "frozen-eggs" compared to freshly-retrieved eggs. Finally, regulatory safeguards should be put in place to prevent fertility clinics and medical professionals from "re-selling" imported donor gametes at a profit to the patient, since it would be thoroughly unprofessional for them to earn a profit simply through the 'brokerage' of donated human material.

 

[Angelica Cheng]

Alternatively, Thomson Fertility Centre in Singapore, also collaborate with Heart2ART egg donor agency in Malaysia, for export of Husband's frozen sperm sample into Malaysia for in vitro fertilization of donor eggs to produce embryos, which are then frozen down and imported back into Singapore for transfer to the wife.

Information on procedures and costs at the Heart2ART agency side:

Altogether, the entire package cost of donor eggs, including IVF, embryo culture and freezing is RM 50,000.

Heart2ART egg donor agency
Website address:es

https://www.baby4u.us/about.html

heart 2 art

Email address: [email protected]
Address:
6-1, Jalan Setia Dagang AK U13,
Setia Alam, Seksyen U13,
40170 Shah Alam
Selangor, Malaysia.
TEL: +603-3362 3729
FAX: +603-3362 5729
Mobile: +6012 389 3840 (Christine)


Information on procedures and costs at the Thomson Fertility Centre Side:

Collection and freezing of Husband's sperm sample: SGD$175 (before GST)

Frozen Embryo Transfer procedure: SGD$3,500 to SGD$4,500 (before GST).
Variability is due to medications and consumables used by individual patients,
as well as whether there is need for Assisted Hatching procedure.


Costs of export and import of frozen sperm and embryos respectively, by Ulink Sdn Bhd:

The Malaysian company Ulink (Sdn Bhd) can now handle export of Husband's frozen sperm sample to any fertility clinic in Malaysia, together with subsequent import of frozen embryos into a local IVF clinic in Singapore.

Their charges are RM4,500 for one-way, or RM9,000 for to-and-fro transportation, including all administrative fees for custom paperwork, as well as custom duties.

Ulink (Sdn Bhd) company website: ulinkassist.com
Contact person: Ms. Charmaine Khoo
Email address: [email protected]
Tel: +6016 625 2923 +603 7866 0640
Address: 8 Jalan 55 1/9A, Petaling Jaya 47301, Selangor, Malaysia

 

[Aries12345]

Hi so to look for donor egg , we can call Thomson Fertility Centre to assist is it?

 

[Aries12345]

Is it expensive ? You means we call export frozen sperm out ?

 

[Angelica Cheng]

Hi so to look for donor egg , we can call Thomson Fertility Centre to assist is it?

There are three parties involved - Thomson fertility, Heart2ART agency and UlinkAssist (courier company). Suggest you call Thomson first, as they will be the one doing the sperm freezing, which is the first stage of the procedure. It seems that Thomson charges SGD$175 for the sperm collection and freezing procedure. Probably have to pay more if you want them to analyze your husband's sperm.

 

[BB8]

Hi Angelica, was reading on your write up on Santa Monica Fertility Centre tie up with Thomson Fertility Centre, got a bit confused, is US$29,800 for fresh collection of eggs? Since the fertilized embryo needs to be frozen anyway to come back to Singapore (assuming husband's sperm is exported to Santa Monica to fertilized the freshly retrieved eggs), wouldn't it be cheaper to just use frozen eggs from Santa Monica Fertility Centre?

 

[Angelica Cheng]

Hi Angelica, was reading on your write up on Santa Monica Fertility Centre tie up with Thomson Fertility Centre, got a bit confused, is US$29,800 for fresh collection of eggs? Since the fertilized embryo needs to be frozen anyway to come back to Singapore (assuming husband's sperm is exported to Santa Monica to fertilized the freshly retrieved eggs), wouldn't it be cheaper to just use frozen eggs from Santa Monica Fertility Centre?

Doctors would advise that sperm and embryos survive the freezing process much better than unfertilized eggs. Hence, where possible, patients should avoid using frozen unfertilized eggs.

Additionally, it is scientifically proven that fresh eggs yield better success rates than frozen eggs.

There are 3 major disadvantages of using frozen donor eggs:

(i) Fresh donor eggs typically produce better quality embryos and higher IVF success rates than frozen donor eggs.

(ii) It is well-known that sperm and embryos, particularly Day 5 Blastocysts are much more hardy and survive the freezing process much better than unfertilized eggs. Therefore, it is always better to transport frozen embryos rather than frozen unfertilized eggs into Singapore.

(iii) Best results are obtained by using the IVF lab affiliated with the egg bank, which recruited the egg donor and froze her eggs. IVF patients should avoid using frozen donor eggs that are transferred to their clinic from an external egg bank. This is because the thawing protocol must be matching and compatible with the freezing (vitrification) protocol (somewhat analogous to a lock and key). Only the same IVF lab that performs both the freezing and thawing processes can ensure this, to attain best IVF success rates.

Please refer to the following video podcast by Dr. John Jain, an American fertility specialist:

 

[Angelica Cheng]

Hi Angelica, was reading on your write up on Santa Monica Fertility Centre tie up with Thomson Fertility Centre, got a bit confused, is US$29,800 for fresh collection of eggs? Since the fertilized embryo needs to be frozen anyway to come back to Singapore (assuming husband's sperm is exported to Santa Monica to fertilized the freshly retrieved eggs), wouldn't it be cheaper to just use frozen eggs from Santa Monica Fertility Centre?

Please also see: https://www.msn.com/en-sg/lifestyle...oices-of-ivf-patients-in-singapore/ar-AAKcvtC

The major advantages of utilising frozen versus fresh donor eggs include:

1. Greater convenience, as there is no need to synchronise the timing and hormonal stimulation cycles of egg donors and recipient patients.
2. Cheaper costs due to negating the travel and hotel costs associated with fresh egg donation.
3. Little or no waiting time as frozen eggs are readily available.
4. More certainty, because the exact number of frozen donor eggs is known and guaranteed. By contrast, for fresh egg donation, the number of eggs that will be retrieved from the donor after hormonal stimulation is unknown and non-guaranteed.

However, there are also several disadvantages of using frozen donor eggs:

1. The costs of transporting frozen eggs into Singapore from abroad is very expensive, as it requires a special cryogenic container.
2. The IVF success rates with frozen eggs are still significantly lower than fresh eggs, despite technological advances such as ice-free vitrification protocols.
3. Because frozen donor eggs are highly delicate and fragile, the thawing protocol must be matching and compatible with the freezing (vitrification) protocol, similar to a lock and key. Only the same IVF lab that performs both the freezing and thawing processes, can ensure this. Hence for best results, patients should use the same fertility clinic or IVF lab that recruited the egg donor and freeze her eggs, rather than transferring frozen donor eggs from one medical facility to another.
4. Asian/Chinese donors eggs may be more expensive to procure from Western egg banks, as compared to Caucasian ones, due to the scarcity of Asian/Chinese donors in Western countries. This problem may be overcome by sourcing from egg banks within Asia.

 

[yellowlion]

Hi Angelica! thank you, this information is extremely useful! I do intent on asking thomson fertility about this..but reading from the previous messages, thomson fertility can facililitate the transfer of frozen embryos?

 

[Angelica Cheng]

Hi Angelica! thank you, this information is extremely useful! I do intent on asking thomson fertility about this..but reading from the previous messages, thomson fertility can facililitate the transfer of frozen embryos?

I heard that the laws may have changed recently, as MOH has been tightening regulations on import/export of sperm, eggs and embryos. Do inform me the results of your inquiry.

 

[Still waiting]

Hi I heard from Thomson Fertility Center that we need not get approval from govt to bring on frozen embryos. Anyone aware of this? Also any success cases that have tried this frozen embryo method can share yr stories pls.

 

[Angelica Cheng]

Hi I heard from Thomson Fertility Center that we need not get approval from govt to bring on frozen embryos. Anyone aware of this? Also any success cases that have tried this frozen embryo method can share yr stories pls.

Did you check with Thomson fertility whether they can freeze the husband's sperm and export to Malaysian clinic to fertilize donor eggs? I heard from Mt. Elizabeth that MOH recently banned freezing and export of Husband's sperm? Before the ban, Mt. Elizabeth had been freezing and exporting husband's sperm to Malaysian IVF clinic for donor egg program.

 

[Still waiting]

Did you check with Thomson fertility whether they can freeze the husband's sperm and export to Malaysian clinic to fertilize donor eggs? I heard from Mt. Elizabeth that MOH recently banned freezing and export of Husband's sperm? Before the ban, Mt. Elizabeth had been freezing and exporting husband's sperm to Malaysian IVF clinic for donor egg program.

Yes I did. They don’t allow exporting sperm overseas and importing embryos into Singapore. Mr Loh feels his clinic and lab are better equipped to aid IVF process than overseas clinic. Also SG doesn’t allow importing of frozen embryos.