Social Egg Freezing (non-medical reasons)

[Angelica Cheng]

Hi Ladies, do give your opinion on Social Egg Freezing for non medical reasons, since the Singapore government is considering lifting its ban.

Q & A on the Quora website:

Social egg freezing - if you have frozen your eggs overseas as a single woman, can you later import into Singapore after getting married?

Answer: You had previously undergone social egg freezing overseas as a single woman because the procedure is banned in Singapore. But do you know that you can legally import your own frozen eggs for local IVF treatment after you get married? There maybe several reasons why you prefer to receive I...

www.quora.com

How do you maximize your chances of future conception and pregnancy with social egg freezing?

Angelica Cheng's answer: Here are things that you can do to maximize your chances of future conception with social egg freezing: (1) First and foremost, freeze your eggs as young as possible, preferably before the age of 35. There is medical evidence that a woman’s fertility drops sharply after ...

www.quora.com

Why is social egg freezing (non-medical reasons) for single women banned in Singapore?

1 person wants answers to this question. Be the first to answer.

www.quora.com

Here is a Forum letter published in the Straits Times:

https://www.straitstimes.com/forum/letters-in-print/permit-social-egg-freezing-with-age-limit

Permit social egg freezing with age limit

The Straits Times’ social affairs correspondent Theresa Tan described the dire situation of older women having dismal outcomes from fertility treatment due to the lack of viable and healthy eggs (Good to lift IVF age limit, but will women still have eggs?, Oct 11).

This, in turn, has sparked calls for social egg freezing to be permitted in Singapore, in tandem with the lifting of age restrictions on IVF treatment. However, the Ministry of Health (MOH) is reluctant to do so, fearing that the procedure could lead to disappointment for many couples who delay marriage and parenthood only to find out later that they are unable to conceive using this method.

The main challenge with social egg freezing is that most women freeze their eggs when they are too old and the quality of their eggs has substantially declined. The high financial costs of social egg freezing tend to deter many younger women from freezing their eggs until they feel desperate after growing older. Hence, it is common to read in the media that most women freeze their eggs in their late 30s or early 40s.

The solution to this problem is to impose an age limit on social egg freezing so as to ensure a good outcome in future fertility treatments. A suitable cut-off age is 35, since most medical publications have reported a steep decline in female fertility after that.

This may seem a bit harsh from an individual point of view, but looking at the big picture, imposing such an early cut-off age would in fact encourage and push more women to freeze their eggs when they are much younger for their own benefit. This would ensure a much better outcome in future fertility treatment, thereby allaying the MOH’s concerns and reluctance to permit social egg freezing.

Additional incentives for women to freeze their eggs at even younger ages could also be put in place. For example, let women who freeze their eggs before 30 years old be eligible to donate some of their eggs to infertile couples in return for heavily discounted medical fees for egg freezing. Because such subsidies will come directly from infertile couples receiving the donated eggs, there would be no additional costs to the Government. Moreover, such a scheme would also overcome the persistent shortage of donor eggs in Singapore.

 

[Angelica Cheng]

Here is another interesting article on social egg freezing:

Forum: Letter of the week #1 Allow use of CPF to pay for egg freezing

I applaud the Government for reconsidering its ban on social egg freezing (Govt reviewing ban on women freezing eggs for non-medical reason, Oct 22). Read more at straitstimes.com.

www.straitstimes.com

Forum: Letter of the week #1 Allow use of CPF to pay for egg freezing

I applaud the Government for reconsidering its ban on social egg freezing (Govt reviewing ban on women freezing eggs for non-medical reason, Oct 22).

Single women who want to freeze their eggs face many financial constraints due to the high cost of the procedure.

Hence, a pertinent issue that the Government has to consider is how to help them pay the medical fees for such a procedure.

Government subsidies would probably be out of the question because social egg freezing is an elective procedure and not a medical necessity, unlike in-vitro fertilisation for infertile couples.

However, the Government may consider permitting the prudent use of CPF savings under conditions based on three criteria for reproductive success.

First, an age limit of 35. Most doctors agree that there is a steep decline in a woman's fertility after age 35.

Second, CPF use should be permitted only if the woman's ovaries are healthy and she has an adequate ovarian reserve, which would enable her to produce a sufficient number of good-quality eggs for freezing.

This can be determined through a medical screening for polycystic ovary syndrome, and to check her serum levels of anti-Mullerian hormone.

While it may seem harsh to disallow women with such medical problems from utilising their CPF savings for elective egg freezing, it would alert them to any fertility problems early, and avoid wastage of their CPF savings.

Third, reimbursement of the cost of egg freezing using CPF should be permitted only if a minimum threshold number of eggs of reasonable quality are frozen for the patient.

This may require multiple cycles of ovarian stimulation with hormones.

 

[Angelica Cheng]

Interesting Straits Times article:

Forum: Safeguards needed if social egg freezing is allowed

As the Government deliberates on permitting social egg freezing in Singapore, it needs to consider legislating various safeguards (Govt reviewing ban on women freezing eggs for non-medical reason, Oct 22). Read more at straitstimes.com.

www.straitstimes.com

Forum: Safeguards needed if social egg freezing is allowed

As the Government deliberates on permitting social egg freezing in Singapore, it needs to consider legislating various safeguards (Govt reviewing ban on women freezing eggs for non-medical reason, Oct 22).

Besides rigorous counselling of patients, the following pertinent issues also need to be addressed.

First, possible failure in storage resulting in irreversible damage to or destruction of the frozen eggs. Currently, most local fertility clinics store either frozen eggs or embryos in cryotanks that need to be topped up regularly with liquid nitrogen. There is a possibility of human error, for example, if laboratory staff forget to top up liquid nitrogen during a holiday.

Patients should store their eggs in a big well-managed facility with lots of fail-safes and power-failure backups, such as the ones managed by private cord-blood banks. Should there be an insurance or compensation scheme to cover accidental loss of frozen eggs?

Second, the conflict of interest faced in the donation of leftover unused frozen eggs to infertile patients. Currently, this is permitted in Singapore and comes mainly from a small minority of couples undergoing IVF who choose to freeze their unfertilised eggs instead of embryos due to religious or personal reasons.

Doctors and clinics persuading former patients to altruistically donate their unused frozen eggs face a conflict of interest because they stand to earn additional fees from performing the egg donation procedure on other patients.

The doctor-patient fiduciary relationship can easily be abused during the consent process if doctors know that their former patients are grateful to them for successful fertility treatment.

There is also the issue of distributive justice if doctors and clinics exclusively control the allocation of donated frozen eggs to other patients.

This prerogative should instead be exercised by a government agency based on a centralised registry and waiting list of patients.

Third, social egg freezing may inadvertently encourage single motherhood.

Are there any laws to stop single women from later exporting their frozen eggs to an overseas fertility clinic? If single women freeze their eggs because they "can't find Mr Right", what can guarantee they find him in the future?

 

[Angelica Cheng]

Commentary: Should Singapore allow healthy women to freeze their eggs?

Two healthcare and social work experts discuss whether it’s time for Singapore to review its stance on egg freezing.

www.channelnewsasia.com

Commentary: Should Singapore allow healthy women to freeze their eggs?

Best practice and industry standards suggest that eggs should be frozen before a woman turns 34 and no fewer than eight to 10 eggs should be available for freezing.

But clinics worldwide offering social egg freezing do not always adhere to these good practice recommendations. Indeed, many foreign centres offering social egg freezing do not meet their industry’s own standards.

The other issue is the low chance of success - even the latest flash freezing processes, trumpeted by many overseas companies, reveal a success rate of no more than 30 per cent of eggs resulting in a live birth.

Yet, consumer reports and research studies provide strong evidence that clinics do not discuss the risks and failure rates, and over-emphasise the potential benefits. One can imagine why, for a procedure that costs US$10,000 for extraction and freezing, and around US$1,000 for storage each year.

Protecting the consumer may be the overriding concern – one cannot begin to imagine the emotional pain where failure takes on a deeper, personal meaning involving dashed expectations of parenthood.

Irresponsible marketing strategies that portray only the possible positive aspects of egg freezing but downplay or ignore the risks and success rates may work well on an audience looking for hope for a child.

There is an argument that given its relatively low success rates of pregnancy, the ready availability of social egg freezing may also be counter-productive, encouraging more women to delay motherhood.

But where success rates among older women remain uncertain, motherhood may not just be delayed but missed out on entirely.

 

[Angelica Cheng]

How do you maximize your chances of future conception and pregnancy with social egg freezing?

Angelica Cheng's answer: Here are things that you can do to maximize your chances of future conception with social egg freezing: (1) First and foremost, freeze your eggs as young as possible, preferably before the age of 35. There is medical evidence that a woman’s fertility drops sharply after ...

www.quora.com

Here are things that you can do to maximize your chances of future conception with social egg freezing:

(1) First and foremost, freeze your eggs as young as possible, preferably before the age of 35. There is medical evidence that a woman’s fertility drops sharply after the age of 37 (American College of Obstetricians and Gynecologists Committee).

Female Age-Related Fertility Decline

Forum: Permit social egg freezing with age limit

(2) Go for egg freezing only if you are confident that your ovaries are healthy and that you have an adequate ovarian reserve. Ask your doctor to screen for Polycystic Ovary Syndrome (PCOS) and blood serum levels of Anti-Mullerian Hormone (AMH), which determines your ovarian reserve. To avoid future disappointment, don’t do egg freezing if you have PCOS or low AMH levels. If you have such medical conditions, the better option is to try conceiving a baby as soon as possible (possibly with IVF), rather than do egg freezing.

Forum: Allow use of CPF to pay for egg freezing

(3) Store an adequate number of frozen eggs of reasonable quality, preferably between 10 to 20, depending on your age. This may require more than one egg freezing cycle. Because egg quality declines with age, the optimal number of frozen eggs would vary with different age groups of women. Currently, an Artificial Intelligence (AI) software is being developed to ascertain the optimal number and quality of frozen eggs to maximize the chances of future conception for women of different ages.

Women May Soon Start Using AI to Tell Good Eggs From Bad

(4) Before you undergo egg freezing, maintain a healthy lifestyle and take fertility supplements for several months to improve egg quality. For example, dietary supplements such as Coenzyme Q10 (CoQ10), DHEA (Dehydroepiandrosterone), L-Arginine, Myo-Inositol, and Glutathione, have all been demonstrated to enhance egg quality and female fertility. There are now commercially-available products that combines all these vitamins into one package to specifically enhance female fertility prior to IVF or egg freezing.

How Supplements Can Improve Egg Quality For Fertility

(5) In choosing a fertility clinic or IVF lab for egg freezing, do not just consider the price, but also check that they have a track record of live births with frozen eggs. The gold standard would be for the fertility clinic to have publications in international journals, which actually prove that they have actually successfully achieved live births with frozen eggs. Yet, less than 5% of fertility clinics and IVF labs in the USA fulfill such criteria.

(6) Check the health status of your womb (uterus) before egg freezing. Besides your age, ovarian reserves and egg quality, the health status of your womb (uterus) is also another important factor that determines your future reproductive success with social egg freezing.

Fibroids Derailed My Egg Freezing Journey| Eggsurance Blog

Egg freezing and using your frozen eggs never follows a linear path. Complications like fibroids can derail the path to pregnancy - it did for me.

www.eggsurance.com

 

[Angelica Cheng]

Does egg freezing give false hope to prospective parents? | The Economist

IVF provides a valuable option for people who for whatever reason are unable to conceive. But there’s another emerging market. That’s freezing of egg or sperm cells for IVF in the future, often years later. Egg-freezing is a relatively new procedure, and was officially considered “experimental” in America until 2012. this is what egg-freezing businesses appear to promise: a chance to put parenthood “on ice”, which appeals to young people who are increasingly interested in having children later, for a variety of reasons. And women are increasingly buying in. The number of egg-freezing procedures has grown rapidly over the past decade. The process isn’t cheap: egg-freezing can cost $15,000-$20,000 USD per cycle, which is a single batch of eggs. It often requires multiple cycles to increase chances of success. Egg-freezing and similar services are part of the burgeoning women’s health industry dubbed “femtech”, and are attracting plenty of interest from investors. Investments in fertility firms grew from less than $200m in 2009 to $624m in 2018. Investors are attracted to the growth prospects, high profit margins and recession-proof demand. Investors, businesses, and prospective parents all stand to benefit. But, the reliability of these services might be oversold. Birth rates from frozen eggs should be taken with a grain of salt: most women who have had their eggs frozen have not yet retrieved them, so the sample sizes are small. It’s just too soon to draw reliable conclusions. Still, clinics might misrepresent the data to encourage freezing. There’s also a lack of sufficient regulation of fertility services, especially in America. So, what’s needed from the fertility sector?

 

[Angelica Cheng]

Check the health status of your womb (uterus) - It is not just your age, ovarian reserves and egg quality that determines future reproductive success with social egg freezing:

 

[Angelica Cheng]

Beware potential catastrophic failures in storage of frozen eggs !

When choosing an IVF clinic/lab for egg freezing overseas, Singaporean patients should consider the following:

(i) Smaller, private clinics that have no affiliation with a university or hospital may be less inclined to disclose incidents of cryostorage failure, as government oversight and supervision may not be as tightly-controlled as public hospitals.

(ii) Some countries may have stricter regulations and better quality control of IVF labs compared to other countries. It may be better to freeze your eggs in a country with stricter laws and better quality control of IVF labs. For example compare Australia versus Malaysia or Thailand. In Australia, IVF labs are regularly inspected and audited by the Fertility Society of Australia (FSA) and the Reproductive Technology Accreditation Committee (RTAC) of Australia. Are IVF labs in Malaysia and Thailand subjected to similar mandatory inspections and audits?

The fact that you can read the news about frozen egg storage failures in the USA confirm that American fertility clinics and IVF labs are subject to strict regulatory oversight and good quality control. Hence, they quickly acknowledged their failures publicly, despite knowing that they will likely be sued for millions of dollars.

Can such transparency and honesty be expected of private fertility clinics and IVF labs in developing countries, where government regulation and oversight are less strict?

Egg freezing industry reeling after two major malfunctions

Egg freezing industry reeling after two major malfunctions

Egg freezing clinics come under scrutiny after two major malfunctions in different parts of the country result in possible loss of thousands of eggs, embryos.

www.nbcnews.com

Embryo and Egg Preservation Failures at Fertility Centers

Embryo and Egg Preservation Failures at Fertility Centers | Rains Lucia Stern St. Phalle & Silver

Damaged Embryos at Fertility Centers Fertility centers freeze human embryos and eggs for individuals and couples who want children in the future. Unfortunately, recent increases in storage failure have not only damaged the viability of many embryos and eggs, but destroyed some couples’ dreams...

www.rlslawyers.com

Fertility clinic informs hundreds of patients their eggs may have been damaged

https://www.washingtonpost.com/national/health-science/fertility-clinic-informs-hundreds-of-patients-their-eggs-may-be-damaged/2018/03/11/b605ea82-2536-11e8-b79d-f3d931db7f68_story.html

Heartbreak, anxiety, lawsuits: The egg-freezing disaster a year later
The news of two tank failures in 2018 horrified thousands of women and fertility doctors around the country. What — if anything — has changed since then?

Heartbreak, anxiety, lawsuits: The egg-freezing disaster a year later

The news of two tank failures in 2018 horrified thousands of women and fertility doctors around the country. What — if anything — has changed since then?

www.nbcnews.com

Malfunction at egg freezing facility affects hundreds of patients
More than 2,000 eggs and embryos may not be viable after equipment failure.

Malfunction at egg freezing facility affects hundreds of patients

More than 2,000 eggs and embryos may not be viable after equipment failure

www.nbcnews.com

Please also see an excerpt from the following article:

What fertility patients should know about egg freezing

NEW YORK — The failure of systems used to store frozen eggs and embryos at two fertility clinics in the United States has rattled people who count on such clinics to help them realise their hopes of having children.

www.todayonline.com

"Mr Jake Anderson, a founder of Fertility IQ, a website that provides assessments of fertility doctors and clinics, noted that both the Cleveland and San Francisco clinics are “large, reputable, subject to oversight,” and they both quickly acknowledged the failures publicly.

But he said he worried about smaller, private clinics that have no affiliation with a university or hospital and whether some would be less inclined to disclose a problem.

“If this happens in other places that are private, people would take this to the grave and they would never breathe a word of this,” Mr Anderson said. “To think that only the well-run places that have boards and clinical oversight — they’re the only ones having this problem? I believe the opposite.”

 

[Angelica Cheng]

Video podcast that explains screening of your ovarian reserves before egg freezing, by measuring your blood hormone levels (FSH and AMH). If you have low ovarian reserves, you must undergo more egg freezing cycles to retrieve a sufficient number of eggs to have a reasonable chance of future reproductive success. This means spending more money:

 

[Angelica Cheng]

Well-balanced documentary that discusses both sides of the debate on egg freezing. Women are also warned of rampant commercialization and aggressive marketing of egg freezing by the IVF industry:

 

[Angelica Cheng]

Forum: Allowing social egg freezing may have inadvertent consequences

There may be some unforeseen and inadvertent consequences of permitting social egg freezing in Singapore (Time to relook policy on social egg freezing, says MP, Feb 26). Read more at straitstimes.com.

www.straitstimes.com

Forum: Allowing social egg freezing may have inadvertent consequences

There may be some unforeseen and inadvertent consequences of permitting social egg freezing in Singapore (Time to relook policy on social egg freezing, says MP, Feb 26).

First, single women who undergo elective egg freezing might later expect to undertake in-vitro fertilisation (IVF) treatment with their frozen eggs. Is it fair to allow them to receive government subsidies for IVF treatment at public hospitals?

This would obviously lengthen waiting lists for subsidised IVF treatment and take resources away from couples with genuine fertility problems, thereby placing unnecessary burden on the already crowded public healthcare system.

It may not be unreasonable to place such patients with frozen eggs at the bottom of waiting lists for subsidised IVF treatment, or completely exclude them from subsidies altogether.

Second, permitting elective egg freezing will inevitably lead to late parenthood. This may not be in the child's best interest. For example, some older middle-aged parents may not be able to cope with the physical rigours of parenthood.

Moreover, there is the unhappy prospect of the children being saddled with the financial, emotional and physical burden of looking after elderly parents during their late teens or young adulthood, when they are just finishing their studies and starting on their careers.

Third, social egg freezing may inadvertently encourage single motherhood and overseas surrogacy.

Unmarried women who choose to freeze their eggs do so with the strong expectation that they will use them one day, regardless of their future marital status.

If they remain single, it is likely that some of them may consider single motherhood with their frozen eggs.

Although current health regulations in Singapore ban unmarried women from undergoing fertility treatment with donated sperm, there are currently no laws that stop single women from exporting their frozen eggs for IVF abroad.

Similarly, some patients who develop health problems later in life may export their frozen eggs for overseas surrogacy to circumvent the increased medical risks of pregnancy in older women.

It would be morally and ethically problematic for the Government to ban the export of frozen eggs by either single women or married couples, as they have an inherent legal right over what they consider as their own bodily material and personal property.

 

[Angelica Cheng]

 

[Angelica Cheng]