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The Impact of Egg Freezing on Future Pregnancy Outcomes

Egg Freezing in Singapore
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The Impact of Egg Freezing on Future Pregnancy Outcomes

Singaporean women can legally opt to undergo elective egg freezing with the passage of the Assisted Services Regulations under the Healthcare Services Act. This landmark move is hoped to address Singapore’s declining fertility rate, which was recorded at 1.1 babies per woman in 2020. This is among the lowest in the world today (the global average is at 2.4 babies per woman).

With egg freezing in Singapore becoming an increasingly popular option for family planning, it is important to understand the potential benefits and risks associated with the procedure, and how it can impact women’s future pregnancy outcomes.

In this article, we will explore the science behind and impact of egg freezing, discuss its advantages and drawbacks, and offer insights into what women can expect if they opt for this method of egg preservation in Singapore.

What Is Egg Freezing?

Egg freezing, also known as oocyte cryopreservation, is a process in which a woman’s eggs are extracted, frozen, and stored for later use. The process involves stimulating the ovaries with hormonal medications to produce multiple eggs, which are then retrieved from the ovaries using a needle guided by ultrasound.

 The eggs are then rapidly cooled to a very low temperature, which halts all biological activity and preserves them for future use.

Is Egg Freezing Legal in Singapore?

Yes, egg freezing is legal in Singapore. Singapore provides women with the opportunity to preserve their fertility and make informed choices about their reproductive future. This option is supported by the Assisted Services Regulations under the Healthcare Services Act.

Benefits of Egg Freezing: Why Do People Freeze Their Eggs?

The issue of freezing eggs in Singapore for future use came about because unlike men who produce sperm throughout their lives, every woman faces a biological clock. Generally, reproductive potential decreases as women get older. Every girl is born with a fixed number of eggs in her ovaries and this number depletes with time. In addition, the quality of her fertility eggs declines with time. Egg quality refers to whether the egg cell contains the normal number of chromosomes. Chromosomes are structures within cells that contain our genes.

Egg freezing can provide many benefits for women in Singapore, particularly for those who want to preserve their fertility for future pregnancy. With the high cost of living, long working hours, and competitive job market, many Singaporean women may want to focus on their careers or personal goals before starting a family.

When women freeze their eggs, they can extend their fertility window and increase their chances of conceiving when they are ready.

There are many benefits of freezing eggs in Singapore. Among them are:

  • Allows women to have greater control over their reproductive decisions to suit their goals (E.g. Delaying pregnancy until after she finishes her studies, or until she achieves that much sought-after promotion at work)
  • Helps to relieve “fertility anxiety”, or the fear of declining fertility with ageing
  • Gives women sufficient time to find the right partner
  • Helps to preserve and protect eggs when the woman is undergoing medical treatments (E.g. Cancer with chemotherapy and radiation therapy)
  • Women with a high risk of cancer due to genetics opt to preserve their eggs before elective ovarian removal

Criteria for Egg Freezing

According to the Assisted Reproduction Services Regulations under the Healthcare Services Act , the criteria for egg freezing in Singapore are:

  • The woman should be between the ages of 21 and 37 years old.
  • The woman must undergo counselling in order to make an informed decision. Counselling includes discussions on the egg freezing cost, invasiveness of the egg retrieval procedure, the risks of having a baby at an older age as well as the chances of the egg retrieval process leading to parenthood.

Egg Freezing Process in Singapore

Here are the steps involved in freezing fertility eggs:

  1. Prior to the procedure, a woman is thoroughly assessed on whether she is a good candidate for egg freezing. This assessment includes blood tests and ultrasound scans of her reproductive organs.
  2. If found to be a suitable candidate, the woman will be started on hormone injections for ovary stimulation for two weeks, a process that promotes the maturation of multiple eggs in the ovaries.
  3. During this two-week period, blood tests and ultrasound scans will be further done to monitor the growth of follicles or fluid sacs containing eggs.
  4. The woman is then given human chorionic gonadotropin (hcg) which is responsible for triggering the final maturation of eggs – a pivotal step in making the egg suitable for fertilisation.
  5. The eggs are extracted from the ovary using a needle, a procedure that is typically done under sedation and lasts for 10-15 minutes. The procedure is usually performed through the vagina, so there are no cuts or stitches involved.
  6. The harvested eggs are examined in the laboratory. Those that are already mature at the time of extraction are processed and flash- frozen (a process known as vitrification) to -196 degrees Celsius. Those that have not achieved maturity can be incubated for 12 – 48 hours until they are mature
  7. The eggs are placed in receptacles and stored in tanks containing liquid nitrogen. These storage tanks are monitored regularly for increases in temperature which may damage the frozen eggs.

Risks of Egg Freezing

Some side effects which are mild and usually self-limiting may be expected with egg freezing. Serious complications are rare.

The process of stimulating the ovaries to produce mature eggs can be thought of as an exaggerated form of the events that occur in the natural menstrual cycle. In the natural cycle, usually only one egg develops to the stage of final maturation. This is unlike egg freezing where multiple eggs need to be stimulated to achieve the best success rates.

As the ovaries swell and fill up with mature eggs during the stimulation process, the woman may experience bloating that is more noticeable around the time of egg retrieval.

Rarely, some women experience a condition known as ovarian hyperstimulation syndrome (OHSS) which occurs because of the ovaries’ exaggerated response to excess hormonal medications. OHSS presents with abdominal pain and distension, nausea, vomiting and diarrhoea. It is usually mild and resolves spontaneously within 1 – 2 weeks after the egg retrieval procedure.

The severe form of OHSS is extremely rare but can lead to shortness of breath, reduced urination, severe abdominal distension and thrombosis or clots in the blood vessels.

Impact of Egg Freezing on Future Pregnancy Outcomes

Egg freezing offers women the opportunity to preserve their eggs for future use. However, the success of egg freezing and its impact on future pregnancy outcomes depend on several crucial factors.

  • Number of eggs – If a larger number of eggs are frozen, there are greater opportunities for successful IVF cycles
  • Age when the eggs are frozen – Younger women produce more eggs of better quality, and which do not have defects in them
  • Age at the time of egg-thawing and IVF – Younger women have a greater likelihood of having successful pregnancies because of lower risk of pregnancy complications such as diabetes and high blood pressure.
  • Quality of sperm – Healthy sperm is needed for fertilisation of a healthy egg for a successful pregnancy
  • The fertility clinic – Check the success rates of the clinic in terms of freezing and thawing eggs

According to a recent study, the overall chance of live birth from egg freezing was 39%. But the chance rose to 51% among women who were younger than 38 when they froze their eggs.

Simply put, the older the woman was at the time of egg freezing, the live birth success rates decrease. As a woman grows older, her egg supply as well as egg quality decline.

This means that the eggs of older women have a low chance of growing into healthy babies. Apart from that, the older the woman is, the more eggs are needed to be frozen in order to improve their chances of a live pregnancy. However, at an older age, there are much fewer eggs that can be harvested per cycle.

Considering Egg Freezing in the Future?

Women who wish to establish control over their reproductive life have considered the legalisation of egg freezing to be a boon. They are no longer at the mercy of their biological clock. They can choose to have their eggs frozen at a younger age and then go for IVF later in life, so that they can fulfil their personal and professional goals.

If you are interested in exploring the complete egg freezing benefits and wish to determine your eligibility, get in touch with a specialist today.

Make an appointment with our fertility nurses from CARE IVF at +65 6659 6638 or WhatsApp +65 8028 9431

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