What is Egg Freezing?
Egg freezing or oocyte cryopreservation refers to the process where a women’s eggs are extracted, frozen and stored as a means to preserve the fertility of a women who wants to conceive at a later time. This allows women to avoid the problem of dwindling egg quality as they grow older.
Why Do Some Women Consider Egg Freezing?
Women choose to freeze their eggs due to medical treatments or conditions that may reduce their fertility or affect their reproductive organs.
- Cancer Treatments: A woman undergoing chemotherapy or radiotherapy may opt for egg freezing as such treatments may be ‘gonadotoxic’ and harmful to the eggs in the ovaries
- Autoimmune diseases: Women with autoimmune conditions like lupus, Crohn’s disease, diabetes or rheumatoid arthritis have a higher chance of premature ovarian failure and infertility and may opt for egg freezing.
- Endometriosis: This is a common cause of infertility and in severe cases a cystectomy may be needed. This refers to the removal of cysts from the ovaries. Endometriosis tends to recur over time and can affect the underlying ovarian reserve.
- Premature ovarian insufficiency: This occurs when a woman’s ovaries stop working normally before the age of 40. Some women may opt for egg freezing in order to preserve their prime fertility potential for future family building.
Some women are not ready to have a baby and start a family during their prime reproductive years. This may be due to their focus on education, career or other priorities. Egg freezing allows her to increase her chances of conceiving in the future when she is ready to start a family.
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What is the Process of Egg Freezing Like?
Though it differs between individuals, the process of freezing eggs typically takes 2 weeks to complete. The stimulation of ovaries to produce eggs is done in sync with the woman’s menstrual cycle for optimal results.
Pre-Procedural Testing
- Ovarian Reserve Testing: In order to determine the quantity and quality of eggs, the doctor may test the Anti-Müllerian Hormone level in the woman’s blood. This allows the doctor to determine the dosage and type of hormonal injections needed for optimal results. An ultrasound may also be ordered.
- Reproductive Hormone Tests: Follicle-stimulating hormone, Luteinising hormone and Estradiol tests will be ordered to allow doctors to pick the treatment plan and dosages of fertility medication during ovarian stimulation that is best suited for you.
- Infectious Disease Screening: The woman will be screened for infectious diseases like HIV, hepatitis B and C, syphilis and rubella.
The Steps of Egg Freezing
- The woman is given a series of hormone injections to self-administer for around 2 weeks. These injections contain medications that stimulate the ovaries to produce multiple mature eggs instead of the usual single egg in a natural menstrual cycle.
- She is observed with regular ultrasound scans and blood tests in order to measure the development of the ovarian follicles and hormone levels; both of which will help determine when egg retrieval can take place.
- When the follicles have reached a sufficient size, she will be administered a final injection which triggers the final maturation of the eggs as well as their release from the ovarian follicles.
- The eggs will then be retrieved under anaesthesia in a procedure known as the transvaginal oocyte retrieval. The egg freezing doctor utilises a transvaginal ultrasound probe with a thin needle attached to retrieve the eggs.
- After the eggs have been retrieved, they are examined for their maturity and quality, and frozen via a flash-freezing process (vitrification) in order to preserve their quality and viability as they are securely stored until they are ready to be thawed and used in the future.
Is Egg Freezing Legal in Singapore?
Starting from 1 July 2023, women aged between 21 and 37, regardless of marital status, will be able to legally freeze their eggs through elective egg freezing, which is carried out for non-medical reasons. This takes effect with the introduction of the Assisted Reproduction Services Regulations under the Healthcare Services Act.
The age limit of 37 instead of 35 years as originally intended is backed by evidence stating that the success rates from egg freezing and the following usage of these eggs are relatively stable for women up till the age of 37 years old.
Prior to the recent changes, egg freezing was only allowed for medical reasons. The shift to allow women to opt for elective egg freezing now takes into consideration that there may be women who want to preserve their fertility due to their personal life plans besides medical need; as well as being in line with the country’s overall push to increase fertility rates.
However, only legally married couples will be allowed to use the woman’s frozen eggs to try for a baby through in-vitro fertilisation (IVF).
What Factors Affect the Results of Egg Freezing?
- Age: Egg quality decreases as a woman ages and thus the chances of developing a healthy embryo also decreases. The younger the woman, the better the chances of success.
- General and Reproductive Health: Poor health can often result in decreased egg quality.
- Number of Eggs Retrieved: A higher number of eggs retrieved will correlate to higher success rates.
- Lifestyle Habits: Excessive drinking or smoking may cause a decrease in egg quality and the success rate of egg freezing.
What are the Possible Side Effects and Risks of Egg Freezing?
- Mild Bruising at the Injection Site: This can be attributed to the needle causing minor trauma to the blood vessels or capillaries during the injection process.
- Nausea: This can be attributed to a lingering effect of fertility medication which results in hormonal changes.
- Mood Swings and Fatigue: This typically occurs due to hormonal fluctuations caused by the medications.
- Constipation: This results from elevated levels of progesterone which occurs after ovulation and after egg retrieval.
- Ovarian Hyperstimulation Syndrome (OHSS): This occurs when the medications taken to stimulate the ovaries to make eggs result in abnormally high hormone levels. This leads to swelling of ovaries, fluid leaking into the abdomen and electrolyte abnormalities. However, under careful monitoring of hormone levels by a trusted and accredited medical professional, the risk of experiencing OHSS is low.
What Should One Consider Before Opting for Egg Freezing?
- Mental Health: Egg freezing can be a stressful and emotional process. The toll on one’s daily life due to adjusting one’s schedules around doctor appointments, self-administering injections, coupled with the increase in hormone levels leading to increased fatigue and becoming more emotional can be temporarily hard on some people.
- Success Rate: Women should be aware of the realistic success rates of the procedure resulting in a baby being born (live birth rate), which significantly depends on the number of mature eggs retrieved, maternal age and overall health.
- Financial Considerations: Egg freezing can be costly. It is important to evaluate the cost of the procedure, including consultations, medications and storage fees; and see if one is able to comfortably afford it.
How Much Does Egg Freezing Cost in Singapore?
The costs of egg freezing will include:
- Doctor’s Consultations + Scans
- Hormone Medication
- Laboratory Procedures for egg retrieval, freezing and storage
It is best to contact the egg freezing clinic directly for the most up-to-date costs relevant to your circumstances.
Dr Kelly Loi's Expertise in Fertility
Dr Kelly Loi is an experienced MOH-accredited gynaecologist and the current Medical Director of the Monash IVF Singapore. Her decades of expertise in fertility treatment, in-vitro fertilisation (IVF) and reproductive medicine ensures her patients are in trusted hands. Dr Loi formerly served as a consultant in the Department of Reproductive Medicine at KK Hospital and was awarded an overseas fellowship in Belgium in the field of fertility preservation for cancer patients.
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