Future-Proofing Motherhood: A Balanced View on Elective Egg Freezing

Rise in maternal age

The average maternal age in Singapore has been increasing from 30.4 in 2013 to 31.6 recorded in 2023[1]. Women are also giving birth at a much later age than before; the number of women giving birth in their 40s has doubled over the past 30 years.[2]

Delaying childbirth is a natural effect of living in a developed economy, where the literacy rate is high across genders. Couples generally aspire to an established career and are financially ready before starting a family. Hence, elective egg freezing becomes insurance for a successful later pregnancy.

“We have seen increased interest regarding elective egg freezing (EEF), particularly inquiring about the procedures, storage, and costs. Compared to medical egg freezing, this rise in interest was expected given that elective egg freezing for non-medical was only allowed in July 2023,” Dr Chieng said.

There is a biological clock to egg freezing

Age is the primary condition that affects a woman’s fertility. Women are born with all the eggs they will ever have, but over time, their eggs diminish in quality and quantity. While the EEF age limit is 37, women have the best chance to freeze enough high-quality eggs when they are younger.

“Egg freezing is preferably done before age 35, after which the chances of egg quality issues due to age will rise,” Dr. Chieng advised.

Simply put, egg quality measures how likely a genetically healthy egg is to implant in the uterus and develop into a healthy embryo. It's a key factor in fertility and the ability to have a successful pregnancy and baby.

Not Just for Single Ladies Building Careers

Egg freezing often gets linked with career-driven women who want to focus on work before starting a family. Many patients are indeed single ladies in their late 20s and early 30s, but that's not the whole story.

Egg freezing is also an option for women who face illnesses like endometriosis or cancer, whose treatments may impair fertility. In contrast, others select egg freezing even with a partner because they have decided to wait to have a family.

A fertility test is still needed

While most young female patients present themselves as healthy in appearance, there is no way of telling the same about their ovarian reserves. Hence, basic fertility testing is still needed to assess the ovarian reserve through a blood test, which is a key indicator of their current fertility health. In addition, a pelvic ultrasound scan is performed to provide a clearer ovarian function, which may help prevent surprises when they are ready to start a family.

Optimise the chance of pregnancy

Egg freezing now does raise the likelihood and promise of a pregnancy later in life.

“Egg condition is closely linked to a woman's age. Freezing eggs will primarily aim to keep your eggs when you are younger so that when you are older and attempting to get pregnant, you might be better off with eggs obtained and preserved when you were younger,” he explained.

To ensure a pregnancy using frozen eggs, the eggs must be healthy and viable at the time of freezing, survive thawing, and successfully fertilize and implant. And, if the pregnancy is smooth and all goes well, couples will be celebrating the arrival of their little one at the end of the maternity journey.

“The chance of live birth from frozen 'vitrified' eggs is similar to the opportunity from 'fresh' eggs, usually used in IVF treatment. The two most important factors determining the chance of successful pregnancy from frozen eggs are your age when your eggs are frozen and the number of eggs stored,” he added further.

Eggs can be frozen for years until the couples decide to use them. However, Dr. Chieng cautions against comparing the chance of pregnancy between EEF now and IVF later. “Freezing embryos, which is part of the IVF program for infertility, is a different scenario and not directly comparable to EEF.”

What to expect

Here's a quick guide

1. Consultation with fertility specialists and a fertility assessment are needed.
2. Counselling to understand the emotional and financial challenges associated with elective egg freezing.
3. Hormone stimulation
4. Blood tests and ultrasound monitor the number of eggs available for collection. Egg retrieval is done under deep sedation.
5. Once the eggs are in the laboratory, it will be vitrified and stored.

Vitrification is a fast-freezing method used to preserve eggs and embryos. Unlike slow freezing, it turns the egg's liquid inside into a glass-like state almost instantly, preventing the formation of ice crystals, which can damage cells. This method increases the chances of successfully thawing and using the eggs or embryos later.

Like most medical procedures, elective egg freezing has no side effects. However, there are potential risks to know before going for elective egg freezing. Some of the risks include:

• No eggs are being collected if the patient has low ovarian reserves (as indicated in the fertility health report).
  • However, before the procedure, the fertility specialist will discuss if egg freezing is a good option for the patient.
• Not all stored eggs survive the freezing/thawing process.
• The AMH test provides insight into the number of eggs remaining but does not provide information about their quality. Hence, some thawed mature eggs may not fertilise.

More than a medical procedure

EEF is family planning for the future.

“Family planning might not be of high priority for most aspiring young women, but if it ever becomes important in the future, there is no turning back. The usual obstacle for IVF success is always about age. There are currently no interventions available to overcome this,” Dr Chieng advised.

With growing interest and information surrounding elective egg freezing, we at VFCS aim to empower you with the knowledge needed to make an informed decision and be better prepared before embarking on this journey.

For more information on the procedure or to schedule a consultation with our fertility specialists, please get in touch with our clinic for assistance.

[1] https://tablebuilder.singstat.gov.sg/table/TS/M810741

[2] https://www.income.com.sg/blog/best-age-give-birth