Egg freezing in Singapore: Procedure, risks, and costs

Equality promotes both social and economic prosperity for any nation. To strengthen the fairness for women in the workplace and encourage more female representation in leadership, the Singapore government released a set of outlines that details concrete actions to promote a fairer and more inclusive society.

The White Paper details 25 action plans for Singapore Women's Development to be implemented over the next ten years. One of the action plans is to give women a choice to freeze their eggs.

Elective egg freezing

After years of discussion, Singaporean women might be able to freeze their eggs – regardless of marital status. If the introduction of the Assisted Reproduction Services Regulations under the Healthcare Services Act is successful, women between 21 and 35 years will be allowed to freeze their eggs from 2023.

However, only legally married couples can use their frozen eggs for reproduction through in-vitro fertilisation (IVF).

Pre-procedure counselling will be provided to women so that they can make an informed choice with regard to freezing their eggs. The session will highlight the invasive nature of the procedure, the risk of late pregnancy, the cost of elective egg freezing, among other things.

If this action plan is approved, elective egg freezing is a significant step towards equality for women. Previously, egg freezing was only allowed for medical reasons that might affect one's fertility. Reasons include chemotherapy treatments or the risk of ovarian cancer that might require one to remove ovaries and fallopian tubes.

What is egg freezing?

Egg freezing is also known as oocyte cryopreservation. It is a process in which one's eggs are retrieved, frozen and subsequently stored for later use. Egg freezing safeguards fertility as the age of the egg remains unchanged from the moment they are frozen.

When a woman is ready to use the egg, the frozen egg will be thawed and combined with sperm. After which, the embryo is implanted in her uterus. Doctors recommend that women freeze their eggs before turning 35 years old.

But why do women want to freeze their eggs? Firstly, the quality and quantity of egg supply decrease with age, and some women might want to preserve their eggs while they are younger and of better quality. It allows them to protect their fertility. Secondly, it permits women to conceive in the future. Some might not be able to find a partner while they are younger but still wish to start a family if they choose to marry later.

What is the egg freezing procedure like?

The egg freezing procedure can be split into three phases.

Phase one: Ovarian stimulation: The woman would meet with her doctor on the second or third day of her menstrual cycle to do a blood test and ultrasound. If there is a potential for success, injections are given by the doctor to stimulate egg production.

She would have to administer the series of injections every day for about two weeks. Regular ultrasound scans and blood tests are done to see if she is responding well to the injections. The final shot that the woman will receive is known as the trigger shot, which completes the egg's maturity.

Phase two: Egg retrieval: About 36 hours after the trigger shot, the doctor will perform the egg extraction. The egg extraction process is performed under sedation or a general anaesthetic.

Phase three: Freezing of eggs: An embryologist will assess the eggs are the egg retrieval. The mature eggs are frozen at -196 degrees Celsius in under one minute through vitrification. The eggs are frozen until the woman wants to use them.

ALSO READ: Egg freezing is banned in Singapore, but Freedom Edge is empowering women with options

Risks of egg freezing

Medical procedures usually come with some level of risk, and egg freezing is not spared. Here are common risks associated with egg freezing:

1. Pregnancy is not guaranteed – Medical research has shown that the chance of a frozen egg that results in the birth of a baby is between 2 per cent to 12 per cent. The success rate is usually dependent on two factors – a woman’s age when she freezes her eggs as well as the number of eggs she freezes. Though egg freezing provides hope for future pregnancy, success is not always guaranteed.
2. Egg retrieval process complications – Though rare, using an aspirating needle for egg retrieval can cause bleeding or infection to one's bladder, bowel or blood vessel.
3. Risk of Ovarian Hyperstimulation Syndrome – Ovarian hyperstimulation syndrome occurs when a woman takes injectable hormone medication to promote egg development in the ovaries, causing one's ovaries to swell. As one has to take hormones before starting the egg freezing process, this is a possible risk that one might face.

Average cost of egg freezing

Egg freezing can be pricey. In Singapore, you are looking at an average cost of about $10,000 for one cycle. Typically, one egg freezing cycle is between 10 and 14 days, beginning with medication on the first day and ending the process with egg retrieval.

If your egg freezing package does not include egg storage costs, be prepared to incur additional fees. Due to hefty costs and the previous ban on social egg freezing, some Singaporeans go overseas for the procedure. Popular countries include Malaysia, Thailand, and Australia.

Typical Coverage for An Egg Freezing Cycle:

• Ovarian stimulation and egg retrieval preparation
• Egg retrieval process
• Egg freezing
• Anaesthesia
• Storage (Usually up to 10 years)

You may incur additional charges such as:

• Consultation fees
• Preliminary testing fees (To ensure that you are fit for IVF)
• Additional fertility drugs needed

Egg freezing costs:

Clinic	Estimated Cost	What Does It Cover?
Virtus Fertility Centre (Singapore)	$9844 – 10,272 w/GST ($9200 - $9600)	All-inclusive of fertility specialist’s fees, and anaestheitist's fees, operating theatre and recovery room charges, laboratory charges (ICSI/IMSI, blastocyst culture) and freezing and storage of embryos for 90 days
Seng’s OG Practice (Singapore)	Contact fertility specialist at +65 6472 7988	Contact fertility specialist at +65 6472 7988
Thomson Fertility Centre (Singapore)	Contact centre manager at +65 6252 7766	Contact centre manager at +65 6252 7766
TMC Fertility (Malaysia)	RM 8,888 ($2,870)	The egg freezing package includes up to 4 specialist consultations and ultrasound scanning, specialist procedure fees: procedure planning & anaesthetist fee, laboratory and OT charges and three years freezing maintenance
Kensington Green Specialist Centre - 晶泽专科医院 - Specialist Hospital Johor (Malaysia)	RM13,999 (S$4,510)	The egg freezing package includes doctor’s consultation fees, medications (up to 12 days), follicle tracking ultrasound scans, anaesthetic fees, egg collection procedure, theatre & nursing fees, laboratory charges and storage charges for one year.
Sunfert International Fertility Centre (Malaysia)	RM20,000 to RM25,000 (S$6,500 to S$8,100)	Procedure covers fertility medications, clinic visits, and egg retrieval
Bumrungrad International Hospital (Thailand)	250,000 THB (S$10,555)	Egg freezing cycle package includes: Pre-screening include doctor Fee​, Egg stimulation with hormones, Egg retrieval and egg storage (up to 3 years), and Pre-program screenings (Fertility Screening)

Advantages and disadvantages

ALSO READ: Women, aged 21 to 35, can freeze their eggs for non-medical reasons starting early 2023

Step towards women empowerment

The development of egg freezing is a step forward for women in Singapore. It preserves their reproductive potential and allows them to have children when they are ready.

Apart from egg freezing, other White Paper action plans include more help for caregivers and swifter intervention for domestic violence , among other proposals. Singapore’s effort towards a more inclusive society for women promotes a sense of belonging and builds stronger social relationships.

This article was first published in ValueChampion.