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The Luxury of Buying Time With Egg Freezing

If time isn’t a luxury then what is? As more and more women decide to take their fertility into their own hands, we look into why egg freezing may be the way to beat the biological clock.

August 29, 2022

With the Covid pandemic putting the world on pause for an extended period, men and women globally have seen important years taken away from them in various ways. For many millennial women, the biological clock that once felt like an hourglass has now turned into a ticking clock. 

It is no wonder there has been a surge in oocyte (egg) cryopreservation, otherwise known as egg freezing. Data collected by TIME saw a 41 to 50 percent increase in women freezing their eggs since 2019. Originally developed for those going through cancer treatments, cryopreservation can now be performed for social reasons in many countries. 

Though initially seen as a sensitive and maybe even taboo subject, especially in Asia, egg freezing has become a more common topic of conversation as women around the world – from businesswomen to celebrities, think Jamie Chung, Olivia Munn and Rita Ora – are speaking out about taking matters into their own hands to challenge evolution and buy themselves more time. 

Photo: Unsplash/Nathan Dumlao

 

HAVING IT ALL 

While the fight for gender equality is far from over, the 21st century has seen great progress when it comes to the pursuit of higher education and opportunities in the workplace. With globalisation added to the mix, the millennial generation wants to work hard but play hard as well. Whether it be to travel, experience more out of life or to simply discover who they are and what they want, millennials want more time. The milestones met by previous generations have been pushed back, or have simply become less immediate priorities. And while society has mostly kept up with this new way of life, the body has not yet adjusted.

Dr Grace Kong from Hong Kong Women’s Clinic explains, “Traditionally egg freezing was done because of a medical condition. Women who had cancer knew the effect that chemotherapy had on the ovarian reserve and so they would freeze their eggs to preserve their fertility. Over the last ten years, women have been coming in for social reasons. They have become very independent and are choosing their own path. They don’t want to start a family too early to have more time to dedicate to building a career or to find the right person to start a family with.” 

Take it from Lorena* (names have been changed to ensure privacy) for example. When asked why she decided to freeze her eggs at 37, the financial asset director said, “It was like buying insurance and it prolonged my ability to have children at a future date, while potentially lowering the risks and complications associated with child bearing. Unfortunately, the biological clock is real, despite the fact that females in this generation are far more empowered, independent and focused on career progression.” 

With more women working later in life, even companies have started offering egg freezing as an employee benefit. Silicon Valley giants such as Facebook, Google and Apple were among the first to cover egg freezing costs in 2014, in a push to attract top female talent. 

Having the chance to freeze eggs at their peak quality also buys people time to find the right partner and avoid panic-partnering. According to a Yale University study on egg freezing, 85 percent of the women were single and many of these women said they froze their eggs because they didn’t have a suitable partner with whom to raise a child. 

Jennifer*, a post-grad student, decided to freeze her eggs at 31 after breaking up with her fiancé. “I was a bit hopeless with the dating prospects in Hong Kong,” she states. She wanted to buy herself more time to find someone, or to have the option to give birth and raise the child on her own should she not find a suitable partner. “And if I got married and divorced, which could very well happen, I would still be able to have biological children with my subsequent life partner at an older age if we wanted to. I also wanted the option to choose the sex of my future children. The upsides just seemed endless.” 

Single individuals aren’t the only ones feeling the pressure. Some couples may not feel ready to make the jump just yet. Raising a child comes with great financial responsibility and it is understandable that some couples may choose to work a few more years until they feel more financially stable. 

The burden of the pandemic has also dampened plans for partners to explore the world and spend quality time together, pre-kids. 34-year-old art curator Nicole* says, “My partner and I met a year ago and we’ve been discussing having kids, but because of the pandemic we still haven’t had a chance to travel together or meet each others’ families, both of which are very important to us, so we have started talking about embryo freezing (when the eggs and sperm are combined).” 

While we are more aware of women’s fertility timelines, we forget that men’s sperm counts and quality declines with age too, though at a much slower rate. Whether it be because of environmental or lifestyle factors, a recently published study spanning 40 years shows that sperm quality has decreased in men around the world. Tim*, a 40-year-old tech engineer, says that he has started thinking of freezing his sperm, as he isn’t sure whether he wants children or will find the right person to have them with. Nonetheless, he would rather preserve the quality now rather than risk any future complications. 

Photo: Shutterstock

 

FREEZING FACTORS 

While there is certainly a myriad of reasons to consider egg freezing, there are just as many factors to consider that go into making a sound decision. 

First, not every country allows oocyte cryopreservation to be done for social reasons, and there can also be strict parameters to navigate. In certain countries, the procedure can only be done within a limited age range. Singapore, for example, will start allowing the procedure to be done for social reasons in 2023 but only for women between the age of 21 and 35, unlike France who just legalised social egg freezing this past year for women between the age of 29 and 37. 

Hong Kong has no age restrictions, however, a woman must be legally married to fertilise the eggs (using IVF). Clinics do offer the possibility to transfer the eggs out of the country, should the patient choose to use the eggs while still single. When it comes to storage, Hong Kong – like many other jurisdictions – allows the eggs to be stored up to ten years.  

“While there is no age restriction in Hong Kong, we do recommend doing it before 35 years old,” Dr Kong adds, “not only because the egg quality starts decreasing exponentially after that age but also because of the 10-year storage rule in Hong Kong. If you freeze your eggs at 32 or 35 you have until 42 or 45 to use them.” 

Cost is another big factor. Egg freezing in Hong Kong will typically cost from HK$100,000 to HK$120,000 for one cycle and the first year of storage, and the storage fee for subsequent years will depend on how many eggs are frozen. The financial impact can be significant and, in most places, not reimbursed, which is why some women choose to fly to other countries to get the procedure done. 

Crystal*, a lawyer who froze her eggs at 32, chose Bangkok to do the procedure, as she felt more secure going through a friend’s referral. Knowing Thailand’s reputation as a medical tourism hub, she considered the expertise of the doctors and low costs appealing. Louise*, an asset manager who froze her eggs at 33, on the other hand, chose Canada. “I’m more likely to settle down there and felt more comfortable when it came to human rights laws,” she specifies. 

While more expensive than other countries offering egg freezing, some found Hong Kong to be a more suitable place to do the procedure, due to travel restrictions, the presence of a strong support system and the comfort of a familiar environment at a particularly vulnerable time. “I had heard the process could be quite unpredictable physically and emotionally, and since I intended on doing two cycles, I knew I had to factor in one to two months. It helped knowing I had a support system here,” says Jennifer. 

A cycle takes about two weeks depending on how the body reacts to the treatment, and how many cycles a woman goes through will depend on her age and how many mature eggs are retrieved. “Usually, a woman around 35 can achieve her egg target in one cycle, and a woman around 38 may need to do two cycles, but it really depends on the patient,” remarks Dr Kong. 

The stimulation process consists of daily hormone injections for about eight to 10 days, which stimulates the ovaries to produce multiple eggs rather than the single egg that typically develops monthly. Once the doctor deems the eggs ready, the patient goes through a minor surgery under anaesthesia to retrieve them. 

Reactions to hormone injections vary. Louise recalls the stimulation phase as very unpleasant for her, as she needed three daily injections (the dose will vary depending on how fast the ovarian follicles are growing) and experienced bloating and general pain. “I was elated on extraction day,” she says. “The operation itself was smooth and painless.” 

Lorena, however, said the process went extremely smoothly for her. As an extremely active individual, she was worried about not being able to work out for two weeks, as doctors usually advise abstaining from working out to avoid the possibility of contorting the follicles. “I still managed to do some light exercises and keep myself sane with work and other activities, so the two weeks flew by in no time,” she says, “I had heard that there may be certain side effects during the hormone injection period such as nausea, bloating and mood swings (similar to PMS) but I experienced none of them.” 

On a personal note, I have also recently decided to go through the egg freezing process in Hong Kong. While feeling younger than my age and being healthy made me think it was something I could postpone, the rational side of me thought it was better to do it now, while I was considering it, to avoid regretting not acting sooner. The process went rather smoothly. The hormones did not seem to affect me, the injections were not as terrifying as I imagined them to be – despite my fear of needles – and I was able to continue light exercise. I was, however, always tired, and even the idea of leaving my neighbourhood was daunting. The few days following my surgery were quite uncomfortable as my body recovered. 

As many, including me, will attest, the egg freezing journey is indeed an emotional one, but one that can provide a safety net in the future. Dr Kong concludes, “Some people see it as paying for insurance, they might not use it in the future and may conceive naturally, but at least they have the protection.” 

Get a closer look at my personal experience with egg freezing.

Photo: Shutterstock

 

NEED TO KNOW 

Quality Versus Quantity? 

According to the American College of Obstetricians and Gynecologists (ACOG), a developing foetus has about six million eggs and one to two million by the time the baby is born. Once puberty hits, 400,000 eggs are left. Fast forward to age 37 and 24,000 are left. By the time menopause hits, around 50 years old, only 1,000 eggs remain. After age 32, the fertility rate starts to decline, with gynaecologists stating that the quality of the egg worsens exponentially after 35. 

What’s The Success Rate? 

  • The probability of having a live birth depends on the age and the number of mature oocytes, determined by ultrasound. A 35-year-old woman with about 20 eggs has a 90 percent chance of having a live birth, whereas a woman the same age with about 10 eggs has a 75 percent chance of a live birth. 
  • About 75 to 85 percent of the eggs retrieved mature.
  • About 85 percent of the eggs are likely to survive freezing and can be used when thawed.

How Much Does It Cost? 

Hong Kong: HK$100,000
Singapore: SG$10,000
Thailand: US$6,000 to US$8,000
United States: US$9,000 to US$15,000
Spain: €3,500 to €5,000
France: €2,000 to €3,000 

*Approximate prices for one cycle; storage fees are not included

Originally published in ECHELON Issue 8

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