Career First, Kids Later? How Egg Freezing Is Rewriting the Rules

Imagine being able to focus on building our career and achieving financial stability without having to worry that time may be running out when it comes to having a family. Thanks to advances in fertility methods and technology, we now have options to gain some semblance of control over our fertility — within realistic limits, of course.

WORDS LIM TECK CHOON

FEATURED EXPERT DR AGILAN ARJUNAN Consultant Obstetrician and Gynaecologist and Fertility Specialist evelyn Fertility and Women Specialist Centre Website | Facebook | Instagram | YouTube | TikTok | X (Formerly Twitter)

HOW LONG CAN A WOMAN WAIT BEFORE HAVE A BABY?

When it comes to fertility, the biological clock is quite real. Dr Agilan shares that:

• A woman’s most fertile period is usually between the ages of 20 and 25.
• Her fertility begins to decline after the age of 25, more steeply after the age of 35, often when she is finally ready to settle down and start a family.

Why Does a Biological Clock Exist in the First Place?

This is because a woman is born with all her eggs already produced, to be released over time during each menstrual cycle.

This means that:

• She has a limited number of eggs that can be used to conceive a child throughout her reproductive years.
• She has 100% of her eggs at birth but the number decreases over time.
• By the time she is 30, she has approximately 10% of her eggs remaining, and the number continues to decline until she experiences menopause, after which she is no longer able to conceive a child.

Aside from the Number, Quality Counts Too

Dr Agilan explains that age does not just affect the number of eggs available for a successful conception. The quality of the eggs is affected too.

“The good quality eggs are often released during a woman’s most fertile age,” he elaborates.

• As the years pass, there is a higher risk for an egg to contain abnormal genetic material or develop into an abnormal embryo.
• This is why the risk of having a child with genetic disorders such as Down syndrome increases when a woman has a child at a later age, especially after 40.

WON’T IN-VITRO FERTILIZATION SOLVE THIS ISSUE?

Sadly, no.

• No matter how advanced in-vitro fertilization (IVF) technology may be, it still requires the woman’s eggs.
• If she has low numbers of eggs and/or there are few good quality eggs available, the chances of a successful IVF will be impacted significantly.

Fortunately, there is a way to freeze a woman’s eggs, obtained when she is younger and hence more fertile, which can then be used for IVF when she is at a later, less fertile age.

HOW EGG FREEZING HELPS TO BEAT MOTHER NATURE AT HER GAME

Dr Agilan shares that, in the past, egg freezing was an option offered to women who were about to undergo cancer treatment.

It still is, but with recent improvements being made to the technology, egg freezing is now also an option for women who wish to preserve their younger eggs for later use.

Vitrification Is a Game-Changing Egg Freezing Technology

Dr Agilan shares that egg freezing experienced a surge in use after the development of a technique called vitrification.

• This process allows the egg to be very rapidly frozen in liquid nitrogen.
• This method greatly reduces the formation of ice crystals that can damage the eggs — a problem that plagued egg freezing prior to the development of the vitrification technique.

The Procedure

Consultation

• The fertility specialist will explain the procedure clearly and thoroughly to the client first.
• Dr Agilan adds that this is a good opportunity for the client to voice any concerns she may have.

Initial screening

• The fertility specialist may first conduct a pre-screening test to obtain an idea of how many eggs the client has left (her ovarian reserve).
• The result of the test will allow the fertility specialist to determine whether egg freezing is suitable for the client and, if yes, how many eggs would likely be harvested per cycle.
• Dr Agilan shares that the fertility specialist usually aims to collect about 10 to 12 eggs.

Stimulating the ovaries

• Once the client is ready, the fertility specialist will offer some injections to stimulate her ovaries into producing a large number of eggs.

Collecting the eggs

• When the time is right, the fertility specialist will put the client under deep sedation and harvest the eggs using a needle.
• An ultrasound will be used to help guide the fertility specialist.

Egg freezing

• The harvested eggs will then be frozen in liquid nitrogen using the vitrifcation process.
• They will be stored in a safe and clean temperature-regulated area within the fertility centre.

Dr Agilan further elaborates that the entire process may take about 2 weeks.

He adds that the fertility specialist will try to accommodate the client’s schedule as much as possible.

The Cost

• The cost may vary from one fertility centre to another.
• Aside from the usual fees for consultation, injections, medications and the egg harvesting procedure, the fertility centre will charge a fee for the storage of the eggs.
• If the client has any concerns about the cost, the matter can be discussed with the fertility specialist.

ANSWERS TO COMMON CONCERNS

How Long Can the Eggs Keep?

• The eggs can keep for a considerable length of time so long as they are stored under the right conditions.
• According to Dr Agilan, a fertility centre typically agrees to store a batch of eggs for 5 years.

Can The Fertility Specialist Guarantee the Success Rate When the Eggs Are Used In IVF?

No.

• Egg freezing serves to preserve a woman’s eggs at a younger age for future use.
• The technology does not improve the quality of the eggs or increase the odds of success when these eggs are used in IVF.

What Happens If the Frozen Eggs Are Damaged or Lost?

• When a client agrees to have her eggs frozen at a fertility centre, she will be given a consent form to sign.
• Details such as accountability will be stated clearly on the form, and the client should read it carefully to make sure that the terms are agreeable before signing on the dotted line.
• Details may vary from one fertility centre to another, but usually, the fertility centre cannot be held accountable if the eggs were damaged or missing due to unforeseeable or unpreventable incidents, such as natural disasters.
• The fertility centre, however, can be held accountable for errors caused by carelessness or negligence.

What Happens If the Fertility Centre Closes Down?

• Ethical and responsible fertility centres have contingency plans for issues such as closure.
• Typically, clients will be notified in advance, and these fertility centres would have made arrangements with another centre to take in the frozen eggs.

What Happens If the Fertility Specialist That Handled the Egg Freezing Later Retires or Transfers to Another Fertility Centre?

• In the event of a transfer or retirement of a preferred fertility specialist, the fertility centre will be happy to continue the existing arrangement.
• If the client prefers not to, they will help facilitate the efforts to transfer the frozen eggs to a fertility centre of the client’s choice.