Eggs-citing option for women who want it all

Eggs-citing option for women who want it all
Egg freezing can give professional Malaysian women delaying motherhood to build their career, a chance of having a family later in life.

More Malaysian women are opening up to the idea of freezing their eggs as they become more focused on their careers but still want to keep the option of becoming mothers later in life.

IF you have always wanted to be a mother but have not found the right time, or the right man yet, freezing your eggs may just be the solution that you have been looking for.

Many Malaysian women gasped in envious disbelief when technology giants Apple and Facebook made headlines around the world last year by offering coverage for their female employees to freeze their eggs, allowing them to focus on their careers without the fear of being deprived of motherhood later on.

Some, however, were spurred by the news to give themselves the same choice and had sought to freeze their eggs.

And the number of those here expressing interest in or signing up for the procedure to prolong their window of opportunity for motherhood has jumped, say experts.

At the KL Fertility Centre, for one, the number of women who have frozen their eggs in the past year has hit the "double figures", and is continuing to grow, says its fertility specialist Dr Helena Lim.

"We are getting more and more women asking about egg freezing," she notes, conceding that the procedure has gained popularity since Apple and Facebook offered it as a perk or benefit for their female staff.

What most people do not realise is that the technology had reached our shores about two years ago, says Dr Lim.

This is because Malaysian in vitro fertilisation (IVF) centres have the expertise to provide such services as the technology used is similar to that used in IVF treatments.

The egg-freezing process also involves collecting the eggs or oocytes from a woman, but instead of being fertilised, they are then frozen so that they are preserved. The eggs are normally stored up to five years. If and when the woman decides she wants to try for a child, they can be thawed to be fertilised in IVF treatments.

According to Dr Lim, the procedure costs between RM17,000 and RM20,000 and a yearly fee of about RM1,000 is charged to store the eggs.

Crucially, egg-freezing, along with other assisted reproductive technologies like IVF, is set to be regulated under a new proposed law called the Artificial Reproduction and Tissue Act.

The Health Ministry is currently in its final stages of formulating the Bill, which is expected to be tabled in Parliament early next year.

Noting that freezing one's eggs all boils down to personal choices, Dr Lim says this procedure can leave the door to motherhood open for women who are of age but have yet to find a suitable partner to have a child with.

"It is hard to compromise, and modern women are caught in such a dilemma. In this scenario, egg freezing offers women a viable option of what they want to do with their life.

"Even if a woman decides not to have a child after five years, there is no pressure and the eggs can be discarded," she says.

There is no hard and fast rule when it comes to the ideal age to freeze one's eggs but Dr Lim points out that it should be done before a woman is 40.

"The best would be before 35. Age is a determining factor when it comes to fertility as the number of eggs produced would lessen as women get older," she explains.

Cancer patients can also opt to freeze their eggs as chemotherapy can affect fertility, she adds.

Dr Lim cautions, however, that egg freezing is not a guarantee for fertility.

"Also, women need to consider that if they choose to thaw their eggs a few years later, fertilise the egg and put it back into their uterus, they would already be older by then.

"As we get older, we may have health complications associated with age like diabetes or high blood pressure," she says.

Aware that society still has doubts over the concept of egg freezing as it is still very new, Dr Lim believes it will be more acceptable as time goes by.

"People also used to say that using contraception will promote promiscuity.

"My advice to women out there is that they should be aware that such a procedure exists, learn about it and see if it is the right option for you," she says.

Judging by the current lifestyles here, Malaysian Medical Association president Dr Ashok Zachariah Philip foresees that egg freezing will catch on in Malaysia as more women are taking on professional roles.

"They may want to develop their careers but at the same time, want to maintain their options to be mothers," he says.

Consultant obstetrician and gynaecologist Prof Datuk Dr N.K.S. Tharmaseelan concurs that it will only be a matter of time before egg freezing becomes widely prevalent and acceptable.

"Many women are still unaware of the process. Some women also do not seem to be bothered by long-term goals of preserving fertility. It will take time, but it certainly will catch up here.

"Take test-tube babies as an example. After the initial resistance in acceptance, it is now universally accepted," he says.

Dr Tharmaseelan, who is also Asia Metropolitan University president and CEO, says freezing eggs would allow women to have additional chances of a later pregnancy.

"Recent laboratory modifications have resulted in improved egg or oocyte survival, fertilisation and pregnancy rates from frozen-thawed oocytes in IVF. Eggs can be frozen and kept for up to 10 years," he says.

Obstetrical & Gynaecological Society of Malaysia president Prof Dr Zainul Rashid Mohamad Razi says the advantage of preserving oocytes early on is that when they are used in future, its quality will be the same as when it was extracted.

He says a more assured method is to preserve the ovarian tissue, which involves peeling off only the outer capsule of the ovary.

"This can then be preserved for many years in liquid nitrogen. When the woman is ready, the tissue can be thawed and re-implanted.

"This method is specifically for young cancer patients who require chemotherapy or radiotherapy, which may cause infertility and premature menopause," says Dr Zainul Rashid, who is a fertility specialist.

However, he personally does not recommend such practice among Malaysian women as "it is going against nature."

"I think the benefits do not outweigh the risks. However, I would highly recommend it to women and children whose fertility is being threatened by diseases requiring chemotherapy or radiotherapy," he says.

Calling it "an expensive and painful affair", Dr Zainul Rashid says egg freezing involves quite a tedious process which requires hyperstimulation of the ovaries with expensive fertility drugs that are injected daily.

"It also requires regular scans through the vagina to monitor the growth of the follicles, which can be quite a painful procedure if the woman is still single and not sexually active.

"The eggs are also picked up through the vagina before they are matured," he says, adding that the process will be performed under sedation or general anaesthesia.

Dr Zainul Rashid says one of the risks of egg freezing is ovarian hyperstimulation syndrome where ovaries become swollen and painful as fertility drugs are used to produce more eggs than the usual cycle and can be potentially life threatening.

"The procedure of collecting the eggs is also associated with risks such as injury to the surrounding organs like the blood vessels, intestines and ureter.

"As the procedure is performed under a non-sterile technique, where the cleaning of the vagina is performed using sterile water and not antiseptic fluid to avoid destroying the sensitive eggs, there is the risk of infection in the pelvic region," he says.

From a religious perspective, Dr Zainul Rashid notes that according to the Islamic Syariah laws, only married couples can use the preserved sperm, oocytes or embryos for themselves when the time arrives.

"However, this rule does not apply to non-Muslims. For the Muslims, preserving the ovarian tissue is permissible as the immature eggs have not started the process of maturation for fertilization," he says.

While he cannot say for sure whether it will catch on here, Dr Zainul Rashid says only time will tell whether egg freezing will be accepted in Asian societies.

"Only a selected few will probably take up this practice as Asians tend to uphold our traditional values," he says.

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