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Tuesday, June 25, 2024

What Singapore’s move to legalise egg freezing says about its society

After years of deliberation, Singapore announced last month that it would lift a ban on single women who wanted to freeze their eggs for non-medical reasons.

But while many have welcomed the measures, others say caveats still required for the procedure show Singapore still has some way to go before the policy can be considered truly inclusive.

Gwendolyn Tan was 31 when she decided to get her eggs frozen.

A single working woman, she’d always wanted to have her own biological children – but didn’t have a partner yet.

The best possible solution for her was to freeze her eggs – to ensure meeting someone was not something she rushed into for the sake of having children.

She hopped on a plane by herself and flew thousands of miles to the Thai capital of Bangkok, where the procedure was carried out. It was not cheap – Gwendolyn says she spent some S$15,000 (£8571; $10932) on the procedure.

But for her and many women in Singapore who wanted to undergo egg-freezing – going overseas was the only option they had.

Egg-freezing is banned in Singapore with few exceptions.

In 2020, the country’s Ministry of Social and Family Development (MSF), said they had to take into account the “ethical and societal concerns over legalising egg freezing”, amongst other factors.

However, last month, in a ground-breaking move, the government announced that from 2023, single women between 21- 35 would be allowed to freeze their eggs.

But with a caveat – they can use the eggs only if and when they are legally married.

This immediately excludes single women who may want to raise children outside of marriage and also same-sex couples who cannot get married under Singaporean law.

Preserving fertility

Globally, egg freezing has become increasing popular.

It involves collecting a woman’s eggs from her ovaries, storing them in a state of deep freeze and thawing them at a later stage.

At this point they are put together with sperm in the hope that an embryo forms and a pregnancy develops.

In 2009, just 475 women froze their eggs in the US, according to date from the Society for Assisted Reproductive Technology. By 2018, 13,275 women had done so – an increase of more than 2500%.

Singapore has seen a similar trajectory.

One clinic in the Malaysian capital of Kuala Lumpur told news agency AFP that in 2021, they had seen a “growing number” of Singaporean women coming for the procedure.

A staff member at the KL Fertility Centre demonstrating for the media part of the egg freezing procedure in Kuala Lumpur
Image caption,This Malaysian clinic is one of the places Singaporean women had to travel to to get the procedure done

And as more in Singapore started to turn to egg freezing – they also began speaking up against the ban.

Emma, who in 2021 started “My Eggs My Time” – a campaign calling for egg freezing to be legalised in Singapore, was among them.

“The response [was] overwhelmingly positive. I received floods of messages from women sharing their stories on why they wanted to freeze their eggs,” said Emma, who is only identified by her first name.

The topic was also one that was repeatedly brought up in parliament by Member of Parliament Cheng Li Hui.

“In 2016, when I first raised it, people were like ‘What is this? You’re too modern for us’,” she said.

“But along the way, there’s been a lot more conversation. Last year [after I brought this topic up], I could really see a big difference [in reactions]. I got many more emails thanking me.”

Many have also welcomed the fact that egg-freezing could help boost Singapore’s fertility rate, which is among the lowest in the world. In 2020, this stood at a historic low of 1.1 babies per woman, compared to a global average of 2.4.

“This is a timely move,” said Shailey Hingorani, Aware’s head of Research and Advocacy, but adds that there are several caveats that are “disappointing”.

A traditional family nucleus

Singapore is one of the world’s most modern cities – yet its also deeply conservative – especially around its concept of family, which it refers to as the “basic building blocks of society”,

The state largely tries to push forward a “limited definition of family… traditionally defined as a father, mother and their children”, says Ms Hingorani.

State policies are arguably geared towards encouraging the growth of such families. Unwed and single parents for example, are only eligible for limited housing grants.

“Singapore’s housing policies do not consider a single unwed mother and her children a “family nucleus”, and thus disallow them from qualifying for certain subsidies,” said Ms Hingorani.

Single people – including LGBT couples who cannot legally get married – must also wait until the age of 35 to buy public housing flats, and even then have a smaller number of options to choose from.

When asked if there were plans to change these caveats, a spokesperson from Singapore’s Ministry of Social and Family Development (MSF) said the country’s public policy “encourages parenthood within marriage”.

Ms Hingorani added this was “disappointing, but not surprising”, and has called for Singapore to “make elective egg freezing accessible to all regardless of marital status, financial capacity and educational status”.

Another issue that has been brought up with the new policy is that Singapore will only allow women under the age of 35 to freeze their eggs.

This is in line with guidelines set by UK fertility regulator HFEA, which says fertility declines with age, so the optimum time for egg freezing is before a woman turns 35.

Yet data has showed that the most common age at which women in the UK are treated is 38, with many freezing eggs into their 40s.

Ms Cheng says women in Singapore may face a similar situation.

“We are a developed nation, we have educated women who have careers and have choices. I think the age limit of 35 is really tight. If a 37-year-old has a good egg reserve does that mean we should stop them from freezing their eggs?” she said.

But the MSF says the age limit is “based on international scientific evidence and professional consensus that egg quality tends to decline significantly after 35 years”, though they said it was possible for women to appeal this age limit on a case-by-case basis.

They added that they “may review this age limit… should there be medical advances which allow a stronger likelihood of conception with eggs that are from older women.”

Gwendolyn Tan
Image caption,Gwendolyn says the move should be celebrated by women in Singapore

But women like Gwendolyn feel that while the government move has its limitations, she believes it will in general “empower” more Singaporean women to get their eggs frozen.

“We should allow women to have agency – it’s my eggs. So if I’m 40 and want to be a single parent, then that’s my choice. But I think ultimately, at the end of the day, the fact that we’re allowing this is obviously a major step change.

Can we do more? Absolutely. But I think for now, we should celebrate this change.”


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