Age limit for women wishing to freeze eggs and for egg donors to be raised from 35 to 37

SINGAPORE — The age limit for women looking to undergo elective egg freezing and for those donating eggs for use by other women will be raised from 35 to 37 years old.

The change to the policy allowing women to choose elective egg freezing is in line with the latest research showing successful rates of egg freezing for women up to 37 years of age, the Ministry of Health (MOH) and the Ministry of Social and Family Development (MSF) said in a joint press statement on Monday (May 15). 

In Singapore, women may undergo elective egg freezing only for medical reasons. The shift to allowing women to choose to do so to preserve their fertility is set to be implemented by July 1.

It remains the case that women may use frozen eggs only if legally married and with the consent of their husband.

MOH and MSF said that the shift in policy "came after careful consideration, recognising that there may be women who desire to preserve their fertility, because of personal circumstances".

"This could include the desire to marry and conceive, but being unable to find a partner while they were younger.”

In addition, the research at this point shows that success rates using eggs from women older than 37 years continues to decline. 

Elective egg freezing is a process of collecting, freezing and storing a woman’s eggs to preserve her fertility. 

The move to allow women to choose to undergo elective egg freezing came after the Government's White Paper on Singapore women’s development in 2022, which set the age limit at 35 years. This age limit was tied to the prevailing age limit for egg donors.

MOH and MSF also said that they would continue to monitor the domestic and international evidence to assess the age limits for freezing and subsequent use of eggs.

“The Government remains committed and will continue to encourage and support Singaporeans to pursue their marriage and parenthood aspirations as early as possible,” they said.

At a doorstop interview on Monday, when asked whether the age review would help increase the total fertility rate, Ms Sun Xueling, Minister of State for Social and Family Development, said: “Having children is a very personal decision. 

“I think talking to couples about the total fertility rate is not something that motivates them to decide whether or not to have children.

"What we want to do is to make available the options for women so that when they do decide to have children, they know that they have an option of using frozen eggs that they chose to freeze when they were younger.”

Ms Sun reiterated that while single women above the age of 21 can undergo elective egg freezing, a woman can use her frozen eggs only if she is legally married and has her husband's consent. 

She also said that the elective egg freezing procedure remains unsubsidised.

“When it comes to conceiving a child, the Government encourages parenthood within marriage," she added.

"So for a woman to use the frozen embryo to have a child, she will need to be married and to also have the consent of her husband. There is no change in (this) policy.”

Associate Professor Sadhana Nadarajah, head of the department of reproductive medicine at KK Women’s and Children’s Hospital, said that raising the age limit from 35 to 37 years of age will not pose a higher risk to the baby and the mother. 

She  added: “Things don’t just change so drastically within two years, such as developing a new medical condition. But surely, the quality of the egg will drop with age.

"There is a gradual drop (in egg quality) as a woman ages.

“However, we need to take into context that most women who do in-vitro fertilisation are usually between 35 and 39 years of age. I think allowing women to freeze eggs up to 37 years of age will help this group tremendously, and it is a step in the right direction.”

WHAT TWO WOMEN, EXPERTS SAY

TODAY spoke to two women who have been considering freezing their eggs. Both welcomed the age limit review, though one said it had come too late for her.

Ms Jusmin Tan, aged 38, who just exceeds the revised age limit of 37 years old, said that she married at the age of 31, and was diagnosed with polycystic ovary syndrome, which can cause infertility.

At 32 years old, she annulled her marriage and wanted to freeze her eggs to preserve her fertility. 

However, egg freezing was not legalised yet in Singapore at the time, and doing the procedure overseas was too costly for her.

Speaking about the review of the age limit for egg freezing, Ms Tan, who works as a company director, said: “The age review is good but it could have been done so much earlier. I’m upset that I can’t do the procedure now since I exceed the age limit. 

“But I’m happy for younger women because they had more choices than I did. We really won’t know when we will meet the right person and would want to have kids.”

For 36-year-old Ms Sulastri Kamis, the review of the age limit has given her a sense of relief and renewed hope over conceiving a child.

The senior clinical operations scientist got married two years ago and moved into her new flat with her husband last year.

She is considering freezing her eggs as her husband is currently pursuing his studies, and the couple is not ready to have a child at the moment, though they do intend on having one in the future.

“I was thrilled when the news first broke that elective egg freezing would be allowed last year, but the age limit of 35 years of age dampened my spirits. I’m glad that it has been revised, and that health policies are congruent with current research,” Ms Sulastri said.

She also said that being given the choice to freeze her eggs takes the pressure off conceiving before a couple is mentally ready to do so. 

“Most people assume you would want to start a family almost immediately, especially if you 'marry late' like me," she said.

"But I think what is most important is understanding the responsibilities of becoming parents and a person’s individual circumstances that lead to a delayed marriage and motherhood," Ms Sulastri added.

“I took a long time to find a life partner, and it was not for the lack of trying. I also spoke to my husband about how we would like to start our family, and we both agreed that it would not make sense to rush in starting a family just because I married later in life,” she said. 

According to obstetrics and gynaecology specialist at Mount Elizabeth Hospital, Dr Kelly Loi, the demographic of women who undergo egg freezing is usually in their mid-30s, well-educated and with good careers, but yet to find a suitable partner.

“They usually undergo egg freezing because they would like to have a family one day and are aware of the fertility issues which occur with advanced age,” Dr Loi said.

They also understand that freezing their eggs at a younger age will give them a better chance of pregnancy success, if they choose to undergo in-vitro fertilisation (IVF) later in life.

From her observation, she also noted that many older couples try to obtain donor eggs from overseas egg banks.

“However, the supply at overseas egg banks is limited. So, increasing the donor egg age limit may make it easier for couples to find suitable donors,” said Dr Loi.

She also said that the age limit review to 37 years of age is “definitely a step in the right direction”, as the success rates for IVF treatment for women above 37 years old tend to drop.

Agreeing, medical director of Thomson Fertility Centre Dr Loh Seong Feei, said: “We are glad that MOH has raised the age limit. The previous age limit of 35 years could be too restrictive, as younger women may not have the emotional or financial capacity to consider the procedure.”

He added that since the White Paper in 2022 announced that elective egg freezing will be permitted in Singapore, his centre has received more than 100 enquiries about egg freezing. 

“Most of the women who make these enquiries are approaching the age of 35 years or have slightly passed that age, and are stably employed,” said Dr Loh.

“By raising the age limit, more women who are considering the procedure can benefit from the programme.”

For women above 37 years of age who wish to undergo the procedure, Dr Loh said that they can appeal to MOH, after they have been counselled on the risks and benefits of freezing their eggs.