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Banking on fertility preservation


Egg freezing at NUH offers women a chance to hit 'pause' on their fertility, reconciling science with compassion in the face of the ticking biological clock.
Issue 2 | September 2023

Banking on fertility preservation

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"Perhaps I should just freeze my eggs."

Such a remark, sometimes made in jest or frustration about the ticking biological clock, is increasingly common in today's conversations. Thanks to modern science, women can now press 'pause' on their fertility journey - a choice unavailable to earlier generations.

Far from being a mere whimsical thought, egg freezing (PDF, 157 KB) represents a profound shift in our perception of fertility, and the National University Hospital (NUH) is guiding women through this intricate voyage.

Behind the scenes

Recently made accessible for women aged 21 to 37 in Singapore for reasons beyond medical necessity, egg freezing promises hope for women grappling with fertility concerns or simply wanting to keep their options open.

Tucked within the NUH is a rather unusual bank - an egg bank. Within its confines lies a womb-like, darkened, pressurised laboratory where embryologists perform the miracle procedure. Strict protocols govern this 159-square-metre space - no perfume, nail polish or aftershave - to safeguard the sanctity of the process.

What goes on in this secretive sanctum? Chief embryologist Joyce Elizabeth Mathew sheds light, "We work in the dark because we try to mimic what goes on in the womb."

Within these walls, the art of egg harvesting transpires. Women undergo carefully timed hormonal injections, leading to the retrieval of their eggs, ideally around 20 per cycle. These eggs, barely visible to the naked eye, are passed onto the embryologists who then dehydrate and freeze them using liquid nitrogen in a process called vitrification, which effectively halts their biological ageing.

At NUH, embryologists go a step further to perform advanced genetic testing on the blastocysts - the furthest stage of embryo development outside the womb. This specialised service identifies embryos with the best chance for a healthy pregnancy, helping couples avoid tough decisions if prenatal abnormalities arise later.

"Patients have invested their emotions and money into this, so we strive to make sure that the specifications and parameters in the lab are optimal for good embryo quality," notes Ms Mathew, highlighting the trust patients place in NUH's team. She also emphasises that the team does more than just practise science; they also care for their patients compassionately.

No panacea

"While statistics may paint a rosy picture of fertility treatments, we must still be extra cautious," says Professor P. C. Wong, head and emeritus consultant at the Division of Reproductive Endocrinology and Infertility in NUH's Department of Obstetrics and Gynaecology. "As a woman ages, the quantity and quality of the eggs drop."

By 40, the success rate for in-vitro fertilisation, or IVF (PDF, 20.4 MB), declines to about 10%. This dispels the commonly held misconception, as reported in a 2019 survey, that IVF is a silver bullet to fertility woes.

Dr Huang Zhongwei, a consultant at the same department, often finds himself counselling couples to manage their expectations. He advocates holistic wellbeing, not just as a preparatory step, but as an integral pillar underpinning the IVF journey.

"A healthy and balanced diet, coupled with regular exercise and appropriate nutrient supplementation, can help create an environment conducive to fertility," says Dr Huang. "Cultivating emotional self-awareness and mental equanimity can also significantly influence the outcome."

"It's a holistic approach - body and mind working together towards the desired goal," adds Dr Huang.

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