Elective Egg Freezing 

Elective egg freezing, or oocyte cryopreservation, is a medical procedure in Singapore that allows women to preserve their eggs at a younger age for potential use in the future. Thanks to major advances in fertility science, particularly in freezing techniques like vitrification, this process has become a reliable option for women who may wish to delay motherhood due to personal, professional, or other non-medical reasons.

In Singapore, egg freezing was traditionally permitted only for medical indications, such as prior to cancer treatment. However, since July 2023, women aged 21 to 37, regardless of marital status, are now allowed to freeze their eggs for non-medical reasons. This marks a significant shift in reproductive policy, which provides women with more autonomy over their fertility choices.

Whether driven by career planning, the absence of a suitable partner, or simply the desire to keep options open, elective egg freezing is increasingly being seen as a proactive step in family planning.

What is egg freezing?

Egg freezing, medically referred to as oocyte cryopreservation, is a fertility preservation method that allows a woman to store her eggs when they are likely to be of better quality, typically in her younger reproductive years. These eggs remain unfertilised and are kept in a frozen state until she decides to use them in the future to try for a pregnancy.

The primary purpose of egg freezing is to extend a woman's reproductive lifespan. As a woman ages, both the quantity and quality of her eggs naturally decline, which can affect the chances of conceiving and increase the risk of miscarriages and genetic abnormalities. By freezing eggs earlier, a woman retains the possibility of having a biological child at a later time, reducing the negative impact of age on fertility. 

How does the egg freezing process work?

Egg freezing takes place over two to three weeks and involves several key stages designed to safely collect and preserve mature eggs. Each step is timed carefully to ensure the best chance of retrieving high-quality eggs, which can be stored and used for future pregnancy attempts.

• Ovarian stimulation — to begin, you will undergo hormonal stimulation using daily self-administered injections. These typically include follicle-stimulating hormone (FSH), often combined with luteinising hormone (LH), to enable the ovaries to produce multiple eggs,  significantly improving the chances of retrieving several viable eggs for freezing.

• Monitoring and follicle growth — throughout this period, you will be closely monitored through serial ultrasound scans and blood tests. These help your fertility team measure follicle growth and hormone levels, which will help them determine the optimal time for egg retrieval. Each follicle contains one egg, and the goal is to let as many follicles as possible reach maturity.

• Trigger injection — once the follicles reach an appropriate size typically above 17-18mm, a “trigger shot” is given, usually an injection of human chorionic gonadotropin (hCG) or a similar agent. This triggers the final maturation of the eggs and prepares them for retrieval within the next 35 to 36 hours.

• Egg retrieval (OPU) — this is a short procedure to collect the mature eggs from your ovaries. Ovum pick-up (OPU) is performed at the IVF centre under sedation or light anaesthesia. Using a transvaginal ultrasound probe, a thin needle is inserted through the vaginal wall to access the follicles. The eggs are gently suctioned out into a test tube. The entire procedure typically lasts 10 to 30 minutes, and multiple eggs can be retrieved in one session.

• Post-procedure advice — after egg retrieval, you will be advised to avoid sexual activity and vigorous exercise until your next period begins. Most women recover quickly, but if you experience significant pain, you should be assessed for rare complications such as infection, ovarian torsion (twisting), or ovarian hyperstimulation syndrome (OHSS).

• Cryopreservation — following retrieval, the eggs are examined in the lab. Only mature, healthy-looking eggs are selected for freezing. These are placed in a culture medium and frozen using a technique called vitrification, a rapid cooling method that prevents ice crystals from forming within the cells, which helps protect the integrity and survival of the eggs.

• Storage — once frozen, the eggs are stored in liquid nitrogen at extremely low temperatures. They can remain in storage for many years, depending on regulatory limits and personal circumstances, and may be thawed later for use in an IVF cycle.

What tests are required before egg freezing?

Before starting the egg freezing process, a series of tests are done to assess your fertility status and overall health. These evaluations help ensure that the treatment is appropriate, safe, and tailored to your individual needs.

• Hormonal and ovarian reserve tests — a blood test will be performed to measure key reproductive hormones such as follicle-stimulating hormone (FSH), luteinising hormone (LH), oestradiol (E2), testosterone, prolactin, and anti-Müllerian hormone (AMH). These levels provide insights into your ovarian reserve, the quantity and quality of eggs remaining in your ovaries. Additional screening for thyroid function and vitamin D levels may also be included, as they can influence reproductive health.

• Infectious disease screening — standard infectious disease screening is required before egg freezing. This includes tests for HIV, Hepatitis B and C, Syphilis, Rubella, and Cytomegalovirus (CMV). These screenings are important for both your safety and compliance with laboratory protocols for the handling and storage of frozen eggs.

In some cases, additional tests may be recommended based on your medical history or risk factors. All test results will be reviewed by your fertility specialist to determine your suitability for egg freezing and to plan your treatment schedule accordingly.

Who should consider egg freezing? 

Elective egg freezing is not a one-size-fits-all solution. It is most suitable for women who wish to preserve their fertility for personal, medical, or social reasons. The decision depends on individual goals, health conditions, and age, and should ideally be made in consultation with a fertility specialist.

• Career or educational priorities — many women choose to freeze their eggs to focus on their careers or further education. This option offers reassurance and allows them to pursue their ambitions without feeling pressured by their biological clock.

• Lack of a suitable partner — some women are not in a relationship or have not found a suitable partner by their early to mid-30s. Egg freezing gives them the option to preserve younger eggs for future use when they are ready to start a family. However, under Singapore law, the use of frozen eggs is restricted to legally married women. Single women are allowed to freeze their eggs, but cannot use them unless they marry.

• Medical conditions — women diagnosed with cancer, autoimmune diseases, or other medical conditions that require treatments such as chemotherapy or pelvic surgery may consider egg freezing as a proactive step to preserve their fertility before undergoing treatment.

• Family history or early menopause — women with a family history of early menopause or reduced ovarian reserve may choose to freeze their eggs while they still have a good supply of healthy eggs. Fertility testing can help determine if early action is advisable.

Egg freezing is a personal decision that depends on a range of medical, emotional, and practical considerations. A consultation with a fertility specialist can help assess whether and when it is the right choice based on your individual goals and reproductive health.

What is the difference between egg freezing, embryo freezing and ovarian tissue freezing?

Women considering fertility preservation have more than one option, and it’s important to understand how each method works and which may be most suitable for their personal circumstances. While egg freezing is the most common elective method, embryo freezing and ovarian tissue freezing are also used in specific situations, particularly for medical reasons.

The table below highlights the key differences between these three approaches:

Aspect	Egg Freezing	Embryo Freezing	Ovarian Tissue Freezing
What is frozen	Unfertilised eggs	Fertilised eggs (embryos)	A piece of ovarian tissue containing immature eggs
Fertilisation required	No (fertilisation happens later, if used)	Yes (sperm must be available at time of freezing)	No (eggs remain within tissue)
Common use	Elective or medical fertility preservation	IVF-related fertility preservation	For cancer patients needing urgent treatment
Recommended for	Women without a partner or delaying childbearing	Women with a partner or using donor sperm	Prepubescent girls or women who cannot delay treatment
Success rates	Dependent on age and egg number	Generally higher due to use of embryos	Still considered experimental in many regions
Storage and use	Eggs thawed, fertilised, and implanted later	Embryos thawed and implanted during IVF	Tissue reimplanted to restore ovarian function
Availability in Singapore	Widely available in licensed IVF centres	Widely available	Limited; considered under research or specialised centres

Each method has its own advantages, limitations, and ethical considerations. Egg freezing offers more flexibility for single women, while embryo freezing may be preferred by couples undergoing IVF. Ovarian tissue freezing, though less common, provides an option for women who cannot delay urgent medical treatment.

A fertility specialist can help assess which method aligns best with your medical needs, reproductive goals, and timeline. 

What are the common risks and side effects of egg freezing in Singapore?

Egg freezing is a safe and well-established procedure, but like any medical treatment, it does come with certain risks and emotional considerations. Understanding these potential side effects can help you make an informed decision and prepare for the process with realistic expectations.

• Ovarian hyperstimulation syndrome (OHSS) — the hormone injections used to stimulate the ovaries may sometimes lead to OHSS, a condition where the ovaries become enlarged and fluid builds up in the abdomen. Symptoms can include bloating, discomfort, nausea, or shortness of breath. In most cases, OHSS is mild and resolves on its own, and careful monitoring of your response to medication can significantly reduce the risk.

• Rare procedural risks — egg retrieval is generally a low-risk procedure, but rare complications can occur in fewer than 1% of cases. These may include pelvic infections or injury to nearby structures such as the bladder, blood vessels, or ureters. The procedure is performed under strict sterile conditions and with ultrasound guidance to keep these risks minimal.

• Emotional and psychological impact — the decision to freeze eggs can stir a range of emotions. Some women may feel anxious, uncertain about the future, or disappointed if fewer eggs are retrieved than expected. Others may find the waiting period and potential outcomes emotionally challenging. Access to counselling and fertility support services is often available and encouraged for those who need it.

While complications are rare, it is important to go into the process well-informed. Open discussions with your fertility specialist can help you understand your personal risk profile and receive the support you need throughout your journey.

Who may not be suitable for egg freezing?

While elective egg freezing is a valuable option for many women, it may not be appropriate or effective in every case. A thorough evaluation by a fertility specialist is essential to determine whether this approach is suitable based on individual health, age, and fertility profile.

• Advanced age — although Singapore permits elective egg freezing up to age 37, the success of the procedure is highly dependent on the age at which eggs are frozen. Women in their late 30s may have a significantly reduced ovarian reserve and poorer egg quality, which can lower the likelihood of a future successful pregnancy, even with egg freezing.

• Existing fertility issues — women with already diagnosed fertility challenges, such as low anti-Müllerian hormone (AMH) levels, poor response to ovarian stimulation, or certain reproductive disorders (e.g. severe endometriosis), may not benefit as much from elective egg freezing. In such cases, alternative fertility treatments, including IVF with donor eggs, may be more appropriate.

• Unrealistic expectations — egg freezing does not guarantee a baby in the future. Success depends on several factors, including the number and quality of frozen eggs, age at freezing, and overall reproductive health at the time of use. Women should approach the procedure with informed and realistic expectations, supported by open discussions with their fertility team.

• Medical contraindications — some medical issues may make a woman unsuitable for egg freezing. These include untreated pelvic infections, active gynaecological conditions, uncontrolled chronic diseases, or blood clotting disorders. A detailed medical assessment is essential to identify and address any contraindications before proceeding.

• Mandatory pre-procedure counselling — in Singapore, all women considering elective egg freezing are required to undergo pre-procedure counselling at a licensed IVF centre. This counselling session provides a comprehensive overview of the process, potential risks, success rates, legal and ethical considerations, and future use of frozen eggs.

Consulting a qualified fertility specialist is the first step in determining whether egg freezing is appropriate. A personalised assessment will help you make an informed choice that aligns with your reproductive goals and medical background.

How should I prepare for egg freezing?

Preparing for egg freezing involves more than showing up for appointments; it’s a combination of physical, emotional, and logistical readiness. Proper preparation can improve your experience, support better egg quality, and help you feel more in control during the process.

• Physical preparation — start by adopting a healthy lifestyle at least a few months before your cycle. This includes eating a balanced, nutrient-rich diet, staying well-hydrated, getting regular exercise, and ensuring adequate sleep. Avoid smoking, excessive alcohol, and recreational drugs, as these can all affect egg quality. If you are taking any medications or supplements, inform your doctor to ensure they are compatible with fertility treatment.

• Mental and emotional preparation — egg freezing can bring up a mix of emotions—hope, anxiety, uncertainty. Educating yourself about the steps, timelines, and success rates can ease worry and reduce surprises. Consider attending counselling if you feel emotionally overwhelmed or need help processing your decision. Some clinics also offer support groups or fertility coaches.

• Cycle timing — egg freezing is timed according to your menstrual cycle, with ovarian stimulation typically starting on Day 2 or 3 of your period. Speak with your fertility clinic early so they can help plan around your cycle. You may be advised to track your periods in advance or use a scheduling app for better accuracy.

• Work and travel planning — the egg freezing process takes around two to three weeks, during which you will need to attend regular monitoring appointments, sometimes every few days. It’s wise to avoid long work trips or tightly packed schedules during this time. Most women can continue working, but flexibility is key, especially closer to the egg retrieval date.

Good preparation helps ensure a smoother experience and supports the best possible outcome. Your fertility team will provide personalised guidance, so don’t hesitate to ask questions and make a plan that works for your lifestyle.

Summary 

Egg freezing is an increasingly popular option for women who wish to preserve their fertility and keep the door open to future family planning. With advancements in reproductive technology and regulatory changes in Singapore, women aged 21 to 37 can now choose elective egg freezing regardless of marital status. The process involves ovarian stimulation, egg retrieval, and cryopreservation of mature eggs using vitrification. 

While the procedure is generally safe, it’s important to be aware of potential risks, legal considerations, and realistic success rates, all of which depend heavily on age and egg quality. Proper preparation, both physical and emotional, can improve the overall experience, and understanding the recovery process helps ensure a smooth journey. Egg freezing is not suitable for everyone, which is why personalised guidance and mandatory counselling are essential parts of the process. 

If you are considering fertility preservation or want to explore whether egg freezing is right for you, schedule a consultation with Holistic Gynae & Fertility to receive expert advice tailored to your goals and health.

Frequently Asked Questions (FAQs)