As the Government deliberates on permitting social egg freezing in Singapore, it needs to consider legislating various safeguards (Govt reviewing ban on women freezing eggs for non-medical reason, Oct 22).
Besides rigorous counselling of patients, the following pertinent issues also need to be addressed.
First, possible failure in storage resulting in irreversible damage to or destruction of the frozen eggs. Currently, most local fertility clinics store either frozen eggs or embryos in cryotanks that need to be topped up regularly with liquid nitrogen. There is a possibility of human error, for example, if laboratory staff forget to top up liquid nitrogen during a holiday.
Patients should store their eggs in a big well-managed facility with lots of fail-safes and power-failure backups, such as the ones managed by private cord-blood banks. Should there be an insurance or compensation scheme to cover accidental loss of frozen eggs?
Second, the conflict of interest faced in the donation of leftover unused frozen eggs to infertile patients. Currently, this is permitted in Singapore and comes mainly from a small minority of couples undergoing IVF who choose to freeze their unfertilised eggs instead of embryos due to religious or personal reasons.
Doctors and clinics persuading former patients to altruistically donate their unused frozen eggs face a conflict of interest because they stand to earn additional fees from performing the egg donation procedure on other patients.
The doctor-patient fiduciary relationship can easily be abused during the consent process if doctors know that their former patients are grateful to them for successful fertility treatment.
There is also the issue of distributive justice if doctors and clinics exclusively control the allocation of donated frozen eggs to other patients.
This prerogative should instead be exercised by a government agency based on a centralised registry and waiting list of patients.
Third, social egg freezing may inadvertently encourage single motherhood.
Are there any laws to stop single women from later exporting their frozen eggs to an overseas fertility clinic? If single women freeze their eggs because they "can't find Mr Right", what can guarantee they find him in the future?
Alexis Heng Boon Chin (Dr)