Forum: Lift age limit for elective egg freezing but strengthen safeguards
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I read with interest the report “Babies born to mums in their 40s on the rise amid Singapore’s fertility decline” (April 20). This encouraging trend was partly attributed to the lifting of the previous age limit of 45 for in-vitro fertilisation (IVF) treatment.
In the same vein, the Ministry of Health (MOH) should consider removing the current age limit of 37 for elective egg freezing. Doing so could help boost the nation’s total fertility rate, which fell to a historic low of 0.87 in 2025.
Since elective egg freezing was permitted in 2023, MOH has received numerous appeals from women above the age limit. As revealed in Parliament recently, about 70 per cent of such appeals were approved on a case-by-case basis as at April 2026.
However, a case-by-case approval process is not sustainable. As the number of appeals grows, the administrative burden on MOH could lead to longer wait times, thereby reducing the crucial clinical window for applicants. For women in their late 30s, every month counts; a protracted appeal process could inadvertently lower their chances of a successful pregnancy.
A more practical solution is to lift the age limit entirely, while implementing robust safeguards.
If the age limit is lifted, private IVF clinics may aggressively market elective egg freezing to older women, raising the risk of misleading advertising. To counter this, transparent and objective counselling must be mandated.
To prevent conflicts of interest, such counselling should be provided by independent fertility counsellors who are not affiliated with any specific IVF clinic. Furthermore, to maintain consistent standards, MOH could establish a systematic counselling protocol for older patients.
As an additional safeguard, it should be mandatory for all prospective patients to receive an official, regularly updated MOH pamphlet detailing the risks and limitations of egg freezing at an older age. This resource should also be easily accessible online.
Finally, it would be prudent to include a mandatory checklist within the patient consent form. This ensures that older women explicitly acknowledge the increased risks and diminished success rates associated with egg freezing as they age.
Alexis Heng Boon Chin (Dr)
