Elective Egg Freezing in Singapore: A Step-by-Step Guide

Elective egg freezing is a medical procedure that allows women to safeguard their ability to conceive later on. The first step usually involves a detailed fertility assessment by a fertility specialist. This is followed by optimisation of the women’s medical condition. Once ready, the process of ovarian stimulation begins. Mature eggs are surgically retrieved from the ovaries and  rapidly cooled using a process called vitrification. These eggs are then stored securely in liquid nitrogen for 10 years or beyond.  When required, these eggs can be thawed and fertilised through in‑vitro fertilisation (IVF).

This guide explains each stage of the elective egg freezing process. It also explores common reasons for considering egg freezing, and covers the regulatory requirements in Singapore.

Step 1: Fertility Assessment

Whether you hope to conceive soon or later on, a fertility assessment gives you a clear picture of your reproductive health and identifies any issues that could make pregnancy challenging.

At Daniel Koh Clinic, we offer a complete range of tests for individuals who are exploring elective egg freezing:

• Hormonal Screen: Tests for hormones such as follicle stimulating hormone (FSH), luteinising hormone  (LH), oestradiol, testosterone and prolactin to see how well your body supports egg development and ovulation.

• Thyroid Screen: Tests for thyroid hormones and antibodies. An overactive or underactive thyroid can make it harder to get pregnant or stay pregnant.

• Ovarian Reserve Test: Test for anti-mullerian hormone (AMH) which is an indicator of your eggs reserve. Higher AMH correlates with better fertility prospects and better response to ovarian stimulation.

• Pelvic ultrasound: A detailed assessment of your pelvic organs including the uterus, endometrium and ovaries. An antral follicle count may also be performed on Day 2 to 3 of your cycle.

Step 2: Financial Counselling

Before you can start elective egg freezing, Ministry of Health (MOH) guidelines require two financial-counselling sessions, one with the embryology laboratory and one with your fertility clinic.

During these sessions you will be counselled on the process of elective egg freezing, time and financial commitments for the program, potential risks, complications and limitations related to the program. Written consent, indemnity forms and relevant documentations are required to be completed prior to the start of any elective egg freezing program.

Step 3: Optimising Health/Medical Conditions

Optimising your health and medical conditions prior to the elective egg freezing program can boost your chances of a successful outcome. Here are a few practical steps that you can take:

• Premedication: Your doctor may suggest supplements, such as myoinositol and co-enzyme Q10, to improve your ovarian response to stimulation, improve egg quality and subsequently contribute to higher clinical pregnancy rates.

• Weight management: Maintaining a healthy body mass index (BMI between 18.5 to 29.9 kg/m2) can improve your chances of success.

• Lifestyle habits: Stop smoking and consumption of alcohol. Engage in regular exercise and prioritise good sleep. These modifications may enhance your hormonal balance and overall fertility.

• Control chronic medical conditions: If you have hypertension, diabetes, thyroid problems or other long-term illnesses, ensure that they are well managed before commencing elective egg freezing.

Step 4:Infectious Disease and Thalassaemia Screen

Prior to ovarian stimulation, the following mandatory tests are performed in the clinic:

• Human Immunodeficiency Virus

• Hepatitis B and C Screening

• Rubella Screening

• Thalassaemia Screening

Step 5: Ovarian Stimulation

Fertility medications such as FSH and/or LH are commonly used for this process. Your fertility specialist will guide you on how to administer these medications at home.

The first injection would usually start on the second or third day from the commencement of your menstruation. The duration can vary depending on the protocol used. Generally, you can expect to administer these medications from day 2 or 3 to day 12 of your menstrual cycle. During this period, you would be reviewed by your fertility specialist once every three days.

Step 6: Trigger Shot

Once your follicles have reached the targeted size, your fertility specialist would schedule a trigger injection in the evening. The exact medication used and timing would depend on the protocol used by your fertility specialist.  The objective is to mature the eggs and prepare them for retrieval approximately 36 hours later.

Step 7: Egg Retrieval

The egg retrieval (a.k.a oocyte pick up - OPU) day is the most important day of the entire process.

Egg retrieval is a surgical procedure to retrieve your eggs. It is performed by a MOH accredited fertility specialist under sedation or general anaesthesia. The equipment include a suction and flushing device and a thin retrieval needle which is mounted onto a vaginal ultrasound probe. The needle is used to penetrate the fluid sacs containing the eggs under ultrasound guidance. Suction pressure is then applied to retrieve the eggs. The duration of the procedure would depend on the numbers of eggs to be retrieved as well as the accessibility of your eggs.

You can expect to return home the same day. It is fairly common to experience mild cramping and small amounts of vaginal bleeding during the first few days. 

Sometimes, you may be prescribed a medication called Letrozole to prevent ovarian hyperstimulation syndrome (OHSS). OHSS can vary in severity. Your fertility specialist would advise you on the symptoms of moderate to severe OHSS and arrange for you to return earlier if required.

Step 8: Cryopreservation & Storage

The collected eggs are cleaned and prepared by trained embryologists prior to vitrification.  Vitrification is a technique that allows eggs to be cooled rapidly from room temperature to -196 degrees Celsius. It prevents the formation of ice crystals which may damage your eggs. It also preserves the structural integrity of your eggs. The vitrified eggs are then stored in a liquid nitrogen tank.

What Are the Common Reasons for Egg Freezing?

Women choose to undergo elective egg freezing for various reasons;

• Plans to delay partnership or marriage

• Family history of early menopause or genetic predisposition to premature ovarian failure

• Medical treatment such as chemotherapy

• Back up plan or personal peace of mind

Legal Guidelines for Egg Freezing in Singapore

Elective egg freezing in Singapore is subject to the following requirements:

• Only women aged 21–37 may freeze their eggs in Singapore

• The frozen eggs may only be used with a legally married spouse.

• Mandatory Counselling: All patients have to receive mandatory counselling on financial cost, success probabilities, genetic risks and disposal options if their circumstances change.

• Storage Management: There is no statutory maximum duration for storage, but egg storage centres must be able to contact you periodically to renew consent for storage.

Schedule a Personalised Egg Freezing Consultation at Daniel Koh Clinic

If you are considering egg freezing in Singapore, Daniel Koh Clinic offers the full-spectrum fertility preservation services, from fertility assessment to long-term storage at our partner laboratory. Dr Daniel Koh and his team provide. individualised counselling and support throughout the process in a comfortable and discreet environment.

To schedule a confidential consultation, contact us at:

Tel: +65 6025 3345

WhatsApp: +65 8824 3400

Email: enquiry@danielkohclinic.com.sg

Alternatively, fill in the online booking form below and our clinic assistant will get in touch promptly.