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July 2015 Pulse

In October 2014, Apple and Facebook made the headlines by announcing that they would pay the expenses of women employees who wished to freeze their eggs. This unprecedented move has revived debate on the ethical issues surrounding this particular use of assisted reproductive technology, as well as its possible social ramifications and consequences.

Mature oocyte cryopreservation or vitrification (egg freezing) is a technique that has been used for the past decade to preserve the reproductive potential of women. In many countries, including Singapore, this technique is used only for medical reasons. For example, it is used on young women undergoing cancer treatment so that they may have a chance to start a family after their recovery.

The procedure is risky. The fertility medication prescribed to the woman in order to procure enough eggs for freezing can produce nasty side effects like Ovarian Hyperstimulation Syndrome (OHSS). In extreme cases, this condition can cause kidney failure, blood clots and even death.

Although the procedure is risky and the success rate unpredictable, the medical use of this technique raises fewer ethical concerns as long as strict protocols and guidelines are in place and observed.

However, in recent years, a worrying trend is emerging in the West where women take advantage of this technology to delay childbearing so that they may advance their careers. Others see elective egg freezing as a form of self-determination, an exercise of their right to decide when to have children. Still others argue in favour of social egg freezing on grounds that such a policy would narrow the inequalities among women with respect to their reproductive decisions.

Social egg freezing is also attractive for countries with low or declining total fertility rates (TFR), like Singapore. In 2010, births per female in Singapore dropped to an all- time low of 1.15. Fertility of women under 30 years also fell significantly, while that of women above 30 rose slightly, suggesting that women are delaying childbearing.

Many commentators, however, have warned that social egg freezing should not be seen as a panacea that guarantees women the opportunities to have a family later in life because current success rate is dismal. But even if the technique is perfected, serious ethical issues remain.

Among the many issues raised by Christian ethicists in relation to social egg freezing is the use of assisted reproductive technology for non- medical reasons.

Generally speaking, performing risky medical procedures on healthy people is always ethically problematic. The retrieval and freezing of the eggs of healthy and fertile women is a highly questionable practice from the standpoint of Christian ethics.

But social egg freezing also raises broader issues such as the medicalisation and commercialisation of women’s bodies. The business side of this trend has also caused ethicists to worry about what has been described as the expanding “consumerist imperialism in medicine”. This may result in the diversion of talents and energies from the strictly ‘medical’ aspects to the more lucrative ‘consumerist’ interests.

Finally, the attraction to social egg freezing may be symptomatic of certain cultural sensibilities and attitudes that would in fact compromise social flourishing. As some commentators have rightly pointed out, beneath the apparently noble rhetoric that heroically champions the autonomy and rights of the contemporary woman, elective egg freezing can be said to be motivated by the woman’s desire to put her interests above those of her children.

By choosing to have children in their 40s and 50s using this technique, women are not giving their children the healthiest and best start in life. In addition, these children are destined to bear the heavy responsibility of taking care of their geriatric parents when they themselves are just starting their careers and families.

The disturbing social ramifications of the distorted priorities that undergird this trend simply cannot be ignored. Thus, to allow social egg freezing is not simply to endorse the use of a reproductive technology. It is to sanction a mindset, a way of envisioning ourselves in relation to others, especially our children.

As the National Council of Churches of Singapore notes in its January 2013 statement on social egg freezing: “Allowing elective egg freezing will be perceived as signalling our acquiescence to the very trends that should be subjected to serious critique, resisted and challenged.”

Dr Roland Chia

Dr Roland Chia is Chew Hock Hin Professor of Christian Doctrine at Trinity Theological College and Theological and Research Advisor of the Ethos Institute for Public Christianity.