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Wednesday, November 4, 2015, 09:20

Embryo of hope

By Frannie Guan

While freezing one’s eggs is a way of deferring childbirth until one is ready, not every one of these frozen ova will materialize into babies. Frannie Guan reports.

Embryo of hope

The unyielding demands on the city’s workers — the sometimes "notorious" work ethic that fuels the city’s fast pace — is a significant factor contributing to a future of economic decline and a shrinking population, say experts.

Yip Siu-fai, a non-official member of Hong Kong’s Steering Committee on Population Policy, points to the city’s notoriously low fertility rate (1.234, 2014), and says the city’s failure to reach the long sought-after, work-life balance is one of the leading causes.

The low fertility rate doesn’t mean Hong Kong women don’t want to have babies, says Yip, but they are putting it off. Some are turning to reproductive technology, delaying pregnancy until past their normal reproductive years, up to age 35. Experts caution, however, that there is a limit to how far technologies can help stretch late motherhood.

Forty-two-year-old Michelle Ng, a finance manager and mother of one girl, wants another child. "A second child can help share the burden of taking care of us when we get old," said Ng. "If we are no longer with them, they can provide support to each other."

For the time being, Ng said she can’t afford to take time off work to have another baby. "Especially in the past year, I have been extremely busy…and I don’t want to miss the crucial period to build up my career," said Ng. She delayed having her first child until she was 35, instead focusing on burnishing her professional standing. But after 35, the likelihood of pregnancy drops sharply, in large part because of the shrinking reservoir of potential eggs.

When a girl reaches puberty and begins menstruation, she produces about 400,000 follicles in her ovaries and with each menstrual cycle. Due to limited hormone production, only one follicle can mature into a fertile egg. The thousand other follicles will die. During a normal, healthy life cycle, a woman will ovulate only about 400 eggs.

"By the time they are 37, women have less than 10 percent of the eggs they had at puberty, and these eggs are often not of good quality," said Dr Louis Chan Yik-si of the Hong Kong Reproductive Medicine Centre.

How late is too late?

Michelle Ng worried that the window of opportunity might close before she could have a second child. A physician client suggested that she froze some of her eggs before they are completely exhausted, leaving her option open to have a baby later on. Ng followed up the doctor’s advice with a blood test. The results showed that her ovary reserve was equivalent to that of a 35-year-old woman. She resolved to have 20 of her eggs frozen.

"We have more and more women coming to have their eggs frozen," said Chan. The statistics collected by the Council on Human Reproduction Technology are incomplete, due to poor reporting and the fact that some women travel abroad. Current figures reveal that the number of eggs stored by the city’s reproductive technology centers increased from 124 in 2011 to 306 in 2014. Ng’s friends and colleagues, including unmarried ones, have gone through the procedure.

Most patients, says Chan, decide on freezing their eggs when they are already in their late 30s or early 40. By then their ovaries are near exhausted. Ng was lucky, he said. A 37-year-old patient who worked in the toy industry for 15 years came seeking help, but after two weeks of hormone injections, doctors were able to extract only one egg. "She cried in front of me," said Chan.

One of the reasons why some patients wait too long, says Chan, has got to do with financial pressure. "By the time they are 25 they probably have not made enough money to freeze their eggs," said Chan.

It cost Ng around HK$60,000 for the full procedure, including freezing the eggs for the first six months. After that the reproductive technology center charges HK$8,000 per year for storage. Under the current Human Reproductive Technology Ordinance, eggs may be stored for no more than 10 years. A woman does have the right, however, to export her eggs to other jurisdictions, when the time limit in Hong Kong expires.

Raising children in Hong Kong is costly and parents work hard for as long as they can, to give them the best possible environment for growing up. Unofficial estimates put the cost of raising a child in Hong Kong at between HK$3 million and 4 million.

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