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Wednesday, November 4, 2015, 09:20

Embryo of hope

By Frannie Guan

Embryo of hope
Egg freezing involves vitrification, that is, an ultra rapid cooling technique that allows the water inside and surrounding the egg to instantaneously cool into a solid state in liquid nitrogen.

Drop in fertility rate

The inescapable irony behind all this is that present-day economic conditions pose a threat to the SAR’s future. In 2014, only 1,234 babies were born to every 1,000 women, over the full span of their child-bearing years in Hong Kong (i.e., a fertility rate of 1.234). A fertility rate of 2.1 is the minimum for maintaining a stable population. The city’s fertility rate has decreased dramatically over the past 30 years. A survey conducted by the Family Planning Association found that the proportion of childless families increased from 16.1 percent in 2007 to 23.4 percent in 2012.

Hong Kong faces a precipitate fall in population, a problem compounded by the fact that it is one of the most rapidly aging cities in Asia, already threatened by a growing labor shortage, affecting the city’s productivity and standing in the global community.

Yip, also a professor at the Department of Social Work and Social Administration at the University of Hong Kong, referred to a survey where 39 percent of women said they had fewer children than they wanted. That was the widest gap between the number of children women wanted and that which they actually produced since 1987, he added.

That people are waiting longer to get married has compounded the problem. Analysis of the latest government census reveals that the average age at which Hong Kong women get married for the first time has increased to 29.1 years. The figure is 31.1 for men. The average age of women having their first child has been pushed to 31.3 years in 2014. The average was 25.1 in 1981.

Late marriage and late parenting, as Yip explained, are due in large part to the city’s unfriendly working environment for families. Not only do people work hard, but they are expected to work long hours. "Sometimes women say they just do not have time to go out to meet men," says Yip.

"I think every developed city faces the same problem…that is, women get married later and later," said Chan. For those who want to focus on career a little longer and at the same time retain their reproductive potential, Chan said egg freezing was probably a workable option.

Embryo freezing is easier

Egg freezing is a leading example of advanced reproductive technology, used worldwide to help women preserve their eggs for future pregnancies. Chinese actress and film director Xu Jinglei made news when at 41 she traveled to the United States to have her eggs frozen. The Chinese mainland bans the practice for single women.

The case triggered public reaction. The loudest voices were those who believe it is a woman’s natural right to have her eggs frozen. They argue that the government should not interfere with family planning at that level. Those who oppose the practice argue that despite the advancement of technology, the success rate of egg freezing is much lower than that of embryo freezing, as eggs, having high water content, are more difficult to freeze.

"Freezing eggs is an invasive procedure, and the psychological burden on the mother should not be underestimated," said Yip. Chan added that the risks involved in the procedure include infection and bleeding, just as in any other surgery. "They need to understand also that it does not guarantee a child," said Chan.

The full procedure takes about 4 weeks. Before the eggs are removed, a woman is required to undergo a health check and counseling. During the final two weeks leading up to the medical procedure, women are prescribed daily follicle stimulating hormone (FSH) injections to stimulate egg production.

After two weeks of stimulation, doctors retrieve mature egg cells from the ovary and choose healthy eggs that will be frozen and stored in liquid nitrogen.

Egg freezing helps women to extend their fertile period, but Yip is doubtful that it offers a solution to the city’s fertility rate. "Going through this should be a last resort," said Yip. "When women plan to have a family, it is better for them to come out with a more effective way to fulfill family objectives by planning ahead."

"Egg freezing arrests time for the eggs, but it does not freeze time for the mother’s fertility and overall health. The mother continues to get older," said Terry Kaan Sheung-hung, co-director of the Centre for Medical Ethics and Law at the University of Hong Kong. "If we think about the right of women to have a child, we should also consider the interests of the child." He contended that it is to the greater benefit of the child to be born to a relatively young couple, than to couples in their late 40s.

He also pointed out that those who may want to use the technology also need to consider what they will do with the rest of the eggs, since usually they won’t use all the eggs frozen and stored. "Do you destroy them or give them to research? That is not an easy choice."

Kaan added that he would applaud the technology in cases of unavoidable health setbacks, such as young women with cancer, freezing eggs before chemotherapy, but he was far more cautious about using technology to overcome problems which actually can be solved by other means.

Ng plans to use her frozen eggs next year. The eggs will be thawed, and then fertilized with her husband’s sperm. She doesn’t want to find a surrogate mother, but plans to carry the pregnancy herself.

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