ABSTRACT
In March 2012, an article in The Straits Times entitled ‘Freezing eggs could reverse falling birth rate’ suggested that employing the latest oocyte cryopreservation techniques could both foster individual women’s reproductive autonomy and impact Singapore’s fertility rate, which in recent years has consistently been among the world’s lowest. The article cited both local and international fertility specialists’ approval of elective oocyte cryopreservation for young women wishing to protect their reproductive potential against ageing and as a potential antidote to the contemporary ‘delay and defer’ model of family-building. Later in 2012, the Ministry of Health announced a review of oocyte cryopreservation policy taking into account related medical, scientific and ethical issues, while the Singapore College of Obstetricians and Gynaecologists endorsed oocyte cryopreservation as an “important, safe and efficient technology”. This paper outlines and analyses the arguments and empirical evidence used both to support and oppose offering elective oocyte cryopreservation as a routine fertility service, before concluding that this remains unjustifiable on the basis of insufficient evidence of its clinical efficacy and safety as regards either pregnancy rates or birth outcomes. If it is to be made available at all for these reasons in Singapore, it should be subjected to rigorous clinic-specific evaluation in accordance with accepted clinical and ethical norms.
For almost 4 decades, Singapore has experienced total fertility rates (TFR) below population replacement levels and which have stubbornly defied a raft of pro-family
policies initiated by the government since the mid-1980s, that have sought to encourage marriage and childbearing, provide support for childcare and facilitate the balancing of work and family responsibilities. Although Singapore is far from alone in this demographic predicament, since most of Europe and other East Asian nations are similarly afflicted, the virtually remorseless downward slide has, in recent years, consistently placed it at the foot of the global fertility “league table”.
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