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Kim Kardashian has done it. Sofia Vergara has done it. Apparently, 99-year-old Hollywood actress Zsa Zsa Gabor had her eggs frozen as early as the 1960s. In January, former Miss World Diana Hayden, at 42, gave birth to a daughter from an egg she had frozen at 34.

“I’m a practical person. I’m also a diehard romantic. The dichotomy here is evident,” Hayden had told the Indian daily Hindustan Times following the birth of Arya Renee Hayden. “So, when I hit my thirties and hadn’t found the right person to settle down with, I decided to opt for egg freezing. I did it to protect myself. I knew that someday I would want children.”

Known informally as “social freezing”, the trend for women in their late 20s and early 30s to freeze their eggs is already popular in the US, where last year Apple and Facebook offered to freeze eggs for female employees so that more women would come work for them. The rest of the world is quickly catching up — including many women in the UAE.

Keeping options open

Dubai-based social media manager Surbhi Kisani, 36. had her eggs frozen in Dubai in January. Emirati projects director Khadija (names changed on request) is undergoing the procedure very soon.

“When I was in my 20s I always believed by the time I’m in my 30s, I would be married and have at least one child. But the last eight or so years, I’ve been focused on my career and for some reason I put marriage and family on the backburner,” says 32-year-old Khadija. “I still want to have a child when I meet the right person and, with egg freezing, I will have the option to have a child or, hopefully, even two [children].”

Even though Khadija is not married or engaged, she feels this will also take some pressure off her future partner as she’d like to enjoy what a marriage has to offer.

“I had been thinking of doing it for a few years. There wasn’t a tipping point until I saw friends in their late 30s and early 40s in stable relationships struggling to conceive,” Kisani says. “So I felt I had nothing to lose with this procedure. I felt things will be in my control.”

The rules about social freezing in the UAE are ambiguous and the Ministry of Health and Prevention declined to comment when Gulf News approached them.
Dr Ahmad Fakih, of the Fakih IVF Centre, told Gulf News it’s not legal here.

However, most IVF centres in the UAE offer the facility, albeit with the condition that the eggs will be used only for the woman to whom they belong and after she provides legal proof that she’s married.

Moreover, the IVF would need to be done here and the eggs cannot be taken out of the country.

“If a woman is not married, she cannot freeze her eggs,” explained Dr Fakih. “Egg freezing [or human oocyte cryopreservation] is a very important concept for fertility preservation and the people who need this are mainly those who are not married and growing older, or singles who have to undergo chemo or radio therapy,” said Dr Fakih. “Only those who undergo IVF treatment and have extra eggs can keep them for future use. Even if it’s a successful IVF but they want another child in a few years, they don’t have to go through stimulation again. Or if the IVF fails, they can use the reserved eggs for a second round.”

Dr Pankaj Shrivastav, of Conceive Gynaecology & Fertility Hospital, Dubai, explained, “Egg freezing was originally created as a backup for women patients who had to undergo treatment for cancer. Sperm and eggs are tissues which are sensitive to any kind of radiation or chemical treatment.”

But until recently such a facility wasn’t available for women because, unlike sperm, eggs aren’t easily accessible and cannot be extracted without a medical procedure.

The process of freezing

“The egg is the largest cell in the human body and for that reason, there is lot of cytoplasm in it, which is basically water. When you freeze something with water, it’ll form crystals, which will destroy the egg during freezing or thawing. Doctors tried something called slow freezing but the results were bad. If 15 eggs were frozen, there would probably be only one which survived. It’s only in the last few years that the vitrification process was introduced, which essentially means ‘changing to glass’,” explained Dr Shrivastav.

“The egg is prepared with certain cryo protectants and plunged straight into liquid nitrogen at minus 192 degree Centigrade from 37 degree Centigrade.
“So it doesn’t have time to form crystals,” informed Dr Shrivastav.

“In 2013, the American Society for Reproductive Medicine declared this technique was no longer experimental due to the wonderful results. After being offered to young women who were to undergo treatment for lymphoma, leukaemia, and women in early 30s who were affected with breast cancer, they decided to offer the facility to everyone.

“Five years ago, we had a woman who came to us for IVF and in her preliminary tests we found the white blood cell count very strange.

“She underwent a check-up and it turned out to be a lymphoma. So we told her about freezing her eggs. Twelve to fifteen eggs can be easily extracted in one sitting. She had her eggs harvested in the UK before going into treatment. Not only did she beat her lymphoma, she’s presently pregnant.”

Dr Daamini Shrivastav, 27, a Dubai-based Pilates instructor and public relations director at Conceive, is not ready to take chances with her biological clock.

“Thirty-four is my scary age. I am lucky to have parents who have never pressured me to marry, but I know there’s a ticking biological clock.

“I haven’t done it yet but am looking to do it in another five years if I don’t meet the right man. I may be very pro-adoption but if I’m in my 40s and my partner doesn’t believe in it, then we have the option to have a biological child.” 

Timing

“The ideal age [to extract the egg] is before 32, but for most women it may not appeal as they think it’s too early if they are busy with a career or studies,” says Dr Pankaj Shrivastav, of Conceive Gynaecology & Fertility Hospital, Dubai.

As women age, their ovarian output undergoes a significant change. Both the quality and quantity of eggs decline, said Dr Ahmed Fakih of Fakih IVF Centre in Dubai.

“We are moving into a phase of social change wherein women are working and have priorities in life other than childbearing. So they are delaying [childbirth]. For these women, after the age of 35, fertility potential begins to drop rapidly — it’s not a gradual decrease. So if they don’t have a plan B, which is freezing their eggs, most of these women will end up either not having children or adopting. Or even having to find a donor egg [the last option being not legal in the UAE.]”

For social media manager Kisani, despite doing it after the recommended age, she is confident that there’s still a 30-40 per cent chance that she could get pregnant. “It’s much better to do it now than in the next few years.”

Moreover, the risks involved are minimal, says Dr Shrivastav. It involves taking hormone injections for two weeks, which now conveniently come in a pen form and can be self-administered, to increase egg production.

Side effects

“Doctors want to harvest as many eggs as possible in one sitting so that the woman doesn’t have to go through the collection process too many times. They start the stimulation on the second day of their cycle and come in for scanning once or twice. The day the doctors find the follicle is ready, a collection is scheduled. Yes, it’s done under sedation and is invasive but without any cuts. Two hours later, she can go home,” said Dr Shrivastav. 

Kisani said all she felt during the process was a little bloating. She had to reduce physical activity due to heavy bleeding.

“It’s pretty normal and over quite quickly. It’s a standard procedure that makes for an uncomfortable two weeks of your life but easier than I thought it would be. You need to be a bit careful, that’s all. The first two weeks I was able to do all tasks; the only side effect I felt was being cranky and emotional, which my doctor had said I would be and advised me to tell everyone to stay away from me.  “I had no mood swings or outbursts. Unexpectedly, I was more emotional for a couple of days after the harvesting.”

Kisani believes the ability of science to offer succour is amazing. “If this option is available to all women, why not? I feel I have insurance and I hope this helps others make a decision,” she said.

“I think it’s unfortunate that single women cannot freeze their eggs for fertility preservation because they are the people who will really benefit from it,” says Dr Fakih.

“It’s unfortunate to see that [for] someone who has to undergo chemo or radio therapy, we are unable to do anything about it. Today, we have technology that gives very good results. So I think people who are detected with ovarian mass that could be cancer, preserving their eggs — whether married or not — should be allowed. And women who are above 35, and still unmarried, should also be able to preserve fertility,” said Dr Fakih.