Whether you want to have a child or not, you have heard the notion of the biological clock. The one that rustles and ticks in the ears of women no matter where they are. Even when a woman is not thinking about it, someone else is and will ask, “The clock is ticking, when are you getting a child?”
Yet, with the pressures of career, education, personal growth, and medical conditions, more and more women are choosing to postpone pregnancy. Some have to wait until they find the right partner, others have to wait until they find career stability while others are waiting for the motherly instinct to kick in. They know that they will desire to have a child at some point and rather than leave it all in the hands of fate, some women are opting to freeze their eggs.
While the numbers of women in the Western world undergoing elective egg freezing has increased rapidly over the past few years, in Kenya, the practise is only gaining ground now.
And according to latest research, contrary to what many people believe, women don’t freeze their eggs for career reasons. They freeze them because they need more time to find a suitable partner, to avoid future regret and to prevent engaging in what is termed “panic partnering”.
Egg freezing, also known as oocyte cryopreservation, is a reproductive technology that allows women to preserve their eggs at a younger age in order to increase the chances of having biological children later. This growing trend allows women to prioritise their goals and aspirations without having to sacrifice their ability to have children in the future.
This option, a desire for an increasing number of women has seen Silicon Valley companies like Facebook and Apple add egg freezing as a workplace perk to retain and attract female talent.
The first successful human egg-freezing procedure was reported in 1986 by Dr. Gianpiero D. Palermo, Dr. John K. Parsons, and Dr. Roger L. Gindoff at the Jones Institute for Reproductive Medicine in Norfolk, Virginia. They used a technique called slow freezing to preserve the eggs. Since then, the technology and methods for egg freezing have improved, with the introduction of a faster freezing method called vitrification. Today, egg freezing is widely used for fertility preservation for women who wish to delay childbearing for medical, personal, or professional reasons. We spoke to two Kenyan women who tell us why they decided to freeze their eggs.
Amira Hassan* is 32, an economist, currently pursuing Masters degree in economics
Why I choose to freeze my eggs. Photo | Photosearch
“The first person that I told of the decision to freeze my eggs was a female colleague. We were having lunch one day when I blurted out my plans. I remember the look; of shock and disdain followed by a lengthy talk of why it is haram to do so. I am a Muslim and according to Islamic jurists, the number of eggs frozen must be limited to the required number of implantation, and cannot be donated or use donor sperms. I am, however, okay with these options.
Since my friend’s reaction, I have not gathered the strength to tell anyone else, including my immediate family.
I have requested anonymity because I want to protect myself from further ridicule. When I started entertaining the idea, I was so excited about it that I was going to start a blog and document my journey. But I have decided to go through it, as quietly as possible and talk about it beneath a veil. I am 32 years-old, and a Kenyan student in New Zealand.
If my life’s trajectory had lived to my expectations, by 25, I would have been married with two children and two degrees to boot. I parted ways with my ex-boyfriend weeks after he introduced the subject of marriage.
He had started talking about the possibility of us getting married and I got too excited. I immediately started scouting for locations, and wedding gowns and this drove us apart. I was too eager to get married but the man, although had hinted at it, wasn't ready.
Since then, I immersed myself in studies and as accolades came in, priorities shifted. At 27, I decided that I had goals and aspirations that I wanted to achieve in my career first. I didn't want to feel like I had to rush into having children before I was ready, and I also wanted to make sure that I had a stable and secure financial situation before starting a family.
I have been doing a lot of research on egg freezing and talked to my OB-GYN about the process. She recommended that I see a fertility specialist, who helped me understand the risks and benefits of egg freezing, as well as the costs involved. I was also given a lot of information about the different types of freezing techniques available, and what to expect during the egg retrieval process.
After careful consideration, I decided to go ahead with egg freezing and opted to do it here because I intend to be back after my studies in the next two years. The process itself was relatively straightforward and not too invasive. I had to take a series of hormone injections for about two weeks to stimulate my ovaries, and then I underwent the egg retrieval procedure. The whole process took about a month, and I was back to my normal routine in no time. This happened in October last year and it has given me peace knowing that I have a backup plan when I am ready to have children later in life. With this, I feel like I have paused time in the future. I also feel like I've been able to focus on my career without feeling like I'm running out of time to start a family.
I would recommend egg freezing to other women who are considering it. It's not a decision to be made lightly, but for me, it was the right choice. On matters of cost, so far I have spent Sh600,000, an amount drawn from my savings. I will be paying Sh10,000 per month to the clinic for the egg storage.”
Caroline Njeri*, 34, is a businesswoman running a clothes-selling business in Nairobi. She froze her eggs in 2015 after being diagnosed with cancer and used them in February 2022. She had her baby in November last year
“Seven years ago, two weeks after my 27th birthday, I was diagnosed with breast cancer. It was a shock, to say the least. I had always been healthy and active, and I had never even considered the possibility of getting cancer. But there it was, staring me in the face.
I immediately began treatment, and it was a gruelling process. I had to undergo chemotherapy and radiation, and I lost my hair and my energy. I felt like I was just going through the motions, trying to get through each day.
One day, as I was lying in the hospital bed, I had an epiphany. I realised that I wanted to have children someday and that cancer, going by what my doctor said and online research, might make that impossible. The most viable option I had was egg freezing. The problem was that I had never interacted with a woman who had frozen her eggs or eavesdropped on such a conversation before. I talked to my doctor about it, and she agreed that it was a good idea. She referred me to a fertility clinic, and I began the process of egg freezing with the support of my mother and siblings.
However, the process was not easy. I had to undergo hormone injections to stimulate my ovaries, and also several rounds of monitoring to make sure that my eggs were developing properly. The procedure itself was also very expensive, and it put a strain on my finances and my mother’s as it cost us almost Sh1.5 million for the entire process of retrieval, and storage. There were also sleepless nights when I wondered with whom to use them with and when. When you have undergone such a procedure and have a medical condition like cancer, it is like you are chasing time. But I was determined to do whatever it took to give myself a chance at having children.
When the day came for the egg retrieval procedure. I was nervous, but I knew that this was the last step in the process. I went into the operating room, and the procedure took less than two hours. I was thrilled when I found out that they had retrieved 10 eggs. I knew that this was a good number and that it would give me a good chance at having a baby in the future.
After the egg-freezing procedure, I continued with my cancer treatment. It was still tough, but I felt like I had something to look forward to. I knew that I had given myself a chance at having a family, and that was something that helped me get through the hard times.
In 2021, the cancer went into remission. I was thrilled to have beaten the disease, but I was also relieved that I had taken the steps to preserve my fertility. I knew that I still had a chance at having children, and that was something that gave me hope for the future. I also met my husband, a childhood friend, towards the end of that year and got married after six months. We went back to the fertility clinic, and they thawed my eggs. I underwent IVF, and weeks later, I found out that I was pregnant. Today, I am the mother of a beautiful little girl, and I am so grateful for the decision that I made to freeze my eggs. I know that cancer was a difficult experience, but I also know that it led me to the most precious thing in my life. And for that, I will always be thankful.”
From IVF expert: Dr. Sarita Sukhija, Founder of Myra IVF Centre
Certified IVF Consultant and Fertility Specialist Dr Sarita Sukhija during the interview at Myra IVF Clinic in Westlands Nairobi County Photo | Dennis Onsongo
Dr. Sarita is a gynecologist with a master's degree in biotechnology on Reproduction and Embryology. She has been practicing IVF for close to 15 years.
Egg freezing is a technique used to save a woman’s ability to get pregnant in the future. We say that a woman’s fertility is highest between 22 and 32. After that, the number of eggs starts declining. We are born with about one million eggs. By the time a woman reaches puberty, there are about 30-40 thousand eggs left. A woman will ovulate about 400 times throughout their lifespan-from menstruation to menopause. By egg freezing, we stop the aging process of the eggs which can be used later.
Embryo freezing is when we take the egg of a woman and the sperm of a man, and they are fertilised meaning that the embryo is already made in the lab and frozen. With egg freezing, only the woman is involved and the eggs can later be fertilised with her partner’s eggs or donated sperm.
We do certain basic tests like blood counts, and blood sugar and tests like Anti-Mullerian hormone (AMH) which is a mark for fertility to know her fertility level. Based on that, we decide on the injections. AMH between one and four units is normal. If it is less than one unit, it means we have less time to have the eggs and ensure quality.
We also ask for other tests like hepatitis B, hepatitis C, and HIV to rule out any kind of viral infections which they may have. After this, we do an ultrasound to check the number of eggs and the status of the uterus.
Every fourth to the fifth day of the menstrual cycle, we conduct an ultrasound to see how the eggs are growing. Once they are mature, which takes at least 10 days, we take out her eggs under a short surgical procedure. We have to go through the vagina and extract the eggs. They are handed over in the laboratory and classified as mature or immature. We expect at least 12 eggs from each woman so we have enough eggs to fertilise.
The fertilisation rate of the eggs is 80-85 percent. Sometimes a woman doesn’t have the 12 eggs in the first round, and we must do another round, to get them.
It’s not a guarantee but it is something that you have in hand. Other methods like IVF are also not 100 percent because despite having eggs and sperm sometimes implantation does not happen.
They can be frozen for as long as the woman wants through a procedure called vitrification. If we maintain the liquid nitrogen, which is changed after every 15 days, it can be stored for as long as the woman wants.
I would say up to 37 should be okay. If you haven’t found the right partner at 32 and don’t want a child yet, you should consider egg-freezing. But we still do egg freezing for women who are past 40 if the eggs are viable.
We intend 10 to 15. For younger women, we can get all of them in one round. For older women, especially past 34, we mostly have to do two or three rounds.
The hormonal injection cost Sh100,000 to Sh120,000 for 10 to 11 days. Then we do egg pickup under anaesthesia, which ranges between Sh200,000 to Sh250,000 including the anaesthesia fee and theatre charges. Once we have the eggs, the freezing charges are Sh10,000 per month or Sh100,000 for a year. The storage fee is the same whether it’s an egg, sperm, or embryo.
It is largely women who are between the ages of 35 to 37 who haven’t found a partner, are in long-distance marriages, or cancer patients, Notably, egg freezing is still not very popular in Kenya.
It depends on the insurance company and I only know of two that cover the procedure. Some corporates like Apple and Facebook cover such procedures.
If the stimulation is done carefully, side effects are minimal and include nausea and mood swings. If the eggs are overstimulated, it can cause hyperstimulation syndrome or even blood clots, which can be life-threatening.
Human errors can happen in situations whereby the embryologist does not check the level of the liquid nitrogen when the eggs are dipped. If the liquid goes down and the eggs are exposed, they will not survive.
We give it about two to three hours for them to expand completely before fertilising and transferring to her body.
If a woman no longer wants her eggs to be stored or cannot afford to pay the storage fee, what happens?
At the end of the day, fertility clinic labs are just custodians of the eggs. The client can consent to having their eggs donated or destroyed.
