We have all heard horror stories about relatives and friends of recently married couples throwing in the “baby question” or taking a sneaky glance at a mid-riff to check for any signs of expansion.
While this can put immense pressure on a couple and make for a very awkward atmosphere, the sense of obligation to fulfil the mitzvah of “peru u’revu” (“Be fruitful and multiply”) is not just restricted to couples but can be felt equally – or sometimes more so – by single people, whether or not they actually want children.
Over the last couple of decades, more and more single women, some of whom haven’t found the right partner to start a family with, or who aren’t at the right time in their life, have been turning to egg freezing in a bid to keep their childbearing options open. This is a process whereby eggs are collected and frozen before being thawed at a future date to be fertilised.
For some women, the decision to freeze their eggs might be because they are about to undergo cancer treatment, which could affect their fertility.
In the Jewish community, it is only recently that fertility support organisations, such as Chana, have been starting to talk more openly about egg freezing in an effort to break down the taboo.
The Hendon-based charity, which recently held an evening titled Empowering Your Future: Fertility Awareness for Single Women, provides six sessions of emotional support that can be used by women at any point duing their egg freezing journey.
They also offer halachic guidance from their rabbinic panel, in case women have any questions about the relationship between egg freezing and Jewish law.
Rebbetzin Aviva Zobin, who is the ma’ayan (educator with expertise in women’s health) at Hendon’s Ner Yisrael community, says that, in principle, halachah (Jewish law) holds a positive view on egg freezing for the preservation of future fertility.
“The procedure of egg freezing through hormonal stimulation, and subsequent fertilisation through IVF, is low risk, and thus does not cross the halachic threshold which might restrict risky elective procedures.
“Moreover, whilst undertaking the procedure is not deemed an obligation under the rubric of the mitzvah of peru u’revu, clearly the motivation is positive – that of building a family.”
Rebbetzin Aviva Zobin, ma'ayan at Ner Yisrael Synagogue, who advises on issues connected to women's health, including fertility
However, the timings of retrieval and freezing of the eggs may have halachic significance, she says, explaining that when appointments, treatments and self-administration of injections fall on Shabbat or Yomim Tovim, guidance should be sought from a rabbi or rebbetzin to ensure the smooth management of these different commitments.
When the frozen eggs arrive at the laboratory, Jewish women can request to have a laboratory trained shomer present as a safeguarding measure to witness the process and ensure their eggs don’t get mixed up with someone else’s, she says.
Eggs which are deemed viable after thawing can be fertilised through a process called intracytoplasmic sperm injection (ICSI), in the hope that they will develop into embryos. These can either be transferred into the uterus or frozen for future use. “On many levels, including Jewish family values, this is optimally in the context of marriage, with the husband’s sperm used for fertilisation,” says Rebbetzin Zobin.
Sometimes, however, more complex scenarios need to be considered, such as cases of male infertility (where donor sperm may need to be used), surrogacy, or where one wishes to donate excess eggs for someone else’s treatment.
When considering these options, which can “come with a variety of complications, whether emotional, sociological, or halachic”, Rebbetzin Zobin encourages women to seek guidance from their rabbi, rebbetzin or the Beth Din.
While the destruction of excess frozen eggs, or their donation to fertility research or training is allowed, there is more halachic debate over destroying unused embryos, so it is also recommended that guidance is sought regarding this matter.
In 2016, 178 women in the UK had treatment using their own thawed eggs, with a birth rate of 18 per cent, significantly lower than the 26 per cent birth rate for women having IVF with their own eggs, according to the Human Fertilisation and Embryology Authority (HFEA).
The whole process is also expensive, with the HFEA estimating it mounting up to an average of £7,000 to £8,000.
The birth rate from egg freezing for women using their own eggs is about 18 per cent, according to HFEA statistics from 2016 (Photo: Getty Images)
Sarah (not her real name) spoke at the Chana event to shed light on her own experience of egg freezing when she was a single 34-year-old.
Two years down the line, she says she has no regrets about going through with the treatment and that she is determined to destigmatise the topic among single women who might feel ashamed or uncomfortable speaking about their fertility.
“It’s a pretty personal thing,” she says. “People don’t necessarily want to investigate it because it’s always easier in every situation to bury your head in the sand and think: ‘Oh, I’ve still got time, and it’s invasive.’
“It’s tough, let’s not sugarcoat it. It’s a tough few weeks, but once you’ve done it, it’s great.”
On the brink of turning 35 when she began the treatment, she told her family, who were “extremely supportive in numerous ways”, but she chose not to tell her friends of her decision.
“I did not really talk about it because most of my friends are married, and I really felt they wouldn’t have understood what this was all about.”
Even though it would have been helpful to have their support throughout the process – whether that would have been driving her to hospital or helping her administer her medicine – she didn’t feel as if they had enough information about the topic to truly be there for her.
That’s why Sarah is being such so vocal about egg freezing now: to be a supportive figure for other single Jewish women who don’t feel like they have anyone to go to for advice in such a family-centric community.
For Sarah, it is crucial that the topic is destigmatised because otherwise, she fears, women will be too scared to consider treatment and may miss the chance to start a family should they want to. Fertility clinics recommend that women who wish to freeze their eggs do so in their 20s or early 30s as egg quality starts to decline more rapidly after 35.
“It shouldn’t be a taboo; it shouldn’t be something that’s not spoken about and brushed under the carpet,” she says. “It should be encouraged, and knowledge is power at the end of the day. It would be terrible to get into a situation where you turn around in three years and think: ‘I wish I had done that.’”
Despite the possible advantages of egg freezing, going through the treatment can take its toll, both physically and emotionally. The process takes typically two weeks and involves 10 to 12 days of self-administered injections to stimulate the ovaries, causing the follicles to produce multiple mature eggs during a cycle.
During this time, Sarah had to travel into central London around every other day to be monitored by her doctor with ultrasound scans and blood tests.
A keen athlete, her fitness routine had to take a back seat, as running too fast or lifting too heavy a weight in the gym might have put her reproductive system under more stress.
When the eggs are ready for collection, women are put under sedation while the doctor uses a transvaginal ultrasound probe with a needle to extract the fluid inside the follicles, which contains the eggs.
“I would say this is the easiest part of the process because you’ve done all the hard work, and now there’s nothing left for you to do. You just have the best sleep of your life,” recalls Sarah.
Once the egg collection is complete, the embryologists in the lab will report on how many mature eggs are ready to be frozen. These can then be frozen for up to 55 years if you renew your consent to storage every 10 years.
Despite having no regrets about the process, Sarah acknowledges that going through it alone can be tough. “When a single person like me does it, it’s almost like a slap in the face,” she says. “Not only have I not found my partner, but I also have to then go through this because one’s biological clock keeps ticking, and time doesn’t stop for anyone.”
Now that Sarah has successfully managed to freeze her eggs, it has become easier to drown out the judgement of others. “I believe I’m exactly where I need to be right now, and the more I remind myself of that, the calmer I am in myself and my inner being,” she says.
“It will happen when it happens. And until then, I’m okay. I think it’s everyone else around you that worries.”
For more information about Chana, click here