As a child, she believed she could have it all. At 33, she faced a tough choice—navigating career ambition and family planning. Ana Alsina shares the journey of fertility preservation in Singapore, the pressures she faced, and the evolving conversation around reproductive choices.
I grew up in an era of “women empowerment,” where the message was loud and clear: women can do it all. My parents wanted to raise strong women—I was one of four daughters—and I grew up believing that I could achieve anything a man could. Equality, not equity, was the goal.
I internalised this idea and shaped my life accordingly, believing that if I worked hard enough, I could have it all.
But as I reached my mid-30s, reality set in. The pressures I face as a woman in the workforce are inherently different from those of my male peers. Many women—myself included—feel the unspoken pressure to climb the corporate ladder quickly, aiming to secure leadership positions before hitting the so-called “fertility cliff.“
By age 37, women have only about 3% of their original egg reserves left, and fertility declines sharply in the late 30s. Yet, this is also the stage when careers typically accelerate, forcing many women into difficult trade-offs.
At the same time, the motherhood penalty—the lasting career impact women face after having children—is well-documented.
A 2023 study from LSE and Princeton found that across the world, 95% of men between the ages of 25 to 54 are employed, compared to only 52% of women. One of the biggest drivers of this gap is motherhood. The study found that 34% of women leave the workforce after their first child, and even a decade later, 14% never return. Those who do often face slower career progression, with many easing back through part-time work before resuming full-time roles.
Knowing this, I feel the urgency to move up as quickly as possible—not just for career growth, but to create more flexibility and security for the future. I don’t want to become part of these statistics; I want to challenge them.
But that’s exactly what makes this decision so daunting.
The Career vs. Family Dilemma
I had a well-crafted plan—married at 30, kids by 32.
But at 32, I wasn’t where I had hoped to be in my career, so I put it off. I blocked out the topic entirely, went into avoidance mode, and focused on work.
At 33, I started questioning myself: Why do I want kids anyway?
Having the space to ask this question is a privilege. In my parents’ generation, having children was expected, almost automatic. Today, my husband and I, like many couples, have the opportunity to be intentional—discussing whether parenthood aligns with our values and lifestyle.
Yet, these conversations can be challenging. Some parents, perhaps well-meaning, dismissed my hesitation as overthinking, while others urged me to act before it was “too late.” Ironically, even among women, there can be judgment when I share that I’ve considered remaining child-free.
If we truly support women’s empowerment, we should also respect different paths to fulfilment—whether that includes children or not. Thoughtful decision-making should be encouraged, not dismissed.
Instead of assuming there’s a “right” choice for everyone, we can create space for open conversations that allow each of us to make informed, intentional decisions about our futures.
A Shift in Perspective
As I wrestled with these questions, I realised that my hesitation wasn’t just about career timing—it was deeply personal.
My parents worked hard to provide for four children—my mother even had to make the difficult decision to work abroad for 12 years, leaving me responsible for my younger sister when she was just three. I was 10.
That experience shaped my perspective in two key ways: it reinforced the importance of financial and career stability, but it also made me deeply aware of the kind of parent I would want to be—present and emotionally available. It wasn’t until much later that I fully understood the weight of the decisions she had to make, and with that understanding came an even greater appreciation for everything she did for us.
After much introspection, I realised that I am leaning toward wanting to build a family. It may not unfold exactly as I once envisioned, but I’m coming to accept that life rarely follows a perfect plan.
Instead of fixating on an ideal timeline, I’m learning to adapt—to make the best decisions with the information I have now, recognising that flexibility is just as important as planning.
Perusing Fertility Preservation in Singapore
At 34, my husband and I decided to proceed with embryo freezing after discussions with our doctor. After three years of marriage, we didn’t want to wait any longer and risk increasing the challenges of conceiving, especially with fertility declining sharply in the late 30s.
Given our medical discussions and personal circumstances, taking action now felt like the right decision for us.
The process took about three weeks. It began a week before menstruation with fertility checks to determine egg quantity, blood tests for STDs and hormone level assessments. There was also mandatory counselling sessions—one for IVF and two for egg freezing (one with a medical provider and one with an external counsellor, as required by Singapore’s regulations).
The counseling sessions were helpful, providing detailed information on what to expect, and prompting key questions to ensure I had thought things through before proceeding.
Watch also: Egg Freezing Explained by a Fertility Specialist | Dr Serene Lim (Obgyn)
On the first day of the cycle, an ultrasound was performed. If all was clear, daily hormone injections began for 9-11 days, with two additional ultrasound check-ins—one around day 5 to monitor progress and another around day 9 to determine readiness for the trigger injection.
The trigger injection was administered 36 hours before the egg retrieval procedure. The injections stimulate the ovaries to produce multiple mature eggs rather than just one during a normal cycle. Extracting all of the eggs in a given cycle does not reduce the total egg count, as the rest would have died naturally during the cycle. Side effects of the injections included headaches, bloating, breast tenderness, and itching or swelling at the injection site.
The procedure itself required just half a day at the hospital. Under sedation, the retrieval took about 20 minutes. Risks included internal bleeding (1 in 50 cases) and ovarian hyperstimulation syndrome (OHSS) (1 in 1,000 cases), though medical advances have minimised these concerns.
Post-procedure, bloating was the most uncomfortable symptom, but staying hydrated and consuming egg whites as well as lean protein helped.
Choosing Between Egg & Embryo Freezing
As a married couple, we discussed egg freezing versus embryo freezing before making a decision. Embryo freezing made the most sense for us, but the choice is deeply personal and depends on individual circumstances.
Embryo freezing is often preferred for couples actively trying to conceive or anticipating IVF, as it provides more clarity on fertility potential and removes the risk of losing eggs during thawing. However, it also comes with legal and ethical considerations—embryos cannot be used without both partners’ consent in the event of separation.
In contrast, egg freezing offers greater independence, making it a more attractive option for single women or those wanting to preserve reproductive choices without immediate commitment. For some, embryo freezing raises ethical concerns around when life begins, making egg freezing a more straightforward choice.
Ultimately, the right approach depends on personal values, future plans, and individual circumstances.
Embryo Freezing Process
Before starting the process, lifestyle and dietary adjustments—such as reducing alcohol and caffeine intake—can help optimise egg quality. However, fertility tests can only assess egg quantity, not quality. Unlike eggs, embryos provide some insight into quality.
Once retrieved, eggs are fertilized using ICSI, and embryos are typically frozen at either day 3 or day 5 (blastocyst stage). By day 5, embryos that have reached the blastocyst stage have a higher chance of survival, as they have begun activating their own genes for growth. However, only about 50% of day 3 embryos develop into blastocysts.
A common question is how many eggs are needed for a successful pregnancy. I was told that 20 eggs provide a good chance for one live birth, meaning multiple cycles may be required.
Embryos and eggs are frozen at -196°C through a process called vitrification and stored in straws. Since all embryos and eggs in a single straw must be thawed together, we opted to freeze good-quality embryos individually to avoid unnecessary thawing of those we might not need. For egg freezing, four eggs are typically stored per straw.
In Singapore, the financial aspect is a significant consideration. Egg freezing costs around SGD 15,000 per cycle, while embryo freezing can go up to SGD 25,000, with additional annual storage fees. I recognise that being able to afford this is a privilege—one that many women may not have. Advances in technology and changing regulations in Singapore have made fertility preservation possible, but access can remain limited for many due to financial constraints.
At my hospital, I was informed that IVF success rates vary by age, with significantly higher chances for younger women. For example, some estimates suggest that for women under 39, the success rate is around 50%, but this declines with age, dropping to around 12% for those over 45. However, individual outcomes depend on various medical factors.
Final Thoughts
Looking back, I see the value in having fertility checks earlier—not as a source of pressure, but as a way to make informed decisions at the right time.
Egg freezing isn’t necessary for everyone, especially given the high cost, but for women in their early 30s who want to explore fertility preservation, it can provide peace of mind. In Singapore, recent regulatory changes now allow elective egg freezing for women aged 21-37, though use of frozen eggs is subject to marriage requirements.
The biggest challenge I faced wasn’t the medical process, but rather the lack of open conversations about this stage of life. Women are willing to talk about motherhood once they’ve had children, but there’s little discussion about the uncertainty that comes before.
If you’re in your 30s and wrestling with these questions, know that you’re not alone. Taking control of your reproductive choices—whether that means having kids, freezing eggs, or deciding to remain child-free—is an empowering act.
The most important thing is making an informed, intentional decision that aligns with your values and the life you want to build.
More from Alsina: http://alsinawrites.com/
