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Eggs on Ice: The Legal Landscape of Oocyte Cryopreservation in Jurisdictions Around the World
15 1月 2025
(This article was published in the January 2025 Issue of the Hong Kong Lawyer)
Egg freezing has become more mainstream in the post-pandemic era. Weddings were postponed along with pregnancies during the pandemic years and this has been significant for millions of women in their prime childbearing years. A report in the US National Library of Medicine stated that females are born with a finite, lifetime supply of approximately 1-2 million oocytes (immature eggs); by the time a woman reaches the age of 51 (the average age for menopause), her eggs have decreased in both quality and quantity, with approximately one thousand eggs left. Freezing high quality eggs during the prime childbearing years for later use is now considered practical when one is not quite ready for pregnancy and childbirth.
Some US companies have offered egg freezing as an employee benefit for over a decade now. The Guardian reported as early as 2014 that Silicon Valley companies were covering egg freezing costs for their employees, in a push to attract and retain top female talent. A Yale University study published in 2018 on egg freezing found that 85 percent of the women were single, with many of them reporting not having suitable partners. There are a myriad of reasons why women may not be ready for pregnancy or childbirth, including career aspirations, family situations, financial considerations, personal circumstances and health conditions.
Egg freezing for reasons other than purely health conditions is known as egg freezing for generic ”social reasons”.
Jurisdictional Variations and Legal Considerations
Not every jurisdiction allows oocyte cryopreservation (egg freezing) to be done for social reasons (i.e., non health conditions) without restrictions. Here is a review of the legal landscape in a number of jurisdictions:
Australia offers a liberal legal regime for egg freezing, allowing the procedure for social reasons. In fact it was the first country to produce a live birth from frozen eggs, in 1984. There are no specific age restrictions, but women are encouraged to freeze their eggs before the age of 35 to optimise success for later live birth(s). The storage limit depends upon state legislation and is generally 10 years in states like New South Wales and Victoria. The Assisted Reproductive Treatment Act 2008 (Section 31A) in Victoria allows its Patient Review Panel to extend the 10 year storage period for eggs and sperm if reasonable grounds are given or if the panel considers there are exceptional circumstances. The Human Reproductive Technology Act 1991 also provides for a storage period of 10 years in Western Australia, with extensions allowed for “special reasons”. Costs also vary by state, but some health insurance plans may provide coverage for a portion of the expenses.
In Canada, the Assisted Human Reproduction Act governs assisted human reproduction technologies, which encompasses egg freezing. Health Canada’s Guidance Document on the Safety of Sperm and Ova Regulations allows eggs to be stored for up to 10 years. There are no restrictions on age or marital status, although some clinics do not provide services to non-Canadian citizens. Social egg freezing (termed elective egg freezing) is not covered by governmental healthcare.
France only recently legalized social egg freezing for all women between the ages of 29 and 37 regardless of marital status or sexual orientation, via the French Public Health Code Article L2141. Although this liberalisation allowed women more autonomy over their reproductive choices, critics decry the reality of the situation since egg freezing is prohibited in the private sector and there could be a wait in the public health system of over two years just for the initial doctor’s appointment. This effectively denies women over the age of 35 the right to egg freezing and is despite the fact that Le Monde reported in 2022 that one in every four couples of childbearing age in France suffers from infertility issues.
In the Hong Kong SAR, there are no age restrictions on egg freezing; however, a woman must be legally married to have the eggs fertilised using IVF pursuant to the Code of Practice on Reproductive Technology & Embryo Research. Since same sex marriage is not yet legally recognised in Hong Kong, women in same sex marriages and single women are unable to access post egg freezing services leading to live pregnancies. The Human Reproductive Technology Ordinance established the Council on Human Reproductive Technology, which oversees the now outdated 2002 code of practice. Frozen eggs can be stored for up to 10 years, and since women are advised to freeze their eggs before the age of 35 due to declining egg quality, this storage limit tries to cap potential pregnancies at age 45. This legal framework illustrates the complex intersection between restrictive marriage laws and reproductive rights in Hong Kong.
Ireland’s Health (Assisted Human Reproduction) Act 2024 was signed by its President on 2 July 2024. There are no restrictions on social egg freezing although it must be privately funded. Where medical treatments have affected fertility, public healthcare may cover egg-freezing costs. Eggs may be stored for a maximum of 10 years, following which new consent must be obtained for any extension. The Assisted Human Reproduction Regulatory Authority has the authority to consider and determine applications for extensions of storage.
In 2023, Singapore’s Healthcare Services Act 2020 which governs assisted reproductive services liberalised egg freezing for social reasons pursuant to the Healthcare Services (Assisted Reproductive Service) Regulation 2023, but only for women from the ages of 21 to below 38 years. However, where egg freezing is not done for social reasons, a woman must be legally married and her husband must consent to the procedure, again representing very conservative societal values. Social egg freezing is not covered under the country’s Medisave, the mandatory medical savings account that all working citizens and permanent residents contribute to, although other reproductive services may be covered.
Spain has had a progressive approach to reproductive technologies since 2006. Assisted Reproductive Technology Law 14/2006 allows egg freezing for social reasons without age restrictions and without time limits. The legal framework supports women’s rights to make reproductive choices, making Spain one of Europe’s most popular destinations for egg freezing. However, social egg freezing is not covered for citizens under the government healthcare system and must be privately funded.
In the United Kingdom, women are able to freeze their eggs for social reasons. The Human Fertilisation and Embryology Act 1990 regulates the practice, and women can store their eggs for up to 10 years and renew consent for each successive period of 10 years up to a maximum of 55 years. While there are no specific age restrictions, the Human Fertilisation and Embryology Authority in the UK advises that women under 38 years of age are generally able to freeze 7-14 eggs. However, access to public funding for egg freezing is reserved for those facing medical treatment that could affect fertility, with the criteria varying between England, Northern Ireland, Scotland and Wales. Social freezing must be privately funded and it is not subject to any price regulations.
Each state regulates egg freezing in the US. In New York state, liberal laws allow egg freezing for social reasons without age restrictions and regardless of marital status. Pursuant to the colloquial “IVF law”, Insurers are required by law to cover egg freezing if deemed medically necessary (and three cycles of IVF following egg freezing).
Other Considerations
Cost may be a significant factor in the decision to freeze eggs. The entire process – from initial consultation to pre-treatment testing, ovarian stimulation, trigger injection, monitoring, oocyte retrieval, oocyte assessment to cryopreservation plus subsequent storage fees can often be costly. The financial burden can be considerable, and in many if not most jurisdictions, social egg freezing is not covered under public healthcare or reimbursable under private insurance plans. “Venue shopping” is becoming more and more popular in order to undergo the procedure in jurisdictions with lower costs, high safety standards and ultimately, high success rates in oocyte thawing.
Conclusion
The legal aspects of egg freezing vary significantly across jurisdictions, which should guide women’s decisions about when and where to undergo the procedure. It is crucial to understand these differences alongside other important factors such as costs, clinical success rates, available support systems and the accessibility of ongoing assisted reproductive technology services (e.g., in-vitro fertilisation, surrogacy) including the specific laws governing them. This comprehensive understanding is important for those considering egg freezing as part of their reproductive plans.
Disclaimer: This article is for reference only. Nothing herein shall be construed as Hong Kong legal advice or any legal advice for that matter to any person. Oldham, Li & Nie shall not be held liable for any loss and/or damage incurred by any person acting as a result of the materials contained in this article.
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