Social egg preservation alternatively referred to as elective or non-medical egg freezing, involves the process of extracting, cryopreserving, and storing a woman's eggs with the intent of safeguarding her fertility for non-medical reasons in the future. Egg freezing technology was initially designed to preserve fertility for women undergoing medical treatments that could impair it, such as chemotherapy or radiation therapy. However, social egg freezing has become increasingly popular among women who wish to postpone childbearing for personal or professional reasons.

Various factors influence the decision to undergo social egg freezing, such as career aspirations, education, financial security, relationship dynamics, and personal inclinations. Women opting for social egg freezing view it as a way to assert reproductive control and preserve the possibility of having genetically related children later in life when they feel more established or prepared for parenthood. Technological advancements in egg freezing methods and enhanced knowledge of fertility preservation have fuelled the increasing acceptance and prevalence of social egg freezing.

Egg Freezing Method:

The method of cryopreserving eggs is quite similar to IVF. A woman receives hormonal injections to stimulate the production of multiple eggs per month. The eggs are extracted from the ovaries through a minor surgical procedure. The eggs are then cryopreserved and safeguarded in the laboratory for future use. These eggs can remain viable for fertilization for up to a decade after freezing.

Criticism of Social Egg Freezing:

Social egg freezing has garnered criticism due to ethical, social, and practical issues. Critics argue that portraying social egg freezing as a 'fertility insurance policy' can create a false sense of security. It may perpetuate the misconception that fertility preservation ensures future reproductive success. Egg freezing does not ensure the success of pregnancy or the delivery of a live child. Age, egg quality, and underlying reproductive health issues significantly impact the outcomes of fertility treatments using frozen eggs.

The commercialization of social egg freezing has ignited controversies regarding access, affordability, and fairness in reproductive healthcare. The substantial cost of social egg freezing, encompassing egg retrieval, storage, and future fertility treatments, can create a financial barrier for many women, especially those facing socioeconomic disadvantages. This discrepancy in accessibility to fertility preservation options widens existing socioeconomic disparities and restricts reproductive autonomy for certain population groups.

Additionally, the focus on delaying childbearing via social egg freezing may neglect the wider societal factors that exacerbate the 'fertility dilemma' for women, including insufficient support for work-life harmony, a dearth of affordable childcare, and societal pressures regarding motherhood and career progression. While social egg freezing provides a technological remedy for the biological limitations of female fertility, it fails to tackle the systemic obstacles and social inequities that influence women's reproductive choices and experiences.

Egg freezing, like other assisted reproductive technology (ART) procedures, entails certain risks. It can provide women with an unwarranted sense of optimism. Though perceived as a backup plan, egg freezing does not guarantee pregnancy. Frozen eggs remain vulnerable to damage during the cryopreservation process, potentially requiring additional IVF or alternative conception methods. While infrequent, frozen eggs face the possibility of contamination during cryopreservation. Rarely, complications during egg retrieval can result in blood vessel rupture or bowel damage.

Religious perspectives on social egg freezing diverge across faith traditions and interpretations. Some religious authorities support social egg freezing as a way to safeguard fertility within marriage and family life, especially when it does not interfere with natural conception. Others raise concerns about the sanctity of life, the modification of reproductive processes, and potential impacts on family structures and relationships.

Offences and Penalties:

According to Section 33 of the Assisted Reproductive Technology (Regulation) Act, 2021:

No medical geneticist, gynaecologist, registered medical practitioner, or any individual shall engage in the following prohibited acts:

• Abandoning, disowning, or exploiting a child born through assisted reproductive technology.
• Selling human embryos or gametes or operating an organization for such transactions.
• Importing or facilitating the importation of human embryos or gametes.
• Taking advantage of the commissioning couple, female individual, or sperm/egg donor.
• Transferring a human embryo into a male or animal.
• Selling human embryos or gametes for research purposes.
• Using intermediaries to obtain or purchase gamete donors.

Violation of any of the prohibitions listed in clauses (a) to (g) of subsection (1) shall result in the following penalties:

• For the first offense: A fine of not less than five lakh rupees but not exceeding ten lakh rupees.
• For subsequent offenses: Imprisonment for not less than three years but not exceeding eight years, and a fine of not less than ten lakh rupees but not exceeding twenty lakh rupees.

According to Section 34, if an individual violates any provision of this Act or any rules established under it, and no specific punishment is prescribed for such violation, they shall be subject to the penalty outlined in Section 33(2). The offences under this Act are cognizable and bailable.

No clinic, bank, or agent shall engage in any form of advertising, including online, related to facilities for sex-selective assisted reproductive technology. Any person who violates the provisions of (a) shall face imprisonment for a minimum of five years, potentially extending to ten years, and/or a fine ranging from ten lakh rupees to twenty-five lakh rupees (Section 32).

If a clinic or bank commits an offense under this Act, its executive head is considered guilty and subject to prosecution and punishment unless they demonstrate that the offense occurred without their knowledge or that they took all reasonable steps to prevent it. If an offense under this Act is committed by a clinic or bank and it is established that the offense occurred with the consent, connivance, or negligence of an officer other than the executive head, that officer will also be held guilty and subject to prosecution and punishment accordingly (Section 37).

No court shall have jurisdiction over any offense punishable under this Act unless a complaint is filed by the National Board, the State Board, or an officer authorized by them. No court with a lower jurisdiction than that of a Metropolitan Magistrate or a Judicial Magistrate of the first class shall have the authority to adjudicate any offense under this Act.

Global Laws about Social Egg Freezing:
The legal landscape for social egg freezing varies widely from country to country. In many jurisdictions, egg freezing regulations prioritize medical applications, such as preserving fertility for individuals facing cancer treatment or other fertility-threatening procedures. Laws addressing social egg freezing for non-medical purposes are relatively uncommon and generally less detailed.

In jurisdictions where social egg freezing is allowed, regulations may encompass matters regarding informed consent, age constraints, storage limitations, and the reproductive utilization of frozen eggs. Certain jurisdictions impose counselling or educational sessions for individuals contemplating social egg freezing to ensure their comprehension of the procedure's potential risks, constraints, and outcomes.

Furthermore, laws governing assisted reproduction, parental lineage, and donor fertilization may converge with regulations on elective egg freezing, impacting matters of parental responsibilities, inheritance, and the legal standing of offspring conceived through frozen eggs. With the increasing popularity of elective egg freezing, legal frameworks are likely to adapt to accommodate the emerging ethical, societal, and technological complexities posed by this practice.

Ethical and Medical Considerations:
The ethical and medical ramifications of elective social egg freezing present a complex and nuanced landscape. Ethically, the choice to engage in social egg freezing poses inquiries regarding reproductive autonomy, adequate consent, and the commercialization of fertility. While some perceive it as a tool to empower individuals in shaping their reproductive destinies, others raise concerns about societal pressures to postpone childbearing, the potential for false expectations, and disparities in access to fertility preservation technologies.

Medical advancements have enhanced egg freezing techniques, resulting in higher success rates and improved safety profiles. Despite advancements, the procedure carries risks, including ovarian hyperstimulation syndrome and potential complications during egg retrieval. While frozen eggs can be utilized for IVF treatments, success rates diminish with increasing age and are influenced by individual factors like egg quality and reproductive health conditions.

The ethical and medical acceptability of social egg freezing depends on individual circumstances, perspectives, and priorities. Prospective social egg freezing patients should carefully consider the potential benefits and drawbacks. Seeking thorough medical guidance and counselling is crucial to making informed choices that align with personal objectives and values.

Islamic View on Social Egg Freezing:
Islamic perspectives on social egg freezing vary among scholars and religious authorities, who emphasize the sanctity of life, natural processes, and lineage preservation within marriage.

Some Islamic scholars consider social egg freezing acceptable under specific conditions, such as preserving fertility within marriage or for justifiable medical reasons that do not bypass natural conception. However, concerns include reproductive manipulation, health risks, and ethical issues related to separating procreation from marital relationships.

Islamic teachings prioritize responsible parenthood, child welfare, and society's well-being, necessitating thoughtful decisions about social egg freezing that balance ethical principles, personal circumstances, and societal considerations. Seeking guidance from knowledgeable religious authorities is crucial in making informed decisions about social egg freezing from an Islamic perspective.

Prof. Sirour, an expert in Islamic law, opines that freezing eggs for women seeking future partners is permissible without ethical concerns. However, fertilization of eggs requires sperm from the husband of the woman using them, within a legal and valid marriage contract. Egg donation is strongly discouraged, and eggs should be utilized by the patient who produced them. He recommended that pregnancy not be delayed beyond the age of 45, as this increases the risk of complications for the woman.

Dar Al-Ifta, an Islamic Jurist, has declared egg-freezing permissible under specific conditions. Egg-freezing is allowed in Islam if done within the confines of a future marriage.

The four requirements for egg-freezing permissibility include:

• Fertilization of eggs with the husband's sperm is only permissible within the marriage union, excluding instances of divorce or the husband's passing.
• Fertilized eggs must be meticulously protected, ensuring strict separation from other preserved eggs to prevent both deliberate and unintentional cross-contamination.
• A fertilized egg must not be implanted into the uterus of a woman who did not initially produce it. Egg donation is prohibited.
• Egg freezing should be conducted with utmost caution to prevent the potential negative consequences on the foetus resulting from exposure to various factors during the procedure, such as those that could lead to birth defects or cognitive impairments in the future.

Dar Al-Ifta's Fatwa affirms the Islamic principle that assisted reproductive technology is permitted, particularly when the sperm and egg originate from the married couple exclusively. Consequently, surrogacy is prohibited under the Sunni school of thought due to the involvement of a third party. Iran stands as an exception among Muslim nations, permitting surrogacy along with the donation of eggs, sperm, and embryos.

Written By: Md.Imran Wahab, IPS, IGP, Provisioning, West Bengal
Email: [email protected], Ph no: 9836576565