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Should Malaysian Muslim Women Undergo Egg Freezing Overseas? – Sayyed Mohamed Muhsin, Dr Che Anuar Che Mohamad & Dr Alexis Heng Boon Chin

Muslim women should see the other side of the coin, and understand Islamic religious principles that ban egg freezing, before making their choice.

A mother with her newborn child. Photo by blankita_ua from Pixabay.

The stresses and complications of modern living have led to an increasing trend of late marriages and delayed motherhood worldwide. This, in turn, has motivated many single women to preserve their fertility by elective egg freezing for non-medical reasons, commonly referred to as social egg freezing.

Singapore will permit the procedure from 2023 onwards. In Malaysia, only non-Muslim women are allowed to freeze their eggs for non-medical reasons, while Muslim women must have a valid medical reason, such as fertility preservation upon undergoing cancer chemotherapy.

Some single Malaysian Muslim women will question the rationale of why they are banned from undergoing social egg freezing in their own country, especially career women who intend to postpone marriage and motherhood responsibilities for the sake of career advancement and lifestyle pursuits.

In the near future, it is anticipated that an increasing number of single Malaysian Muslim women will seek to do social egg freezing in Singapore and other countries.

Elective egg freezing is often promoted by feminists and social libertarians as a means for women to gain freedom and control over their bodies.

Nevertheless, Muslim women should also see the other side of the coin, and understand Islamic religious principles that ban egg freezing, before making their choice.

Social Egg Freezing Is A Controversial Issue In Islam

To date, contradictory fatwas on social egg freezing have been issued in different Muslim countries. On the one hand, a fatwa issued in Egypt in 2019 permits social egg freezing by single women, provided certain conditions pertaining to laboratory standards and clinical practice have been met.

On the other hand, three fatwas issued in Malaysia in 2003, 2015, and 2022 imposed a blanket ban on single Muslim women freezing their unfertilised eggs to be used later in marriage.

The basic underlying principle of these fatwas is that sperm and egg cells produced before marriage should not be used during the period of marriage contract (akad al-nikaḥ) to conceive a child, as this is thought to violate the sanctity of marriage and muddle the legitimacy of the conceived child’s lineage (nasab). 

This is somewhat similar to Shariah injunctions that a child is considered illegitimate (walad al-zina) by default, if the timing of birth occurs less than six months after marriage, as he or she must presumably have been conceived by illicit sexual relations (zina), involving the merging of sperm and egg cells before marriage.   

The latest Malaysian fatwa issued in 2022 further articulates another two additional objections to social egg freezing.

Firstly, the release of female egg cells outside the human body by unmarried women is deemed similar and tantamount to masturbation by a single man (istimna).

Secondly, single women wanting to undergo elective egg freezing due to anticipated late marriage is a matter of conjecture that has not yet occurred, rather than certainty.

In principle, Shariah must be grounded in certainty and cannot be based on mere conjecture, unless in an emergency situation or dire need, such as in the case of female cancer patients undergoing chemotherapy that might destroy their future fertility.

Muslims must note that variations in issued fatwas do not represent an aberration. Instead, fatwas should be viewed as intrinsically flexible, changing to accommodate different times, places, peoples, and local cultures. 

Therefore, fatwas issued in Malaysia inherently uphold the welfare and interests (maslahah) of the Muslim community in Malaysia, based on local conditions and culture. 

Avoiding religious bans on social egg freezing by moving to another country is thus not appropriate behaviour for a sincere Muslim.

Menopause Is Naturally Programmed In Women, And Likely A Part Of God’s Grand Design

Previously, menopause in women was widely thought to be a form of disease. However, in recent times, there is an increasingly accepted scientific viewpoint that the menopause is, in fact, naturally programmed in women as an intrinsic part of their normal life cycle.

Indeed, very few mammalian species are known to undergo menopause, including humans, orcas, and short-finned pilot whales, all of which are intelligent social organisms that live in family groups.

Scientists have long been puzzled as to why the females of these species lose the ability to have children but continue living for decades after.

A popular secular scientific theory is the “Grandmother Hypothesis”, which posits that menopause evolved in women to extend their lifespans, so that they can contribute to the upbringing of their grandchildren and pass down accumulated cultural wisdom and traditions as respected elders, which in turn enhance the survival prospects of their extended family or tribe.

A Muslim viewpoint and Islamic perspective on such a secular hypothesis would instead posit that Allah is being most merciful and gracious in extending women’s lifespan with menopause, knowing that childbirth takes such a heavy toll on the female body, particularly for older women.

By deliberately sparing older women from the pains and risks of pregnancy and childbirth through menopause, God wisely ensures surviving female elders within the extended family who can help take care of young children and pass down their cultural heritage to the next generation.

Hence, social egg freezing to facilitate late motherhood would be seen as tampering with nature’s or God’s finely tuned and intelligent blueprint for humanity.

It may also cause avoidable harm to them such as medical risks and potential loss of the chance of motherhood, while Islamic principles would instead favour the elimination of potential harms. 

Evaluation Of Social Egg Freezing Based On Islamic Legal Maxims (Qawaid Fiqhiyyah)

To further resolve conflicting opinions, it is best to critically examine whether social egg freezing is aligned with Islamic principles based on Qawaid Fiqhiyyah (Islamic Legal Maxims) that incorporates Qaṣd (intention), Yaqin (certainty), Ḍarar (injury), Darurah (necessity), and Urf (local customs).

This is often used as a roadmap in debates on Islamic bioethics, which usually requires an independent or original interpretation of new issues (Ijtihād) that are not explicitly mentioned by the Quran and Hadiths (prophetic traditions).

The first legal maxim related to Qaṣd (intention), refers to evaluating new medical technologies based on the goals and objectives of its applications.

Elective egg freezing to deliberately postpone marriage and motherhood responsibilities for the sake of career advancement and lifestyle pursuits, seems to contradict the following Hadith associated with the Prophet’s son-in-law Ali bin Abi Talib (Narrated by al-Tirmizi 171 and Ahmad 843), which recorded the Prophet as saying, “O Ali, do not delay in three things. Prayer when time is due, funeral for the deceased, and marriage of a daughter when you find an eligible suitor”. 

Additionally, there are conflicts with priorities set by Shariah, because motherhood and nurturing children are considered far more meritorious for women than chasing their dreams of career advancement, lifestyle pursuits, and other materialistic goals.

The second legal maxim related to Yaqin (certainty) within the context of Islamic bioethics, refers to the current state of scientific knowledge and evidence of the safety and effectiveness of new medical techniques.

Currently, the success of egg freezing is relatively low. Even with the latest ice-free vitrification technology, the success rate does not exceed 2 to 12 per cent per frozen egg, as reported by the American Society of Reproductive Medicine (ASRM).

To date, the pregnancy success rates with frozen eggs are still much lower than that of fresh eggs.

Hence, egg freezing is not a guaranteed path to motherhood, and there is a risk that women undergoing egg freezing may lose the chance of motherhood altogether.

The majority of single women who freeze their eggs do so in their late 30s and early 40s, when the quality of their eggs has decreased significantly.

The high costs of egg cell freezing tend to deter younger women from freezing their eggs. When they do freeze at an older age, their egg quality would have greatly declined, thus compromising their chances of reproductive success.

The third legal maxim related to Dharar (harm) questions the risks of potential harms associated with new medical techniques. With egg freezing, there are potential harms associated with medical risks, as well as sociological issues.

Older women using their own frozen eggs are at higher risks of medical complications during pregnancy. Additional medical risks involve ovarian hyperstimulation syndrome (OHS), in which the body overreacts to hormones injected during the ovarian stimulation process, causing severe bloating, difficulty in breathing, and abdominal pain.

Severe OHS can be life-threatening, although it is rare. Moreover, day surgery for egg extraction is an invasive procedure that carries a small risk of bleeding and infection. Hence, elective egg freezing for non-medical reasons is contrary to the Islamic principle of “avoiding harm is better than achieving benefits in medical treatment (tadawi)”.

There are also potentially harmful sociological effects of social egg freezing. The option of freezing eggs without a reasonable and valid medical reason is anticipated to encourage many single Muslim career women to postpone marriage and childbirth.

Therefore, the wanton use of this technique without restrictions will likely exacerbate the trend of late marriages and delayed motherhood among highly educated women within the urban Muslim community. 

This is not a trivial issue, considering that the fertility rate in Malaysia has fallen below replacement level, resulting in an ageing society with dire economic consequences.

In addition, aggressive advertising and marketing by fertility clinics may be confusing and give the wrong impression that elective egg freezing is a guaranteed alternative pathway to future motherhood.

This can lead to much future disappointment if patients fail to conceive with their frozen eggs. Hence, patients should rightly be informed of the lower chances of IVF success with frozen versus fresh eggs.

Moreover, older women who had conceived with their frozen eggs may be less able to cope with the physical demands and rigors of motherhood compared to younger women.

The fourth legal maxim related to Dharurah (necessity), questions the necessity of using new medical techniques, and whether there are other alternatives available.

Without a strong medical justification such as cancer treatment that can cause infertility, it is highly questionable whether elective egg freezing for women who deliberately want to postpone marriage and motherhood is really necessary. 

An Australian study estimated that at best, only one in five women will eventually use their frozen eggs. Hence, there is a high level of wastage, which in turn casts doubts on the necessity of the procedure.

Some foreign IVF clinics may encourage and even offer payment for donation of unused frozen eggs to other patients, which would contravene Shariah injunctions against sperm and egg donation, as this would lead to muddling of lineage (nasab).

The fifth legal maxim related to Urf (local customs), refers to taking into account local customs and traditions (if they are compatible with Shariah), when deciding on any new issues, such as novel medical techniques.

Elective egg freezing for non-medical reasons, may be contrary to conservative social norms and values of the local Muslim community. 

Unless she is among the few or the only person who offers a highly critical speciality to her community (such as a sports star representing her country in international competitions), it would be considered selfish for single women to use this technology to deliberately delay marriage and childbirth, so as to focus on career advancement and lifestyle pursuits.

In conclusion, in addition to valid reasons mentioned by the aforementioned fatwas issued in Malaysia, closer introspection and critical analysis based on Qawaid Fiqhiyyah (Islamic Legal Maxims), affirms that elective egg freezing by single and healthy Muslim women for non-medical reasons is not aligned with Islamic principles and social norms of the local Muslim community.

Sayyed Mohamed Muhsin is an assistant professor in Islamic jurisprudence at International Islamic University Malaysia, Dr Che Anuar Che Mohamad is an assistant professor in the Faculty of Pharmacy at International Islamic University Malaysia, and Dr Alexis Heng Boon Chin, originally from Singapore, is an associate professor of biomedical science at Peking University, China.

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of Ova.

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