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Egyptian woman's egg-freeze decision creates debate on taboo subject

A woman's public confession that she had her eggs frozen has shocked Egypt and prompted public debate about an issue rarely discussed in the highly conservative society.
A doctor examines a pregnant woman at a hospital in the province of Fayoum, southwest of Cairo, Egypt February 19, 2019. Picture taken February 19, 2019. REUTERS/Hayam Adel - RC15CBE129E0

Reem Mehanna caused an uproar in mid-August when she announced in a Facebook video that she had frozen her eggs two years earlier. Mehanna, 38, had sought to increase her chances of having children when "I get married after building a career." The video, which went viral in Egypt, sparked wide controversy over an issue considered taboo in a very conservative society.

 Mehanna's revelation also spurred a public debate about the ethics of fertility treatments when not medically necessary in a country where young women face enormous pressure from their parents and relatives to get married and have children before they turn 30. The topic of egg freezing, rarely publicly discussed before, had raised eyebrows when it came up in the TV drama "Sabae Gar" ("Seventh Neighbor"), broadcast last year on the privately owned Egyptian CBC channel. The series drew criticism on social media as Hala, one of the main characters, contemplates preserving her eggs for use when she is better situated to have children, "regardless of whether or not I am married at the time," she tells her doctor. She later proposes to a young man, telling him she needs his help to have a baby.

Despite the backlash provoked by the TV series, Mehanna decided to go public about her decision "to raise awareness about a topic that many young women in Egypt know little about," she told talk show host Amr Adib on his show "Al Hekaya" ("The Story"), broadcast on the privately owned Saudi MBC channel on Sept. 1.

"I did something a couple of years ago that I have kept secret until today. I've now decided to disclose that I froze my eggs. Yes, I froze my eggs because I'm still single," Mehanna confesses in the video. "When I told the doctor that I wanted to undergo the surgical procedure, he was shocked and told me that he had never heard such a request from an Egyptian woman before," she adds before going on to explain the process.

 Mehanna said she got the idea to freeze her eggs from an article on fertility preservation and surrogacy that she had read in a British medical journal more than 15 years ago.

"I was only 20 at the time and decided then that if I were still single by the time I'm 30, I too would freeze my eggs. I had not found a suitable marriage partner yet so when I turned 35, I decided it was time to have the surgery," she told Adib. Mehanna added that she refused to be pressured into getting married for the sake of having a child. "Many girls have done that but have ended up being unhappy in their marriages. We see so many marriages ending in divorce. I will only tie the knot when I meet the right man, someone with whom I can spend the rest of my life."

In the patriarchal society where girls are raised to become wives and mothers, many Egyptian women do not have the privilege of choosing when to get married or even who to marry. Women, especially those in marginalized rural communities, cave to pressure from their families and society for fear of the social stigma associated with remaining single. Many women marry to escape their families' nagging and the gossip of prying neighbors. Others do so to avoid hearing that "the train has passed them by," a disdainful Egyptian phrase commonly used to refer to women who are over 30 and still single. 

The number of unmarried women over the age of 30 is rising in Egypt, according to the national statistics agency. Appearing on the privately owned Al Rahma TV channel in December, polygamy advocate Sayed Ghanem warned, "The 11 million women who have passed the acceptable age of marriage are a ticking time bomb in society." Egypt's National Security Council has also described the growing number of unmarried women as "a threat to the security of the nation." In the conservative society where marriage is the institutional and cultural gateway to societal recognition and sexual activity, many young men are unable to afford the high costs of marriage such as exorbitant wedding expenses, hefty dowries and housing. So acute is the problem that some observers speak of a "marriage crisis." There has also been a spike in divorce rates with the number of cases nearly doubling over the last 10 years from around 100,000 to a record 186,000, according to Minister of Social Solidarity Ghada Wali. She told members of parliament in November that 20% of Egypt's 980,000 marriages each year end in divorce.

Mehanna's announcement was met with mixed reactions from Egyptians on social media. Some praised her decision as "brave" and "inspiring" while others slammed it as against Islamic values. "The Prophet Muhammad advocated early marriage for stability, warmth and affection. You will regret having prioritized your career over marriage," read one critical comment that was later deleted.

The "mixing of lineages" as a result of frozen eggs being deliberately or accidentally switched and "loss of virginity" were some of the concerns cited by opponents of egg-freezing in street interviews conducted by a reporter for Al Hekaya. But Dr. Sherif Basha Seif, a fellow of the UK-based Royal College of Obstetrics and Gynecology and founding director of an in vitro fertilization (IVF) clinic in Mohandessin, dismissed such fears as unfounded. In a phone interview with Al-Monitor, he argued that a woman does not lose her virginity while freezing her eggs. "In cases of unmarried women, we do not extract the eggs via the vagina. To keep the hymen intact, we remove them instead through a tiny incision in one side of the abdomen," he explained.

"In Egypt as in some other Arab countries, egg and sperm donations and surrogacy are forbidden by law so there is absolutely no fear of the mixing of lineages," he added. Under a 2001 law, surrogacy is a crime punishable by a five-year jail sentence.

"A woman who chooses to have her eggs frozen so as not to run out her biological clock can rest assured that the eggs will be safely preserved until she is ready to start a family. It is obligatory for couples to provide doctors with a copy of their marriage certificate before the IVF process can be carried out."

IVF, a process that takes place outside a woman's body, is legal in Egypt and fertility centers or clinics have mushroomed across the country in recent decades. "It has become quite common for young women in their early 30s to freeze their eggs. It happens for social reasons such as late marriage and for medical reasons. In the latter cases, young women suffering from cancer sometimes choose egg freezing before chemotherapy to ensure the eggs are healthy," Seif told Al-Monitor.

The process, however, is restricted to married couples and regulated by a set of strict rules derived from Sharia. For instance, third-party reproduction (sperm, egg or embryo donation) is prohibited in Islam, as is the fertilization of stored eggs after divorce or the death of a male spouse. Eggs must be safely stored, labeled and protected to prevent mix-ups and IVF embryos must be tested before their transfer to the uterus to eliminate the risk of abnormalities and disease and ensure healthy babies. While the above standards were clearly spelled out by Egypt's supreme religious authority Dar Al Ifta earlier this month, some ultra-conservative clerics still reject egg-freezing, insisting it is forbidden.

"While IVF is permissible in Islam as long as the sperm comes from the husband and the eggs from the wife, there is a strict interpretation that prohibits egg and sperm freezing if [done] before marriage, rendering the process haram or religiously forbidden," Dr. Saad El Din Hilaly, professor of Islamic jurisprudence at Al-Azhar University, said in a telephone interview broadcast on MBC's Al Hakeya.

He was referring to Salafi clerics who follow the Hanbali School of thought, a puritanical strain of Islamic jurisprudence. Al-Azhar, the highest religious authority in Sunni Islam, and the majority of Egyptian Muslims follow the Hanafi School of law, the oldest and most liberal of Sunni Islam's four schools of jurisprudence.

"It is only natural for women to want to have children and IVF is an option that allows women who have advanced in age to become mothers despite their reduced fertility," Seif said. He hopes that Mehanna's "pioneering step" and "bold" announcement will empower and encourage other women to follow in her footsteps.

While Mehanna's message is indeed revolutionary, one has to wonder if it can lead to transformative change in such a patriarchal society that is often resistant to change and wary of new ideas. There is also the high cost of IVF (egg freezing costs 30,000 Egyptian pounds [around $2,000], according to Seif) putting the process beyond the means of average Egyptians.

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