Illustration by Jaimee Haddad.
BEIRUT — “My mom was in tears throughout the whole process, telling me I should have settled for any of the grooms who had proposed to me for the chance to have kids ‘naturally,’” Luna Dawoud says with a laugh. “When I turned 36 and saw no prospective partner in sight, I decided to start looking into egg freezing.”
Oocyte cryopreservation, also known as egg freezing, is a medical procedure where eggs are collected from a woman’s ovaries and preserved so she can have children later, without worrying about fertility issues.
Dawoud, a Lebanese digital marketing consultant from Tripoli, now based in Dubai, told L’Orient Today this was one of the “best decisions” she has ever made — despite the emotional challenges.
She is one of many women who have decided to do the procedure in Lebanon, where the medical practices and cheaper prices attract the Lebanese diaspora as well as medical tourists from the wider Middle East.
Lebanon’s critical economic situation — deemed as one of the worst since the mid-19th century by the World Bank — and the tense security situation, exacerbated by the ongoing fighting between Hezbollah and Israel, seem to have little effect on the country’s draw as a destination for women who want to freeze their eggs.
Lebanon is a regional hub for egg-freezing
Leading one of the primary fertility and egg-freezing centers in Lebanon, Al Hadi Medical Center, obstetrician and gynecologist Dr. Chadi Fakih explains that cost and greater flexibility in how the procedure is conducted are among the main reasons why women from other countries will make the journey.
Lebanon is a key destination for egg freezing in the region, especially for women from Iraq and Syria, Fakih says. He even has women from Zambia and some countries in Europe visit him for the procedure, which costs around $1,500 in Lebanon and could reach up to $10,000 in countries like Spain, where insurance often only applies to cancer patients undergoing chemotherapy.
Obstetrician and Gynecologist Doctor Chadi Fakih at one of the labs at Al Hadi Medical Center, a fertility and egg-freezing center in Lebanon. (Credit: João Sousa/L'Orient Today)
One of the reasons for this price difference, Fakih explains, could be the number of fertilized eggs re-inserted into a woman’s uterus. He says that in France it is illegal to insert more than one embryo at a time, while in Lebanon two can be inserted simultaneously. “This flexibility reduces costs and minimizes the psychological burden of multiple procedures.”
However, according to the American Society for Reproductive Medicine (ASRM) and Society for Assisted Reproductive Technology (SART), placing multiple embryos at the same time can cause health issues for the mother such as high blood pressure, diabetes, and possible delivery complications, as well as complications for the babies such as preterm delivery, low birth weight, delayed lung development, and neurological issues.
A woman releases one egg per menstrual cycle every month. Dr. Fakih claims that the decision to place multiple eggs in the uterus depends on the “health of the mother and the quality of the embryos, so it’s a case-by-case situation and the doctor assesses the number of embryos placed before the procedure.”
The majority — 73 percent — of Dr Faikh’s patients had their eggs frozen to lengthen the time they could wait before having children, the doctor explained, while 27 percent froze them for medical reasons. A woman’s fertility tends to decrease after age 34 and it’s around this age that the majority of his patients visit him for the procedure.
His clinic, located in the southern suburbs of Beirut, has become a destination for women from all socioeconomic backgrounds and Fakih believes this is the result of there being fewer taboos around the decision to delay motherhood.
Many of these women choose to freeze their eggs because “they haven’t met the right man, are still studying, or are career-driven and don’t want to settle and have kids right away because having a kid is a full-time job,” Fakih explains.
Some women might also have the procedure done due to certain medical conditions, such as cancer or autoimmune disorders, that could cause the number of eggs to deplete or affect their quality. One of Fakih’s patients was a 32-year-old woman about to undergo chemotherapy.
Doctor Chadi Fakih overseeing the work work on of his Laboratory employees at Al Hadi Medical Center. (Credit: João Sousa/L'Orient Today)
Fakih has also seen women from working-class backgrounds go above and beyond their financial capabilities to “secure the cost of the procedure and freeze their eggs.”
“It’s a process that can be challenging mentally and emotionally but we try to guide the woman step by step and we assure the safety of the embryos at all costs.”
When Israel threatened to bomb the southern suburbs of Beirut in the last few months, Fakih’s clinic had to evacuate 10,000 embryos elsewhere in Lebanon, safe from the threat of war.
Egg freezing is generally safe but comes with ‘a few health risks’
In her clinic in Verdun, Beirut, gynecologist Dr. Nada Riashi explains to L’Orient Today that while the process is generally safe, it does come with a few risks.
“The process involves hormonal stimulation of the ovaries to potentially produce more eggs per cycle before they are retrieved,” Riashi says. “The issue with hormonal stimulation is that patients may experience severe ovarian hyperstimulation syndrome, which can lead to blood clots, shortness of breath, abdominal pain, dehydration, and vomiting.”
Women who get pregnant past their mid-30s face increased risks, and Dr Riashi advises women to “consider egg freezing and delaying pregnancies for the worst-case scenario.”
“Medically and biologically, it's more advisable for a woman to conceive and give birth in her 20s. However, I understand that the best-case scenario is not always feasible.”
‘I won’t settle for less’
For Dunia*, who is still contemplating egg freezing, the matter is “purely cultural.”
She started considering it seriously last year after breaking off her engagement, deciding she would only settle for a “hardworking man who values me.”
“I’ve always dreamt of being a mother and having a sweet little family, playing games, taking care of them, and being their best friend,” Dunia says shyly to L’Orient Today.
“But I won’t settle for less in a man just because I have a dream of being a mom,” she adds. After ending her engagement, she started saving money for the egg-freezing procedure.
The 35-year-old high-school physics teacher is concerned about maintaining her hymen, as in the Arab world, breaking it before marriage — even for medical reasons — is frowned upon.
“I have the money, but I’m still waiting for the social courage,” she concludes.
Illustration by Jaimee Haddad.
How does egg freezing work?
Freezing eggs in the early 30s may improve the likelihood of being able to have a baby later in life; however, there are varying success rates.
Once a woman decides to freeze her eggs, fertility medicines are administered to boost egg production. Once the eggs are mature, they are extracted from the ovaries using a long needle guided by ultrasound. This procedure is typically done on an outpatient basis with sedation, and it is generally not painful.
After extraction, the follicular fluid containing the eggs is poured into a petri dish, where the eggs are identified using a microscope and then withdrawn for freezing. Eggs are typically vitrified — a fast-freezing process. When a woman is ready to attempt pregnancy, the eggs are thawed, injected with a single sperm, and after a few days, good-quality embryos are transferred to the uterus. This is done in the same manner as in vitro fertilization, using a long, thin catheter inserted via the vagina and cervix into the uterus, where the embryos hopefully attach and grow.
However, “not all good-quality eggs survive the freeze and thaw process, so freezing eggs does not guarantee a 100 percent chance of future pregnancy,” Fakih warns.
Doctor Chadi Fakih's clinic were the egg freezing procedure often takes place. (Credit: João Sousa/L'Orient Today)
What does the procedure feel like?
“The process is not a breeze. I had to inject myself in the stomach — but what is actually my uterus — with hormones for several days, which caused mood swings, bloating, and general discomfort, but is the chance at motherhood worth it? Absolutely,” Dawoud affirms.
Dr Fakih warns that the process requires mental strength and is psychologically demanding and that patients should have psychological and physiological support from a doctor.
“Throughout the process, my mood swings were crazy because of the hormone injections I was taking, and I almost decided to stop the procedure,” Dawoud recalled.
“What kept me strong is the vision of me one day inshallah holding my baby in my arms … That is — when I find the right man,” she said with a laugh.
* Names marked with an asterisk have been changed to protect the person's identity.