Tunisian women demand right to freeze eggs to preserve chance of motherhood later in life 

Singer and performer Nermine Sfar has resparked the debate over Tunisian women's right to freeze their eggs, after revealing she intends to undergo the procedure to preserve her right to motherhood. Sfar, who is in her thirties, announced her decision via a Facebook post earlier this year, triggering wide-ranging reactions across social media, some critical and others expressing solidarity with the singer.

At the forefront of her supporters were feminist activists who demanded changes to the laws governing reproductive medicine, which currently deprives some women of their right to motherhood.

While women in Tunisia are more politically and socially empowered in many ways than women in most other Arab countries, state legislation still prevents unmarried women from freezing their eggs in cases where they want to preserve the chance of marrying and having children later in life. For this reason, those who choose to do this – and who have the funds – are forced to travel abroad to Spain, or elsewhere in Europe, in order to freeze their eggs.

"While women in Tunisia are more politically and socially empowered in many ways than women in most other Arab countries, state legislation still prevents unmarried women from freezing their eggs in cases where they want to preserve the chance of marrying and having children later in life"

Women have an innate right to motherhood

Karima Ayari (42) stresses that "women should be able to defend their innate right to motherhood by all means possible. Freezing eggs is a scientific solution forbidden to Tunisian women because of our backward laws".

Ayari, who underwent fertility treatment after marrying in her forties, says to Al-Araby Al-Jadeed, The New Arab's Arabic-language sister publication, that she had to undergo repeated attempts to get pregnant through artificial insemination. This experience has made her a strong advocate of the right of women to become mothers later in life.

"Continuing to forbid women from freezing their eggs displays the backwardness which Arab societies suffer from," she says, adding: "If freezing your eggs had been allowed, I'd have done it earlier in my life without hesitating, even if I'd had to take out a loan to cover the cost of the procedure – which is high."

Tunisian law allows women to have their eggs frozen in specific health-related cases, for instance, if a woman gets cancer and has to undergo radiotherapy. Article 11 from the Law of Reproductive Medicine (2001) prohibits the "freezing of gametes or embryos."

However, in section six of the law, it makes an exception for married persons undergoing or preparing to undergo medical treatment which could affect their ability to have children – they are allowed to freeze their gametes for future use within the framework of a legal marriage bond and in accordance with the rules and conditions stipulated in the law.

Scientific advances can be used in line with new societal trends

In this context, Dr Imad Ghannam, a member of the Scientific Association of Obstetrics and Gynaecology, believes that amendments to the law on reproductive medicine are long overdue in Tunisia. He emphasises the right of women "to preserve their ability to have children at a later age.

#Tunisian women debate rights on freezing of #reproductive eggs

This announcement of the singer #NermineSfar, Tunisian star of social networks, triggered a debate in the #country where women are calling for the liberalization of this practice outside #me…https://t.co/kWGX58RlVN

— Cuneyt Cetin (@cetincuneyt) March 5, 2022

"Scientific advancements have given women many ways to assist them to have children at a more advanced age", he adds, stressing that "it should be the general public that is discussing this issue, of course taking into account the scientific opinions published by associations specialised in obstetrics and gynaecology." He believes that discussing "these issues is no longer taboo, and the debate on this will continue and civil society organisations will press for a review of the law."

Dr Ghannam says he has helped women up to the age of 47 to get pregnant, emphasising that the number of women having children at more advanced ages is increasing every year due to societal changes. Medical laws should keep up with these changes, he says, but predicts that, "it won’t be long for [changes to the law] to be enacted in Tunisia, since France changed their law last July to allow women between 29 and 37 to freeze their eggs, at their own expense.

"Tunisian medical laws are affected by their counterparts in France so we may see the adoption of the same decision in Tunisia in the not distant future."

"Women should be able to defend their innate right to motherhood by all means possible. Freezing eggs is a scientific solution forbidden to Tunisian women because of our backward laws"

More generous funding needed

On a different point, Dr Ghannam is critical of the fact that even for women allowed fertility treatments under current laws, the "National Health Insurance Fund won't cover the costs for a fertility treatment like artificial insemination for women over 43, and only offer one-time coverage to women under 43."

For this reason, he demands a "complete review of the procedures guaranteeing national health insurance funding for artificial insemination in the context of helping women have children."

In a study by the Arab Gulf Centre for Studies and Research, Tunisia was ranked second in the Arab world for the rate of women who are remaining single for longer (the study looked at the percentage of women who remained single beyond the age of 35 and spanned the years 2013-2021). Increasingly late marriages are posing problems linked to fertility, as well as challenging social norms when it comes to older women having children, and societal acceptance of the changing situation for Tunisian women.

On a different note, while most Tunisian women are still barred from freezing their eggs, in August 2018 a medical team carried out an operation at Aziza Othmana Hospital which was the first of its kind in Tunisia and Africa. The team re-implanted frozen ovarian tissue of a married woman in her thirties who had had cancer and undergone chemotherapy.

Following this, a procedure called intracytoplasmic sperm injection (ICSI) was used (which involves injecting a single live sperm into the centre of an egg) and this resulted in the birth of a baby girl, Beya, who was born in 2019, the first live birth through following the ICSI process with frozen eggs in Tunisia and Africa.

This is an edited translation from our Arabic edition with additional reporting. To read the original article click here.

Translated by Rose Chacko