To All the Single Ladies Wanting to Start a Family … In the Future?

The Human Reproductive Technology Ordinance (“HRTO”) was drafted in the late 1980s, when the median age of first marriages in Hong Kong was 28.3 for men and 25.6 for women. This median age has now increased to 32.2 years for men and 30.7 years for women. The overall median childbearing age of women rose from 29.6 in 1991 to 33.6 in 2021; The fertility rate among women aged 20 to 24 has decreased by 77% in the past 30 years, while that of women aged 40 to 44 has increased by 91%. These statistics shows the significant changes in the societal norms in Hong Kong over the last few decades. They reflect the reality that many women now receive higher levels of education and there is high participation of women in the labour force. This in turn may deter, if not delay, marriages and childbirth. Hong Kong now has one of the lowest birth rates in the world, with an average of 0.8 child born per woman, below its neighbouring countries like Singapore, Japan and Taiwan.

With the higher childbearing age, issues with fertility have also increased. Although advances in medical technology have been able to manipulate the fertility window for women, a woman cannot enjoy the benefits of many of the available treatments in Hong Kong unless she is legally married to a man.

Here are some important facts that you should bear in mind when making plans to start a family in the future:-

1)   Yes you can freeze your eggs… but there’s a maximum storage period

Unmarried women are legally entitled to extract and freeze their eggs. However, if you are a healthy young woman wishing to preserve your eggs for future use, the maximum storage period for your eggs is 10 years.

Only women under certain circumstances, e.g. cancer patients or other patients who may be rendered infertile as a result of certain medical treatment, can store their eggs for 10 years or until they reach the age of 55 years, whichever is later.

Although there were discussions earlier in 2023 in the Legislative Council around extending the maximum storage period for frozen eggs, this was rejected. The reason was that extending the frozen storage time of eggs “was not aligned with” the government’s goal, which was to encourage couples to “have children early”.  

2)   If you want to use your stored eggs for IVF treatment… you must be married and infertile

Under s15(5) of the HRTO, no person shall provide a reproductive technology procedure to persons who are not the parties to a marriage, although this restriction does not apply to obtaining gametes i.e. eggs or sperm, hence unmarried women can legally have their eggs extracted and frozen.

However, the HRTO and the Code of Practice on Reproductive Technology makes clear that other reproductive technology services, such as IVF, are confined to “infertile couples” only. Therefore, although you can freeze your eggs, you cannot use those frozen eggs for reproductive purposes, until you are married, and you and/or your husband proves to be infertile.

If you are party to a same-sex marriage, this is not an option for you either, as same-sex marriage is not considered a valid marriage in Hong Kong and service providers are consequently barred from offering their assistance to a same sex couple.

3)   IVF – Public or Private Hospital?

There are 3 public hospitals in Hong Kong which offer subsidised IVF treatment to married women under 40, but they must have a valid doctor’s referral. However, even if you were to get a referral to one of these hospitals, the average waiting time is 7.5 to 12 months for your first assessments and after that another 4 to 7 months to begin your first treatment.

Further, IVF treatments may require multiple cycles to achieve pregnancy, and only three cycles of ovarian stimulation are subsidised by the public hospital system. If an IVF attempt is unsuccessful via the public hospital process, you will have to queue up again for several months before a further shot is available to attempt another cycle.

Although wait times are significantly shorter in private hospitals, you will have to pay for that privilege and the prices for IVF treatment will be significantly higher. With public hospitals, the subsidised price ranges from approximately HK$10,000 to HK$24,500 per cycle. At private hospitals, the cost per cycle ranges from HK$80,000 to HK$150,000.

For many, this is an emotionally and financially challenging process.

4)   If you are considering surrogacy… you must also be married

Commercial surrogacy is prohibited under s17 of the HRTO and this has an extra-territorial effect. It is a criminal offence “whether in Hong Kong or elsewhere, [to] make or receive any payment for” negotiating or taking part in a surrogacy agreement. However, altruistic surrogacy arrangements are permitted in Hong Kong, i.e., if the arrangement does not involve any commercial elements.

But even an altruistic surrogacy is not an option for unmarried women (or same-sex couples), because under Hong Kong law, the service providers cannot provide human reproductive technology to anyone except parties to a monogamous heterosexual marriage.

5)   If you wish to adopt as a single parent… your chances are slim

Pursuant to the Adoption Ordinance s5(1), a single person can apply for adoption as long as the applicant fulfils the following requirements:-

(a)  Is the mother or father of the infant;

(b)  Is a relative of the infant and has attained the age of 21 years;

(c)  Is a person who is married to a parent of the infant; or

(d)  Has attained the age of 25 years.

The single applicant should also have sufficient child care ability and other support.

However, all eligible children are placed into the “adoptees pool”, and the Social Welfare Department will then try to match the children with available waiting parents on the list. The aim is to achieve the best possible match between parents and child. All things being equal, prospective parents who are married in a valid marriage will stand a better chance of being selected than a single applicant.

Since a same-sex couple cannot adopt jointly as spouses, one of the parties will have to apply to adopt as a single parent.