Written by: Rita Behadini and Era Gjakova
““Life is so fast and dynamic,” says N.S., “and no matter how good you are at managing time, there are simply things you cannot achieve.” Lawyer N.S., has personally used the option of egg freezing. According to her, women who have the financial means should allow themselves to “extend the deadline” for becoming mothers.
Women’s participation in the labor market and career ambitions make the ticking of the biological clock an additional challenge for those who want to realize themselves as mothers later in life. “I thought carefully about whether I should do it or not,” she says, “I tried to get fully informed about the whole process and concluded that it was worth it.”
“Egg freezing is not a difficult process at all and is a very good opportunity for women to fulfill themselves in the familial aspect, and honestly, it is a step that every woman who has the financial means and feels the need should take without thinking twice.”
Neither the Ministry of Health nor the Health Insurance Fund in North Macedonia have data on women who choose to freeze their egg cells with the aim of having a child in the future. This procedure is not carried out in public clinics and hospitals in the country and is not covered by the Health Insurance Fund. The only option is to undergo the procedure in private clinics.The same applies to Kosovo.
“Since egg freezing (cryopreservation) as a healthcare service is not covered by the Fund, we do not have data to respond to your questions.”
Health Insurance Fund of North Macedonia
The lack of state funding for this procedure discriminates against women and makes it impossible for those who are unemployed, have lower incomes, or work in lower-paid professions to access this option.
According to Vetëvendosje MP in Kosovo, Albena Reshitaj, egg freezing can give couples, or rather women, more opportunities for family planning and preserving fertility, especially in cases where they face medical treatments that may damage it. “This procedure can create an additional opportunity for many women to have children in the future,” she states. “However, it is very important that this is accompanied by full medical information and a clear legal framework that guarantees safety and ethical standards in the use of these technologies.”
What does the law say in North Macedonia and Kosovo?
In North Macedonia, the freezing and storage of egg cells is regulated in detail by the Law on Assisted Biomedical Fertilization,and the process is carried out in authorized healthcare institutions. As for Kosovo, there is still no comprehensive and fully functional law regulating assisted reproductive technologies. Currently, this field relies mainly on general legal provisions of the Law on Reproductive Health (Kosovo, 2007) and the Administrative Instruction on Assisted Medical Fertilization (Kosovo, 2013), which do not sufficiently regulate this complex and sensitive sector.
“Egg freezing and storage is one of women’s reproductive rights as part of fundamental human rights and freedoms,” explains for “Mollëkuqja”
Arta Mero
In the Law on Assisted Biomedical Fertilization, the process of egg freezing in North Macedonia is regulated from Article 30 to Article 33, which define which institutions may carry out the procedure, under what conditions it may be performed, and the obligations of healthcare institutions regarding the security and integrity of reproductive cells. The law also emphasizes that: a man and a woman who, based on medical knowledge or experience, are at risk of infertility due to health reasons, may store their sperm, eggs, ovarian, or testicular tissue in an authorized healthcare institution for personal use (Article 33, paragraph 1).
“A woman has absolute rights over her body as well as the right to decide the fate of her reproductive material, meaning she can decide to freeze and store her egg cells for various reasons, including subjective, medical, or humanitarian ones: for personal use, to delay motherhood, to wait for the right moment for marriage, due to career, due to upcoming medical treatments, for reproductive health reasons, overcoming infertility, donating eggs to infertile couples, planning single parenthood, etc.,” emphasizes Arta Mero.
The State Commission for Assisted Biomedical Fertilization under the Ministry of Health in North Macedonia is responsible for procedures carried out under this law. In Kosovo, this body is called the Commission for Assisted Medical Fertilization (FAM).
“Kosovo definitely needs a clear and well-structured law regulating assisted biomedical fertilization. Many couples face infertility and are often forced to seek treatment abroad; therefore, a solid legal framework is essential,” says MP Reshitaj. According to her, a good law must balance three elements: the needs of couples for treatment, the protection of the child’s interests, and the legal security of the system. Without this balance, she warns, new problems may arise in the future.
"At the moment, the University Clinical Center of Kosovo does not offer the egg freezing service until a legal framework is created for this, but technically the Gynecology Clinic declares that it has this possibility. So women in Kosovo find it difficult to perform such a procedure in state institutions, while in private ones the prices are high."
Paulina Nushi Muhaxhiri
In Kosovo, the draft law on Reproductive Health and Assisted Medical Fertilization in 2023 sparked public debate because it envisioned allowing in vitro procedures for single mothers, enabling them to create families even if they were not married. The draft law has not been approved by the Assembly in Kosovo despite being put to a vote several times since October 2023.
“Regarding the Draft Law on Reproductive Health and Assisted Medical Fertilization (Kosovo, 2023), in principle it is an important step toward regulating this field. However, in its current form it has shortcomings that need to be addressed before final approval. In particular, it is important to clearly regulate issues related to reproductive cell donors, transparency of procedures, and the protection of the child’s right to know their biological origin,”
Albena Reshitaj
How much does egg freezing cost?
“Mollëkuqja” researched several private clinics in Skopje and Pristina to assess the cost of this procedure. In North Macedonia, as in Kosovo, nine healthcare institutions have valid licenses to provide assisted reproductive services, all of them private.However, healthcare institutions in Kosovo were much more reserved and less transparent in sharing pricing information.
Lawyer N.S. paid 2,000 euros for the egg freezing process and pays 250 euros per month for storage. Prices for egg freezing, from the start of therapy, hormonal treatments, egg retrieval, to storage, vary depending on individual patient needs and the packages offered by healthcare institutions.
Some institutions offer egg freezing as a package, while others charge separately for each stage. Hormonal tests may cost between 15 and 30 euros, while individual hormonal therapy can range from 300 to 1,300 euros depending on the hospital and the patient’s needs. As for egg retrieval, freezing, and storage, institutions have different offers.
“Mollëkuqja” analyzed prices up to the egg retrieval stage, annual storage costs, individual hormonal therapies, and the duration of the entire process. According to the data, the highest price for egg retrieval services is 2,000 euros, while the lowest is 200 euros. Storage costs depend on the number of eggs and duration, ranging from 245 to 2,700 euros. The entire process lasts between 8 and 30 days, depending on the individual needs of the patient.
Analyzing the above-mentioned parameters, “Mollëkuqja” calculated the initial amount a woman would need to begin the procedure, including storage costs according to available packages. The lowest estimated cost is 1,500 euros, while the highest reaches nearly 4,300 euros. This is undoubtedly a high cost, especially considering it is not covered by the state. According to Professor Arta Mero, this practice creates room for discrimination against women who cannot afford it, limiting access primarily to higher socioeconomic groups.
“Although the possibility of freezing and storing egg cells is regulated by law in North Macedonia, its use is still limited due to cultural traditions in our society. Additionally, given the high costs of storage or purchasing eggs for allogeneic fertilization (when fertilization cannot be done with one’s own eggs), not all women in a society like ours have the financial means to access this family planning option. Therefore, not all women have access to this method of delaying motherhood,”Arta Mero
“My family knows me, so they were not surprised and accepted it well. Personally, it isn’t as if I have shared this information in spaces that lack the capacity to understand the process, so I haven’t faced any prejudice. But in the spaces where I have shared it, it has been well received,” N.S. tells “Mollëkuqja.”
However, this is not the reality for many other women who face prejudice for how they choose to become mothers. Social pressure, in addition to high costs, often discourages women from using the options available to them by law.
"The burden of pressure falls on women who are asked to become mothers, generate income and keep up with their education and emancipation. The state should work on creating a legal framework that allows women to freeze their eggs at the UCCK so that they can carry out planned pregnancies according to their age when they want. Pregnancy should not be social pressure but a desire and realization of a woman's objectives when and how she wants," journalist Paulina Nushi Muhaxhiri tells Mollëkuqja.
Advances in science and technology have expanded the reproductive age limits for women, giving them the opportunity to pursue professional goals without being constrained by marriage or the pressure of the “biological clock.” Egg freezing is a fundamental reproductive right that enables women to decide for themselves about their bodies and reproductive future, regardless of whether the reason is subjective, medical, or humanitarian. At its core, this technology represents the empowerment of women to choose when and how to become mothers.
